TONE 2019 Annual Conference Speakers
The Heart of a Nurse Leader: Values-Based Leadership
Bob Dent, DNP, MBA, RN, NEA-BC, CENP, FACHE, FAAN
Senior Vice President, Chief Operating & Chief Nursing Officer • Midland Memorial Hospital
Bob Dent is the Senior Vice President, Chief Operating and Chief Nursing Officer at Midland Memorial Hospital in Midland, Texas. He maintains academic appointments with Texas Tech University Health Sciences Center and the University of Texas of the Permian Basin. Bob serves as President on the Board of Directors of the American Organization of Nurse Executives.
Dr. Dent’s career spans more than 30 years in healthcare in such roles as nursing assistant, LVN, RN, assistant director of nursing, director of nursing, licensed nursing home administrator, chief nursing officer, dean of health sciences at a community college, and chief operating officer. Dr. Dent served in small rural to large urban hospitals.
Dr. Dent is the recipient of Modern Healthcare’s Class of 2006 Up and Comers in Healthcare Administration; Texas Organization of Nurse Executives 2013 Excellence in Leadership Award; Texas Tech University Health Sciences Center Distinguished Alumni 2014; and 2016 Richard Hader Visionary Leader Award.
Dr. Dent academically progressed in nursing completing a vocational nursing program at Texas State Technical Institute; Associate Degree in Nursing (ADN) from South Plains Community College; Bachelor of Science in Nursing (BSN) and a Master of Business Administration (MBA) with an emphasis in Health Care Management from the University of Phoenix; and his Doctor of Nursing Practice from Texas Tech University Health Sciences Center. Dr. Dent is Board Certified, Advanced Nurse Executive (NEA-BC); Certified Executive in Nursing Practice (CENP); a Fellow with the American College of Healthcare Executives (FACHE) and a Fellow with the American Academy of Nursing (FAAN).
Over the course of his career, Dr. Dent combined his expertise in nursing and leadership to co-author three books, a number of journal articles, and presentations related to culture, improving workplace environments, interprofessional collaboration, and nurse staffing.
Every nurse is a leader, whether or not they have a formal management title. In this presentation, I'll challenge every nurse to be the leader who inspires others to do their best and be their best. I'll share values-baseed life and leadership strategies that every nurse can use to be a better caregiver, a better leader, and a better person.
This is more important than ever, because in today's fast-changing healthcare world we need leaders in every corner, not just in the corner office.
- Recognize the three essential elements of a Culture of Ownership to eradicate toxic emotional negativity creating a more positive and healthier workplace practice environment.
- Identify with and relate to The Twelve Core Action Values described in The Heart of a Nurse Leader to be a values-based leader.
- Each participant to examine their leadership to be able to stand up on their values during turbulent times in healthcare.
Overuse and Overdose: Opioids and the Impact on Healthcare Providers
CEO, Foundations Recovery Network, Divisional VP, Addiction Treatment Services • Universal Health Services
Matt Feehery joined Foundations Recovery Network in July 2018, bringing his vast experience to UHS’ Addiction Treatment Services business. In his role as CEO of Foundations Recovery Network, he drives the strategies, growth, performance and oversight of FRN’s six residential treatment facilities and 13 outpatient programs across the country.
Feehery has worked in the addiction treatment field since 1979, most recently as CEO of the Memorial Hermann Prevention and Recovery Center (PaRC) and senior vice president of Behavioral Health Services. During his 16-year tenure, he led and managed the 144-bed residential drug and alcohol treatment center, nine regional outpatient centers, a mobile psychiatric assessment team of psychiatrists and licensed clinicians serving 13 acute care system hospitals and three mental health crisis clinics as well as a psychiatric case management program. Other key roles include executive director, CEO and consultant for numerous alcohol and drug treatment organizations and psychiatric hospitals throughout the country, including one of the nation’s first alcohol and drug treatment centers, New Hampshire’s Beech Hill Hospital.
“Becoming a counselor was an interest that developed into a calling,” Feehery says. A Licensed Chemical Dependency Counselor (LCDC) and board-certified Advanced Alcohol and Drug Counselor (AADC), he earned his MBA in healthcare management from Our Lady of the Lake University in San Antonio, Texas, and his bachelor’s degree in human resource management from St. Edward’s University in Austin, Texas. Feehery is a regional vice president with NAADAC (the Association for Addiction Professionals) and recently served as president of the Texas Association of Addiction Professionals (TAAP) and chairman of the Behavioral Health Services Council for the Texas Hospital Association (THA).
