Bill Klaproth (Host): This is today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth, and with me is Nicole Lescota, Vice President of Nursing over Women's and Infant Services, and Tiffany Francis, otherwise known as Coach Tip, Talent Develop Partner. Both are with Grady Health System as we discuss Grady's recipe for developing nurse leaders.

Nicole and Tiffany, welcome.

Nicole Lescota, DNP, MSN, RNC-OB, C-EFM: Thanks, Bill. Thanks for having us.

Tiffany Francis “Coach Tip”, MSHS: Yeah. Thank you Bill. Happy to be here.

Host: Absolutely. Interested to learn about your new recipe for developing nurse leaders. For sure. So Nicole, let me start with you. Why did you decide that you needed a new recipe, if you will, in how you develop nurse leaders?

Nicole Lescota, DNP, MSN, RNC-OB, C-EFM: I think that probably every nursing leader out there can confidently say that at some point in time, they were probably tapped on the shoulder and brought into their current role without very much even education or development or support. They were just told, Hey, you were a great nurse, you were a great charge nurse. I think you'll be good at being a manager or a leader. And then next thing you know, here you stand in and you're a nursing leader without any background or support. Same thing happened when I started here at Grady. We had a lot of novice leaders that had a lot of great experience on the floor, wonderful staff nurses, charge nurses and were tapped on the shoulder to step into a leader role, but did not really have anything behind them to help development in their role.

Maybe they did go to school, maybe they got their master's degree, but any real on the job type of training. And so with that, it was obvious and it was evident that there was more support needed. And without having a defined program here at our organization, I kind of just home grew one, and developed it using the AONL Nurse Leader competencies as a pedestal to build off of and grew from there. We read books together, we had meetings together. We learned about all the different nursing leadership competencies, had them do self-assessments, et cetera. And throughout the course of a year, we were able to go through all of those nursing leader competencies and develop a great program for them.

There came a time where we had newer leaders throughout the organization and because of what we had done here with my service line, my leader had said, Hey, can you bring this program and do this also with some of our other newer leaders here at Grady? And although we had the nurse leaders going through this program that we home grew, if you will, we still came to recognize that there were gaps. There was further knowledge that was needed, further support that was needed, and there was not a consistency of nurses that are transitioning into their leadership roles, that this would continue to happen, that this program would continue to grow.

So if, for example, I was no longer here at the organization, who would be guiding these nurses as they transition into their newer roles, whether that be as a manager or a director of nursing. And that's really when I took a step back and I learned a little bit more about the AONL Nurse Manager Transition to Practice and tapped on the shoulder of our HR leadership and said, we need to create something.

We need to bring something within Grady that is a more permanent solution that is not person dependent to help to grow our leaders so that no matter where we are in place and time or who is here; this program will be hardwired and be able to move forward. So it's kind of a little bit of a how we got started and then, where we were going and how we moved into the program.

Host: No, that's a perfect explanation and exactly what I think is important to know why you decided to do this. So, and I think you're right. We have a habit of, in any business really, you take your best workers, your hardest workers, and you elevate them to management when they might not have any management experience at all.

So I think this is really smart what we, what you're doing right now. Nicole, were there other opportunities that you saw at the time that made this the right time to bring in Transition to Practice as you mentioned?

Nicole Lescota, DNP, MSN, RNC-OB, C-EFM: I will say that the development of our human resources team with our talent development coaches, it really gave us the opportunity to partner with them. And I don't know that that's something that specifically has been done with other organizations, as they did the Transition to Practice program.

But because our own human resources department was developing this cadre of talent development coaches, it seemed like the perfect opportunity to say, dive in and say, Hey, what can we do specifically for nursing? How can we partner with you to bring this program to Grady, and use the talents of the team within human resources to collaborate with nursing leaders to bring this program to us.

So yeah, I think the time was right because of the direction our human resources team was going.

Host: And Coach Tip, how did nursing leadership and training and development, how did you then partner to make this program successful?

