A cheerful smile spread across new nurse Alexis Adams’ face as she described what sparked her desire for a career at Arkansas Children’s Hospital (ACH) in Little Rock.
"I chose to work at Arkansas Children's because I did want to specialize in pediatrics, and my clinical rotation here was such a friendly environment as far as staff, and the patients go. It really just drew me in, and I knew this was my home," she said.
Arkansas Children’s core values of safety, teamwork, compassion and excellence and the family-centered approach to caring for pediatric patients attracted 125 new nurses in July, the largest cohort in the health system’s 111-year history.
"It's really that feeling of family and belonging, and we're here to support and care for each other is what I think sets Arkansas Children's apart from all others," said Heather Cherry, D.N.P., M.H.A., R.N., N.E-B.C., senior vice president of patient care services and chief nursing officer, during professional nursing orientation day July 11. She joined ACH in April. "When I met some of the new nurses just this morning, that was the one thing they mentioned too, 'It's different here. Everyone knows each other's name and has really welcomed me,' and I think it's that welcoming and just nurturing, 'You're part of us, you're part of our family' is what drew me here and really the possibilities to make things even better than they are."
Professional Nursing Orientation Day
There are 1,524 total nurses employed across the health system, including ACH, Arkansas Children's Northwest (ACNW), Arkansas Children's Care Network (ACCN) and Arkansas Children's Research Institute (ACRI). Each receives extensive training to provide the best care to patients and families. The current nurse orientation time is 20 to 22 weeks (about five months), depending on the specialty. There are also individualized orientation plans based on experience.
In addition to the Pursuit of Excellence Pathway onboarding and specialized training, new nurses participate in professional nursing orientation day, a two-day orientation program followed by area-specific EPIC training. Orientation day includes presentations on clinical ethics, creating a healthy work environment, patient experience, safety and other topics to prepare nurses for their new roles. There are three nursing cohorts for the ACH residency in February, July and October. The July cohorts have historically been the largest, with last year's attracting about 60 nurses.
Cherry, who joined Arkansas Children’s in April, said one of the key ways ACH supports new nurses is by allowing them to shadow different units to see where they are the best fit.
"I think being able to experience what nursing is like in an ICU versus an emergency department or med-surg unit is huge because they're going to probably spend a very long time there. Making sure they are able to pick where they feel like they can best share their nursing knowledge and skills and be able to take care of patients, I think, is really, really important," Cherry said. "So just really being able to match people where they belong, that's what really sets us apart here at Arkansas Children's. It's done different ways across the nation, and it allows that opportunity where nurses can sort of try things out before deciding, 'This is where I want to start as a nurse.'"
Lametria Wafford, M.N.S.c., R.N., N.P.D.-B.C., has been in health care for a little over 20 years, serving at Arkansas Children's as interim director of nursing excellence, working as the magnet program coordinator, director of academic nursing, professional development, nursing research and the transition to practice programs, which includes residents, new hires and our clinical teams that support nurses. During orientation, Wafford led the "Teamwork: Creating a Healthy Work Environment" presentation.
"I think the one thing that really creates that healthy work environment is the teamwork and making sure that we just have those conversations. When our environment will have challenges to it, and that does happen, it's really about having those conversations," Wafford said. "One of the most critical components of that is active listening, and it's something recently I've learned a little bit more about. It's making sure that you are totally present so that you can listen - not just listening to respond, but listening so that you can understand."
Listening and understanding patient needs are also vital to patient experience. Dante Griffin, M.A., C.P.X.P., L.S.S.B.B., vice president of patient experience for ACH, presented "Compassion: The Patient Experience" to new nurses, along with Tammy Diamond-Wells, M.S.N., R.N., N.E.-B.C., vice president of patient care services. Griffin, who has spent about 15 years in health care, said he tells both new and seasoned nurses to look at the perspective of the patient, who might be afraid and anxious, and lowering those fears via A.I.D.E.T., meaning acknowledge, introduce, duration, explanation and thank you.
"It's huge that the new nurses focus on patient experience from the beginning. I think this sets the stage and the standard for everyone else in the facility," he said. "If new nurses come in and they are not focused on patient experience, there is kind of a trickledown effect, so no one in the case will be focused on it if they are not. So, they come in 100%, 100 miles per hour, and so we want to capture that enthusiasm as they are coming to the door to continue providing great care for our patients in the hospital."
What Nurses Say About ACH
The variety of training and preparation of orientation day has lasting impacts on nurses as they move forward in their careers. Nurses Demond White and Cassandra Lackey, R.N. I, graduates who joined ACH during the February cohort, utilize skills they learned during orientation. They both remember the excitement and nerves of "walking into the unknown" on day one, but White explained that the team-centric approach made it feel like home.
"Teamwork is huge to me. And just my coworkers, the people, the staff, their willingness to actually be helpful, asking, 'Hey, are you understanding what we're talking about?' Just kind of going the extra mile to make sure we are understanding or picking up on orientation," White said.
Like many nurses, White, a hematology-oncology nurse, said his passion for children drew him to ACH. But what makes him stay is the hospital's willingness to continue educating.
"I'm one of those people who has a lot of questions; my mind is racing, and (no one) gets frustrated when I ask questions. Taking that time to answer questions means a lot," White said. "If you love kids, I mean, what better place could I think about for you?"
Lackey, a pediatric intensive care unit nurse, said based on her clinical experience at ACH, she knew she could join and “love my job.”
"I think something that is unique to Arkansas Children's is really that we provide family-centered care. I've seen other places, and a lot of times, visitors and families don't really get acknowledged. But here that's a lot of what we do is teach our families and visitors how to care for their kids when they get home, and I love that," Lackey said.
The teamwork preached at orientation is not a hollow idea but one she’s experienced, even in the challenging moments.
