Bill Klaproth (Host): This is a special episode of Today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership, recorded live at the AONL 2024 conference. I'm Bill Klaproth, as we talk about a greatly titled session called Nailed It! How Peer Mentorship Led to Successful CNO Transitions. One of my favorite titles of the conference. With me is Jenna Virant, Vice President of Patient Care at M Health Fairview, and Laura Rangaard, Vice President of Patient Care and CNO at St. Francis Allina Health. Jenna, welcome.

Jenna Virant: Thank you. Great be here, Bill. Thanks for having us.

Host: You bet, and Laura, welcome.

Laura Randgaard: Thanks so much. Glad to be here.

Host: Yeah, glad to have both of you here. So, Laura, let me start with you. Tell us about your session and why you wanted to address CNO transitions.

Laura Randgaard: Well thanks so much for the opportunity. I think that, one, we wanted to address this topic because there's a lot of high risk transitioning into a role like this. There also isn't a great playbook for us as nurse executives. And we really wanted to talk about how important it is to lean on each other in these transitions and to utilize the great relationships we can develop as peers to really coach ourselves through a transition.

Host: Yeah, that's really interesting. I like how you said, there's not a great playbook for this, right? So that's where you said, let's try to develop something that people can use. So, Jenna, what are some of the tactics or initiatives or plans that you came up with to help a CNO with the transition?

Jenna Virant: Well, an interesting part of our story is that we went through this transition together within about a month of each other transitioning from director roles into chief nursing officer roles. And so we got to kind of create our own playbook and document and record along the way. And we started kind of our basic framework of our learning plan through reading, Michael Watkins book, The First 90 Days, was a book that we referenced in just getting started in our process.

And then we referenced AONL's Nurse Executive Core Competencies as well. But Laura and I started by meeting in downtown Minneapolis in a coffee and bread shop, and got together and we knew there was inherent risk, as Laura had said. We have read the literature, 61 percent of CNOs in their first year are deemed unsuccessful in reaching organizational goals.

That's pretty high, right? That's pretty high.

Laura Randgaard: weren't comfortable with and statistic.

Bill Klaproth (Host): Yeah.

Jenna Virant: Yeah, and through our own experiences as well, we had seen many unsuccessful transitions of CNOs in their roles. And so we wanted to be really intentional and move our organizations forward and support nursing and patient care. So we started by developing our own learning plan.

And what we did was we had three different meeting times together, three consecutive meetings. We tackled different topics and we built strategy in each of those meetings. And in our presentation we get into the detail of what each of those meetings look like. And then we built in regular cadence for touch bases to share our learnings and observations, our assessments throughout our process after we transitioned into the role to get coaching and feedback and peer mentorship from one another. Laura, what would you add?

Laura Randgaard: I think one of the things that I'll add, you know, there were obviously really important technical things that we designed together, but I think the commitments we made to each other in terms of being vulnerable, willing to be completely transparent and honest with each other, and willing to coach each other were really kind of those principles that I think helped us be successful in that kind of approach and plan together. So, that's what I'd add. Yeah.

Host: Did each of you have the same challenges?

Laura Randgaard: I think we had very similar, so obviously both of us had workforce challenges. Obviously in healthcare right now, that is our core challenge. We had teams that were recovering, I would say, in different ways coming out of the pandemic, so I think that was an obvious challenge that we both shared.

I think once we got into the culture and the real deep needs of the teams, we had some variation, you know, on what the specifics were for our challenges. And we had some different tactics we needed to use, but we both, I think, could focus really quickly. Like, we could understand each other's challenges pretty, pretty fast. Because we shared, I think, a lot of similar challenges.

Host: So one of the issues that you say is when someone becomes a new CNO is feeling lonely and isolated. So having peer mentorship really sounds important. Yes?

Laura Randgaard: You

Jenna Virant: It was kind of a lagging indicator that we didnt go into it thinking that that was going to be as potent as it was, I guess. I thought you know, we went into it with strategy and to work to get to know our teams and develop our leaders and improve safety and quality and have fun and joy while doing it. And we found out along the way that we were able to, like, prevent that loneliness and isolation. it was pretty cool.

Laura Randgaard: Yeah, I think it's also a job you don't naturally receive a lot of feedback. Yeah. Because of the position that you're playing, you may not get any direct feedback on any of the behaviors that you're doing that may be unintentionally, not helping your cause. And I think part of the loneliness can be seeing a change or a response that you weren't hoping for in the team and not having anybody to think about it with.

And so we could kind of prevent that loneliness with each other by being really honest and saying, Boy, this fell flat. Can I talk it through with you? And can you listen, for where I could course correct or how I could think about this differently?

