Amanda Wilde (Host): Welcome to The Pulse at Tallahassee Memorial Healthcare. I'm Amanda Wilde with an inside look at the people, services, and opportunities in the world of nursing at Tallahassee Memorial HealthCare. My guests are Suzanne Walker-Assad, Director of Critical Care Operations, and Josh Epps, Director of Medical Surgical Units at Tallahassee Memorial Healthcare. Welcome to you both. Thank you so much for being here.

Josh Epps, MSN, RN, SCRN: Thank you for having us.

Suzanne Walker-Assad, BSN, RN: Thank you.

Host: I'm going to ask you both to share a little bit about your path to your current role. And I'll just start with you, Suzanne. Can you share your journey in a nutshell and how it shaped your approach to leading nursing at TMH?

Suzanne Walker-Assad, BSN, RN: Sure. I am from Tallahassee. So, I went to nursing school here. I did my clinicals here at TMH. I had a great experience and was lucky enough to land a preceptorship here in our cardiac ICU. I fell in love with the unit and then was blessed enough to start my career there. I worked as a nurse, charge nurse—progressed pretty quickly as a preceptor and was eventually able to move into the educator role.

From there, I moved into management as their assistant nurse manager, and then transitioned into our neurotrauma ICU as their assistant nurse manager. And then, from there, I moved into the Director of Critical Care. I did progress pretty quickly into my different roles here at TMH and it was thanks to just a ton of support, and programs that continue to help me to grow, I guess, in my career.

And really, it has honestly guided how I lead today. I had so much support and I definitely would not be in these roles if it wasn't for those people that were helping me along the way. So, I try to have that same mindset . You know, look for nurses early that want to grow in their career and want to maybe move around or change or expand as a preceptor or into maybe education or management or maybe even grow within the hospital. So, yeah, I've had a great career here and been really blessed along the way.

Host: I really love that value of coming through the organization fluidly with lots of opportunity and discovering what you do best and having that chance to do it. Josh, what about you? Did you also come up through this organization?

Josh Epps, MSN, RN, SCRN: For the most part, yes. My career did start over in Panama City. And in one of the hospitals over there, I started as a frontline nurse in a medical surgical ICU. I was there for about two years. And then, rather large hurricane, hurricane Michael came through the county and practically destroyed the hospital for that time being.

My wife and I then decided to move over to Tallahassee and kind of look around the area and see which hospital made the most sense for my wife and I. And that's when we made our way to TMH and I started my bedside career at TMH in the Vogter Neuro and Trauma ICU as a frontline nurse, later transitioned to a charge nurse, and then was presented the opportunity to get into leadership, which I never thought I would go into. I always thought I was going to be one of those clinical people through and through, get a nurse practitioner or CRNA and kind of continue my career on that way. But I was fortunate enough to be presented the opportunity as assistant nurse manager from my previous boss, who I had a good relationship with, and later transitioned into the nurse manager role, which I was in there for about five years.

A little over a year ago, I transitioned out of critical care into the medical surgical space, which was a an eye-opening opportunity for me because it was something that was kind of out of my comfort zone. But I knew I needed to continue to grow as a nurse, but also full understanding of the entire hospital and its operations.

So, this past year has been very eye-opening, and I've learned a ton, really starting to get to see the full operational, full picture. And I've really enjoyed the people and the peers and just taking little bits from here and there and continue to grow as a leader here at this organization.

Host: Looking at that bigger picture, what are the major nursing areas and specialties at Tallahassee Memorial Healthcare, and how do those work together to support patient care?

Josh Epps, MSN, RN, SCRN: Absolutely. So here, at TMH, it's a very large hospital. We offer a ton of specialties. We have our medical surgical units, there's eight of them, which kind of offer little subspecialties mixed into those. We have our critical care areas, which Suzanne is over. She can talk about those a little bit more.

Women's and children's, which includes our family care areas as well as our peds and PICU and NICU, as well as our Bixler ER, which is a level II trauma center. And then, our operating room, which is rather large in our new  centers.

Suzanne Walker-Assad, BSN, RN: Like you said, it is a very large hospital. Lots of opportunities here, lots of different areas. Although there are specialty areas, we do tend to kind of all intertwine, with patients coming from ER into the different areas and maybe if they upgrade or downgrade or having to go to the OR, we do at the end of the day tend to all kind of work together.

Like you said, there's a ton of services here. We do have two specialized ICUs that he spoke of. We have our CVMS ICU and our neurotrauma ICU. So, one heavily focuses on stroke and trauma, the other surgical patients and your cardiac patients, CV patients. But yeah, we all tend to just kind of, at the end of the day, work together. But lots of areas for nurses to look at, that at the end of the day, all kind of touch each other.

Josh Epps, MSN, RN, SCRN: I was just going to elaborate a little bit more on the teamwork aspect and us all working together. There's tons of opportunities and meetings that we have throughout the week where multiple leaders from all the different areas get together, and talk about how things are going operationally, if there's things that we can do better, as well as ultimately how we can provide support for the frontline staff and also care for our patients.

