Joni:

Hi, this is Dr. Joni Watson. Welcome to The Handoff, the podcast for nurse leaders. Brought to you by Works, the technology empowering next generation health system workforce management. I'm thrilled to introduce our episode guest today.

We have Dr. Amy Wilson, the Chief Nurse Executive of SSM Health. SSM Health is a Catholic, not-for-profit health system that serves communities across the Midwest with a robust and fully integrated healthcare delivery system. Dr. Wilson is critical in ensuring SSM Health provides an exceptional, coordinated, and patient-centered care experience. With more than 20 years of leadership, she brings a wealth of knowledge and expertise to her role.

 Prior to joining SSM Health, Dr. Amy Wilson served as system Senior Vice President for the Nursing Center of Excellence and Senior Vice President of clinical Operations at Ascension. Her impressive career also includes leadership roles at the Children's Hospital of Alabama in Birmingham, Alabama, Psychiatric Services. Dr. Wilson's academic credentials are equally impressive. She holds a Bachelor of Science degree in Nursing from the University of Alabama at Huntsville, a Master of Science degree in Nursing, with an emphasis on Quality Improvement and Outcomes Management from the University of Alabama at Birmingham, and a Doctorate in Nursing Practice from Vanderbilt University. Join us as we explore Dr. Amy Wilson's journey– her perspective on how SSM Health is building a dynamic workforce, embedding technology and care models, and nursing's role in the move to value.

Welcome, Dr. Amy Wilson, to The Handoff.

Amy:

Thank you, Joni. I'm excited to be here with you.

Joni:

Excellent. Well, Amy, you and I have worked together before. We have a textbook chapter on healthcare complex adaptive systems in the upcoming third edition of Weisberg and Davidson's Leadership for Evidence-based Innovation in Nursing and Health Professions. That will be published October the fourth.

And, I love viewing and questioning healthcare with you because we have a different workforce today than ever before, and this really happened because we have a different society. Our world has largely moved from the industrial age to the digital. Yet practicing nursing and all medicine except for treatment and therapeutics, it's like walking back in time. A lot of times, we have a team of professional nurses who simply have different needs working in very different environments. And we continue to hear about the workload burden being too high, not having the right technology, needing more flexibility and control, growth opportunities, and needing more voice and influence.

We've been talking about these pieces for a while now, at least for all of my nursing career. What are you doing these days? What are you working on? You've been thinking a lot, I know, and working on some of these nursing workforce redesign pieces and decreasing burnout.

How are you thinking about this now from a strategy perspective?

Amy:

Yeah, so Joni, this is one of my favorite topics to discuss with you because we both have such an appreciation that healthcare is a complex adaptive system. And around the idea of complexity in leadership and really the leadership of yesterday not being the leadership that we need today in this very dynamic environment that we all live and work in.

And so I think it's important to start thinking about it from that perspective. And so from a strategy perspective, then if you start to frame this from complex adaptive systems and start to think about what does the future of nursing look like? Then I think there's really five categories that we have to– are that you can divide this up into– or  that we could discuss.

So I think the first one is a really dynamic workforce and what does the future of the workforce look like? Like you said, the needs of our nurses today are very different and not just the needs of nurses, quite frankly, the needs of all of our healthcare clinicians, none of us are the same that we were five or 10 or 15 years ago.

So, what does the dynamic workforce of the future look like for all of our clinicians? We also have to think about pipeline development. So I would say number two is really pipeline development. What does that look like?

As we continue to see a declining workforce, we continue to see our workforce wanting different things in the future. So how do we start to develop a robust pipeline to come in and fill all of the needs of our aging population? 

The third category is starting to think about the use of technology as a complement or an enabler to our work. Really, how do we decrease the administrative burden that is placed on our nurses and our other clinicians and not just our nurses? What about our leaders? All of the administrative burden that's placed on the nurse leader, the nurse manager, one of the most important roles in the organization.

I think the fourth category that we've heard a lot about and maybe haven't quite cracked (but is really important) is future care models across the continuum. As we continue to think about the important move to value, we know that we have a declining workforce.