Host: So Laura, for someone in your position, you too, Jenna, what are some of the first steps to take to create this peer mentorship and set yourself up for success.

Laura Randgaard: I would say the first thing is, one, you know, just be willing to be vulnerable. We really set competition aside. We both needed to win. And I think the first thing is just being really vulnerable and, really seeing that as all nurse leaders, we really need to win collectively for our teams. The second thing I would say is to be on the lookout for colleagues and peers alongside of you that naturally are challenging you with good questions, that are starting to show some signals that they'll share feedback with you.

That's somebody you want to keep in an inner circle and then leverage at a time that you're going to make a transition.

Host: Yeah. Thoughts on that, Jenna?

Jenna Virant: I think Laura and I have a history of thought partnership and coaching one another. When we first met, we've been friends now for, friends and colleagues for about seven years. I was a director and she was helping to coach and work on quality improvement and performance improvement in my areas.

And so we naturally had a relationship based on inquiry and reflection and coaching and support of one another in our career progression. And so, I think the first steps is to, like Laura said, look at your inner circle and people who have similar core values as you, people who, aren't afraid to share hard feedback with you and give you the truth and honest feedback. So.

Host: Are there key takeaways to remember, Jenna?

Laura Randgaard: I think the big takeaways are to find your circle. You know, find the circle of colleagues that will be honest with you, as Jenna said, and give you really important feedback in your best interest. And then just continue to have a learning and growth mindset. I think curiosity is something that Jenna and I both try to really operate with a high level of focus on curiosity.

And so find that partner, find, you know, that curious, thought partnership together, and then think about how you want to approach a learning plan. Yeah.

yep,

Host: That's good stuff. So, Laura, then, what are the results of this so far? You put this plan in place. Obviously, it's working. Tell us about the results and things maybe you learned along the way.

Laura Randgaard: Yeah, I think the results that we've had, again, workforce I think was our most dominant challenge together as leaders. And we both saw stability in both our frontline workforce and our leaders. We saw some revival and helped our leaders kind of find their right seat. So I think that was one of our strong outcomes.

We've both seen a return in some quality and safety metrics as well as helping us get back into routines that support quality and safety. You know, I won't speak for Jenna, but I would just say I've found a lot of joy in my first two years in this role, which I think is in large part to just knowing, she's somebody I can phone a 9-1-1 to at any time. I'm not alone. So I think those have been our proudest outcomes.

Jenna Virant: Yeah. I would agree. I think we've also worked to establish different multidisciplinary focuses and innovative care delivery models in both of our sites. And to empower our frontline team members and redesign and regrow our professional governance councils has been really such an encouraging joyful thing to do at both of our locations as well.

 Laura's accepting a Trust Women's in Leadership Award the day we get back into Minnesota, just so proud of, like, her efforts in that space. My team in particular has won the Minnesota Best Workplace Hospital Award by the MHA Association. And so we've got some really fun, exciting things going with our teams that I think just seeing them being built up and elevated and empowered and have voices in how we deliver care at our organizations is really encouraging.

One thing we didn't mention, Bill, is that we are competitors in the same market. So we are neighboring, yeah,

Laura Randgaard: the

Jenna Virant: We are neighboring hospitals at like the deepest competitors in the Twin Cities market. But we know that we can't, nursing can't fail, healthcare can't fail, our hospitals can't fail. And so we have a deep commitment to patient care and our team members why our kind of, that's why our story is kind of interesting to people as well. So.

Laura Randgaard: We both know that we need to be successful, for the good of the whole. And so we really set that aspect aside and we celebrate each other's wins, even if perhaps maybe one of her strategies is some sort of down, for me organizationally overall, I know, her success is my success.

Host: Yeah, wow, that's very well said. Well, this has really been interesting and informative, hearing your stories. And certainly the plans that you've put in place to help with a transition like this will definitely help others. Before we wrap up, I'd love to get final thoughts from each of you. Jenna, let's start with you. Anything else you want to add?

Jenna Virant: Gosh, I would say it's nursing's a team sport, and so when you've got your A team, your team that's supportive, that's got your back, that can be there for you in the good and the bad, is, makes it so much more enjoyable and sustainable.

Host: I love it. Nursing is a team sport. I love it. Laura, how about you? Final thoughts.

Laura Randgaard: I would just second Jenna's comments. You know, it's really about us as a team, and I think about all the innovation that we need to do moving forward, and that will only come if we're kind of willing to break down those artificial boundaries as organizations, is really just lean into each other as leaders, and yeah.

Host: Yeah, very well said. Well, thank you both for your time today. We appreciate it.

Laura Randgaard: Thank you Bill.

Host: Yeah, you bet. And once again, that is Jenna Virant and Laura Rangaard. 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.