Host: Just taking that point you were making, Suzanne, what education or training or certification opportunities does TMH offer to help nurses grow and advance in their careers?

Suzanne Walker-Assad, BSN, RN: Well, there is a wide variety of opportunities. They will start here with their orientation, which depending on the area would depend on the length of time of how long they get that training. But within that training of being, you know, right there on the floor with their preceptor learning their patients, they will also have didactic courses, we have skills courses. And then, opportunities throughout their career to also to continue to advance their career. So if they want to go back to school, TMH offers scholarships and reimbursements. They also offer reimbursement for certification. If you want to really like specialize in your area and get a certification for that area, they will help to reimburse the cost of the exam as well as to increase your pay, which is a huge benefit.

And then, we have several different programs for learning in advance as far as like Leadership TMH. And we have a nurse residency program. So, really multiple programs in this organization that help you depending on where you're at in your career.

Host: Well, Josh, you went through this, I believe, based on what you said, supporting new nurses to ensure they feel confident and prepared at the bedside. How does TMH do that?

Josh Epps, MSN, RN, SCRN: Yeah, absolutely. I came in with a little bit of experience. So, my total experience is a little bit different. But since my time here, we've developed a nurse residency program, which is for our new graduate nurses that come into the organization. It allows them to get comfortable with the hospital in general and get to meet a bunch of different people throughout the hospital.

They may actually not get to work with on a day-to-day basis. But it allows them that comfortableness to learn and to learn how to communicate with physicians and really bounce ideas off of each other, but also get presented with a lot of didactic material. It's a year-long program. It's constantly being further advanced and developed. We have good leaders that are over that, that are really passionate about the new grad nurses, that are coming into the organization.

Suzanne Walker-Assad, BSN, RN: Yeah, I mean, I know it's a great program that goes over a year. So, they're not just off orientation and then right on the floor. They have this program in case they need support along the way. There are others that they can talk to that maybe are in different areas that they can share ideas or different leaders that they will work with and just learned people throughout the organization to kind of help them along the way. It's an amazing program. We also have a ton of support as far as our leadership here at TMH. We have managers right there on the floor as well as A&M and educators. Each unit has their own educator, which is incredible. They're offering classes all the time, and they're right there on the floor to help nurses as they have questions in real-time.

Host: Well, Suzanne, you had talked about training and certification and educational opportunities. And you just mentioned now leadership roles are available. What opportunities also exist for nurses to explore different specialties as they grow within TMH?

Suzanne Walker-Assad, BSN, RN: There's several opportunities. We can set up shadows so they can go around and shadow in different areas to see if it really is a good fit for them. We also try to identify those things early on. So if they tell us that they want to grow from med-surg to maybe intermediate care, to ICU, we try to follow those nurses to ensure that we're giving them the resources they need and just letting them know that we're staying in contact and ensuring that is the path that they want to stay on.

Josh Epps, MSN, RN, SCRN: Yeah. On top of that, we do have our 30, 60, 90-day check-ins with all of our new people that are coming in, as well as our yearly evaluations. And that allows the frontline leaders to really get to further know, the intentions of the colleagues on the units, and really know what they're passionate about and what they want to work towards.

I feel like all the leaders here at TMH really want to see their colleagues continue to grow, whether that's in a leadership route or clinically. And we're going to do whatever we can to fully support their journey with their career.

Suzanne Walker-Assad, BSN, RN: Those yearly evals really help. They give us an opportunity to help write references for them if they are looking to go back-to-school or help connect with other leaders in the organization in case they're wanting to try something new. They really do help to guide us on what next steps are.

Josh Epps, MSN, RN, SCRN: And within our director group, we've already started kind of brainstorming on opportunities that we have with mentorship programs and starting to partner, certain people that we've identified going into leadership areas, who they can partner with to get them what they need to take that next step.

Host: With this diverse, supportive, opportunity friendly environment, I'm wondering how would you describe the impact TMH nurses have had on patient outcomes that you have seen?

Suzanne Walker-Assad, BSN, RN: Nurses definitely play a huge role in patient outcomes. They are with the patient the majority of the time they're helping to collaborate the care to reach out to the providers or physical therapist, respiratory therapist, nurses really do impact patient care. So, it is important that they are in locations that they enjoy, that they want to learn more, and that they enjoy that patient population.

They support the patient emotionally. We have spiritual care and several other groups that can come in, and they really are the person that's coordinating all of that care. So, they play a huge role and had a huge impact.

Josh Epps, MSN, RN, SCRN: Yeah. And Suzanne touched on a little bit beyond the clinical care TMH provides that compassion, the education, emotional support to not only the patients but the family Members. And our frontline colleagues are they truly play an essential role in every stage of the care journey for our patients here at TMH.

Host: Thank you both very much for these insights and for the vital work you do every day.

Suzanne Walker-Assad, BSN, RN: Thank you for having us.

Host: Explore why nurses love caring at TMH, and take the next step in your career. To learn more and apply for open positions, visit tmh.org/nursing. If you found this podcast helpful, please share it on your social media and check out the entire podcast library for topics of interest to you. This is The Pulse at Tallahassee Memorial Healthcare.