Bill Klaproth (Host): This is a special AONL podcast as we record live from the AONL 2023 conference. With me is Kate Baron. She works in trauma surgery as an Acute Care Nurse Practitioner at Yale New Haven Hospital in New Haven, Connecticut. She is also the Past President of Nursing Professional Governance. And we have Lisa Phalen, President Professional Nursing Staff at Rush University Medical Center in Chicago. She is the current President of Nursing Professional Governance, as we talk about the impact of Professional Governance President and Council Chair. This is Today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth. Lisa and Kate, welcome. It's so great to have you here on a really cool topic. So excited to talk about about this. So let's jump into this with you Kate first. First off so when it comes to Professional Governance, what is it that we need to know about this? What is the issue that we're trying to build awareness around?

Kate Baron, MAIOP, RN, BSN, CNII, SCRN: Really great question. I think especially like in my experience as being a nurse at the bedside and kind of going throughout my nursing career, sometimes I wonder if like the average nurse even really understands what the profession of nursing is. And so we kind of practice at the bedside doing all these tasks, and we're taking orders from physicians a lot of the time under the profession of medicine and lose sight of the fact that nursing itself is its own profession and that we are in charge of it. And that there's not somebody at the top saying, do this, do that, do this. It is us. It is the nurses who get to dictate what that profession looks like. And so that means things like um, you know, if we think taking your blood sugar every three hours is better than taking it every six, and we have the evidence to back it up; as a profession of nursing, we have a voice. We can make these recommendations. And so like the medical model might look and say like, oh, we know checking your blood sugar has to be this to keep it under a certain number and we're going to treat it. But nursing has a different lens that it looks through the care that we provide patients with, and we are in charge of that. We're the experts at that. And if somebody else is making those decisions, then we don't govern our own practice.

Host: Right. That makes sense. You're just not a facilitator. You actually are making those medical decisions on the spot.

Kate Baron, MAIOP, RN, BSN, CNII, SCRN: Correct.

Host: we can't lose sight of that when we talk about the nursing profession.

Kate Baron, MAIOP, RN, BSN, CNII, SCRN: Right.

Host: Yep.

Lisa Phalen, RN, BSN, RN-BC: any thoughts on that?

Oh, Kate actually said it beautifully. Nursing forgets that we do, we, we have to take ownership of what we are in charge of, and they don't realize that. And I think since COVID and the pandemic nursing has lost that completely. We've stopped being innovative. We stopped being creative. And knowing that we have the, you know, the accountability and the ownership to take over our practice. And, and it's hard cause we have so many new staff out there that don't understand that either they just think that they're going to take orders, and orders, but to know that we can look at it in a different way than anyone else can, and that's our practice.

Host: And Kate even said that sometimes the nurses lose the sight of the fact that nursing as a whole

Kate Baron, MAIOP, RN, BSN, CNII, SCRN: professional Sure. And like sometimes if you um, use extreme examples. It's easier for anybody to understand, but like education is its own profession. Nursing is its own profession. Medicine is its own profession. But you know, and we practice alongside of so many different healthcare professionals that sometimes it all gets mixed together. Which a lot of nursing is like there that's part of being a nurse, but there is a very specific piece to it that's ours and we govern that.

Host: So nursing is its own profession, as you said. So Lisa, for a nurse leader listening to this podcast, what is important to remember? What is an important first step to take for educating nurses that nursing is its own profession as we talk about professional governance?

Lisa Phalen, RN, BSN, RN-BC: So that's one of the big things that I've been trying to do this year as the president. Education is a lot, a huge piece of it is educating the staff of what professional governance is. Cause they don't understand that they have that ability to take ownership of their practice. And I know people always are like education. There's only so much education you can do. That's why we've had, I had Tim Porter O'Grady come to our hospital to kind of give us a blueprint of like what we should be doing as staff just so everyone understands what to do. And I think people have to realize too, that just listening and, and being aware of what's going on is a huge piece of it. And It's been very difficult cause I think when I stepped into this role two years ago, it was all about money. And everyone went in that direction, but forgot that there's so much more to nursing about than just money and that they have to really pay attention to their profession. And they're not doing that. So we had a, we've had to kind of like rotate back to kind of get them back to take ownership of that and to know that they have that ability to do that. Like they, it's not, well, what I think we were during COVID, we were told what to do constantly and there was so much change that I think people got used to that.

