Arkansas Children’s Recruits Largest Nurse Cohort in 111-Year History

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."