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Scott Webb (Host): We have a nursing shortage in this country. It started before the pandemic and has only worsened as our nursing heroes have faced COVID-19 on a daily basis. And joining me today for a conversation about the benefits of a career in nursing, and how the entire nursing community supports each other are Jim Williams, PhD, Registered Nurse and Vice President of Patient Care Services and Chief Nursing Officer at McLaren Flint.

I'm also joined by Monica Baranski. She's also an RN and the Vice President of Patient Care Services and Chief Nursing Officer at McLaren Bay Region. And finally I'm joined by Kathleen Carolin. She's the Vice President of Patient Services and Chief Nursing Officer at Karmanos Cancer Center in Detroit. This is McLaren's In Good Health, the podcast from McLaren. I'm Scott Webb.

It's so great to have you all here today. And Monica, I'm going to start with you. As I mentioned in my open, we've had a nursing shortage for a number of years, and I know you're a proponent of building a career in nursing. So, why would you recommend a career in nursing to those who are listening?

Monica Baranski RN, BSN, MSA (Guest): Actually, we recruit nurses every day. And some of the things I share with nurses is there's not a career that I know of, that you have so many opportunities in. For example, you can be in the hospital, you can be in the schools, you can be in industry. And today we see more and more, outside of the hospital opportunities where these nurses can go if they're not quite into the hands-on. There's a lot of opportunities to get out of the hospital and education, et cetera. Like for instance, I just hired eight school nursing positions that were going to be for the school nurses, for the school year only, and now they want to expand it to year round because of the COVID situation. And these kids have so many needs because of that. So, I would recommend nurses to get into here, feel it out and go for it. And I was just told this morning, at a meeting that nurses are just flocking to the schools of nursing and that excited me because we are desperate with the increase in healthcare needs.

Host: It's interesting that you mentioned that. My son just graduated high school last year. And a lot of his friends that he went to school with, that he grew up with, a lot of them went into nursing school.

Monica: Oh, I'm excited.

Host: And Kay, want to bring you into the conversation. What drew you to nursing?

Kathleen (Kay) Carolin (Guest): You know, I think it was intuitive. When I was in high school, my mom got cancer and she died at 39 and she was actually treated at another NCI designated comprehensive cancer center in New York. And so I think watching her go through that experience and how important the nurses and the care team were to her. And I will tell you how impactful it was, after she passed away, one of the nurses wrote me a letter and so I think it was just intuitive. I think I was meant to become a nurse.

Host: You know, I've heard that before, when I've spoken with doctors and nurses, that a lot of them had a personal experience, unfortunately, and I, and I'm sorry to hear about your mom, but as you say, it sort of opened up a calling for you, you sort of just knew.

Monica Baranski RN, BSN, MSA (Guest): Right.

Host: And Jim don't want to forget about you. I know you built a standing career in nursing leadership, but you probably still remember many of your patients from your early career. So tell us about a patient you'll never forget.

James (Jim) Williams PhD, RN, MSN, CENP (Guest): Well, there have been a number of them.

Host: I'm sure.

Dr. Williams: I started my career back in 1983 actually, I've been a nurse for 37, 38 years. And probably, my first 10 years of my career, I spent mainly in the clinical arena, at the bedside. For a while I worked at the University of Florida Shands Hospital and I went there to specifically work in their open heart program and I got the chance to take care of their very first heart transplant patient. I worked nights and the gentleman came in and had his heart transplant done in the late afternoon evening, came out of surgery about 10 o'clock and I was there to take care of him for his first night postop with his new heart. It was definitely an experience. And one that I remember to this day. Dr. Michael Carmichael was the heart transplant surgeon. And he had left the bedside to go get a couple of hours of sleep and you know, had warned me not to do anything to his patient. But when he came back in the morning at six o'clock, I had the guy off the ventilator and sitting up in the chair and he had done fantastic. And it's one of those patients that I'll never forget. And I carry with me.

Host: Oh, that's a great story. I mean, you think about how long you've been at it, right, 37 or so years. And to still remember that patient from early in your career is really amazing. And I know, you've worked in several markets. You've mentioned Florida, also Ohio. Was it challenging to adjust to Flint, Michigan? And what do you like most about the market?

Dr. Williams: You know, it was a little different. I had never worked in a union environment until I moved here and took the job at McLaren Flint. In my past, all my other hospitals did not have union. And, in Michigan there are a large number of unions, but what I really quickly learned is that it's not that much different. It's really all about building relationships. It's all about connecting with your staff and making sure that they have the tools to deliver exceptional nursing care because at the end of the day, that's what it's about. Right. We want to make sure that our patients get the best care that they can get.