People got used to people telling us what to do, and now we have to go back to taking the accountability, realizing that this is our profession. Realizing that we can, we have that voice. We're able to make change in our practice and people need to know that.

Host: Yeah, some really good points there. As you said, we need to pay attention to the profession. Now, as you said, two years ago, it was money. So Kate, what are some tactics or in or initiatives that you've brought or thought about or are doing to raise awareness for professional governance of the nursing profession?

Kate Baron, MAIOP, RN, BSN, CNII, SCRN: So I mean, it's a great question. It's lots of different things. things. One thing is to, to be with the nurses. So sometimes with nursing professional governance, what you see is a lot of different meetings. It, they take kind of the cream of the crop or the outspoken nurses who tend to have a little bit of leadership and stuff, and those are the folks that get around a table and start helping to make some of these decisions. I guess we have to back up nursing professional governance, and the profession of nursing isn't just anybody who's on a council. This is for all nurses, every nurse at every bedside in every setting on every shift. And that's what these folks at the tables are making decisions in regards to. I always say it's student council. We're nurses just like you. We're helping to be the voice to this nursing profession. And so for me, repeat the question.

Host: So you're taking cues from the bedside nurse then, so I'm just wondering when it comes to building awareness for this, pay attention to the profession nursing as its own profession,

Kate Baron, MAIOP, RN, BSN, CNII, SCRN: yeah.

Host: you trying to educate or,

Kate Baron, MAIOP, RN, BSN, CNII, SCRN: Uh, Yeah, so by, by working alongside these nurses and kind of bringing awareness to the different types of things that we work on. So say um, if a nurse is all of a sudden griping about an issue that's happening at the bedside. That's an opportunity to say, you have the authority to make that change. Here, let me show you how. That's not just something we have to complain about. We can actually put that into motion. And as long as we've got the evidence to back it up and stuff, let's move. And so educating in that way and letting them know that their voice matters.

Host: Yeah, for sure. So when it comes to letting them know their voice matters, education, as you said, Lisa, do you have any results or, or have you seen

Lisa Phalen, RN, BSN, RN-BC: changes?

Host: you're making progress at this point?

Lisa Phalen, RN, BSN, RN-BC: So that's we are. It's hard. It is, I think one of the largest things is Kate's, right. You have to really get out and be with that, with those staff. I was, I'm still am a bedside nurse. I work on an oncology unit. I'm there once a week, so I'm there out to see what's going on on the floors. A big piece of what I've done in the last year is I've been rounding on all the units. I've been getting into areas that I don't even know about. Like I've been a nurse for 18 years. I've learned so much about ambulatory care and periop care because I've had to get out there to see, cause those are perspectives that I don't understand. I've done a certain specialty for so long. So that's a huge piece is I think getting out, talking to the staff, really understanding. It's hard. I mean, Yale New Haven's probably huge, right? We are big. Rush. Is Rush is I, there's 3000 nurses. It's, it's, hard to still be like, well, we've never seen you.

And I was like, okay, there's one of me. And 3000 of you. So it, it's takes time. But I think the more present that you are and, and you're willing to listen to anyone that has and it is education is a huge piece of it. And understand letting them know that you do, you have a voice, you have that ability to, to do something about it and we are those that link, that helps like if you have an issue, we sit at the table with all the senior nursing leadership, so we're able to help you understand and maybe fix that problem that you are having a problem with so.

Host: Right. So for a nurse leader listening to this, Kate, what can they do at their own hospital, their own healthcare system, to start to raise this awareness?

Kate Baron, MAIOP, RN, BSN, CNII, SCRN: Talk with us, as humans. I think um, I can speak. I'm sure this is the case for Rush as well. But at Yale New Haven Hospital, like even, especially at the start of COVID they know me by name asking me, what do you need? What do the nurses here need? What's happening? Like, what's the scuttlebutt, tell us what the complaints are. Tell us what they need. Tell us their ideas because they value and they know that the nurses at the bedside are the ones coming up with the innovations telling us, get us whiteboards so we can put them on the windows because we need to be able to communicate, get us this. You know? So they created this whole you know, a system to say, what do you need. And get it back.

