Joni:

Hi, this is Dr. Joni Watson. Welcome to The Handoff, the podcast for nurse leaders brought to you by Works. Today we are joined by Dr. Sonna Harding, the Chief Nursing Officer for HCA Florida Twin Cities Hospital. Dr. Harding brings with her a wealth of experience and a profound commitment to patient care. With nearly 25 years in nursing leadership, Dr. Harding's journey is as inspiring as it is impactful. Before stepping into her role as CNO in February, 2022, Dr. Harding served as the assistant chief nursing officer at HCA Florida Ocala Hospital where she will return as Chief Nursing Officer in April of this year. 

Her dedication to nursing leadership extends far beyond titles. Dr. Harding's career has taken her across the country where she's worked as an interim director in hospitals of all sizes. Dr. Harding's passion for nursing and patient care goes beyond the hospital walls. She holds a doctorate of nursing practice from Chamberlain University College of Nursing, and has made significant contributions to the field. 

But it's not just her professional accomplishments that define Dr. Harding. She's a firm believer in the power of storytelling in healthcare, understanding its role in shaping culture and enhancing the patient experience. Today we're discussing this very topic with Dr. Sauna Harding from her extensive experience to her humanitarian efforts. Dr. Harding's insights promise to be enlightening as we explore the value of storytelling in healthcare and its impact on moving culture forward towards positive patient experiences. So without further ado, let's welcome Dr. Sonna Harding to the show. Thank you so much for joining us today.

Sonna:

Oh, thank you for having me. This is a real pleasure and an honor.

Joni:

Absolutely. I have been looking forward to our time together since we first met and you shared some of your journey and your passions for storytelling. It's hard to shake some of it out of my mind, honestly. You tell stories so beautifully. And first for our listeners, can you share with us how your nursing leadership journey sort of pulled you along and influenced your career trajectory?

Sonna:

Absolutely. I never thought I was going to be in nursing leadership. I started nursing school when I was in high school, and I really never thought that I would be in nursing leadership, but the opportunities just presented themselves. I actually had a night shift charge nurse role as my very first position and who would've ever thought that straight out of high school. And then I was there several years in that role and the director of nursing position opened and I thought, why not? I've always been an early adopter of change and I wanted to be able to influence practice for the teams that I worked with. So when opportunities came open, I would just take those opportunities as they would come and say, “yeah, let's not wait for someone else to do this.” And I've had the privilege of being in positions where I've had great nursing mentors in leadership and I've learned a lot from them. And through their mentorship, it's really trained me to be the nursing leader that I've wanted. On the other hand, I've had nursing leaders that I've seen that have not been so effective and I've learned from them as well of what not to do. But just going along that path was something that really came natural.

Joni:

That's amazing. And it's equally important to know what you don't want to do in leadership as much as what you do want to look like in leadership. So both are valuable experiences. I love your perspective of let's not wait for someone to do this. That's really beautiful. I hold that thought as well. I kind of call it leadership. Like you just see the gap and you just fill the gap. Let's not wait. We can get it done right now. So that's a beautiful perspective. When we've talked before, you've really emphasized the power of storytelling in patient care. So tell me why are you so passionate about this and how has it shaped your approach in nursing leadership?

Sonna:

That's a really good question. And as a nurse leader, we have to give a lot of directives. And sometimes that message may not always be easy or a popular one. And so I have found over the years that if you find a message or a story that you can relate to why that change is so important and share that background of maybe stories that apply to that, it's easier for the staff to understand. And I had an opportunity as a very young nurse to hear a seasoned nurse share her stories and it left a lasting impression on me. And I thought at the time, if I'm ever in a position to lead others, I really want to cultivate that skill and use it to influence others. And I think I've been able to do that with the different teams that I've had to jump in and lead and manage many, many messages on different levels.

Joni:

Wow, that's great that you learned that so early in your career because you're right. When people understand, really “the why” behind things, it's easier for us to connect with the work. And as nurses, we're kind of trained in that narrative sort of format. And so it's easy for us to either be connected to something or disconnected if we know the why or we don't. One of the things that I really love about you is you've shared with me previously that you're quite involved as new team members are being oriented and onboarded. And so when you begin orientation with a team as a chief nursing officer, which is so important by the way, thank you for doing that. You really share the why behind the work. How do you craft these narratives to connect with your team on a deeper level?