So, the markets are very similar. Healthcare is very community oriented. So, you know, each of the places that I've worked, things have been a little bit different, but at the end of the day, we really all had the same goals and that is improving care.

Host: And Monica, I'm sure a nursing career isn't for everyone. So, what characteristics do you think are important for those entering the nursing field?

Monica: Well, I think one of the things the young people need to know that you have to be very dedicated to the field of nursing and you have to have a passion for it. People get into it thinking it's a glorified career. And I look back at my almost 39 years. I'm dating myself and I've never worked so hard in my life that last several years. And I'm not even at the bedside and there's so much demand. And I don't want people to come into the field thinking it's piece of cake and tell your son and his young friends that they have to love it. I could never do this if I didn't have passion and dedication.

And then the other thing I think people like in management and Jim and Kay can say the same thing. You don't punch in and punch in eight and a half hours anymore, even if you're a bedside nurse. You're committed to stay if there's a crisis, if there's a code, somebody goes bad. You're there for the duration until you get through that.

And then another thing that young people have to know, society's getting pretty tense and the expectations out of the patients that seek healthcare has increased so much. So, you're not only just a nurse, but you're dealing with the families, the community, and you have to drive excellence. Sometimes people say, it's not a hotel. It is sick. People need more than somebody that goes into a hotel because they're sick. So, just to tell those young people, they have to have passion and drive to come into nursing.

Host: I will do that. And we're doing that through the podcast as well. And coming back to you now, Kay, did you always want to be an oncology nurse? And do you think it's important early in your career that you know exactly which type of nursing that you want to pursue?

Kay: No, I don't. And if you were to ask me if I always want it to be an oncology nurse, no, I didn't. I started out much like Jim, as an intensive care nurse. My first job was as a surgical intensive care nurse. I then went to psychiatry and I was a psych nurse for a number of years. And then was recruited back to manage the intensive care units again. So, I ran a couple of medical intensive care units and then was recruited over to oncology to manage the bone marrow transplant unit. So I don't think it's important that you know exactly what you're going to do.

I think that's what's really wonderful about nursing is that there's such a large scope to it. And so I think you're able to get into it and try new things and see kind of where the journey leads and where you are most impactful and where you get the most joy.

Host: And Jim, back to you. When you started in your career, did you want to be the chief nursing officer? Did you want to be the head honcho, you know, and as you've worked along the years, how have you worked to build the skills to be in that leadership role?

Dr. Williams: You know, originally I wanted to be an educator. I had from early on in my career, I was a preceptor for new nurses. I really enjoyed teaching at the bedside and helping new nurses learn about critical care and critical care concepts. I was a critical care educator at one of my first hospitals.

And then all of a sudden I had a new mentor. We got a new CEO at the hospital. This was a Marion Community Hospital in Ocala, Florida. And we got a new CEO, he's a pharmacist. And for some reason he took me under his wing and he really brought me into the leadership realm. He hired me as one of his administrative directors, gave me departments that I knew nothing about. He gave me medical records. He gave me coding. He gave me risk management and he basically said, you know what, you're going to learn how a hospital works. And the way you're going to learn it is by diving into this and running these departments and I did, and I picked up these departments and I spent hours every day, just trying to figure out exactly what was going on and in each of these new departments.

But I tell you, I look back on that experience and it really taught me about operations in the organization. And today I can run any department in the hospital. I understand how hospitals work, but that gentleman, Terry Uptain, my first real mentor, he really brought me to the place that I am today.

Host: Which is definitely a good place. And Monica, you touched on this a bit earlier, but when you talk about nursing, I'm sure that many people think about caring for a patient in a hospital bed. But as you know, nursing includes a wide variety and a wide range of disciplines. So, maybe you can describe some of the roles that nurses may have in a hospital setting.

Monica: In a hospital setting, I like the nurses to start out on a basic med surg arena because they get a lot of variety, but in our hospital we have behavioral health and now we have geri psych where the patients 65 and older are in a population seeking behavioral health. We have critical care, we have ER, we have surgical services. We have case management and utilization review and we have chart reviewers. They audit the charts, so the nursing role has from bedside to office. And then of course you have three chief nursing officers online that are at the helm of nursing, and we cover all of these aspects of nursing. They're under us.

So, the varieties go on and on and nowadays nurses want a challenge and I say that's one thing about nursing, you just don't stay in one place if you don't like that, or you're not passionate about it. You can certainly look for another opportunity and that's right there waiting for you.