Our workforce wants things differently, we need to move to value in healthcare. And so as a result, that's going to require a different care delivery model than we've seen in the past. And we've all been kind of playing around the edges of this and we've made a little progress here or there, but we haven't done anything yet transformative. And so there's still the opportunity for us to really think about transformation in space. And then I think lastly, and you really said it earlier, it's this idea of value-informed nursing care and what is the nurse's role as we move to value?

You and I both know that there's a lot of history in nursing that was predicated on thinking about social determinants of health before we even called things “social determinants of health,” thinking about taking care of the whole person. And in some ways, as we got very acute care-centric, we almost moved away from some of that. And so as we start to re-center on recognizing that there are many things that go into whether a person is healthy and thriving in their environment—we’re really thinking about what nursing's contribution is to that. And how we perform and what our role is as we continue to move to value.

Joni:

Amy, I am emphatically shaking my head. Yes, yes, yes, yes. I mean, you succinctly provided a great overview of, I mean for sure of what's happening at SSM Health, but really what all nurse leaders could take and apply to their practice environments. That's a lot. Even though it's five things, that's a lot to unpack and think through. How do you even begin to accomplish that type of transformation?

Amy: 

Yeah, I think that's a great question, and it is a lot, right? It’s a lot to think about, but I think it goes back to how you started. Our conversation today is really starting to talk about healthcare as a complex adaptive system. And we've talked a lot about– we’ve known in healthcare for a long time that we are a complex adaptive system. Probably the first time it was really referenced pretty succinctly was in Crossing the Quality Chasm back in 2001.

But here we are, all these years later. It's just now starting to be embedded in our higher education, in our graduate education, our doctoral education. And so there are a lot of folks who are just unfamiliar with what it means to live and work in a complex adaptive system. And then to even start to think about or recognize that maybe the leadership that we all grew up under might not be the right leadership in a complex adaptive system.

So, for me, one of the things that we've started doing is simply doing education on what it means to live and work in a complex adaptive system, how things evolve, what emergence means, learning to be comfortable with attention, understanding that the tension is where transformation comes out of. It doesn't mean that one's right and one's wrong, it just means that we all have to learn to be comfortable with the uncomfortable and that because of the dynamic world we live in this digital age-- that we all live and participate in everyday today, there's this constant undercurrent of change, and that's okay.

And that is so different from the way we thought about change in the past. Where we think about, oh, the change happens and now we're going back to the status quo. And the change happens, and I want a break, and we don't get breaks in that anymore.

 It's this constant underpinning of change. And then sometimes there are bigger changes that happen. And so we've been talking a lot about that, and just starting to help people change their mental model or their mindset. Around, it's okay to be uncomfortable, and it's okay that you don't have all the answers as the leader, and maybe that's not even your role anymore.

And so with that, once we start setting up that stage, then we can start talking about, What is complexity in leadership and what does it mean to be a facilitator of these amazing dynamic talented teams that we're all privileged to work with every day? And how do we tap in and harness all of that intellect to start to solve some of these big complex problems that we have?

I share with our team a lot, and I have this fundamental belief that we're better together than we are as individuals. I think we're blessed in healthcare. We have some of the most talented dynamic teams of any other profession. And so we should learn to tap into that and harness that talent and that energy to solve these complex problems because I believe the answers are there if we'll think about our leadership and what our role as leaders is differently than we thought about it in the past.

Joni:

Amy, this is so great. I feel like I could nerd out on this and talk about this all day, honestly. And the reason that when we talk about complex adaptive systems, sometimes– I don't know about you–but sometimes when I mention CAS or complex adaptive systems, I get a little preliminary glaze over people's eyes. Because we haven't really made it practical. It's all been this kind of weird, ethereal theoretical type of work.

But really, we can work practically with complex adaptive systems. And I love that you're teaching leaders at SSM Health about CAS just to have that foundational knowledge so everyone can speak the same language and have the same mental model moving forward. So, for our listeners, let's dive into some of the more practical operational pieces of what you've been doing at SSM Health.

So if you could, maybe go through the five areas that you've talked about? And talk about– practically speaking– how do you work through those at SSM Health through the lens of complex adaptive systems?

‍Amy: 

Yeah, that sounds great. So let's take a dynamic workforce to begin with. So we've talked a lot about that. Our workforce looks differently today. So the first thing is we as leaders all just have to start to learn and accept and understand that's okay. We have heard nurse leaders, nurse managers, operators, other clinicians say really negative things sometimes about the current workforce. I think sometimes we also don't recognize the changes that have happened in each of us too as society has evolved and changed.