Sonna: 

So orientation I believe is a really critical time for both the organization as well as the new employee. And employees make decisions a lot of times of whether or not they're going to stay and be a right fit during that time frame. So the culture of the organization has to be strongly emphasized and leaders need to share why they love doing what they're doing and why they feel the work they're doing is impactful. So sharing stories and telling my why with them allows them to understand our expectations, but also right from the beginning, they know the culture is being set by that leader, which is me. I'm there in that frontline. And also so they know that they're supported in coming into a great organization. And I think that is vitally important. So I craft those narratives to share stories about my work, my background, my family, because we all have healthcare and we've all interacted in some way. And so if you can relate differently through a story, I think people really take away something different than just me sharing a list of things that they must accomplish or do while they're in here.

Joni:

Yeah. Can you give us an example of maybe one of those powerful narratives or storytellings? I mean, you mentioned it helps people coming into your organization both know you, but kind of understand the culture before they even start working. Give us an example of what you mean by that.

Sonna:

So my why really, and I shared this story with you before, but it's so impactful because patient experience is so important for me and the work that we do in a hospital, it's all about patients. Everything that we do, the patient is at the center. So for me, January 13th, 2014, my life really changed. I had been in healthcare for such a long time. My husband had been working in not in the healthcare field, and in the early two thousands, the economy took a turn. And so he ended up coming to work in the hospital where I worked, went on and got his lab degree, became a clinical research biologist. So we knew a little bit about healthcare and we'd worked together for several years in that same hospital. But on January 13th, 2014, our lives changed. So I came home from work, he came home from work, we had dinner and we just talked about our day, usually under normal circumstances.

But this evening I noticed he was kind of not himself. And so 41 years old, you don't think too much about it, you just kind of let him go rest for a little bit. But I went back to check on him and he was laying in the bed and I said, “Are you okay?” And he said, “Well, I'm just not feeling really well.” And so I didn't think too much about it. I went back out to the kitchen and just a few minutes later I heard him come out and I heard him fall to the ground and I went out and there's my husband 41 years old, laying in the living room. His hands are clutched across his chest. He's gray, he's diaphragmatic. He's obviously having some type of cardiac distress. So I did what a nurse does that lives close by the hospital. I grabbed him up, took him to the hospital, I took him to my hospital, I took him to my team. I took him to people that I knew and was very comfortable with, and I handed him off to a team of people that I had trust in.

Everything kind of changed over that course because they did all the tests, they did the procedures, everything came back normal. And so I was there waiting and watching and involved with all of this, but there was no real answer for me because we didn't really know what was going on. Everything came back fine. After a while, they told me to go home and get some rest. They thought it wasn't cardiac because all those things came back clear. And so I went home reluctantly, but I felt like I was leaving him in good hands. I was. But I got a call at about 5:30 in the morning. I maybe had been home for about two and a half hours, and it was an ICU nurse, and Mark was not in the ICU when I left. And she said, “You need to come in right away. His levels came back and they're extremely high. We're taking him to the cath lab right away.”

So I rushed back to the hospital and I got to the hospital and went to the waiting area. Now, I remind you that I know that hospital, I know the back halls that the doctors walk down. I know where they sit. I know where they read those caths. I know what goes on during that situation. But at that moment, I was not a caregiver. I was not a nurse at that hospital. I was a family member who was very scared. I had questions and I had concerns. And just within an hour, the doctor came out and said, your boy dodged a bullet today. He had three vessels that were 99% occluded, 95% occluded. And we didn't realize it because he has this disease called Kawasaki. I had no idea what that really meant. And so it's changed our life.

But from that moment in that story, I can tell you that I've thought through this differently because our patients come in scared. They don't know that hospital, they don't know the language that we use. They don't know where the doctors sit, they don't know what goes on in that cath lab. And I thought, how much more do we have to build that trust? Because I know it and I still had questions, I still had concerns. So we have to think, what does it feel like to be on the other side of that bed and how do we have to talk to that patient and understand what they're going through? And so for me, that's my why, and that has changed my perspective of healthcare and how we have to really show those patients that they can build their trust in us.

Joni:

Wow. I mean, first of all, I have little tears welling up in my eyes. I mean chills when you tell that story. So just a clarification. You share that story at every orientation?

Sonna:

I do.

Joni:

Wow. That is impressive. Vulnerability and strength in leadership Sonna, because I mean, I'm a nurse of 20, 21 years and I too can imagine myself knowing the back hallways and where the cardiologist sits to read and the movements that team members do. So as you're describing that story, I mean obviously it resonates with me. And so yeah, I can absolutely see how that would sort of set the tone for who you are and the kind of culture that you expect and want in your hospital. And so it definitely shifts, I think, the way that our relationships are formed. And so it's really interesting because sometimes in my leadership I have struggled with the vulnerable side of myself. How much do I share? But knowing how powerful it can be and the authenticity that it brings to my leadership, I'm wondering from your perspective, what do you think about the balance between vulnerability and storytelling and maybe its effects on retention and outcomes within your team? Did you just start telling the story immediately? Did you have to process through it? I mean, when did you get to a point where you realized, gee, you know what, this is a part of my story and my why and I want to share it.

