Gregory  is a nurse recruiter and Pathway to Excellence coordinator at VA Southern Nevada Healthcare System. Greg shares the personal impact of designation, using the Pathway framework and future plans for VA Southern Nevada Healthcare System.

What has the Pathway designation meant to you?

VA Southern Nevada Healthcare System is proud to have been the first facility in the Las Vegas valley to have earned ANCC Pathway to Excellence® designation in 2019.  There are sixteen (16) hospitals that serve Clark County Nevada. At this time only two hold ANCC nursing excellence designations. 

ANCC says that Pathway designation is the premiere global credential for a positive practice environment. As a 0.5 FTE  facility Nursing Excellence Coordinator and a 0.5 FTE nurse recruiter I get to see some things from a different perspective. I am excited to get to meet every new nurse on the first hour of the first day of new nurse orientation.  Many to most of our new nurses have limited to no knowledge of Pathway to Excellence® and what designation means for our nurses and to the organization.  Many to most of them are not familiar with the concepts of shared decision-making processes like Unit Based Councils.  By the end of that first hour of orientation they are well informed. 

While our newly hired nurses might not be knowledgeable as to Pathway to Excellence®, they are certainly aware of our culture.  For the past several months I have been providing our new nurses a quick recruitment survey.  From this tool we have determined that nearly 90% of the nurses that we hire from our local community come to work for us as VA Southern Nevada has been recommended by a colleague that works here.  Local “word of mouth” is a great recruitment tool for us and it is because of our culture.

Pathway to Excellence® advances to our culture and values.  When I describe our shared-governance structure and the PTE program to our nurses, I frequently get asked, “sounds like a lot of work, what’s in it for me?”  I love this question as I get to fire back at them,

-we deserve to have a culture where our voices can be heard, and we have opportunities to make positive changes on our units and in our clinics. 

-We deserve to have a culture where our leaders are accessible, transparent, and will respond to us. 

- We deserve to have a workplace where we feel physically and psychologically safe. 

- We deserve to be able to meet our patient’s needs and our nursing standards.

- We deserve to work for an organization that values our well-being.

- And finally, we have a culture where nurse have opportunities to not only grow in our profession but thrive in professional development. 

This culture that VA Southern Nevada has been able to achieve, that is what Pathway to Excellence® means to me.  Our nurses deserve to “live Pathways”.

How do you feel the PTE framework has supported you during this time?

As both the facility Nursing Excellence Coordinator and a nurse recruiter, I have been able to weave many of our pathway initiatives into our nurse retention plan.  We have created a 16-point retention plan.  Many of these items are directly related to the Pathway Framework.   I have three really good examples to share.  Learning this a best-practice form a past pathway to Excellence® national conference, we have implemented a brown bag lunch with the Nurse Executive program.  Managers recommend 10 nurses per month to attend.  Great group discussions occur.  By the end of the hour nurses feel they have been heard and leadership feels inspired by the positive stories the nurses share.  Definitely a win/win for all. 

We have nearly 30 Unit Based Councils, each month at our nursing executive council meeting one or two of our UBCs present their “Success Stories” to the group.  The nurses have an opportunity to create slides that tell their stories and to be able to present their unit accomplishments to the group.  Managers are so proud to show off to their managers the accomplishments of their UBCs. As the excellence coordinator, I get to find out all of the important, interesting, and creative projects that our direct care nurses have been pursuing. Another win/win for everyone.

Our UBC’s do some very serious work, but also they like to have fun.  Our nurses are all very competitive, in a friendly nature. Another item that we have implements is UBC photo challenges.  At certain times of the year such as the Nurses’ Month, Halloween, Christmas, etc., we hold photo contests.  The winning UBC receives a small prize but mostly bragging rights. This year for Christmas we had an Elf at Work photo contest.  Each UBC submitted a photo of an elf at work on their units.  So much fun for the nurses and a great way to improve or maintain group cohesiveness and camaraderie.  In September and October 2021 during in the middle of the COVID pandemic our UBCs had a pumpkin decorating contest.  One of the COVID unit nurses told me that this turned out to be so very important to her as it provided a positive distraction during a time of hopelessness and helplessness. Everyday nurses would jump in an add an item or idea to their display.  This display greeted them on their way into the zippered unit.