Joni: 

For sure.

Amy: 

When you live in a world where you can order anything you want on your smartphone and have it delivered to your house within a matter of a few minutes or few hours or a couple of days, you view the world differently than you did prior to us having that wonderful technology. And it's not wrong, it's just different.

And so that's the first thing is just really starting to accept that our workforce looks different. It doesn't mean it's right or wrong, it just means we've evolved as society and we have evolved as a workforce. And so, once you kind of move past that and you come to acceptance of that, then I think you can start to say and ask questions and start to really understand. Well, what is it? What needs do our workforce have that we didn't have before? What needs do I have as a leader that I didn't have before?

And so some of the things that you are seeing us do practically here at SSM Health is we are really taking this idea that nurses and other clinicians need flexibility seriously. And we've been taking this seriously for a while now, and it's really afforded us a lot of different avenues to provide flexibility to our workforce.

So some of those include things like on-demand staffing, so really kind of a gig economy as a complement to our own core full-time and part-time SSM Health nurses. This gives our nurses a break. It gives everyone the opportunity to have time off to enjoy holidays off to have PTO off all of those things that are important to them. It also provides us good coverage when unexpected situations come up with individuals in the workforce so that we still have appropriate staffing and coverage for all of our patients that we're privileged to serve.

So that's been a really big game changer for us, and we're using that all across the system and have been for a number of years. We actually started that here at SSM Health prior to the pandemic. So we've gotten really good at being able to use an on-demand workforce. We're also starting (and have started ) to directly hire international nurses instead of going through an agency where these are typically contract or contingent workers.

We have actually partnered with a firm and are doing direct hires. It's a fair amount of work for us on the SSM Health side, but we have a dynamic legal team and a dynamic HR team whom we're able to partner with. And that's really provided us some flexibility here.

And we have already started having some of our really wonderful international nurses arrive here in the US. They are so excited to be here and so excited to join SSM Health and join the nursing workforce. It's been interesting to get to know some of them. Some of them have dreamed of this for a long time, and some of them even went to nursing school knowing that once they obtained experience that this was the path. And they've been working on this path independently for a number of years.

So we've really embraced international nurses as part of our strategy. We're doing other things like daily pay, so all of our staff here at SSM can be paid on a daily basis. They opt into this option. And so again, really providing flexibility and thinking about meeting the needs of our workforce differently than we have before. And then like many others, we really have a regional float pool that is dynamic across all four of our regions. And this again, adds another layer of complement to our full-time and part-time staff.

So you see we have everything from full-time and part-time, staff to weekend options, to what we would traditionally think of as PRNS,  then ministry float pools, regional float pools on demand, and we're starting to even think about playing with job sharing across the region.

‍Joni: 

Wow, that's incredible, Amy. Wow.

Amy:

So, as we think about technology, one of the things that we've been playing with is thinking about how do we take away some of the administrative burden with technology for so long? Technology and healthcare has almost been a detractor. It's felt like one more thing to do, especially if we think about the EHRs or we think about other forms of technology and healthcare, sometimes they've been hard and cumbersome to use.

And so we've really been asking ourselves the hard question of, How do we reimagine what technology looks like? How does technology start to reduce administrative burden for our nurses, our nurse managers, and can we utilize technology as an enabler instead of a detractor? And so one of the areas that we've been focused on is scheduling. So think about our wonderful managers and all the things that we need them to do. One of the things we don't need them to do is scheduling, but yet this is fearful, right? 

This requires a lot of trust. There's a lot of fear around scheduling because it's such an important task even though it's a task. And so we're starting to think about this not only from the manager side, but also from the nurse side around flexibility and how do we start to strike a balance between manager autonomy and nurse autonomy. So we've been designing a future scheduling platform and like I said, two of the top priorities are nurse experience and schedule autonomy, and then striking that balance between nurse and manager autonomy. And so we do believe that we've got to have a modern and dynamic mobile app, and we're working on that. We're probably further away from that than I'd like to be, but we're definitely getting closer today than we were yesterday around that. But other priorities are really things like, How do we have independent shift swapping.