"A couple of weeks ago, I had a really rough shift dealing with just difficult patient situations, and I had several coworkers reach out to me after the shift, or message me on Facebook and sit with me in the breakroom, just ask me if I was doing OK. And just to make sure that I was OK so I can continue caring for our kids," Lackey said. "To me, it means everything to have my coworkers that I know will be right next to my side if I need them."
Nurses Alexis Adams and Isaiah Fay Pineda joined the July cohort after participating in the ACH student nurse internship program the past year, gaining experience in pediatrics while still in nursing school. Fay Pineda, who grew up having extensive speech therapy, said the program improved his communication skills, allowing him to overcome his nervousness about speaking with families. It's an essential skill as he adapts daily to different experiences as a nurse on the special staffing team. He finds out right before his shift what unit he'll be working on that day.
"Something that really drew me into Arkansas Children's was, of course, the core values, especially excellence. For me, as soon as I walked through the door, I just see excellence in motion," he said. "From the security and the support staff at the front entrance giving you a smile, greeting you, telling you where you need to go from walking through those halls and seeing the doctors and different physicians and nurses; everyone is here to champion children. And that was the biggest thing for me moving forward and ultimately choosing Arkansas Children's as my home."
Adams, a hematology-oncology nurse, said she is excited to bring her compassionate nature to the job daily while carrying the lessons she learned from orientation throughout her career at ACH.
"Professional nursing orientation day has been really educational. We learn a lot in school as far as diagnosis and medications, but today we're learning more of the patient as a whole and ethics and how to care for that patient and their families," Adams said. "I think today at PNO I realized how important it is to speak to the patient and actively listen to them. That's something that, again, isn't really stressed in school, but to make sure that they know that you're there for them is a big takeaway from today."
Leader Spotlight: Heather Cherry
Heather Cherry, D.N.P., M.H.A., R.N., N..E-B.C
., senior vice president of patient care services and chief nursing officer, joined Arkansas Children’s Hospital in Little Rock in April, bringing 23 years of experience as a nurse with her.
For about two decades, she’s served in health care leadership roles, including at St. Louis Children’s Hospital, Alton Memorial Hospital in Alton, Ill., and Texas Children’s Medical Center in Houston.
Her career as a nurse, something she admits she's "loved every minute" of, gives her unique insight and ability to help champion nurses every day at ACH. She began her career as a NICU nurse but has supported many teams throughout the years, including vascular access teams within a NICU, emergency department and emergency call center, renal dialysis and clinic support operations.
During professional nursing orientation day, July 12, Cherry shared about her passion for nursing and hopes for the future of ACH nurses.
What drew you to a career in nursing?
Just being able to help people. When I was young, my father and my grandfather were really, really sick and were in and out of the hospital, so I saw the great care they received when they were really ill. I think that just drew me to what I could do to help support people in their challenging time and really help them get better. That's really kind of what sparked an interest in nursing and just trying to take care of everyone.
Looking back, is there a patient that really touched your heart, letting you know you were in the right profession?
One of the earliest things that I remember is when I first became a nurse, I was working as a NICU nurse, and there was a really sick Down's syndrome baby that I had taken care of. His mom had to go back to work, many times NICU babies are in the hospital for long periods of time. She had to go back to work, and she felt really bad about that. I was his primary nurse and just did a lot of things like dress him up in cute clothes - she had brought clothes in, and we had clothes - sent pictures to her and helped make her feel like she wasn't missing anything, just different messages and things. I just really grew attached to that baby. Before he left the NICU, he had been there for close to three months and his mom had brought me a little ornament that was an angel, and it had his name on it. It still sits on my tree today; it was like 22 years ago. But it really made me feel like I'm in the right profession, and I'm doing what I love."
How has nursing evolved since you started your career?
I think one of the biggest things that I remember when I first became a nurse is paper charting and so thinking about how nursing has changed today, everything is electronic. The technology I think is probably the biggest thing that stands out - how we document our care. I lived through paper to computers, and now we have technology that is very proactive and can alert us of things. That wasn't always like that 23 years ago. So I think, in a way, it's evolved because clinicians have become a part of how to make it better and more intuitive for nurses so that they can really focus on delivering patient care and getting information to them in a timely way.
What are the top things nurses need to thrive in health care?
When I think about what are the things that nurses need the most, I think about a strong foundation of clinical orientation, learning that environment, having a great preceptor and mentor to help them learn the foundational skills that they need as a nurse. That's one of the most important things, having a really good start as a nurse and having that support while learning. I also think that it's really important that nurses have opportunities to be involved in making things better. We talked about technology, and I think technology is what it is today because nurses have voiced opportunities to make things better. I think it's important nurses look for opportunities to be involved with shared governance and different committees on what we can do to make things even better in the future. And I also think that just continued development, professional development, being involved in professional organizations, encouraging our nurses to be part of our Arkansas Nurses Association and being able to go to conferences like our Magnet Conference, which is the largest nursing conference of the year, so many workers have the opportunity to do that, too. There's lots of different ways to help support nurses, and those are just a few things I think are really beneficial that help grow and develop nurses.
What is your best advice for new nurses at Arkansas Children’s?
The best advice that I can give the nurses is to look for opportunities to be involved. And to also not forget the lens into which they bring. I talked to many of them this morning, and I said, "You're the newest set of eyes to Arkansas Children's, and you're going to see things in a whole new light that we may not see." So, I encouraged them that if they see things that could be better or different or they have great ideas, that they should bring those up. That's what I think is really exciting for nursing. Some of the best ideas come from a bedside nurse who sees something and thinks, "I wonder why we do it that way" or "Maybe we could do it this way." I think just that curiosity and the ability to help support growing and evolving I think is really going to be important.