Episode 02: Dr. Claire Zangerle – Chief Nursing Executive – Visionary Leadership, Nurse Retention, Adapting to COVID-19, and Hospital Diversity

Season 1

Sep 30

Summary

In this episode, we’re joined by Dr. Claire Zangerle, Chief Nursing Executive of Allegheny Health Network. We have an amazing discussion that includes empathetic and visionary leadership, how AHN sees the COVID-19 pandemic accelerating the future, better home care for patients, self-care in a stressful profession, the impact of an ongoing nursing shortage, AHN’s creative RetuRN to Practice™ program, and the need for diversity in nursing.

While our conversation is often focused on nursing initiatives, all listeners will gain inspiration from the examples that Claire shares.

Show Notes

Defining and Cultivating Empathy as a Nurse and Leader

One of the core functions of a nurse is taking care of people in their most vulnerable states and doing that well requires empathy. As the famous Atticus Finch line reads, “You never really understand a person until you consider things from his point of view… until you climb into his skin and walk around in it.” Claire confirms this belief with the advice to “…put yourself in the patient’s shoes and think about if this were your family member going through this particular situation.” This builds the “empathy muscle” so you don’t disconnect yourself from the patient.

But as she points out, in her role as CNE, it goes beyond the care for patients. She must have empathy for her nurse leaders in their health system since they’re the ones leading clinical teams. And if those teams aren’t well cared for, they can’t care well for the patients. Her point suggests empathy as a chain event that starts at the top of an organization and ripples to the “end-user” that in this case is a patient.

What It Takes to be a Visionary Leader

Many people (especially in leadership) desire the ability to cast vision, but it’s often seen as aspirational, not practical. Claire summarizes this dichotomy well: “I always say that there are global strategies with local autonomy, because I think everybody needs a roadmap, everybody needs their vision of where they need to go as their own nursing organization, their own hospital, but they also have to have that larger goal and that larger vision to say, these are my short term visions, these are my long term visions, and this is how I want to get there.”

She continues with by explaining that to cast vision, you must use the bigger picture of what you can attain to motivate people to reach their goals.” If you don’t have that, you are easily discouraged by the randomness of your actions.

There is a balance in having a vision and an actionable plan, and Claire shares – in her experience – the importance of having smart, honest people around you that can execute a vision or push back when it’s not achievable.

Responding to the COVID-19 Pandemic as a Health System

Like many hospitals and health systems, AHN pivoted the way they care for patients and their own employees during the COVID-19 pandemic. The support of the communities and even hospital competitors made a huge difference and allowed the leadership to focus on the most pressing issues. This resulted in constant access to PPE, meal donations, care packages, flexible work schedules, and dedicated “zen” or decompression rooms.

In many ways, though, the pandemic is accelerating the future of healthcare that many were already striving for. Claire predicts that we will see improved clinical outcomes as patients become more comfortable with telehealth and home health care. Medication adherence works in the favor of patients who are more likely to do a telehealth call than visit their physician’s office. This is especially true for mental health visits, which are important in times like this when depression and anxiety are on the rise.

Highmark – AHN’s parent company – recently announced a collaboration with home health technology company, Contessa, which helps deliver care at home to keep patients from spending more time in a hospital than needed.

Restoration When Life Demands Energy and Creativity

It is difficult to imagine restoration for a Chief Nursing Executive in the midst of a pandemic and leading so many different initiatives, but Claire insists on finding ways to decompress even if she admittedly does “a better job encouraging others to do that [more] than [herself].”

Outdoor yoga classes have been helpful for her as well as listening to and reading books. She’s currently reading Grit by Angela Duckworth for the second time, and she discusses the vital role it has played in helping her navigate the pandemic with her team and honoring the reality that other people’s grit may look different than her own.

The Nursing Shortage is Real

There is a lot of research to show that the U.S. faces a significant nursing shortage made more apparent during the pandemic despite some hospitals furloughing nurses. Claire points out that there is also research to suggest it may not be a true nursing shortage, but she invites those researchers to join a staffing meeting or look at the operating rooms that require skilled nurses who are all retiring. She says the key to combatting the nursing shortage is not having a one size fits all approach, but addressing the needs where they are.

One way they’ve done this is through AHN’s RetuRN to Practice™ program – referred to in the episode as “Return to Work” – for nurses who have an active license but aren’t actively working. Claire describes candidates as those who used to practice, but because of various life circumstances didn’t want to keep up with the demands of everyday nursing practice. The solution was to offer flexible work arrangements catered to part-time staff with the goal to convert many into permanent full or part-time employees.

Towards the end of the conversation, she also mentions the importance of nurse leaders sharing the value of nursing in order to encourage the current workforce and attract future talent. She believes that being a nurse is one of the most meaningful careers that allows a person to make a difference in the lives of their community, and this vision will attract people to keep pursuing nursing as a career.

Investing in Nursing Diversity

As the issue of systemic racism has been on the forefront of minds in 2020, Claire discussed initiatives AHN has taken to invest in nursing diversity. One key way was dedicating leadership resources to create structured change, which they did with the first-time hire of a Chief Diversity Officer. Their desire is to attract a more diverse nurse workforce which creates better health outcomes.

In addition to this, each AHN hospital is in the process of creating diversity councils to facilitate conversations and actions related to race and diversity. It’s another example of global strategy influencing local autonomy. The AHN leadership sets a strategy that equips their individual hospitals to serve their local community in a specific way. Claire believes continuous education for all employees is necessary to see lasting change.

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