Tiffany Francis “Coach Tip”, MSHS: Yeah. Thank you, Bill. It all came together, remarkably when I first started at Grady. So a little bit on a historical lens. I just started with Grady, January of 2025. So I am coming around to my one year anniversary and I'm very excited about it. And before I onboarded at Grady, I worked in academia. So my background was spent heavily in higher education, where I had the opportunity to work more closely with career services, professional development and things of that nature. So as soon as I was on board and I met with our HR leaders and it was presented in the way of exactly what Nicole just said; this is the opportunity to help upskill and to help reengage with some of our leadership staff from a clinical lens to make sure that they feel supported as they are going down that path or continuing that path of leadership. So from there, we were afforded the opportunity to visit the AONL headquarters in Chicago. And there we got a chance to meet a world renowned facilitator who is Amy Trueblood.

And when she set the stage on how the curriculum should be presented, my first reaction was, I really want to see how is it going to be interconnected with some of the training and leadership development components that we have already in HR and some of those components were understanding emotional intelligence, so understanding and how you value EQ and how to become more self-aware and value and social awareness, but also the management piece.

So, the relationship management between not just the leader, but the leader with their respective staff. Because that seemed to be one of the high area peak interest is a lot of the leaders they needed to be developed more as far as how they're communicating with their staff or how do we really kind of close that gap on retention?

Because again, oftentimes when someone is promoted to a manager, their colleagues alike who are around them, they may no longer look at them in that lens of equality. So again, just making sure that it was an equitable space to, for the nursing leaders to learn and to grow and just to continue going down their prospective career path of leadership.

Host: And then what was it like to see leaders across the system go through the program together as a cohort?

Tiffany Francis “Coach Tip”, MSHS: Oh, it was incredible. So the first session we kicked off in the summer, so we had our first session around June the 25th, I think it was. And we also had the Director of AONL Partnership, Alyssa Adams. She came all the way up from Jacksonville and just for geographic needs. We are located in Atlanta, Georgia, so I know that, that was a short trip for her, but we had her support from the start.

And again, this is something, this is new initiative. So of course you had the natural angst and a little bit of, at least I'll speak for myself, a little bit of anxiety because you don't know how are they going to receive this material. The material at AONL is very robust and not to say that what we have now at Grady isn't, but I think Nicole said it best when she mentioned that there were some professional development curriculum in place, but it was more from a foundational approach, and this was an opportunity to make sure that our leaders were getting that, that prescriptive content that is from a national or a global lens. So it's not just unique to Grady. So again, once we set center stage, of course, we did all the things. We had breakfast, we had snacks, coffee, just so everybody can get well acclimated in the space. And then we kicked it off with an inspiring leadership story. And I think that really helped put the face of just, this is a human experience. So it kind of just takes some of the blinders off and just really opens it up as a safe space, non-judgmental zone. So that we understand just because we are, we're all respective leaders. We're still human, so we're going to make mistakes. We're going to do some things that, that we want to see improve.

It's not life or death in that sense. So seeing them collaborate at the very beginning, again, shaking off the nerves and, and participating in some group activities, it made a world of difference. So it took you out of that non-traditional classroom setting where there's a facilitator and notes to follow. We really were able to bring our own creative lens while supplementing the AONL curriculum.

Nicole Lescota, DNP, MSN, RNC-OB, C-EFM: Tiffany, I think that, if you don't mind, I would like to just add on to that. I love what you said. Just even the whole environment that was created. I get the opportunity to work with these nursing leaders every single day, whereas in your role, you may not see them and quite frequently they're approaching me in the hallway. They're stopping me, after a meeting or things of that nature. And they're saying, how appreciative they are to have this time allotted to them to grow in their own development as a leader. That it's the first time that they've really felt like they had something solid to utilize as a platform for learning.

But more importantly, they've really enjoyed having the time with their peers and their colleagues and seeing and hearing how they're going through a lot of the same things that they're experiencing every day, some of the challenges, the triumphs, the things that they find difficult.

Their difficult staff member to deal with or to help to coach, or how do you handle these difficult patient situations, et cetera, and know, knowing that they have these peers that they can rely on. I think the other thing that they were kind of fearful of coming into this was that it was just going to be more work for them.

They were a little hesitant, I think, coming in to the class, oh no, I'm going to have to do these modules. Oh no, I'm going to have more work to do and do I really have the time to do this? And they have also expressed to me how utterly grateful they're, they have been to have this additional knowledge and this platform to be able to learn.

So it's been rewarding for me to see how excited they are about it and being part of the group.