Host: Yeah, it sure is. And you've discussed here, the commitment, the passion that's needed. And I'm sure during this challenging time, 2020 and 2021, there've been a lot of challenges, especially for nurses. So, maybe you can talk about how you supported your team and why it's important to build relationships with your staff nurses.

Monica: Actually, this is probably one of the hardest times of my 39 years of nursing. COVID brought about a whole different thing and we practiced pandemic exercises throughout my career. You get ready for a licensing and credentialing and you have to have like mock pandemic run throughs. And now the real thing hit and supporting nurses was so important because they were getting depressed as we watched patients die, sometimes a couple of day because of COVID and you had to lift them up. And not only did we, as administrators have to lift them up, but we brought in the community to help support them and rally around them. So, it was never ending. And I don't know if I want to say I was fortunate or unfortunate, but I was at the helm in the command center.

So we had an everyday command center, where we redo policies and procedures, how we were going to get patients in and out, visitor hours. But, we could see nurses getting weary and, you know, you couldn't let that happen because they needed to be here for patients and families. So constantly, we do fun things. Get the families and the communities here to give them treats and snacks and rally around them. So, it was a crucial time and we did it. We don't see an end in the near future, but we're still rallying around them and keeping them supported.

Host: And Kay, bringing you back in, and I know probably you're going to blush a little bit, but you are recognized as a 2020 COVID-19 hero. I wish I could put an echo on that hero by Crain's Detroit Business Publication. Can you talk about why it was important to work shoulder to shoulder with the staff nurses during the height of COVID?

Kay: Yes. If you'll bear with me, I'm going to tell you a bit of a story about the nurses I work with. So, I think when I was chosen as a COVID hero, I think that I was recognized because, as the CNO, I was the face of nursing here. I cannot tell you how significant it was for me to witness the nurses that I worked with and what heroes they were and the incredible care they gave to the patients that they cared for and to each other. So, here's my bit of a story. I went into the intensive care unit and we had a very sick gentleman there.

And I had a young nurse who was six months pregnant, who was caring for this patient with COVID and the wife was in and I needed to go in talk to the patient's wife. There were some things going on and I went to go in and the nurse stopped me and said, what are you doing? I said, I'm going to go in and speak with the patient's wife.

And she said, you don't need to go in there. I said, yes, I do. I said, and you know what, you're in there, you're in there. If you're in there, I can be in there. And she stopped me and she said, all right, if you're going in there, I'm garbing you up. I'm putting your PPE on you and that is so typical of the nurses and how they take care of their patients and how they take care of each other.

And she was saying to me, you're not putting on your PPE all the time. I'm going to make sure that your PPE, your personal protective equipment is on you correctly, if you're going to go in there. So, for me, to be able to try and be present with those nurses who really were the heroes, who were in with the patients during those times when, you know, we're a cancer hospital.

So, we have sometimes patients in here for an extended periods of time with no families or visitors with them and our nurses, we're with them all the time. So, for me, it was an honor to be with them and I was blown away when the nurses recognized me as the hero.

Host: Well, Well, I happen to think you're all heroes. You just happened to be on the cover, which is nice for you. And Jim, I know, you hold a PhD in Healthcare Administration, so how's that level of education been helpful to you as you've continued to lead the nursing team at McLaren Flint?

Dr. Williams: You know, I originally went back for my PhD really more for myself. I really enjoy teaching. And it was part of my retirement plan because I had spent so many years in a leadership position at some point in time, I really would like to go back to teaching, and try to share some of my experiences and the things that I've done with new students and continuing students. I also realized that nurse leaders, today, they really need to get, really need to get their doctorate. We don't have as many doctorate prepared nurses in nursing compared to other health disciplines. And it really is up to us leaders, the executives at the bedside to really think about, okay, what do we need to do to bring doctorate level prepared nurses into the profession? And I think it is so important for us to do that.

Host: Yeah, it is. And when we think about the advice, that's great advice for some more doctorates in nursing, love it. And what other advice do you have for nurses who are interested in moving into that leadership role?

Dr. Williams: Don't forget about the patient. If you're going to go into a leadership role, you're going into a leadership role in order to be able to help your staff give good quality care. So, at the end of the day, keep the patient and the patient's family at the forefront. If you do what's right for the patient, if you do what's right for good patient care, you can't go wrong. Cause it's a good business decision at the end of the day to provide good quality care.