How do we split shifts or do cross specialty floating? How do we job share? This is the platform that starts to enable us to be able to job share in a way we haven't been able to do just simply because of the complexity of staffing and scheduling and how hard it is. And so, one of the benefits of being in an organization that is dynamic like SSM Health and really is an integrated healthcare network is that we really have anywhere a nurse could want to practice.

And so how do we start to allow them to job share in one or two or even three roles in a way that makes sense? that doesn't require more administrative burden on the part of our nurse leaders or other leaders in the organization? And a really robust scheduling platform that has some level of automation and maybe even AI in it starts to allow us or enable us to do this in the future.

‍Joni: 

Yes. That is so beautiful, Amy. I love that you've pointed out that an organization as large and dynamic as SSM Health, you really have everything that a nurse could want to do in their career, in their life in order not to just bring practical support and financial provision to their family and their life, but also for their joy of their profession of doing what they want to do.There are things that I want to do on Monday and Tuesday and by Friday. I want to do something a little bit different, but still using my nursing expertise.

And so that's incredible, Amy. That's really beautiful. Absolutely. I'm curious, so you've talked about dynamic workforce options, the future of scheduling autonomy. You touched on reducing managerial workload and technology really has the potential to reduce workload burden on our managers. Anything else that you're doing in regards to technology to support managers at SSM Health?

Amy:

Yeah, so still thinking about the staffing scheduling and payroll piece, we are really envisioning a future where a manager never has to do staffing or scheduling again. So we're starting to centralize this and it's a huge learning curve for the team, and it's a huge change curve because it's one of those things that we've held so near and dear as nurse leaders thinking that we have to control all of that. But if we go back to what you and I discussed in the beginning around complexity leadership and what is my job now as a leader in this complex adaptive system, it is not to control everything and it is to get comfortable with the fact that no matter how hard I would like to, I actually can't control everything.

Joni:

That hasn't worked out very well for us.

Amy:

It has not. And so there's real freedom in getting to that place where you start to believe and understand that my role as leader is really facilitator and enabler. And if I am the facilitator and then the enabler in great high-quality patient-centered outcomes, why am I spending 80% of my time on staffing, scheduling, and payroll?

So we are re-imagining that, starting to pull that up centrally. We have a very dynamic group of all levels of nurse leaders across the organization who are coming together to design this, and we're starting to do this a little bit in pockets. And so where we've been able to start, there's been really good feedback around the opportunities and how much time managers are getting back. So, as we continue to build out this scheduling platform, then that will allow a lot of administrative burden to be released from our nurse managers.

Another thing that we've been doing is about a year and a half or almost two years ago now, we created something called a “clinical recruitment team.” And it is a very different way of thinking about clinical recruitment. And so we actually centralized some of this function. We did a small test to change and really did some pilot work in some areas that we were struggling around recruitment and hiring. And we were able to take nurse managers, move them out of a nurse manager role into what we call a nurse influencer role. And they are influencers on social media really creating interest and attraction in SSM Health and then to our jobs and roles here at SSM Health. And they are able to interact and engage in nurses who express interest very quickly, sometimes within an hour or two hours, and really even interview them there right on the spot and actually make a hiring decision for SSM Health and for the nurse managers.

So then if the nurse wants to come in and meet the nurse manager or have a tour of the unit, then they'll facilitate that. But we're eliminating this idea that there has to be this back and forth email exchange, and then we have to work on calendars, and then there has to be a screening process and then they move on to the nurse manager. And so something that's taken us sometimes 2, 3, 4, even up to six weeks, we've reduced down. And if the nurse is really interested, then we can do this within 24 hours or two or three days if they want to come in and see the environment.

And so our idea here is that we're hiring for fits, and there is a place for you at SSM if you are the right fit and you are a cultural add to our organization. So if you are and you're placed in a particular unit or department or one of our practices or ambulatory site settings, and we get you there and it's not a great fit, then we'll find another fit for you. Because there is the right fit for you and for our organization if you have made it through our hiring process.

And so that again, has been a huge learning curve. I do not want to present that it has been bump-free because as you know, it has been quite bumpy and quite messy. But we have gone from it being quite bumpy and quite messy and lots of concern about that process in the beginning to now this becoming a pull in the organization.