Sonna:

So I really didn't realize the impact that this was going to have until I began sharing the stories. And I was working in a really large hospital and I didn't have the opportunity to connect individually with all the nurses that reported. But we had an initiative because our patient experience was not where it needed to be. And I thought we have to tell the story differently because we talked to the staff and said, you have to make 'em happy. You have to make them feel like they want to be here. And you share all of those things. But we were not changing our outcomes. And so I made it an initiative to do a presentation, and I had all of the nursing staff attend and I thought, how do I get a message to them to really be impactful? And so I thought, no, there's no other way than to share my why.

And if I was in the situation or if they had a one in a situation, how would they feel differently? And so as I began to share, it was obviously a bit emotional for me to be able to share that story because of all the things that we've gone through with my husband's help. And some of it wasn't easy to tell and it brought back a lot of memories. But as I began to open up a little of my personal life, sometimes as leaders we think we have to be stoic and strong, but in the end, everyone has issues and hard times that they're going through. And I remember the very first time I presented that story and people are there, [thinking] “here's another meeting we have to attend” and we're going to hear the same old stuff. 

But as I began to share that story, the room stilled and everyone focused on me like they had never had before. They were making direct eye contact, they were sitting up, they were listening, and they actually heard me and saw me as someone vulnerable and as someone that they looked at differently. And I think I held over 30 different classes to ensure that I had all of the staff. And after every meeting, I had several of them that would stop me and thank me for sharing that story. And some shared I've had similar situations or I've gone through things and no one really seemed to understand. And I noticed a difference in that connection with the staff after that because I think they saw me as someone human, someone that was real and someone that was there more than just telling them what to do because there was a reason and a “why” behind it. And I think it was a year or so even after we first started, I would have staff come up to say, “How is your husband? How's he doing?” And it made an impact.

Sonna:

Wow. Sonna. That is absolutely beautiful. Thank you for walking us through that. I mentioned in your intro that you have kind of lived all over the United States, but I know that you came from a smaller town and you've actually lived and worked in the Coton, California area. And so you have been in a wide variety of places. How have you adapted your leadership style to meet the needs of different communities as you've transitioned in leadership?

Joni:

I've always been adaptable. I think that's one thing that is a skill that I have in leadership, but it doesn't matter where you work, people are still people. You have to connect with them in the same way to understand what their needs are. And obviously every community has its own needs and staff in each of those areas have their own needs. But it's all about connection. It's about getting out there, being visible, sharing with the staff, talking with them, and just being genuine. And it has been everywhere that I have been, I have loved it. It's been a challenge in different ways, but I have found something positive to either take with me from leadership, something that I have given to them as I've been there. And so my style is really just, I have got to know the people that I'm working with and meet them where they are.

Joni:

It warms my heart Sonna. I mean people first. That's what it's about. It really is. And people are amazing when we get to know them and when we get to take care of them. So that's absolutely beautiful. Now, you've witnessed all throughout your career as you have been a storyteller at the impact of simply listening to patients and their families. You had a sort of seminal event that really kind of shifted your focus. Can you tell me, do you have any other experiences where listening, which seems really simple in today's age of work and care, where listening made a significant difference in either your perspective or a patient's experience?

Sonna:

I have many examples, but there's two that really stood out to me. And one, it was related to my husband because we had been in and out of the hospital over and over with this. He's now got, it's a chronic issue for him. And chest pain is real every day. And it's very difficult sometimes to know when to go to the hospital. But every time we would go in, it seems like we were either go through a process that was long and drawn out. When you're having chest pain, you want it resolved and you want to work through it. And I understand there's questions that have to be asked because chest pain is taken very seriously and I understand that. But I remember many visits to the hospital, but one in particular really stood out to me. And you heard me say that we traveled and been all over, but we were out in a very small little town in California. And Mark woke up with chest pain in the early morning, and it was one of those times where we had to go to the hospital and he dreads every time. And I don't talk about it often, but we had a significantly different approach this one morning when we went in, shared what was going on. But the nurse stopped within the first three minutes of triage and she said, is there anything that I need to know about your health history that would impact your care today? And I almost came to tears because usually it would take about two hours before we could get to the point where we could really find a solution. And I began to tell her the things that didn't work and what did and just shared his history. And within two hours, we were actually walking out of the hospital. And that was so unusual. 