Inducted into the TAAP Hall of Fame in 2013 for his service and commitment to the addiction counseling profession, Feehery also received the prestigious George R. Farris Management Excellence Award from Memorial Hermann Health System in 2012. Additional honors include the Behavioral Healthcare Champion Award in 2011, the NAADAC Organizational Achievement Award in 2010, the TAAP Addiction Professional of the Year Award in 2005, the TAAP Counselor of the Year Award in 1995 and the Fr. Charles Wyatt-Brown Distinguished Service Award in 1981.
This presentation will address the impact opioid overuse and overdose are having on communities and health providers. Opioids present multiple challenges for first responders, hospital emergency departments, pre-op and post-op utilization, discharge planning and pain management strategies. Approaches to developing effective guidelines and practices will be assessed from the pharmacy and physician office to the hospital ER. Recent federal legislation, the history of the epidemic, the Texas response, and relevant treatment options will also be explored.
- Identify the causes, influences and impact of the opioid crisis on individuals and communities.
- Understand and develop sensible strategies for managing opioid utilization in healthcare settings.
- Review the medications and related therapeutic options for treating people with opioid dependence and addiction.
State of Healthcare and Trends
W. Stephen (Steve) Love
President/CEO • Dallas-Fort Worth Hospital Council
Mr. Love is currently President and Chief Executive Officer of the Dallas-Fort Worth Hospital Council which promotes collaboration, cooperation and advocacy on behalf of its 90 member hospitals. The Hospital Council also has approximately 80 Associate Members (business and industry), including prominent accounting, legal and consulting firms. The primary mission is to promote patient safety, quality healthcare and coordination in the delivery of healthcare within the North Texas market. He served as 2015 Chair for the Conference of Metropolitan and Regional Hospitals Association in the United States. He serves on the Dallas American Heart Association; Cure Glaucoma Foundation Advisory Board; North Texas Eye Research Institute; Children at Risk, the Metropolitan YMCA Board of Directors and the Board of Directors of Prism Health North Texas and Mothers Against Drunk Driving Dallas. Mr. Love also serves on the Healthcare Administration Advisory Board for the University of Texas in Arlington. Mr. Love has worked in healthcare management for over 40 years. He has demonstrated leadership in tax exempt, investor-owned, specialty and private hospitals in operations, finance and corporate governance. Prior to joining the Dallas-Fort Worth Hospital Council, Mr. Love was Senior Vice President and Chief Financial Officer of a Fortune 500 healthcare company that owned over 50 hospitals and managed approximately 200 facilities in the United States. A native Virginian, Mr. Love is a graduate of Virginia Tech.
Federal Healthcare Update, State Healthcare Update, Coverage and Access in North Texas, Trauma Coverage and Funding, Social Determinants of Health
- Public Policy Initiatives
- Coverage, access and treatment of patients
- Action Plan to educate consumers
Founder • Bravo CC
Libby Spears, founder of Bravo cc, has a long rap sheet for breaking rules, challenging the status quo, and evangelizing the importance of confidence, courage, and credibility for every professional. She believe that you get there by discovering how to use communication to build and nurture relationships. While her troublemaking tendencies didn't serve her well as a young kid at school, she has honed it into her greatest strength. Today she works all over the United States with professionals who want to improve how they communicate and lead. She is an educator, liberator, and entertainer--the perfect mix for learning.
In 2010, over a grande vanilla latte with my good friend, I was told her a story about a client who was struggling. "You know the problem," I told her, "I am their back up plan for when things aren't going well but when they get better they just go back to the way they have always done things. If they just understood who they want to be we wouldn't have to keep doing this."
You see, up to that point, my marketing materials all said "When it's time for Plan B." It made sense--most of my clients came to me because they needed help working on their presentation skills because what they had been doing was not working. I was their Plan B. Clever right? Eat your heart out Nike!
This conversation + cup of coffee was an epiphany for me. Could I articulate a message that Plan A ("But this is how we have always done things!") leads to Plan B and this formula is not a long term success strategy?
Today this question guides the philosophy of my business and how I "do life." I love sharing with others how they can find their Plan Be through a series of focused activities. What's Your Plan Be? taps into your strengths while challenging you to also name your limitations and address them in meaningful ways--so that they don't become a liability. What's Your Plan Be? is a challenge to Name it, Claim it, Live it!
- Learn how to shift their mindset from a Plan A/Plan B mindset to a Plan Be Mindset
- Complete their Three Words--an activity designed to instill confidence, courage, and credibility as leaders
- Learn how they can activate the Plan Be program in their team and organization to create a high performance team
In Creating a Healthy Workforce, Does a Unit Based Intervention Decrease Experienced and Witnessed Disruptive Behaviors?