So this has become such a benefit and people are seeing the value of this. We have operators now saying, can we do this for ORT? Can we do this for our radiology techs where we're struggling? And so we just recently expanded that team into our other clinical areas and they will be utilizing that same process. So those are two really great and practical examples of how we're thinking about reducing manager workload burden.

Joni:

Wow, Amy, there is so much gold in that piece there. Thank you for sharing the ideas and the pieces that you're implementing and also the real-life struggles of it. Because again, you are doing this all within a complex adaptive system that has tensions. I mean, anyone who has served in nursing leadership roles or even HR or operational leadership roles, you can clearly see the tension there of lots of people relinquishing control.  But then to reimagine what nurses can do and are doing to spur the profession forward in these unique roles, that's just incredible, Amy.

So thanks for leaning into those tensions. I mean, clearly something beautiful and different has emerged, and that's really the point of complex adaptive systems is that we get something totally different in that transformation. So you're using quite a bit of technology, and you've touched on that our workforce is different, right? I can order something today and get it in a couple of hours where I live, honestly. And as technology continues to evolve, I'm curious how you see the role of nurses changing. There are a lot of headlines these days. What new skills or competencies are required for future nursing roles?

Amy:

So that's such a great question. And we have been starting to think about technology in our clinical space. And one of the things that we've been working on, which has been a lot of fun in the organization, is just level-setting what a unified documentation platform looks like across the organization. We are fortunate here at SSM Health, we are a full EPIC shop and we use EPIC across the continuum. But despite that, we had multiple builds of EPIC.

So you know this story well, and those of you listening know this story well, we all think that we're special and we're different. And as a result, that sometimes manifests itself into multiple EHR builds. And that is what has happened here at SSM Health, both because of that and because of some acquisitions that we have had over time. So in order for us to really think about technology in the clinical space, then the first thing that has to happen is we have to have a unified documentation platform with one build across all of SSM Health. And so the nurses came together-- actually this month is their one year anniversary-- and we took nurses from our staff nurse practice council all across our system. We made sure we had appropriate representation from all of our care delivery sites, both inpatient, ambulatory, post-acute. And we put them in a room together.

No surprise to you, I didn't let any nurse managers show up or CNOs or nurse executives. We took the people who are doing the work, who were the best to decide what the work should be and put them in a room together and started building community with our technology partners. So our clinical informaticist and our enterprise-wide team will do about three hours of prep work for every hour of work. The nurses are together and they come in and they have been rebuilding the entire system based on evidence into one standard unified documentation platform.

Joni:

Oh my word. 

‍Amy: 

I know. It's so exciting and it's so exciting to see our nurses grow. These are going to be our future nurse leaders. The transformation that has happened in them over the last year as individuals and as a group has been phenomenal. And the change wave that has occurred across SSM Health because of their leadership has been phenomenal because now they are the biggest proponents for a standardized documentation platform all through the lens of reducing documentation and administrative burden. And so this starts to then allow us to think about: How do we start to use automation? How do we start to think about technology differently?

There's been a lot in the press lately about automation and AI, and we've always used some technology in healthcare. And I found myself even kind of laughing about this as I hear some of these stories. I can hear some of the same things that are being said now or some of the same things that were said when we went to an EHR the first time. And so again, all of that just comes out of the fact that we're all very uniquely human, and there are things that we need to do to make sure that AI is appropriate and ethical and all of that. And we're probably a fair ways away from really thinking about that in healthcare. But there are other things that we can think about with automation, but we will always first and foremost, be a human organization, a relationship organization in healthcare.

What we do is about human beings and critical decision making and connection and meaningful relationships. Without that, we won't actually have healthcare so that none of that, in my opinion, can or will go away, and it won't go away here at SSM Health, it's just who we are as an organization. But if we can continue to think about technology automation and maybe even AI one day around reducing workload burden to give our amazing clinicians time back in meaningful relationships with their patients, then I think that will make us all be better for it. It will allow better diagnostics. It will allow more understanding of what's most important to that patient and that family. And any time that we get to spend building relationships and community and connection, meaningful connection with our patients and our families, I think ultimately provides us with better outcomes. And if automation and technology can do that for us, then we should lean into that, knowing that the goal is to give us more time and meaningful connection.