And Mark has responded. He's like, “maybe we should live in this little town because they seem to care.” And I thought how impactful that was because it's such a small thing, but it changed the trajectory of our care for that moment. And it was so huge. But it was just two minutes. It changed in two minutes. So that was one personal one, but one that really stands out to me that kind of tore at my heart very much is I worked in a hospital for 14 years, in the same facility. We had a patient that came in over and over and over, and the staff were very frustrated because he would have the same issues. And it seemed like he was there for pain medications. And no matter what they did, he wanted more. And he had a pretty significant history of being in our hospital over and over.

And the staff would get frustrated and they would all say, “I'm not taking care of him. I don't want to take care of him.” And I would go in and he wouldn't really share a whole lot. But one day I got a survey back from a patient experience survey, and it was handwritten and wrapped around the page and up and over across both pages, there was handwriting on it and it got feebler and feebler harder to to read the more. But there was a plea in that survey saying, “I know I'm at your hospital over and over and over, and I don't want to be there and I don't know how to help myself. I have tried so many things and when I come, I'm at my wits end and I can't control it.” And he put a website on there for me to research.

And I went on the website and I started reading about similar symptoms and situations and I thought, we're missing something for this patient. We were doing wrong by him. And so I went back to the staff, pulled a big staff meeting together and I said, “Y'all, you need to listen to what was shared on this survey. I want you to listen as I read it. I don't want you to say anything, but I want you to listen.” I read it. And the staff were shocked. They were upset. They knew who it was. They knew who it was. And at the end, I read his plea because he ended, “Please help me.” And I said, “Guys, he's going to be back. We have to figure out how we're going to treat him differently.” And it was, I think the next day or the day after, and his name showed up on our admission and I watched to see what would happen. And I went to the nurses station and there were three nurses standing at the nursing station that said, I'll take this patient. And they did. And from that moment, I think he kept coming back to our hospital for about two years. And I never again had another nurse say they would not care for him. They worked with him and he actually died about two years later. And I know those nurses, many of them went to his funeral.

Joni:

Oh my word, Sonna. I had to reach for my tissue during that story. How powerful. And to hear it straight from our patients. I mean, that's a great example. And a lot of those surveys we get back electronically now. And so oftentimes we don't even share some of that information with the frontline team members. But what a beautiful opportunity that you paused and listened, and then you gave the team the opportunity to listen as well, and that they were moved into action. I mean, that's literally the definition of compassion, to be moved into care through love and wanting to take care of someone. Wow, that is beautiful Sonna. So kudos to you in your leadership and how brave of that patient to share how they didn't want to be there and that they really were just looking for help. That's incredible. So Sonna, you have given us a lot to think about storytelling, and I really feel like storytelling's kind of having a moment.

Maybe it's confirmation bias, but I kind of see it everywhere that I look. Harvard Business Review did a huge article about it just a couple of issues ago because it leads to beautiful outcomes when people connect the work on the why together. And so we know about some of the things that have kind of shaped you up until this point as a leader, but I'm curious, what are you reading or learning or doing to sharpen your skills or to take care of your mind, body, spirit, soul? What are you reading or learning about these days? Any great recommendations?

Sonna:

Well, it's funny because I just finished my doctorate degree last year, so I've done a lot of reading and a lot of research, and there's nothing really currently that I'm focused on, but I love nursing, leadership books, motivational reading, and storytelling. It's all part of who I am and what I truly love. But we take a lot of books, different leadership books, nursing leadership books that are fun, and I incorporate those into my nursing leadership team meetings. And so we pull from those and work together. But to pull out any one thing right now, I don't really have anything that I'm recommending or can share.

Joni:

No worries. That's great. So Sonna, we've talked about a lot of different things today. What do you want to Handoff to nurse leaders at all levels and in every setting of care?

Sonna: 

I think it's really important to stay genuine and be real for those that you lead. And they know that if you are, and I think sometimes the need for them to see you as human is important, but you can lead with strength and softness at the same time. Holding them accountable, but yet also being there with them. And those are things that I share when I mentor new leaders, let them see that you're real and be there with them. Lift them through the hard times as much as you can, but motivate them to do more.

Joni:

I love that. Leading with strength and softness at the same time. That's a great way to describe it. Sonna, where can people follow you or connect with you or find more of your work these days?

Sonna:

Well, I'm on LinkedIn. You can always reach out to me there. I love to connect and I'm always interested in reading stories on LinkedIn too, of others accomplishments. I think that is a great way to connect and share.

Joni:

Great. Excellent. Everyone, be sure to find Dr. Sonna Harding on LinkedIn to continue conversations. Sonna, I love your passion for people and care and the way that you bring the why to life through storytelling. Thank you for your leadership and thank you for handing off this strong perspective and guidance today.

Sonna:

Thank you for having me. I appreciate it.