Jamie Sodek, MSN, RN, CIC
Quality Nurse Manager • Baylor Scott & White Medical Center - Temple
Jamie Sodek obtained her Bachelor of Science in Nursing from the University of Mary Hardin-Baylor in 2007 and her Master of Science in Nursing from Texas A&M Corpus Christi in 2017. She obtained her Certification in Infection Control & Epidemiology in 2015. Her clinical experience includes OB/GYN and Neonatal ICU. She worked as an Infection Preventionist from 2011 – 2017 and currently is the Quality Nurse Manager in Nursing Clinical Excellence at Baylor Scott & White Medical Center – Temple. She has presented several posters at various conferences on Central Line Associated Bloodstream Infections, Hand Hygiene Programs, and Creating a Healthy Workforce by Addressing Nurse Bullying & Incivility. She is passionate about improving patient outcomes and fostering a culture of kindness for all healthcare workers.
Background: The goal of sustaining a healthy work environment, prompted the leadership team to contract an internationally known expert to determine the presence of bullying in the work-place because of reported uncivil occurrences in the acute care units.
Methods and Procedures: An internationally recognized consultant, Dr. Renee Thompson, DNP, RN, performed an on-site, 2day focused assessment with multiple small groups, followed by an on-line assessment deployed to all RNs. Review of the assessment identified the need for unit-based interventions to promote a healthy work place. Staff and leaders were provided with strategies to recognize and address bullying and uncivil behaviors through a series of workshops. Three units were selected as pilot units to work closely with Dr. Renee Thompson to further develop a culture of caring and professionalism within their departments.
Evaluation: In addition to anecdotal success stories shared by the department leaders, a pre- and post- intervention survey showed a decrease in the number of experienced and witnessed behaviors on the pilot units. Furthermore, this work has been spread throughout every nursing department within the hospital, has been introduced to providers and other disciplines within the hospital, and helped to lay the framework for an entire Baylor Scott & White Health system focus on workplace violence. Collaboration with Human Resources has supported appropriate disciplinary actions to ensure a healthy work place environment.
Implications of Practice Change: Heightened awareness of uncivil behavior has empowered staff to support a “Zero” tolerance for uncivil behaviors. The contracted services have been continued for two additional years to sustain and spread the initiative throughout the remaining acute care units and expand to the ambulatory settings. There has been a shift in culture to one that fosters kindness and professionalism towards all employees, associates, and patients.
- Upon completion of this poster review the attendee will analyze the impact a unit-based intervention focused on creating a healthy workforce has on staff perception of experienced and witnessed disruptive behaviors.
- Upon completion of this poster review the attendee will summarize the role and responsibilities of the nurse leader to employ strategies to cultivate a healthy workforce.
- Upon completion of this poster review the attendee will hypothesize strategies to sustain staff compliance with expected professional behaviors.
Shonna Bracco, DNP, RN, NEA-BC
Vice President of Patient Care Services • Baylor Scott & White Medical Center - Temple
Dr. Bracco has been a Registered Nurse since 1996. She holds a Doctor of Nursing Practice degree from Texas Christian University and is board certified as a Nurse Executive Advanced and has earned a certificate in Fundamentals of Magnet. Dr. Bracco completed the SMU Cox School of Business Nurse Executive fellow program and is a graduate of Baylor Scott & White Executive Education Program. She currently serves as the Vice President of Patient Care Services at Baylor Scott & White Medical Center-Temple where she has oversight of eleven acute care nursing departments. Dr. Bracco has a passion for Workplace Violence Prevention and Caring for the Caregivers work in healthcare.
Becky Calhoun, MSN
Nurse Director • Baylor Scott & White Medical Center-Temple
Ms. Becky Calhoun began her career as a Medical-Surgical nurse with her BSN in 2012. In 2014 she became the Nurse Manager for a Neuroscience Unit. While on this unit this team achieved Gold Standard Stroke designation through The Joint Commission and Becky received 100% staff engagement scores from her direct reports. Becky completed her MSN and was promoted to a Nurse Director role in 2017. She holds national certifications in Medical Surgical nursing, Stroke Certification, and Nurse Executive Advanced.
After a quality improvement project found that on average only twenty percent of violence against staff was being reported each month, this facility opted to address these behaviors and put processes in place to support their employees. Violence against healthcare providers on medical surgical units is a continually growing epidemic. As seen in this project, literature suggests episodes of workplace violence are significantly under reported (Occupational Safety and Health Administration, 2018). Many workers fail to report these episodes because they feel it is a hazard of the job and nothing will be done to address the issue.