Joni: 

Yes. I love that, Amy. So you have also mentioned earlier all of the different ways that SSM Health is working on your pipeline. And you're focused on producing more nurses rather than taking them from other places a lot of the time and with a lot of your interventions. Can you discuss your strategies for developing a robust nursing pipeline?

Amy: 

Yes, absolutely. So one of the things that I'm really proud of that we've done here at SSM Health is created a role of nurse extern. And I know many organizations have roles like this, but I think our role is uniquely different. We are hiring students while they're in school.

We are placing them in the role of a nurse extern, and we are actually paying them to learn. So they're in a non-productive role. They are not in a CNA or a PCT role, and they are partnered with one of our RNs in the organization. They actually work hand-in-hand with that RN, and the RN delegates to them under his or her leadership, any skills or assessments that they have already learned, and been signed-off on in school. And so they are able then to spend additional clinical time learning and really refining those skills and their assessment.

So this has really been instrumental for us. One, it helps us once the nurse graduates, passes boards, and starts working as a new grad RN with us because we have accelerated their learning and development in a way by pulling it upstream into their education instead of all on the back-end after graduation.

And then two, it starts to create stickiness and relationships with us, with the nurse, with the student nurse who is learning to be comfortable in our organization who's developing relationships, very positive relationships, with the other nurses and care partners and managers in the organization. And so we're really working and we've done some analytics on the front end to start to say what is our turnover rate? What is our vacancy rate? And we're able to start predicting how many slots or vacancies we're going to have in the future. And then we say, we need this many externs and we hire them somewhere around 18 months prior to graduation. And so then they have about 18 months with us, and then the transition's much easier. And then we're doing the same type of predictive analytics for our hiring with international nurses and then with our experienced nurses as well. 

And so, thinking dynamically that there's not one pipeline that will be the only solution for us, but it's really about all of these coming together, and then our analytics have been able to provide us, we're able to actually predict and budget for how many of each category we need to hire. And so it's really about pulling all of this upstream and thinking strategically about what our needs are going to be in the future, not only with turnover and vacancy like I mentioned, but also with new service lines or new services or new care site settings that we're going to need.

So again, you can see there's a lot of collaboration that has to take place all across the organization with finance and strategy and operations and HR in order to do this. But doing this really changes us from being a reactive organization to being a proactive organization and starting to plan for all of this ahead of time.

And then lastly, I would say that we're thinking we're being very thoughtful about who our strategic partners are with nursing schools. Really thinking about what a bi-directional relationship with a nursing school looks like? So that we're both meeting each other's needs and thinking about where these nurse externs come from. Where are they going to school, where are they most likely to stay? That does not mean that we don't collaborate and have relationships with lots of folks in our community because we do. And I fundamentally believe we have an ethical obligation to train the next generation, but it does mean that maybe we spend more time, effort, and resources on those who are likely to stay and provide care in our community.

And so, thinking about what that looks like long-term. Are there ways to increase seats with some of those organizations, whether it's through scholarshipping or other opportunities? And so really again, being strategic about those partnerships with the schools and thinking all upstream about this instead of waiting until people finish and graduate. Then everybody's worried about where all the new grads are going and where they want to be hired? And so we're thinking two or three years out about what we want to do two or three years from now.

Joni: 

Oh, wow. Amy, there's so much to say about all of these pieces. The thing that I love, and this is why I really just enjoy talking with you, is because you really are grounded in the fundamentals of complex adaptive systems that this is a different world. We are different people. The colleagues that we work with are different people. Our world is different and the things that we have been doing are not the solutions to our problems because our problems are different.

And so when you mentioned that the externs were non-productive roles, I mean, my gears in my head just kind of paused for a second because how long have nurse leaders been saying this? It's great that we have externs and can hire these students and even pay them to learn. But so many times we have struggled in the tensions of finance and operations with benchmarks and productivity that it has restrained some of our interventions.

So it takes a lot of work, like you mentioned, to work with all of those different departments and colleagues. But because we are in a CAS, we're all connected yet interdependent, and so we have to work together. So kudos to you. Absolutely beautiful.