In our facility we have many nurses who are engaged and creating a positive practice environment. For example, we have 12 Nursing Committee.  Five years ago, these committees were all led by nursing leadership members. We have invested a considerable amount of time and education in leadership of our direct care team. Today In eight of these twelve committees our direct care nurses are either chairing, co-chairing, or both.  There are also 29 Unit Based Councils in our organization.  Nearly every nurse in our organization has a voice in their practice. These are the ways that we operationalize shared decision making at VA Southern Nevada. This provides wonderful opportunities for our nurses to become engaged and involved.  Through this involvement out nurses become stakeholders in processes that are important to us all.  Leadership qualities gained in part by leading committees and UBCs provides growth opportunities for our direct care nurses.  Many of our nurses who have held these positions have gone on to become Assistant Nurse Managers and even gone on to become Managers.

What do you hope to do in the future to support your PTE designation?

My goal for the upcoming year and the years after is to be able to market our Pathway inspired culture to all nurses and to be able to Pathway “touch” every nurse in our facility. 

We hope to be able to continue to send between 10 to 20 RNs and LPNs to the National Magnet/Pathway to Excellence conference. Nothing has motivated and engaged our nurses better than the experts at ANCC.  

My CNO and I will continue to go to every new nurse orientation and share our journey with every new nurse entering the facility. This came directly from the 2016 Pathway Standards EOP 6.1.

Our organization holds a four-hour “Excellence Inspire and Renew” pizza lunch class quarterly to 44 nurses to provide education and share our designation highlights.  Nurses must be endorsed to attend by their managers.

I send out a weekly “Did you Know?” email to all nurses made up of questions from the EOPs.  Example is this week’s message, “Did You Know that our organization provides opportunities for professional growth and development for nurses?” and then a bullet point list of 13 learning/training items that describe how VASNHS provides opportunities for professional growth.

We have implemented a free, no cost, fun, weekly program called “Wear Blue Wednesday”.  Blue being the color of the Pathway button, unit’s send pics to me every week and I send emails out to the nurses broadcasting which unit/clinic/services is supporting PTE by wearing blue.  This is FREE (Leadership likes that) and the nurse’s love it too.

I also have a “giving back” weekly email that I send highlighting unit/clinic/services that have participated in community volunteer activities. This is also FREE (Leadership likes that).

Our Pathway Café Coffee Cart for night shift has been very well appreciated by our off-shift nurses. We round from 2 to 5 am every 2 months and reach on average 70 nurses per night with hot beverages, snack foods, and great conversation. This was a “best practice” shared at PPD day at the 2022 conference in Philadelphia.

Our Quarterly UBC Officer’s Meetings provides updates for our PTE designation process.

10 nurses a month are provided an opportunity for a brown bag “Lunchtime discussions with the CNO.”  Nurses must be recommended by their managers to attend.  This is also Free and was also a “best practice” shared at the 2019 PTE conference.

Our 29 UBCs are holding a Nursing Excellence Poster Fair in April to highlight the 6 Pathway Standards being met across VA Southern Nevada.

Every manager, every nurse leader has the Pathway Designated button their email correspondence.

I send out “wear blue Wednesdays” emails to the Managers and UBC officers showing the services/teams/units/clinics wearing blue to “support Pathways until we CRUSH the survey.”  We have over 50 photos in our lineup, many units have sent more that one photo. Again, Free to the organization.

I also send out “Nurses’ Giving Back” emails to eh Managers and UBC Officers highlighting the community volunteer work participation going on by our nurses. Again, Free to the organization.

2023 will be the 4^th year that VASNHS has practices Nurses’ Month in May.  The activities being planned are a collaboration between our Nursing Retention and Recognition Committee and Shared Governance.

Our UBC’s will continue to have challenges during the holidays and other significant periods for unit decorating, pumpkin carving, Elf at work and whatever other wonderful ideas that our nurses can think of.