Strengthening Connections Across the Prairie
By Jena Pierce on
Directors of Nursing (DONs) or Chief Nursing Officers (CNOs) have challenging positions. They oversee nursing staff at their hospital, are responsible for the safety of patients, manage budgets, keep policies up to date, and ensure the facility meets regulatory and healthcare standards. In rural areas, the position can also be isolating. There may not be another DON for 60 miles or more. But these positions have many things in common and deal with the same issues no matter where they are in the state.
Connecting Nurse Leaders
The North Dakota Critical Access Hospital (CAH) Quality Network, housed within the Center for Rural Health (CRH), part of the University of North Dakota School of Medicine & Health Sciences, serves as a common place for North Dakota's CAHs to share best practices, tools, and resources related to providing quality of care.
This is one place where DONs can specifically come together, ask questions of each other, share their experiences, and collaborate in the sense of policy sharing.
One goal of the Network is to improve information sharing and networking at the regional and state level among tertiary facilities and stakeholders to prevent duplication of efforts. One way they have met that goal is through the development of DON networking meetings.
Anahita Anvari-Clark, clinical project coordinator with CRH, facilitates these virtual calls. "A need was identified years ago to bring the nurse leaders together so they could have a space to talk amongst themselves. This is one place where DONs can specifically come together, ask questions of each other, share their experiences, and collaborate in the sense of policy sharing. Why recreate the wheel if someone already has something," she said.
Value of Collaboration
Currently, the meetings are held monthly over Zoom to talk and collaborate with one another. The meetings are closed, meaning they can only be attended by a DON from one of the 36 CAHs in the state, and an average of 15-17 DONs attend the meetings.
During the hour-long meeting, topics come up, such as questions about various policies, which vendors facilities are using, or how others would handle a certain situation. This was especially timely during the measles outbreak in several counties in the state early this year.
Jenny Holand is CNO at Unity Medical Center in Grafton, North Dakota, a role she has held for ten years. She has worked in healthcare for over 30 years, including in long-term care, in hospital settings, and home care and hospice.
Now I have the knowledge and background to be able to help new DONs transition to their roles.
"I try to attend every monthly meeting because it provides a wealth of knowledge," Holand said. "When I stepped into my position, I didn't have anyone to mentor me as I transitioned. My goal was, after I gained some experience, I wanted to be able to help others new to this role. Now I have the knowledge and background to be able to help new DONs transition to their roles."
Feeling Less Isolation
CRH understands how isolated staff at the CAHs can feel. Often, they don't have counterparts they can compare notes with. "We feel a responsibility to connect and provide resources with the CAHs to try and make their work easier," said Dr. Jacob Warren, director of CRH. "Having networks like this one, for nurse leaders, will not only help the staff members, but will help the CAHs continue to provide the excellent healthcare North Dakota is known for."
Sarah Thomte is CNO at St. Luke's Medical Center in Crosby, North Dakota, located in the sparsely populated northwest part of the state.
Working at a small CAH, I don't have someone nearby I can talk to about these things. The networking has been great.
"This group has been extremely beneficial," Thomte said. "I don't feel alone or on my own. Working at a small CAH, I don't have someone nearby I can talk to about these things. The networking has been great. I know who to call to ask about certain things, and when I go to conferences there are familiar faces. There are so many DONs with a wealth of experience; this has been valuable to learn from them."
Real-time Assistance
As a complement to the monthly calls, the CAH Quality Network, funded through the North Dakota Medicare Rural Hospital Flexibility (Flex) Program at CRH, has established an email listserv, specifically for the nurse leaders. Both Holand and Thomte find the listserv helpful.
"I just sent out an email this morning," said Holand, "asking if anybody had a tip sheet on the Epic Downtime computer, and I got a response almost right away. This allows us to help each other in real time and not have to wait for the meeting."
Thomte appreciates both the meetings and
listserv. She makes a point to attend every meeting if
her schedule allows. She especially values the
discussions around survey experiences.
"This really helped me prepare for the survey I worked on in 2022. I went in with more confidence," she said. "The policy sharing has also been very helpful. I could spend an entire day writing a new policy, or I can email the listserv of this group, and they will share their policies. It saves time and energy."
Anvari-Clark appreciates the engagement she sees during the meetings. "Several new DONs have been joining the calls and are getting more comfortable asking questions. We have some seasoned ones that will always ask questions and speak up. Part of the purpose of these meetings is collaboration and learning from each other. These connections and collaboration help to make healthcare in North Dakota stronger."
is the communications manager at the Center for Rural
Health at the University of North Dakota School of
Medicine & Health Sciences in Grand Forks.