By conducting staff interviews, developing education with key stakeholders, and implementing standard resources and visual aids, workplace violence prevention and reaction was addressed in this quality improvement project. First, the under reporting of workplace violence incidence through education and communication on what and how to report was addressed. This education was achieved through a huddle script that was presented at the daily safety huddle, at the Nursing Leadership Council, and daily unit huddles for two weeks. In this facility, huddle scripts are standardized, written materials to be used by huddle leaders to provide education to staff. Prior to the first intervention this facility had an average of 5 episodes reported per month, after huddle script education the facility has seen an increase in reporting to an average of 25 episodes per month for the last 6 months.
The second aim of this project was to prepare staff and leaders to address behavior and to create a “no violence zone” culture. Three medical/surgical units with high incidence of violent patient episodes were selected for a pilot project. All staff on these units were given education through online modules on how to address violent behavior and how to protect themselves. Leaders from these units completed the modules, as well, as a 1.5 hour class on addressing aggressive patients.
“No violence” signs were placed in patient rooms and waiting areas. The Broset Violence Screening tool was used to score each patients likelihood of escalation. High or moderate risk patients also had a sign placed outside to alert staff of potential for aggressive behavior. Staff caring for high risk patients were provided a personal duress alarm to be worn on their name badge to call for assistance if needed (The Joint Commission, 2018).
For 5 weeks the units participated in the pilot. During this time 3,570 Broset screenings were completed, 535 patients screened moderate risk for escalation and 130 screened high risk. During this time frame there were 26 incidences of escalations and the personal duress alarms were used 10 times. On the pilot units the number of adverse events per week reduced from around 3 per week to an average of 0.8 events per week. Data showed staff and leaders felt the education provided improved their knowledge on how to manage violent patients. As there are 11 Medical-Surgical Units in this facility, future plans include implementing the education and training used on the pilot units facility-wide.
- Increase compliance with event reporting of workplace violence.
- Develop 3 strategies to implement a workplace violence reduction program.
- Create a culture of zero tolerance of workplace violence.
Effective Interventions to Increase Nurses' Work Related Resiliency
Laura Sweatt, MSN, RN-BC
Magnet Program Director • Methodist Mansfield Medical Center
Laura Sweatt is the Magnet Program Director at Methodist Mansfield Medical Center, where Laura leads the pursuit of nursing excellence, including shared governance, professional growth, and nursing research.
Laura successfully led the journey to Magnet Designation and received the D Magazine Excellence in Nursing Award, among other distinctions in the field. Laura helps nurses engage in the profession and develop leadership skills to meet the ever changing demands of healthcare.
Workplace wellness is an increasingly available resource within hospital organizations. The expansion of wellness services across a multi-site urban-based hospital system requires the consideration of innovative strategies in being able to promote healthy work environments across a large workforce of nurses. Resiliency building activities are significant interventions that can build nurses' resources and address the effects of emotional dissonance while nurses are at on-shift.
This study sought to determine: 1) if a toolkit of resiliency building interventions provided to nurses while on shift does increase resiliency on the Conner-Davidson Scale over a four week period and 2) which toolkit items are most often utilized by nurses.
A quasi-experimental pre-and post-test interventional study was conducted with a sample of seventy seven registered nurses participating. Statistically significant findings with paired t-test pre/post test Conner Davidson resiliency scores: DF=77, t-value = 12.141, p-value = <0.02
Top interventions utilized were: Breathing exercises 83.1%; Lavender inhaler 57.7%; Meditation 29.6%; and Bejeweled 28.2%
Top identified work stressors: Patient interactions; Patient family interactions; High admission/discharge turnover; Patient death; Staff concerns
97% of participants report plans to continue use of interventions further validating the value of in shift/at work" strategies for building resiliency."
- Identify top five work stressors for direct care nurses.
- Identify three strategies for building resiliency.
- Analyze effectiveness of a resiliency tool kit for direct care nurses.
