Christi Welter (Host): Welcome to Nurses Connect, a podcast from Children's Health dedicated to exploring critical issues and dynamic topics that shape the nursing profession today. I'm Christi Welter, Program Manager of Nursing Communications. My co-host, Brendan Lewis, is unable to join us today and will be back with us next time.

On this episode, we're discussing nursing roles that go beyond the bedside and how these positions enhance professional nursing and benefit healthcare organizations. Joining us today is Barry Owen, Vice President and Ambulatory Associate Chief Nursing Officer, and Elyse Clark, Director of Telemedicine Clinical Outreach. Welcome to Nurses Connect, Barry and Elyse.

Barry Owen: Thanks.

Elyse Clark: Thanks, Christi.

Host: Can you get us started off by just telling us what is Beyond the Bedside?

Elyse Clark: So, Beyond the Bedside, we've defined it as a nurse that is no longer at the bedside for more than 50% of the time, and they do not have a direct connection to nursing leadership.

Barry Owen: Correct. When we originally started the Beyond the Bedside group, it was coming out of the pandemic. And it has evolved from 2020 into what we are today of 2026. The beginning of the Beyond the Bedside was sparked out of a need to reinforce our nursing staff during the pandemic. And during that time, we knew about all of these registered nurses that were working in jobs that were not direct patient care. They were working in some of our other departments like accreditation, in legal. what else are in there?

Elyse Clark: Virtual health.

Barry Owen: Virtual health.

Elyse Clark: Informatics.

Barry Owen: Yeah. During the pandemic when we were needing nursing staff and nurses that had worked at the bedside in some format in their life, we were able to pull them forward during that time to fill in gaps, to meet the needs during that time.

Fast-forward, we brought the Beyond the Bedside again, and we evolved it to maintain those nurses that work in departments that aren't necessarily patient-forward. We lovingly say that they don't take care of patients. They do work that impact our patients, from that standpoint. And so, there's quite a bit. It's like about 100.

Elyse Clark: There's more than. It's 100 and almost 70, I think.

Barry Owen: Hundred and seventy in our head. And it's all across our organization in different departments as we were listing that through.

Host: Can you tell me how you identify who these nurses are, and what you do to get them engaged?

Barry Owen: The executive leadership, we really focused in on that definition. You're a registered nurse that is working in a department that doesn't have a connection to the nursing strategy, and your upline leadership is not a nurse. Really focusing on keeping our Beyond the Bedside nurses connected to the nursing strategy.

And originally, we built this out as an advisory cabinet, meaning Tammy and I really wanted to have a grouping of nurses that were small that represented all of the beyond the bedside nurses with questions like, how do we keep you engaged in the nursing strategy? How do we fulfill your desire to be a registered nurse and meet your professional development at the same time? How are you connected back to Tammy Webb as our chief nursing executive with the strategy? And how do we support you in that? In a Magnet organization that is nurse empowerment, nurse visibility, that was definitely something that was missing. And we were able to kind of capture that, double down on it, and it is what it is today as we are evolving.

And Elyse kind of played a huge role into that because she served in the cabinet and then also in this role. So, I'll let her talk a little bit about how we keep them engaged, which has been interesting.

Elyse Clark: Yeah. So starting off in the cabinet, we created a distribution list with everyone that met that definition of Beyond the Bedside. And so, we were kind of sending out information on what we were discussing in the group and whatnot. And so then, it kind of snowballed where people were like, "Well, how do I get involved?" It's like, "I want to be a part of this. Like, I miss that connection to nursing." And so then, we started talking internally about, "Well, what do we do to include more people in this?" And that's when it evolved into getting a part of nursing shared governance and creating a Beyond the Bedside forum.

And so, this past year is when we started the forum. And now, anybody that meets those definitions of being outside of the bedside 50% and they don't have that nursing connection, can be a part of our forum and be a part of that.

And so, we have our monthly meetings that we do. We send out communications. What we're really working on this year is recognition, because so many people don't really realize that nurses are in these roles and what we do. We're kind of very niche and very unique in what we do. We started working with our communication teams on, okay, how do we showcase these people and what they do? And so, we're doing a monthly communication that goes out in various different platforms across the organization to share that knowledge and keep people engaged.

Host: And why is it so important for these nurses to remain engaged and know what's going on within the nursing community at Children's Health?

Elyse Clark: As a nurse, you realize like deep down, you're always a nurse. Like, it never really leaves you. But when you don't have that connection, it does kind of fall to the background. So, like, having this made me feel that connection to nursing again, just having a space where I'm meeting with other nurses. Because on a day-to-day basis, I don't see other nurses. I don't talk to other nurses. So, this is my connection back to that.

