CNO Point of View


It's about nursing's joys, challenges and meeting a community's needs

May 6-12, we celebrate nurses during National Nurses Week and rightfully so since the profession is a critical part of healthcare. Nursing is the nation's largest health care profession with more than 3.1 million registered nurses practicing nationwide. Nurses comprise the largest single component of hospital staff, are the primary providers of hospital patient care, and deliver most of the nation's long-term care.

The nursing profession is not immune from many of the issues facing other healthcare professionals as well as the industry as a whole. The challenges have different faces depending on whether you are a nurse manager or working directly with patients, but one thing remains true, nursing is one of the highest callings with one of the highest levels of stress.

Chief Nursing Officers have to manage not only the challenges facing the nursing staff of their facility but also juggle other challenges the facility and industry are dealing with. This role can be compounded in the rural setting where many facilities are struggling to just keep the doors open and the lights on. Regardless of the issues they face, one theme tends to resonate among CNO's in West Tennessee - they are passionate about nursing. Three CNO's from across West Tennessee weighed in on what they love about the profession, why they chose it, the issues they face and what they hope to accomplish.

In addition to being CNO's, the roundtable participants have all lived or worked in rural areas of the South for a significant amount of time. They all hold Master of Science in Nursing Degrees. And they are all very passionate about not only being a nurse but the role nurses play.

Born and raised in Huntsville, Alabama, Dyersburg Hospital's CNO, Jan Zimmer's father was a member of Wernher von Braun's team in the early years of the space program. Her undergraduate degree is from Jacksonville State University and she has a master's degree in Critical Care Nursing/Nursing Education from the University of Alabama in Huntsville.

"A college education was always a family priority for me. In my senior year of high school, it became important to me to pursue a profession focused on others and the more I learned about nursing the more I felt drawn to it. The summer after I graduated high school, I worked for a long-time family friend that was a Director of Nursing in a nursing home," said Zimmer. "Ms. Ruth assured me that one summer with her would help me make up my mind about nursing and she was right. My first day as a nursing assistant a precious, sweet patient held my hand and told me how kind I was. I immediately fell in love with the profession and all it could/should be for patients and families. The day of my college graduation my father told me he had always prayed one of his daughters would be a nurse. I was overjoyed when I realized that my father's prayers had gently guided me to this noble profession."

Zimmer says she would not be the nurse she is today were it not for role models along the way. "My very first clinical instructor, Jean Dukes, RN, MSN, PhD was a daily role model of professional nursing for me and to this day inspires me to the best I can be," she said. "Early in my career I worked with a CV surgeon that taught me more about patient centric care than any book ever could. My job description was literally 'make this experience better for our patients and their families.' Thanks to what I learned from him, I always knew that if I had the opportunity, I would want to create an environment where patients and families were at the heart of all we do."

Wendy Trickey, CNO at Hardin Medical Center in Savannah, was born in Monticello, Illinois but moved to Cairo, Mississippi at the age of ten. The Mississippi girl loves living in a small rural town and all the things they have to offer. She received an Associate Degree in Nursing from Northeast Mississippi Community College. The working mother of twin boys earned her BSN from the University of North Alabama and ultimately completed an MSN in Nursing Leadership from the University of Alabama.

"I chose nursing because I wanted to do something that mattered, that affected others in a positive way, and be part of something that made a difference. I believe most nurses feel this way and that is why nursing is the most trusted profession. Nursing is a hard job and not everyone can do it. We are with people in some of the best moments of their lives, but also in some of the worst moments," said Trickey. "For me the reason I do what I do is in the answer to a question I sometimes ask myself, 'Does what I am doing matter?' It does and so I am still here."

Early in Trickey's career, a charge nurse gave her some sage advice. "She told me that if you get really comfortable with what you are doing then you need to find something else to do. This keeps it interesting and you will continue to grow as a nurse. To me, continuing to learn is an important aspect of being a nurse," said Trickey. "I once had a Director of Nursing that also impacted me. She was one of the kindest and most compassionate nurses that I have ever met. She always made me think about things from many different perspectives, not just mine. This makes it easier to connect with patients and staff so that we can work together better."

Baptist Memorial Hospital - Union City's CNO, Lori Brown also hails from Illinois. She moved to Northwest Tennessee when she was 16 and has never left. She graduated with an Associate Degree in Nursing from the University of Tennessee at Martin in 1983 then completed her BSN and MSN degrees at Western Governors University in 2014.