Host: Yeah, it does seem that it always comes back to the patients, which as a patient and we know of course, nurses and doctors are also patients themselves, but as a patient, it's good to know that nurses and especially their leaders, their mentors are all working towards the same goal, which is the best patient care. Love it, Jim, thank you so much. And Kay, I know the Karmanos Cancer Center is an NCI Designated Cancer Center, part of McLaren Healthcare. You've been with Karmanos for more than 20 years, which is not necessarily the norm in today's work world. So, tell us why you stayed with the same organization for more than two decades.

Kay: I've reflected on this a fair bit lately, during this time. And I think what it is, is that I love the culture at Karmanos. So, if you work at Karmanos, you buy into the singular focus or mission that Karmanos has. So, I'm going to just take a minute and share with you. Karmanos's vision is a world free of cancer. And its mission is to lead in transformative cancer care research, and education through courage, commitment, and compassion. And so everyone who works here and all the nurses who work here know that we're here to care for patients, and to do the journey with our patients who have cancer. And I think that brings a unique culture and one that I am honored to work with.

Host: Well, you know, Kay, culture is so important for all of us. You know, none of us are born into knowing exactly what our families are gonna be like, our churches, schools, teams, the workplace is going to be like, and I think you're so right. I think culture is so key and obviously a contributing factor in you staying there for more than two decades which is really great to hear.

And what advice can you share for a new nurse, who's just not sure what type of nursing is a fit for him or her. And you know, maybe some of the things we've discussed here, just looking for the culture or trying different specialties or things like that. What's your advice?

Kay: So, you're right. I think, as you talk to my colleagues, we've all had interesting journeys to get to the place that we are today. I would say that when you're in school, you are afforded an opportunity of experiences and you come out and I think that you start with what is most interesting to you and where you think you can be most impactful. What it is that speaks to you or calls to you for that patient population that you want to, to care for, serve, work with, and then I believe that for most of us, or I think for most of us, the journey unfolds.

You have more experiences, you continue your education and you have some joy in this and you find where you are most impactful in working with those particular patients in that patient population, and you find the culture that you want to be part of and how you want to use your career to impact the care of patients and to positively impact the profession.

Host: And Monica, no pressure, but I'm going to finish up this great conversation with you today. You've touched on this a little bit, but the healthcare industry is really seeing nurses leave the profession. There's a desperate need for nurses as we've discussed that need to be, you know, committed and compassionate and just really dedicated. What would you say to a nurse who's considering his or her career choice as a nurse?

Monica: You know, Scott, it's a good that you asked that because I have nurses every day saying, I don't know if I can continue on and some days we have those same days and you just got to say, hang in there with us as a team because without you, we're one less nurse and it makes it harder on all of us. So, nurses look back and say, I can't leave my team. I've never seen so much dedication and cohesiveness because you're in the trenches together. So, sometimes you got to give them a few days and weeks to reconsider, but they usually come back and it's like you would put a lot of effort into this career, please don't leave us now. But it is a challenge, like you said, but we do all we can to keep them and maybe change where they're at like we have COVID teams and we try to get them in a different unit to give them a break. So, that's important too.

Host: Yeah, Monica, I'm sure there's probably a high burnout factor. And there are times when nurses, cause they're people, they're humans and this has been exhausting and the full PPE and all of that, where they just, they need a break, you need to rotate them out and to give them something maybe just a little less heavy, right? Just to kind of take their minds off of all of the trauma and grief and everything. Right?

Monica: Truly. Sounds like you have some nurses in your family.

Host: I don't, but I do, I do regularly speak with doctors and nurses, and I do understand, you know, pulling 12 hour shifts in the COVID ICU, that that's a lot for anybody. And to do that day after day and knowing how desperately we need nurses, it's good to hear that you're doing everything you can to help them mentally, physically, keep them fresh, keep them focused and not leave the profession really amazing, Monica.

Monica: Yes. Well said, Scott, thank you.

Host: Yeah, I think the common thread that's run through our conversation today is it really always comes back to the patients. Really. It starts with the patients, everything else, you know, job satisfaction and culture, all of those things are important because we're all humans and nurses, even though they may be heroes, they're also, you know, human heroes.

So, those are all things for them, to stay focused and stay interested and stay with a career in nursing. But really for all of us, it's such a comfort to hear that, you know, patients always come first and I think we all really appreciate that. So, thank you. And thanks to all of you for listening. To learn more about nursing at McLaren Healthcare, visit mclaren.org/nursing.

And if you enjoyed this podcast, please share it on your social channels and check out our entire podcast library for additional topics of interest. This is McLaren's In Good Health, the podcast from McLaren. I'm Scott Webb. Stay well.