SPEAKER_00 0:03

Welcome to ACNL in Action, brought to you by the Association of California Nurse Leaders. I'm your host, Charlene Platon. Our guest today is Kennet Asensio Holmes, Chief Nursing Officer for Sutter Health, where she leads teams across the entire integrated health system. Among other things, Kenneth is responsible for executive nursing leadership and workforce development. Center employs over 16,000 nurses throughout its dozens of hospitals and clinics, making Kenneth the perfect person to talk about workforce development and the leadership pipeline. Thank you so much for joining us today, Kenneth. It's great to have you.

SPEAKER_01 0:43

Thank you, Shirley.

SPEAKER_00 0:45

And I'm so excited to talk about this topic with you about the nursing leadership pipeline. And, you know, when we think about a leadership pipeline, I think that people often think about this linear type of process, right? Start to finish. And when we think of that, we logically think of the starting point as nursing school, right? And I think when we think about that, you know, what role would you say that healthcare systems play when it comes to working with academia to increase enrollments in nursing school and ensure student success? And how does that play into leadership?

SPEAKER_01 1:21

Yes, healthcare systems, we have a huge responsibility to ensure that we are working with academia and really increasing the enrollments, it only benefits all of us in healthcare. When we look at our nurses across the system, it's making sure that we are ensuring that we are in the communities where our patients live, and we're also working with those different schools from those areas to build and establish that nursing career. Currently, Center Health uh has 147 schools that we are associated with to actually serve that mission of making sure we're taking care of our communities.

SPEAKER_00 2:08

Wow, 147 schools. That's amazing.

SPEAKER_01 2:12

Yes, it is.

SPEAKER_00 2:14

That is awesome to hear. And and I'm I'm curious too, because you know, wanted to ask about that because we recently had a nursing student that was a guest on our show, and one of her professors had actually spoke really glowingly about her behind the scenes and identified her as someone who would be a future nurse leader. And, you know, when we talk about that, how can healthcare systems help to identify these future leaders or potential leaders and get them into this pipeline as early as possible? And if you want to share maybe about how Sutter does that with some of the partnerships with schools, that'd be awesome to hear too.

SPEAKER_01 2:52

I'd love to. Not only are we in nursing schools, but actually even in some of our high schools of talking about nursing as a career and really also working with our medical assistants of the pipeline of potentially becoming a nurse. Uh, there isn't an area that we don't want to be at to encourage people of what nursing could be and what it could be in their future. And so starting young is great for us because then we want to pipeline them into the schools that we're associated with and to ensure that they're coming from those schools and working for us at Sutter Health.

SPEAKER_00 3:32

Yes, absolutely. And I'm curious, do you happen to have any data, at least for the nursing piece, on what the success rate might look like with that transition from school to um employment, et cetera? Well, I maybe an estimate.

SPEAKER_01 3:45

Yeah, I could actually talk about more of our first uh year turnovers and items like that. So when um I would say in 2024, uh we hired 2,636 nurses at Sutter Health. And when we look at those 2,336 nurses, um that first year turnover for us was 8%, which is really kind of unheard of. Um our overall turnover for Sutter Health of all uh staff was 10%. Uh, and the focus really of a new nurse for Sutter Health is making sure that we're providing them the mentorship that they need, the education, and ensuring that they know that they will have a partner as they grow in their career.

SPEAKER_00 4:36

Wow, that is a fantastic metric and um outcomes because both, you know, both uh those percentages with 8% and with 10%, those are still less than the national turnover average, as far as I have um heard of most recently when it comes to turnover for nurses that leave the profession. And would you say that um, you know, just hearing those numbers, do you think that a big part of it was that pipeline then?

SPEAKER_01 5:03

I think it's the pipeline, but I also think it's when you come into Setter Health, you're just not coming in. We have an entire program that we're setting up for you and really starts a new employee orientation and really starting to go through the leadership essential courses that we have, how you can work as a team and be effective, and what your career could be like here at SETR Health. And so that really foundation as you join Setter Health begins your journey. And as a new nurse, when we're looking at our new nurse teams, really what does our frontline nurse lab look like? Well, we have one, and it's really helping that frontline nurse who's just joining our organization to feel that belonging, that connection, the mentorship, and the peers. It's so important that as we launch new nurses into a program that we are providing them that safe haven that I have a peer and I have a mentor that's going to help me through my career.