Host: It's always good to get that positive feedback when you try something new. So that's always a very good thing to see. So Nicole, it sounds like you've seen new skills, perspectives, confidence even, emerge in your nurse leaders. Would that be correct?

Nicole Lescota, DNP, MSN, RNC-OB, C-EFM: Definitely agree with that. Even starting off with the second session that we have where they start to look at their nursing vision and I've been a nursing leader for 17 years. And I have never written my own vision statement. Isn't that something? We follow what the organization's vision statement is.

We think about that as our true north and our guiding principles. But what does that mean to write a vision statement for yourself, who you are as a leader, who do you want to be as a leader? And maybe there are other leaders that you have worked with, that you want to emulate. Maybe those mentors that you see yourself being more like.

And just that exercise alone, I think was a huge confidence builder for people because it gave them the opportunity to say, yes, I want to emulate these behaviors. But I also, these are the unique skills that I bring to the table and how I can help effective, be an effective leader to the staff that I lead. So, that's been really rewarding as well.

Bill Klaproth (Host): That's really interesting. Have you, so then all of the nurse leaders, you've asked them to create their own vision statement, if you will?

Nicole Lescota, DNP, MSN, RNC-OB, C-EFM: Yeah, so that was part of the session two, is creating a vision statement and then having them go back and kind of those who are willing to share what that looks like. And I see them bringing that back up as they're working on whether it's their quality issues or patient experience goals and how they're going to approach that from the vision that they see for their own units that they, that they lead and the people that they lead, and the patients that they serve. So, it's been very telling.

Host: Yeah, it sounds like it's resonating with them, which is really important and it is good to have those guideposts or touch points that you can fall back on or remember or look at every day to help you get through the day. So you try to reach your full potential as a manager and following those guideposts, if you will, or the vision statement, really can make a difference.

So I love how you say that. So really good stuff. Nicole, let me ask you another question then. So I imagine this also has strengthened communication, leadership alignment, and maybe even more importantly, patient outcomes. Would that be correct?

Nicole Lescota, DNP, MSN, RNC-OB, C-EFM: Definitely. As the leaders are growing in their role, their confidence in their ability to lead and drive outcomes, we are seeing more ownership and when they're seeing the positive outcomes, it's giving them the confidence builder that they need, that they actually have ability to have an impact.

So yesterday we had a charge nurse development day and we brought in our managers who have been, many of them been going through this class and they stood up in front of everybody. We had about a room, about 200 people to share their excitement about seeing the improvement in their outcomes, whether it's a reduction in falls or a reduction in hospital acquired conditions.

And we saw a lot of success stories. Many of them approached it from the beginning feeling like doing audits or doing plan do study acts, the PDSAs, checking chart checks, working collaboratively with the staff and making sure that we're hitting all the bundles and preventing falls or preventing central line infection, that it was very tedious and onersome, it seemed like more work to be done.

But then they're actually seeing the results of that work that as they're putting in this effort, they're having less hospital acquired conditions. They're seeing an improvement in their patient experience, and now they're approaching it from a standpoint of not something that they have to do, but something that they get to do.

And then sharing that very proudly with the rest of the organization. You see the joy and the excitement on their faces that they really do have an impact, not only on their own units, but on the entire organization.

Host: Absolutely. So when I hear you talk, it's easy to understand that this has made a difference, not only in their own job performance, their own job satisfaction, right, but that it has also improved patient outcomes. It's really kind of a win-win here, and it really just makes sense if you have a really high functioning, happy workforce, that's going to translate to better patient outcomes.

So Coach Tip, how do you keep the learning alive? How do you keep this going? What steps are you taking to build on this foundation?

Tiffany Francis “Coach Tip”, MSHS: Yeah, so that is the most exciting piece. So it's been absolutely a pleasure to work alongside Nicole. We both get a chance to really just let our creative juices flow. So a lot of what I do from an HR perception, it is going to be very complimentary to the AONL curriculum, which we absolutely make sure that we use that kind of as our steer.

So that's our vehicle. And one of the things that we did was make sure we took the time to really place them in the room with sitting with four at a table, because again, these, the way we have it set up, we have two different cohorts. So we have one cohort, which are directors, and then we have a second cohort, which are managers who are aspiring to be directors.