Amy: 

And Joni, I would just say I think it's important for as other nurse leaders here to hear this, to think about what I think is probably the most important ingredient in this model, and that is cross collaboration of dynamic teams. So if you're trying to solve a nurse problem and you look around the table and the only people sitting around your table are nurses, then you're not going to solve the problem. And I think sometimes in healthcare, we think about things in silos and verticals. And so I encourage myself as well as all of our team here at SSM Health that we have to be a horizontal organization. We have to think about dynamic, cross-functional interdisciplinary teams and ensure that we have the right team members around the table. So all of these things that we've talked about require robust analytics and financial analytics and ROIs, we're not doing any of this without a strong return on investment.

And so having the right folks around that table with you is incredibly important. Developing those relationships with your HR team members, your operations team members, your strategy team members, your finance team members, and then having everybody come together around a table to provide their input and do that conflicting and contrasting. Everyone will have a different perspective. And that's good.

That's actually what we want because this is when we walk away with a better idea or solution than we ever would as individuals. And so again, I think that's another example of complexity leadership or thinking about how to use the complex adaptive system in order to drive the outcomes and results that you want, is to make sure that the team members sitting around the table are cross-functional and dynamic. And if everyone's agreeing within the first few minutes of the meeting, you don't have the right team members.

Joni: 

Spot on, Amy. Spot on. So I am always curious about what other leaders are reading or doing, and trying to sharpen their skills. You clearly think differently than a lot of nurse leaders or executives across industries. Amy, what are you reading or learning about or doing these days to nourish your soul or spur your thinking forward?

Amy:

Well, no big surprise to you that it happens to do a lot with practical applications of complex adaptive systems. And how do we take what you said earlier– this big robust can-feel-like-a-scary theory– and actually find the practical ways to put this into practice? And so there's some good folks out there.

One, Aaron Dignan, is one I've been thinking about a lot lately. I love that he kind of boils this down to being people positive and complexity conscious, and it's a good way to start thinking from a pragmatic way about how to apply these lessons. So that's where I spend my time kind of thinking. And then I love to do other things too. I think it's important that we all take care of ourselves, mind, body, and spirit. And so it's not just spending time reading, sometimes it's about disconnecting, being in nature, really spending time with family and friends.

And I love to do things outside and go on hikes and have time for meditation. And I think when you do those things and you spend time and introspection, reflection, and retrospection, you start to realize that sometimes the things that we think are a big deal are often not as big of a deal as we think they are. And so I think that's an important leadership component. And characteristic too, as we're thinking about the big problems of the future is to not get so locked in and ingrained in them that we fail to take time and care for ourselves and the others around us.

Joni: 

That's great. Amy, what would you like to hand off today to nurse leaders at all levels and in every setting?

Amy: 

Yeah, that is such a great question. I think what I would say is that we should remember that healthcare is a dynamic evolving profession. And as a result of that, nursing is a dynamic evolving profession. And I really want us as nurse leaders to start to get comfortable with that. You heard me say earlier, we have to learn to be comfortable with the uncomfortable. And I think that is an incredibly important leadership characteristic and competency.

Every generation of nurses will want different things and need different things. You and I wanted different things and needed different things than the generation before us and so on. And so it's really about understanding that generations develop because of the world around them, because of the things that they experienced while they were growing up into adults. And so it will always be different, and that's okay.

Again, it's not good or bad. So as each passing year will bring us new systems and new technologies that can help us further improve our patient care, we should start embracing those as nurse leaders. We should start really critically evaluating them and evaluate them from a place of “Yes,” instead of a place of “No.”

So many times we show up with: We're going to prove why this won't work. And instead, why don't we take the path of let's prove how this could work or how do we get to: Yes, it's just a very different mindset. So I would encourage all of us to not be stagnant. Let's embrace this continual disruption and let's use it to build the future of nursing that we want to see for our profession.

Joni:

So good, Amy, embrace and evaluate from a place of YES, that is gold. That is gold. So, we've talked about a lot of things today, Amy, and I have no doubt that leaders are going to want to connect with you, continue conversations. Where can people follow, find, or connect with you these days?

Amy:

Yeah, probably the best way to connect with me is on LinkedIn.

Joni: 

Excellent. Beautiful. Well everyone, be sure to find Dr. Amy Wilson on LinkedIn. Amy, thank you for sharing your time, your energy, expertise, passion with us today to spur our beautiful profession forward. It's been a delight. Thank you so much.

Amy: 

Well, it's been an honor to be with you as always, Joni. So, thank you for such a great conversation.