SPEAKER_00 6:13

That's amazing. And I'd love to hear more about that program too, because it sounds like it's a unique program to Sutter.

SPEAKER_01 6:20

I think that there's others that have something, but for SETTR Health, I think what makes us unique is that we have a nurse residency program, which many of our other competitors around have as well. But really, we also have a transition to practice. So as you become a new nurse, but you really want to be in the emergency room or you really wanted to work in IECU, we have these transition programs that you can move into that we will teach you how to be there and provide months of training so that you can fill those hard-to-fill positions. Um, and really making sure that clinical development or preceptor developments are solid so that when a patient, when an employee comes out, we have a program for them.

SPEAKER_00 7:08

That's great. And and so it sounds like really, you know, when we think of benefits, people might usually think about salary or other benefits like their 401 or things like that. But it sounds like these strategies like this program with the residency, um, the courses that you have integrated have been really working well for increasing retention.

SPEAKER_01 7:27

They really have. And I think that the other part of that is listening to our nurses, listening to our nurses of what it is that they need, and listening to what kind of courses can we make sure that they have available to them.

SPEAKER_00 7:42

Yes, that's fantastic. And do you would you say that the the program improves or changes, maybe, you know, takes in feedback pretty regularly from the from the nurses who come in?

SPEAKER_01 7:54

Yes, I I would. And I'd also just I'd love to talk about real quick about feedback. We're recently we had our nurses um really give us a feedback on the amount of time that they were spending on the computer and really the clicks and how they were burdensome. And we doubled down on our technology and really looked at how that redundancy was happening and how we could decrease that time. And it was their voice of saying, hey, this is an issue, and us reacting to that issue and providing less time on the computer and more time with our patients.

SPEAKER_00 8:34

That's great. And I think that it's really valuable to hear about listening to the feedback because this is something that nurse leaders can do, right? When they when they hear feedback, they could take it, implement it, and help to make the uh environment even stronger. And uh, do you have other suggestions too for what nurse leaders can do within either their units or their departments to help create these environments and help these new nurses or even seasoned nurses who are interested in these environments to continue to feel supported and respect, respected, and empowered?

SPEAKER_01 9:08

Yes, I think communication is key and really knowing your staff. And we take a lot of pride on our managers, our assistant uh supervisors, being out with our teams. The other part of that is really teaching even our charge nurses who are there how it is to lead, right? And so um so many times, uh, well, leaders born, right? No, not quite. We have to train them. And so we have a charge nurse program for the charge nurse to get leadership skills, and then from there, a transition of a nurse manager program to teach the communication, the finance, um, the focus on our quality care, and making sure we're taking care of our staff as well as our leaders.

SPEAKER_00 9:59

That's great because it's it's really support for nurses at all leaders, right? Including charge nurses, including managers and above, it sounds like. And it makes me wonder too, because you know, for you for you and your own journey in leadership, I'm curious how um how you became a nurse leader yourself and how you felt supported throughout your time as a leader.

SPEAKER_01 10:22

Well, it my my career spans uh several decades, and um by the beginning of my career, there wasn't a lot of um uh classes to teach you. You went out on your own, the uh hospital itself didn't have that, or you learned from somebody else. Um, and I think that um leaders aren't born, they're uh identified sometimes as hey, you you're really standing out. Would you like to lead this? Um most leaders are curious, and so they want more information. And I would say that I was definitely a curious leader. So if I could go to a class or if I could get a book, I found myself um going that direction. Um, and I pivoted, I was in acute care for a period of time early in my career for about 10 years, and then I actually went into the ambulatory surgery center world because I had an OR background. Um and again, being curious to find other leadership opportunities and um understanding I don't know everything, but uh I'm sure I can find someone that does, or I'll actually get mentored by somebody. I've had some amazing uh nurse leader mentors who have always um continue today in my head of take one step at a time, make sure your team's following, and know that each day you give your best to your team.

SPEAKER_00 11:52

That's so inspiring. And and I think that a lot of people who are listening could relate because just like you said, I I do agree that uh leaders are not necessarily born, but they are identified and and especially when they do show that curiosity, it does lead to you know wanting to solve certain problems, it it leads to wanting to find these solutions, to um make some decisions to help um bring those into action. So so that's really inspiring to hear your story. And um, and I'm curious too if if you maybe want to share any um any thoughts on what happens when a person identifies someone who would be a great leader, but maybe that person themselves doesn't see themselves as a leader.