So when I'm actually speaking about the first cohort, the directors. So we have them all sit at a table of up to four where they get a chance to really interact with individuals that they may not always talk to on a day to day. And I think that that really creates some best practices because you may have someone from a different unit.

I know I said earlier, before we kicked off, I mentioned labor and delivery, but you may also have someone from the burn surgical unit. And those two departments don't typically coincide on a day to day, but some of their, the practices that they may use as far as working with their staff and doing team huddles, some of those different dynamics and some of those different measures that they take to really just make their staff feel heard and valued, it could be utilized across the board.

So I would say one of the things that we do is really make it engaging. So again, we don't want anyone sitting in a silo. We don't want anyone kind of sitting in an island off to their self. To some points that have already been made, it is really going to be a lot focused around building that confidence. So making sure everyone in each group, making sure that every voice is lifted, making sure every voice is heard, every idea is shared, because oftentimes it happens. Grady has over 9,000 employees, so it is challenging to always feel that you are being seen.

You don't want anyone, especially in a leadership role or any really role, even in a more of a frontline or entry level role, you don't want anyone to feel like a number, like their opinion doesn't matter. So I do think that just the strategicness around just making sure that they're sitting with someone new and someone different in leadership.

I think it helps that, it really helps to cultivate their shared ideas and it also helps them to take something back to their team that they may not have been aware of before, that will really help increase that, that collaborative spirit.

Nicole Lescota, DNP, MSN, RNC-OB, C-EFM: If I could tag onto that, because a little bit of your question was about sustainment too. And how we would make sure that this is part of what we do here at Grady. There is an opportunity for you to continue to grow and we have pathways for you. I think that's one of the beautiful things that we have done with partnering with our human resources team. There were eight of us that went for training, so we are all attending each other's classes.

So from even a facilitator or a faculty standpoint, we have a sustainment method because we have a significant number of people who are able to lead and step in and help one another. But then from a sustainment standpoint with the staff, we're actually including that as a ladder, a model for how you can grow within the organization.

So if you're starting off as a brand new nurse, what does that look like for me down the line, how do I quote unquote, kind of like graduate into being a preceptor, being a resource nurse, being a charge nurse. What kind of education is there for me? What kind of opportunities are for me to maybe even one day be a manager or even a director here at Grady? And we have created that pathway for them as they have opportunities for growth.

Host: Got it. That really makes a lot of sense. I appreciate both your time today. This is really an important topic. Before we wrap up, I'd just like to get some final thoughts from each of you. Some key takeaways. Coach Tip, if I could start with you. One, how can somebody duplicate what you've done here and final thoughts on this project?

Tiffany Francis “Coach Tip”, MSHS: Absolutely. So the duplication piece of it is first, if you're in HR, make sure that you build your network. My mantra is, my self-proclaimed mantra is, your network equals your net worth. And simply what that means is just building connections within your organization, especially an organization, as massive as healthcare, there's so many different department leaders that you can engage with on a day to day, and that you can find out what's working for that department, what's working in that strategy of team building, what isn't working, what needs to be included. Oftentimes leaders have so many bright ideas and sometimes it's just finding the right time or the right voice that can come into that space and just lend and be that vehicle for change.

So networking. I would absolutely encourage everyone from the sound of my voice, if you're not really that person who truly wants to be that networker and or maybe your personality is more on, on a introvert side, you're not really extrovert; I always tell a lot of my students, staff-client alike; I'm more of an ambivert these days. So, and all that simply means is I'm extroverted around people. But I do value my alone time. But I bring that up, I lift that personality type in, because networking can be done in various different ways. It doesn't necessarily have to be that person that spearheads all the ideas, but sometimes you can do this in a way that's a little bit more practical in a digital age. You can create a survey, and if you're in HR and you have those good graces from your leadership team, you can create a survey that you would share and say, Hey, what type of professional development is needed for this department? And really take the time to analyze that feedback. Really take the time to see if there's some prescriptive measures that you can take along with your team to create a program that's going to be properly suited for a clinical department.

So, that would be one thing that could absolutely, easily be duplicated and for last words, I would absolutely say the advice is it is an investment. It's an investment that will pay off a long term. Meaning when we look at today's workforce, we have a four different generations in the workforce. We have our younger guys, our, our Gen Z, we have our millennials, we have our Gen X, we have our baby boomers.