Barry Owen: Nurses tend to have a culture of nursing, and we tend to have a lingo in nursing, and we have an identity to other nurses, and that's what we found in the Beyond the Bedside nurses is they've lost it. We're trying to capture that and give them a space that can come forward and that it's encouraged and that it's fostered, and that we know how to bring that forward and either teach them, allow them to bring that forward in whatever forum they're in. You might be sitting in a room full of non-nurses, well, then you're unique and you have a skill set that nobody else has. Use it.

Host: The invaluable experience from working at the bedside and the years as a nurse, that they can bring to the table in any role at our organization, I assume. You mentioned that you're trying to give them a forum to use their voices. What are some of the discussions that are had and how are they influencing nursing or even other aspects of Children's Health?

Barry Owen: Well, you're also seeing a connection that we naturally offer in the organization in such a strong nursing structure is outside connections. With the intent of the Beyond the Bedside nurses is like you get to have your professional development in your department, in your line of work. And your nurses, your nursing leadership will support you in that as nursing professional development.

We also keep opening doors to, like, Texas Nurse Association, American Nurses Association, encouraging the Beyond the Bedside, go become a part of your professional governance organization, whatever that looks like that is feeding that. And we have found some opportunities and certifications that we didn't even know we had. And nurses that have come forward, "I would like a certification in this." Like, we can help with that. "Here's the form. Let's fill it out. Get it approved," right? And so, we've learned so much over the past four years.

Host: And you mentioned a feeling of feeling seen. Can you speak to that, Elyse, as a nurse that does work Beyond the Bedside? You know, what has it meant to you to be able to connect with other nurses through this forum?

Elyse Clark: Yeah. So in my role, I have no connection to nursing whatsoever. None of my senior leadership are nurses. And so, I did feel like I've kind of lost that connection to nursing, and I felt like I still use my nursing judgment, and it comes up in a lot of different ways. I might not be very vocal about where that's coming from, but I'm like, "I need to start saying that that's where it's coming from," and kind of explaining that that's how I know some of these things, is because it's from my previous experience. Because I think just letting people feel comfortable with saying that they're a nurse and that this is where it's coming from is important so that they do get that recognition for the years of nursing experience that they do have.

So many of the people on our Beyond the Bedside group have been nurses for a very long time, I think—Gosh, I wish I could pull up the survey right now, but I think it was like 60% or something of the Beyond the Bedside group have been nurses for over eight years. It was really impressive statistics.

Owning my experience and knowing that that's where I've gotten so many of my leadership skills, all of that is from things I did way back when at the bedside or as a charge nurse or as an associate unit manager, where you're still kind of at the bedside learning those skills. And then, translating it into different areas is so important and kind of knowing that history is really a good point.

Barry Owen: Just to add to that in the conversation is I, by no means, devalue our non-nursing leaders whatsoever. And bringing that forward is strong leaders that lead with humility and want to have a strong team appreciate someone on their team, and we see that in this organization. Appreciate somebody on the team that is bringing a different skill set to the table than anyone else. And so, it's a balance. It's not, "Oh, you're a nurse, you make a bad leader." Absolutely not. It's, "Oh, you have a skill set and an expertise. I have a skill set and expertise, and we merge these to have a better product," whatever the, whatever that is.

In my opinion, nurses that have spent any time at the bedside, who has been that person feeding and changing and medicating and loving on them and working with the families and making sure these kids are completely enveloped in care, and you have done that day in, day out forever, that's not just a skill set. That is an implanted memory that you bring to the table like-

Elyse Clark: Yeah. It personalizes

Barry Owen: It personalizes it. Like in a business scenario in my experience—and I do this a lot, is bring it back to the table of there's a kid at the end of that decision that has a mom and a dad and a family that's scared—and impact, and how bringing that always back, too. And I'm a cardiac ICU nurse by background. Like, I know what that feels like. If you've never done that level of patient care, the look, the feel, the smell, the whole gamut of what it takes to take care of a patient in the hospital, you can't duplicate that. That is not an experience you can duplicate in a sim lab.

And if you did it a long time, if you did it just a little bit, that becomes who you are. That becomes part of your lived experience that really does start to color your decisions and a quick advocacy like, "Eh, the parents aren't going to like that," or, "That's not going to feel right," or, "Your nurses are never going to do that," or any of those pieces, that is just a little nugget nobody else at the table's going to have.

Host: Yeah. Nurses bring such valuable perspective to these discussions, I'm sure. You mentioned earlier some of the roles that they're working in, and you talked about how they bring their expertise to these roles. How do you think they found themselves kind of moving out of bedside nursing or clinical nursing and into various roles across the organization?