SPEAKER_01 12:37

Yes, I it's interesting. Sometimes they don't see themselves as a leader, and I think that's really where our responsibility comes in is to let them know that, you know what, this is what I'm seeing. I would love for you to take one of our courses in leadership. And it they're not committing themselves to be a leader, but now that ability to go into a course to learn about leadership, that leader will say, Okay, what else is there available? Okay, we can we have this that we can put you in. Okay, let's go ahead. And I will tell you that um we here at Center Health have what we call Setter Health University, and that has allowed us to be able to have tracks for uh staff that are maybe thinking of leadership, maybe thinking of preceptorship, maybe thinking of education. And it opens up an array of things of that maybe that is a niche that you're looking at, and maybe it's a career that you want to develop even more. And we have that available to our nurses.

SPEAKER_00 13:42

That's great. And and uh it's it's nice to hear about the resources too that are available for leadership because I think that people may not always know what resources are out there, especially when it comes to the leadership pipeline and their organization. And another thing that I've heard of a lot is just the dilemmas between um remaining a clinical staff member versus making the, you know, the decision to join leadership. And I think that when you're trying to, you know, um, as yourself look at your own career, you also might think about dilemmas like the staffing shortage and you know, you might think about having to choose between those two, right? Like trying to fulfill staffing needs, but then also wanting to strengthen your own leadership pipeline. And so, you know, I'm curious what your thoughts on that might be. You know, if you want to promote people who are really bright and who have great potential, but then you have to think about who might replace them and and help to fulfill those staffing needs. So, how do you balance those two?

SPEAKER_01 14:44

Well, uh I'm always looking for talent. Um, I'm always uh looking for giving opportunities for that talent. Um, and I would say my uh CNEs share that as well. We have to be developing our talent early. Um, as we see retirement happening to others, we have to have a pipeline of new leaders coming in, and the only way we're gonna do that is to develop them. And do I pull a great frontline staff person away from the bad side? If that's something she's really interested in, yes, because I don't want her to go anywhere else but Sutter and give her the infrastructure that she could be great and be the future CNO of Sutter Health. Um, that's really our our our obligation, as well as we also have the ability to keep our nursing teams because we're growing them and because they know they also have other options. And I think that leads to our decrease in first-year turnover and our retentions.

SPEAKER_00 15:58

Yeah, and that's uh really important um to to think about those different situations and how you might balance that because it could be it could be something to juggle. Um and I I also at the same time agree with what you said about always being on the lookout for for those uh nurses who do have that potential because you know, our leaders um greatly impact our entire work environments, our organizations, and um, you know, could could make a a really great positive impact or you know, sometimes challenging impact, depending on on the person.

SPEAKER_01 16:34

Very true.

SPEAKER_00 16:37

And you know, for for people who are listening who might be in leadership positions themselves and who might have people in mind that they want to uh, you know, have them consider leadership roles, uh, what would you say is some advice for them? You know, what are some of the best ways to prepare nurses when they are ready to step into that leadership role? Um and you know, maybe they do, or maybe they don't have some of the access to resources that Sutter provides, or what are your thoughts on that?

SPEAKER_01 17:06

Well, I think the first thing you can do is identify them and sit down and have a one-on-one. Um, to know that someone's thinking that they could be a leader in the future is probably possibly not even in their mind. They were just doing their job, do a great job, helping out, showing leadership qualities, but never really thought of themselves as a leader. To have that one-on-one, to sit with that individual that you can see as a diamond in the rough, is the first step. Before we talk about all the classes that Sutter has that you might not have, that one-on-one will be everything to that employee. And if you have CEUs available, we probably reach out to ACNL, they have amazing programs, and so that's another avenue to start putting that your diamond in the rough in a course that then spurs that curiosity more. And you know, that's what CEUs really are for is to go on and to develop yourself even further. And so, my advice to others that might not have the robust programs we have is sit down and have the one-on-one with that staff member. Let her go or him say, You mean me? You you think I'm I could be a leader? And let that kind of sit there and then start offering, yes, and here's a course at ACNL, here's a course over here, here's a course that we have here in our own company, and watch your leader develop and then be there for them for mentorship.