U.S. Disaster and Public Health Emergency Preparedness: Uncertain Times and 21st Century Threats
Tener Veenema, PhD MPH MS RN FAAN
Professor • Johns Hopkins School of Nursing, Johns Hopkins Bloomberg School of Public Health
Tener Goodwin Veenema, PhD, MPH, MS, RN, FAAN, is Professor of Nursing and Public Health at the Johns Hopkins School of Nursing and the Johns Hopkins Bloomberg School of Public Health. As an internationally recognized expert in disaster nursing and public health emergency preparedness, she has served as senior scientist to the DHHS Office of Human Services Emergency Preparedness and Response (OHSEPR), DHS, FEMA and the Veterans Affairs Emergency Management Evaluation Center (VEMEC). An accomplished researcher, Dr. Veenema is a member of the American Red Cross National Scientific Advisory Board and is an elected Fellow in the American Academy of Nursing, the National Academies of Practice, and the Royal College of Surgeons, Dublin, Ireland. She is editor of Disaster Nursing and Emergency Preparedness for Chemical, Biological and Radiological Terrorism and Other Hazards, 4th Ed., the leading textbook in the field and developer of Disaster Nursing, an innovative technology application (“App”, Unbound Medicine). Dr. Veenema was awarded the Florence Nightingale Medal of Honor (International Red Crescent, 2013) the highest international award in Nursing for her professional service in disasters and public health emergencies and was the recipient of a Fulbright U.S. Scholar Award (2017). She served as the National Academy of Medicine (NAM) 2018 Distinguished Nurse Scholar-in-Residence and has been a member of several NAM committees including the CDC Standing Committee for the Strategic National Stockpile, CDC Committee on Evidence-Based Practices for Public Health Emergency Preparedness and Response, and the CDC/NIOSH Committee on the Use of Elastomeric Respirators in Health Care.
Dr. Veenema received master's degrees in nursing administration (1992), pediatrics (1993), and public health (1999) and a Ph.D. in health services research and policy (2001) from the University of Rochester School of Medicine and Dentistry.
Disasters and public health emergencies are increasing in the United States creating a mandate for national preparedness and workforce development. Simultaneously the nature of 21st Century threats is constantly changing creating uncertainty and confusion as organizations try to prepare. Nowhere is this burden more evident than upon the U.S. health care system, public health departments and their staff. All health care professionals and nurses must be able to provide competent, basic care in a timely and appropriate response. At a minimum all health care professionals including nurses must possess knowledge about disaster and public health emergency response, and have the skills and abilities to participate in a timely and appropriate response.
- Recognize the burden on health care systems and clinical challenges encountered as a result of recent U.S. disasters.
- Appreciate the need for organizational and workforce readiness for disasters and public health emergencies of international concern.
- Recognize the unique knowledge, skills and abilities required in disaster nursing.
Trauma Surgeon, Lieutenant and Deputy Medical Director • Dallas Police Department
Kellie Kainer, MSN, RNC
Assistant Clinical Director - PFW NICU • Texas Children's Hospital
Kellie started her nursing career at Texas Children’s Hospital as a GN in 2002 in the level 3 NICU. She has served in many roles in the Newborn Center such as Neo Response nurse, Charge Nurse, and Simulation Instructor and Program Director. Kellie was a Patient Care Manager for 5 years before becoming the Assistant Clinical Director in the PFW NICU in February 2016. Kellie received her Bachelor of Science in Nursing from University of Texas Medical Branch, in Galveston, TX and her Master of Science in Nursing, Leadership, and Management from Walden University in Minneapolis, Minnesota. She is an exceptional clinician and is passionate about empowering parents of high risk infants and helping others learn through simulation.
Shannon Holland, MSN, RN, NEA-BC, CCRN-KC
Director of Nursing - Critical Care • Texas Children's Hospital
Shannon Holland, MSN, RN, NEA-BC, CCRN-K has been a nurse for over 15 years and has spent her entire career in pediatric critical care. During the last 12 years, she has held various leadership positions at Texas Children's Hospital including her current position as Director of Nursing with responsibility over an 84 bed Pediatric Intensive Care Unit (PICU). Shannon has a special interest in international nursing and interprofessional quality and safety program development.
Kathy Weseman, DNP, RN, CCM, LNC
Volunteer Red Cross Nurse - Disaster Health Services Coordinator and Supervisor • American Red Cross
Kathy Weseman DNP, RN, CCM has been a RN for 39 years and has worked in various clinical, management, and educational positions in nursing. I have been a Red Cross volunteer nurse for almost seven years serving in various leadership positions in multiple Texas and national disaster relief operations. I also work daily disaster health services cases in Texas and assist in providing leadership and guidance to disaster health services volunteers in Texas. My clinical research project for my DNP was formalize the virtual process for Red Cross disaster nursing in Texas. The paper is Pilot Texas Red Cross Virtual Disaster Health Services Model – a case study. I co-managed the virtual disaster health services team for three large flood disasters in Texas and Louisiana in 2016. I am also retired Navy and serve as a service to Armed Forces volunteer nurse for the Red Cross.