Elyse Clark: I think it's probably different for everyone. Yeah, it's really different for everybody. I was a NICU nurse, for example, and so my world was very siloed. I was just in the NICU for my entire nursing career, and I wanted to see kind of the bigger picture. I like to put the pieces together.

And so, I couldn't really figure that out in the NICU. I needed to see what was going on elsewhere. So right before COVID happened, I got an opportunity to transition into virtual care. And so, that is where I got to see how all the little pieces of the hospital, ambulatory, everything worked together because virtual care can touch all those places. And so, that was really interesting for me. I mean, there's really so many different reasons that people go outside of the bedside.

Barry Owen: You see nurses that are more technically-minded that really like work in informatics. There's whole degrees in nursing informatics that really, like work in Epic, how they build the modules and make the packages and all of that stuff I don't understand. But they love that type of work. And so, there's a natural gravity to take them in that direction.

The nursing world in general is supporting that by advanced degrees in some of those. Informatics is a good one that kind of comes to mind. Obviously, there's nurses that like the legal aspect. We have attorneys that are nurses. So, you get to go do that. It's a great example of how nurses can fit in so many different locations and ways, depending on what your life is leaning you towards. And there's probably a door to be opened, but it doesn't mean you have to disconnect from the larger grouping of nursing strategy and the volume that we have.

One of our Beyond the Bedside nurses who's very vocal, her life and love was care coordination and living in the care coordination world. Well, as she became more of a leader and she progressively moved up in the organization, well, it put her into utilization management. It put her in this entire different subsection of nursing that is more around utilization management, how we get paid, payer contracts, those kind of things that are super important. That's kind of a strange pathway that just was natural. You just went and went. Our accreditation partners, here at Children's are—I think all of them, I think all of them are registered nurses. People that like regulatory, like compliance, like that type of work with Joint Commission and CMS, and they bring that flair of nursing that comes across to it. But their job doesn't require them to be a nurse. But I value them in my partnership with them because I deal with those guys all the time, and I'm like, "Yes, I realize you're a nurse." I'm a nurse, too.

Elyse Clark: That's the beauty of nursing to me. You can really do whatever you want to do with it. It's really open. The doors are open. You just got to find which fits you best, I guess.

Host: Yeah. Yeah.

Barry Owen: It's really important to our organization to keep our nurses connected, and we see the value that all of our registered nurses, despite department, bring to our patient care. And nurses have that lens of patient care forward in that manner.

Host: And do you have any advice that you might give to another organization who's looking to get their nurses more plugged in to their own nursing strategy?

Elyse Clark: I think they need to do what we did. I mean, obviously, the nurses have really appreciated it and have really enjoyed being a part of it. So, I think getting a group together and seeing what their organization wants to focus on within that group is the best way to start

Barry Owen: I agree. The evolution was natural for us when we started it as an advisory cabinet. We need to seek the advice of the team. And so, that's why it was an advisory board. And we arranged some outings and provided some experiences for that group to stay connected in that. And so, I would recommend starting that way.

If you're in an organization that doesn't have a fairly robust and mature nursing professional governance structure, I would start it as an advisory cabinet to learn, even if the intent is you're only going to do it for a year and then going to fold in. This year is the—well, '25 was the year that we took that next step, sunsetted the advisory cabinet, and then pulled it forward in the forum, because we recognized that you're missing a lot of people. And then, part of our nursing professional governance structure as it matured and we went into forum formats across the organization, it was just kind of a natural fit.

Host: All right. Well, we are about out of time. Is there anything that you would like to speak on that I haven't asked you about?

Elyse Clark: No, I just want to say thanks to Barry and Tammy for getting this group together. I think it's been so impactful for not only me, but a lot of the other Beyond the Bedside nurses, and I am excited to see how it continues to grow and evolve.

Barry Owen: Thank you for that. And thanks for this time to be able to have the conversation around it. I always encourage every registered nurse, no matter where they are, to find your voice and use it. It becomes easier when you're around people with a like-minded voice. Find your voice and use it. I have consistently seen over my long career of nurses that feel devalued and by whatever reason, sometimes it's structural, sometimes it's because of the org structure that they're not recognized as a registered nurse and their leadership sometimes doesn't value that skill set. And I advocate for those nurses. And I'm like, "Sounds like you got a task to do." We as registered nurses are empowered to use the voices that we have been cultivated to use. And don't give your power away. Bring your value to the table, bring the skill set to the table. Put it out there, use your words, and keep on trucking.

Host: Well, this has been a great conversation. Thank you both for joining us today and for sharing your experiences and your expertise with us. If you want to know more about nursing at Children's Health, we encourage you to visit childrens.com/nursingannualreport. Here, you'll find information that summarizes a variety of our nursing initiatives. Thank you to our listeners for joining us today, and we'll talk to you next time on Nurses Connect.