Host: So did you send out surveys then, or How did

Kate Baron, MAIOP, RN, BSN, CNII, SCRN: Are you interested in?

Host: elicit this feedback from the staff?

Kate Baron, MAIOP, RN, BSN, CNII, SCRN: Well, in that particular, um instance that I'm talking about, I worked in the ICU at the time and that was like a lot of just tell me stories. Give me your feedback, and I would personally bring it back to this daily thing. But in general, we have within professional governance, what they call council, so groups of people who cover different types of settings within the inpatient and the outpatient world. So oncology, the ICU, cardiology and they focus on different things. Those nurses, they're in charge of kind of going out and getting that information and bringing it back. And it can be one of the challenging things with professional governance to, to take what you're doing and actually get it all the way to the bedside, get that information back and have them come back. And so we're continuously like working on that.

Host: It seems like that would be a project. Yeah. Yeah. And how about Lisa, for you at Rush? How have you been trying to raise this awareness?

Lisa Phalen, RN, BSN, RN-BC: It's about, it's the same. We function the same way. We have a exec committee that has representatives from every service line that are able to bring their issues to us, and then we get it back out to the staff. And it is challenging. Again, it's only a rep from each service line that has to get it out to 3000 people.

And I think communication is a, is hard because email only goes a certain way. People don't read them. Then if they, if, even though we're doing a lot of work and they don't see it or they don't hear it, they don't think we're doing anything. So it's, it's hard to get that back out. But it's always a work in progress. We're actually trying to find newer ways to, to help with the communication, cause that's the, I think that's the hardest piece cause it is with, with a facility as large as ours it's hard. I think it'd be, if it's a smaller hospital, I think it'd be a little bit easier, which is great. But yeah, it's just getting it out to so many people.

Host: Yeah, that makes sense. So this has been a great discussion and thank you both for your time today. So as we wrap up, I just would like to get each of your final thoughts this. So Kate, let's start with you. Anything

Kate Baron, MAIOP, RN, BSN, CNII, SCRN: Yeah,

Host: want to add?

Kate Baron, MAIOP, RN, BSN, CNII, SCRN: I think that my takeaway for professional governance is A, yeah, that we are the voice for every single nurse. That's everybody. And then kind of when I went into professional governance, I didn't know it was supposed to be fun. I didn't, I really didn't. That this is something fun and we really need to educate because a lot of the nurses at, at least my institution, if you go up and you say, what is professional governance? I want them to be able to confidently say, well, that's where we go when we want to have a voice. That's where we go to, to own our profession and make a change and support each other, as, you know, a group. Right now it's a little like, well, you know, and so I was going to respond to you before we do like, um, these fun videos, but like, kind of really engage people.

Host: Okay. Well that's great. Well thank you for that. I appreciate it. And Lisa, final thoughts from you.

Lisa Phalen, RN, BSN, RN-BC: I actually, Kate, you said it great because it is. I love professional governance. Like I, I'm kind of upset that my role is kind of over in two months cause I have enjoyed it because I have gotten out, I've gotten to meet a ton of people and I want all those nurses to be excited about what they are able to do. I want them to realize that this is a great profession. That you have the ability to, to change, to take ownership of it, and to really just truly be able to be a huge part of it. And I, I want them, I want them to be excited. I want them to be. It's so hard. It's hard, but at the same time, like so much fun to really push people to really understand what nursing is and what the, what we have such power that, and they don't realize the power that they have.

Host: Right. right. Well thank you both for your time today. This has been great. Kate and Lisa, Thank you.

Kate Baron, MAIOP, RN, BSN, CNII, SCRN: Oh, thanks for having us.

Host: Once again, that's Kate Baron and Lisa Phalen. And for more information, please visit aonl.org. And if you found this podcast helpful, please share it on your social channels. And check out the full podcast library for topics of interest to you.

This is Today in Nursing Leadership. Thanks for listening.