SPEAKER_00 18:48

Yes, absolutely. And um, I really uh appreciate your recommendation to look both internally and externally when it comes to these resources, uh, because if those organizations maybe don't have some, you know, some of these robust um programs available or courses available, they can reach out to groups like ACNL who do offer mentorship opportunities, who do have committees, other leadership opportunities for nurses to join, and uh targeting nurse leaders at all levels. So that's really wonderful advice. And and then of course, when you look internally, just trying to really understand what resources are available and then um really uh connecting those dots right between the leader and those different resources so that they so that they are well connected and um and so that they know what's out there.

SPEAKER_01 19:36

Well, and ACNL is amazing, and I say that because we built our nurse manager program with ACNL. So I mean it's just just an amazing organization and use the resources that are there. Um, they're valuable.

SPEAKER_00 19:55

That's great. And and I'd love to hear more about that because uh if maybe an organization or maybe nurse leaders who would like to use a similar resource with ACNL would like to use some of their management uh resources, how can they do that? Or what would you recommend?

SPEAKER_01 20:11

Oh, I we actually reached out to ACNL for our nurse manager. We knew we wanted to have a robust nurse manager program, but we wanted to be tied with ACNL so that we had the strength of ACNL who had gone through it multiple times on their own, and we could follow that program and then have them teach us. And so um that's actually how we got our nurse manager program um started here. And ACNL was here on site to help us with that.

SPEAKER_00 20:45

That's amazing. Thank you for sharing that. And uh, and that's just another way to be able to collab uh you know, collaborate with these programs and these resources that are around us and available. So that's really wonderful to hear. And I was also curious in terms of your own leadership journey. I'm I'm interested in um whether you can share maybe what has kept you going throughout all of um this time as a nurse leader. What what are maybe some of your favorite experiences or or what do you enjoy most about leadership?

SPEAKER_01 21:17

Oh wow. Um I have to tell you what I love today about nursing leadership is growing the next. I always tease people to say, my job is to uh develop and grow somebody who can take my job. Um and to watch somebody grow and hasn't taken my job yet, but but actually becomes a VP of something or becomes you know a researcher because we gave them you've got this, you can do this, let's drive this. Um for me, that just is everything at the Stage. Um, almost paying it back to the people who gave it to me. Um, and to be sitting here, that responsibility is huge, but it's also one of my greatest things that I get to wake up in the morning and be able to provide that for others and watch them grow. It's it's the best.

SPEAKER_00 22:24

I completely resonate and thank you for sharing because that is a really beautiful part of leadership that is uh is a very unique part of the leadership role, I would say, is uh, you know, just taking what you've shared earlier about identifying those um potential leaders, um, really connecting them to some of these resources, being able to help them in in some cases, and maybe seeing their work, seeing them grow and then seeing them advance to the next stage. Uh, it sounds like an incredibly rewarding um opportunity as a nurse leader. It definitely is. Yes, and I would and I would uh say that as someone who's also a nurse leader myself, uh that has also been one of my biggest joys in leadership is uh being able to, you know, nurture some of these uh these um nurses who have great potential and and also helping them to see what they might not have seen in themselves. And it's and it in turn it creates a huge ripple effect in the in the not just the organization, but I would say in nursing as an industry.

SPEAKER_01 23:29

I I agree with you. I mean, nurses want to work where their work has greater purpose, where they're making a difference and where they're seeing. When we stop and think about that, that's really our role. Our role is to give our nurses the ability to grow, to make a difference. And really, our mission at Center Health is patient first, but people always. And if we're driving that every single day, that is influencing.

SPEAKER_00 24:04

Yes, I love that. Thank you for sharing that. It's uh it is uh an important uh connection for nurses to be tied with purpose, and that absolutely exists within leadership as well. And I do want to also talk about, you know, when we think about the pipeline, we talked about the beginning of the pipeline with nursing school, a little bit about juring when they're in their organizations and working, advancing in organizations just like Sutter, which has uh different resources. And when we think about maybe the end of the pipeline, maybe we think about retirement, but we know that a lot of the time when it comes to nurses, retirement's not often the end of their work as a nurse, you know, to be honest. And and so, you know, nurses can become mentors, they could become thought leaders, they could join organizations like ACNL. But what are some ways that organizations can be part of that transition uh for nurses, part of that pipeline, and help outgoing nurse leaders to stay connected?