And when we look at those different personality types, we look at those different language barriers, we want to make sure that everyone collaborates together and what better way than to have them to go in and work on projects that are based around professional development, that are based around leadership training?

I really strongly feel that no matter the title, everybody can be a leader and they all in their own regard in their own department. So, letting them know that once you invest in one, you invest in 100 if not more. Because if that leadership feels that confident and they feel that they have that support, that's going to of course create a trickle down effect. And they're going to encourage their staff. And again, you may have someone who is working in an environmental services role and they may want to one day have dreams of becoming a CNA and take that more allied health approach. And again, it all starts with just making sure it's an, it is an equitable space, but also making sure that it's a space that has those pathways there and those openings for conversations where they can really see themselves long term in the future. So that would be my advice, that this is absolutely an investment for one that may inspire a hundred more.

Host: Great words. Investment for one, that might inspire more. I love that thought. So thank you Coach Tip. And Nicole, if we could turn to you, any advice you would give to other health systems thinking about doing this, and any final thoughts you'd like to wrap up with.

Nicole Lescota, DNP, MSN, RNC-OB, C-EFM: I definitely would love to speak about that collaboration that we have with human resources. American Organization of Nursing Leaders has come up with an, a terrific program with the Transition to Practice. It has everything that you need to get going. Wonderful training for the faculty. Very enriching for the team of eight that went to Chicago to get that training or that training could be done within your own organization.

There are different models that are offered. You could do online of course, where there's a cohort that is completely trained by faculty from AONL or you could do what we have chosen to do, which is to do the facilitated cohort. I'm a big believer in the facilitated cohort. I think it gave the opportunity for our leaders to learn from one another and not only learned best practices in leadership from AONL; but also learn how that is incorporated here at Grady. What does that mean for the way we work here? And I see the benefits of both programs, but for me, that was what I believed would work best for us. So that was a really big, that's one of the recommendations I would give is to go with the facilitated.

I think that the benefits are there and it's really been beneficial for the leaders. The other thing is, I think it's pretty basic to say and everybody should know that this is, is that just as Coach Tip had said that when you invest in your team and invest in their growth and development, then they'll invest back into you.

It will reduce your turnover, it'll improve your outcomes, and we're starting to see the fruits of that labor. And so it is, although it may be somewhat of an expense, the long term expense, it covers it hands down. The other perfect thing about it is that it is not a homegrown, and it's not person dependent.

Unfortunately, the way the program was for us here within the organization where I had set it up, it was very dependent on a few small people who were keeping it going. But now we have something that's sustainable that somebody else could come in and pick up on and take off with, and highly recommend having an official program that you can utilize and not to mention, sorry, we didn't even mention this at all, but the support that you get from the faculty at AONL and also from other organizations who have gone through this. We have been collaborating with them, asking them questions.

How did you handle this? So you also have your own network of resources to make sure that we're approaching this in the best manner possible. That would be my takeaway really, is first of all, invest in the program. Second of all, facilitate a cohort.

Host: Well that makes sense and I love how you said that. And invest in your team and they will invest in you. And thank you for the AONL shout out. Obviously, AONL is there to be a great partner with you. So thank you so much for mentioning that. Well, Nicole and Coach Tip, thank you so much for your time today.

This has really been informative and great job at Grady Health System.

Nicole Lescota, DNP, MSN, RNC-OB, C-EFM: Thank you Bill. Thanks for the time today. Appreciate it.

Tiffany Francis “Coach Tip”, MSHS: Yes. Thank you so much, Bill, and it because of AONL, Nicole and I are besties.

Nicole Lescota, DNP, MSN, RNC-OB, C-EFM: Yeah,

Tiffany Francis “Coach Tip”, MSHS: appreciate it.

Host: Another benefit.

Nicole Lescota, DNP, MSN, RNC-OB, C-EFM: Probably, another benefit, it would not not have been a partnership that might have been as likely, but here we are.

Tiffany Francis “Coach Tip”, MSHS: Exactly, exactly.

Host: I it. Well, thanks for pointing that out. We appreciate it. Well, once again, that is Nicole Lescota and Tiffany Francis, otherwise known as Coach Tip. And and you can contact Alyssa Adams, Director of Education Partnership at AONL to explore how this program can support your nurse leaders.

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.