Brown chose nursing due to the impact it has had on her life. "As a child I was ill the first five years of my life which caused frequent visits to the hospital," she said. "As a teenager my grandmother was in ICU for an extended period of time. One of her nurses really served as a role model and facilitated my decision to become a nurse. I actually got to see her about 20 years ago at a nursing banquet and thanked her for the role she played in my life."

Besides those that influenced her to enter nursing, Brown has also had mentors throughout her career. "Some of my nurse managers early on in my career pushed me to become a leader by getting me involved in projects," she said. "Several of my CEO's recognized my desire to become a leader and actually put me in positions to help advance overall knowledge of information outside of clinical that would help in my current role."

As a CNO for over 25 years in two different states, Zimmer has seen the national nursing shortage in many different phases. "Today, more than ever, our communities need devoted, compassionate nurses in all settings but especially in the acute care setting," she said. "Our profession has grown tremendously over the years and the expertise nurses bring to the workforce is highly respected and desired. This opens up many exciting doors for nurses while at the same time creates a void in the traditional bedside nursing positions. Thankfully, there are many educational partners working in nursing to help remedy the problem and produce highly skilled, energetic graduates to support the needs of the community. In Dyersburg, we are extremely fortunate to have Dyersburg State Community College literally right next door."

Retention and recruitment are high on Brown's to-do list for 2019. "We will be recruiting or next group of Clinical Nurse Residents as well as Nurse Interns," she said. "We also hope to improve overall nursing retention through the continued roll out of a Clinical Ladders Program. We will hold two Nurse Camps this summer. This is a program for high school students that is one of our strongest recruitment initiatives. We currently have about 18 nurses who actually participated in Nurse Camp while in high school."

Joining the West Tennessee Healthcare family is a tremendous opportunity for Dyersburg Hospital in Zimmer's opinion. "We are collaboratively working on standardizing and optimizing patient care throughout the entire system. A part of that process is the implementation of a single source electronic medical record for all facilities, which is a significant accomplishment for Dyersburg Hospital," she said. "For the remainder of this year we will continue our journey toward integration as well as focus on attracting and retaining the talent we need to provide the very best care."

"A huge concern I have as a nurse leader is being able to continue to impact the health of our community," said Trickey. "With so many closures of small rural hospitals in the past several years, this is a real concern to me. Access to healthcare has been negatively impacted. People in rural areas that have lost their local hospital must drive further for their healthcare needs. They no longer have a hospital in their community that they can go to and some are simply unable to travel to get their healthcare needs met."

Keeping up with the latest technology and utilizing it fully is a challenge for Hardin Medical Center. "Tele health has been utilized in the past and we are once again evaluating it," Trickey said. "Can we offer services like this to the people in our community and will they be utilized? Developing ways to identify, then meet the healthcare needs of those in our community by offering beneficial and sustainable services are important."

With the U.S. projected to experience a shortage of Registered Nurses (RNs) that is expected to intensify as Baby Boomers age and the need for health care grows, our CNO's encourage those who are considering a career in healthcare to look at nursing.

"If you have a passion for nursing and want to be involved in making a difference in your community, this profession is for you and by all means pursue the goal," said Trickey. "Nursing is a wonderful profession that is encompassed by the human experience."

For nurses who want to move into administrative roles, Zimmer encourages them to devote themselves to all aspects of the profession and learn it inside and out. "Find a mentor that inspires you to get out of your comfort zone and explore new opportunities. Seek wisdom and guidance. Enroll in an educational track that will teach you about this business of healthcare and the awesome responsibility healthcare leaders have today," she said. "Understand the political environment that influences our ability to care for our communities. Join professional organization(s). Start leading, be it a committee, a task force, a group at church, a group at your children's school, just start leading. Bring optimism to the workplace and never, never give up."

"Nurses who want to move into leadership roles need to participate in ongoing education, whether it is advancing their degrees to getting certifications, to reading articles," said Brown. "They need to place themselves in positions to get leadership experience such as on teams and committees. They need to ask for projects to be a part of and let leaders in the hospital know they eventually want to be a leader. This will open opportunities to participate in education as well as projects that will advance their overall knowledge and leadership skills."

"Nursing is the best job in the world, and we are blessed to be able to do what we do, yet we have so many challenges that make what we do sometimes very difficult. We will always face difficulties. We will always wish that things might be better so I want to help work with other nurses and see if we can be the change to make it better" said Trickey. "I have a very optimistic outlook when I think of where we can go as a profession. I believe it is possible, but only if we can work together as professionals. We do make a difference every day, yet we can do better."


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