SPEAKER_01 25:06

Well, yes, you named several. I think another avenue that we're gonna be seeing, and we are seeing already, is really our virtual programs, right? And so we think about virtual ISU, um, and we think about our nurses that are ready, not quite for retirement, but that 12-hour shift is just too much anymore. And to be able to use that skill set, which is years of being in the ISU, and to have that mentor for a new, we just talked about this mentorship that we're doing with so you can go into ISU, but you have that buddy that's there for you when you need it. Uh, and it it it's those programs that I sit there and think about how wonderful is it that I can, I'm a new nurse and yet I'm not quite sure what I want to. I can reach out to my virtual ICU nurse and say, hey, I'm I'm gonna give this. How what do you think? Yep, you're good. Let's I'll I'll stand by with you. And so huge opportunities for us in a virtual sense to help our uh staff at the local levels. Um, and then mentoring, and we can't say enough about mentoring and education uh and being able to provide that um for all our patients as well as our teams.

SPEAKER_00 26:36

Absolutely. And I'm so glad that you mentioned the current landscape with opportunities within virtual nursing, because the nursing profession just continues to become more dynamic and it continues to evolve as the years go by, and as our settings also increase where we could take care of patient populations or offer our expertise. So uh I do think it's a great opportunity to think about virtual nursing and how nurses of all levels can be involved, but especially nurses who uh are maybe outgoing from their clinical roles in an organization doing maybe direct patient care, but can also still expand that through virtual nursing and then also acting as a mentor.

SPEAKER_01 27:16

Exactly.

SPEAKER_00 27:18

Yes, it's it's uh an exciting part of nursing because it's a profession that will always be so interesting, always be so dynamic, and and there's a lot that nurse leaders can do as well. Yes. And you know, as we wrap up our conversation, I feel like there's just so much that we could talk about when it comes to the nursing leadership pipeline, but I wanted to give you the floor just to share any final words of wisdom, any final, you know, uh concepts, comments that you want to share when it comes to nurse leadership, our leadership pipeline, or anything else that comes to mind on the topic.

SPEAKER_01 27:55

I think the first thing I would think about is um nursing engagement is so important. Um and we we take um different EOW scores and different things like that. But when I think about our nursing engagement here at Sutter Health, and we were 73% and last year we were 81%. That's because of the listening. It's because of the transparency and the communication to our teams. It's the inclusion and belonging for all of our teams, and really ensuring that we're caring for each other, our patients, that strong sense of purpose and driving to be the best place to work has been huge for us. Uh, and really to say to every nurse out there, you pick the best profession you could think of. And be curious, uh, keep reaching, uh leaders, one-on-ones, ensure that you see that that new leader that's going to come in, because there'll be a dynamo when you do.

SPEAKER_00 29:07

Yes, absolutely. And it's it's like how you mentioned that uh, you know, the that motto of of um always focusing on people and all those components of whether it's identifying or listening or really connecting and and um using those insights, using the feedback to make the environment better and to really connect uh with the nurses of our future. Yes, and I'm excited for their journey. Yes, absolutely. Well, I just wanted to say congratulations to you and to Sutter for such amazing outcomes and for sharing about your leadership journey as well as the support that Sutter provides for um nurses in your organization. And uh any final thoughts before we but before we end our um conversation for today?

SPEAKER_01 29:57

I think my last final thoughts is that we don't have to do it alone. Um ACNL is there for us. Um I'll have my email out, um, reach out to support people. Um, but really um this is not something any of us should do alone. The nursing community is strong and we have the ability to share our information so that we can make it stronger.

SPEAKER_00 30:28

Absolutely. And thank you so much, Kat, for joining us today and for sharing your wisdom and nursing leadership. Thank you. Our guest today was Kat Asensio Holmes, Chief Nursing Officer for Sutter Health. We would love to hear your feedback. Email us at social media at acnl.org and connect with us on LinkedIn and Facebook at ACNLNurse. And as always, if you like the show, please remember to rate, review, and share. ACNL in Action is presented by the Association of California Nurse Leaders with new episodes on the first Friday of every month. To learn more about the show or ACNL in general, visit us at acnl.org. Thank you for listening.