Executive Nurse Leader interview with Dr. Jill Larkin

– Hello and welcome to a discussion with a key influencer for Duquesne University’s Executive Nurse Leadership and Healthcare Management track. I’m joined by University of Pittsburgh Medical Center’s Senior Director of Strategic Initiatives at the Center for Nursing Excellence, Dr. Jill Larkin. Dr. Larkin, thanks for joining us.

– Oh, thank you for having me today.

– So Jill is a Duquesne alum and one of the members on the Executive Leadership Advisory Board, so she helped shape our curriculum with real-world, practical innovations that we’ll be bringing into the curriculum. So with that in mind, tell us a little bit about how you got into your position and what the future holds for people who may be looking into this program.

– So, nursing is a great role for lots of individuals. And so, taking leadership roles in nursing requires not only the education at an academic medical center, like Duquesne and which I received my master’s and my MBA as well as my BSN prom but it’s also using that real world experience and Duquesne does that the best. So they partner with people in the real world in lots of capacities of healthcare so that you can understand as a student what is like to actually put these things into practice. So not only do they build them into their curriculum but they give you the opportunity to learn while you’re in school, the real world work.

– So do you think that that’s kind of the evolution of education and is different from where we were with college curriculum just a few years ago.

– Duquesne has always been kind of on the forefront of providing different experiences for nurses as they’ve gone through their education but the executive track that they’re building today and what we’re kicking off today is really taking it to the next level. So nurses and executive roles are continuing to grow. So we need to make sure that the executives have the educational background and support they need in order to take these jobs.

– So it’s going to be important that we talk today a lot about how COVID has really redefined and reshaped the entire medical field and the industry. So kind of looking at a 30,000 foot view with everybody being stretched so thin, physicians, doctors, hospital executives over the last year or so what are some of the gaps that were exposed by COVID?

– I actually think that COVID brought a lot to the forefront for healthcare, and several of those things are related to holing health care to the forefront of everyone’s mind. And with that, it also brings identifying those gaps. And so as you mentioned, there have been gaps that have been exposed through COVID and one of those things, it sounds so is that our patients hands healthcare field have a gap in technology. So having our patients be able to sign up for vaccines has been difficult. Our patients that are in the elderly population group don’t know how to find things on the internet and to be able to lock and register via technology. They’re counting on their family and friends to help them. So we have to find alternative ways to make sure that they get vaccinated and have the same opportunities as others. But I think that’s an important technology piece as well as telemedicine. In the past, our physicians and our nurse practitioners and others maybe held off having to tell medicine visits. They didn’t think that it really fit their practice. And today telemedicine has skyrocketed for lots of things not only for doctor’s office visits but also for sharing knowledge and care across different healthcare organizations. So that’s just two examples of technology but other things include communication strategies as well as scheduling. How do you manage your staff schedule and really allow them to participate in that but how do you know where people are? And when they’re working, scheduling systems are important part of the process as well. So technology is a big piece to the future of healthcare.

– I’m glad you talked about staffing, of course and that’s a big part of your role. And as we’re looking at an industry that has to be nimble really from the top all the way down to what’s happening on the ground level. So talk about what’s happened over the last year where just to be able to maintain the status quo keep things afloat. You had to be incredibly innovative being able to be nimble at the last second to be able to bring critical care to patients.

– I can’t say that enough, being able to turn on the dime and be able to pivot is really important especially in a state of crisis that our country was in. And so how do we do that? Innovation and setting the stage for innovation and creative ideas and sharing those ideas before that pandemic hit is important. So giving your staff and other leaders a voice during that time is important but also are the interdisciplinary teams and nursing for our healthcare organization. let a lot of those interdisciplinary teams. And they did it through working with our physician colleagues or through other experts across the system. So developing those interdisciplinary teams to be able to identify and be prepared to handle this pandemic. So that’s so important, but I think also being able to review processes as things change. So we may put something in place today that we need to change tomorrow. And so how do you do that? How do you pivot and change quickly and how do you support the staff during those times? So all of those things are very important and communication being visible, being around as leaders so that staff can see and talk to you and hear from you is really important. So all of those things are essential as part of what we found in the pandemic but I can honestly say probably innovation, listening to your team and being there for them, but also leading interdisciplinary teams is really important.

– I liked that you talked a lot about leadership so it’s not just that you have the functional knowledge in this role, but you also have to be able to get buy-in. You have to be able to have those soft skills that get people to understand that you’re not just changing for the sake of change. So what type of person does it take to be able to not only implement the program, implement the changes but also get buy-in because it’s so important.

– Yeah. I think that it’s being that authentic leader and that transformational leader both those things are important. So staff need to know that you’re going to say and do things that are good for them and be able to trust you during these times. And so doing that and preparing that and be part of that before the pandemic hits is important. So being that authentic and transformational leader prior to a crisis is just as important as act during the crisis and after the crisis. And so I think just being there and being visible is so important to them.

– You really are in your role, you wear many hats, but one of course is a liaison to the outside world. We know that during the pandemic, that supplies were critically low and you’ve probably got people working on the ground for looking at you saying, we need more help, we need more supplies. So how is it that you’re able to contact and maintain good communication with the people in the outside world who were ringing the supplies and also talking to public health officials who not only have to help your hospital, but have the whole community to look at how in your role were you able to foster that type of good relationship so that the people inside your hospital were able to get what they need?

– I work for a large academic medical center at UTMC and we were prepared ahead of time. So one of the things is good emergency management planning. And so that those supplies are available. And how that’s done is that our supply chain team really did develop partnerships prior to the pandemic. So that was in place. And so we were very ready for that. However, you also need to modify what’s going on with your practices, both at the clinical site but also as you mentioned with your partners. So, you know, one of those partners is our academic partners and being able work with them to say how can we bring students on board? What is the best student experience that we can provide? But also how can we do that in a safe way that maintains their health and the patient’s health but also maintains effective supply chain management. So there’s lots to go on when you’re thinking related to that. And so we really do need to work and partner with each other. And I think that that really this pandemic has brought that to light. So not only is it your academic medical centers but also your healthcare officials so public health and department of health the state and the federal level all are important to how we manage patient care during the pandemic and being conscious about what they’re saying but also following the science. So using evidence-based medicine, evidence-based practice to really make those decisions along with responding to what is happening at those local and federal levels.

– So I’m sure that there are a lot of people in the nursing field right now who look at your position and think I’d really like to be a part of that but obviously it’s a ton of work. So I know a lot of nurses personally who have said that they want to be able to have a role in finding solutions. They were able to see some inefficiencies in their own hospitals during COVID and think they could do something that’s better more helpful on a wide ranging scale. We’ve also seen nurses who quite frankly have been burned out and are looking to find a role where they do have a great impact but aren’t dealing with the hands-on day-to-day. So if you can talk a little bit about the type of person who needs to take on this leadership role for students who may be looking to be a part of this executive nurse leadership track.

– I think that’s a great question. And one that I’m very, very passionate about. I really think that nursing offers so many opportunities and both at the frontline level, as well as in the leadership level and more so today than have ever before, we need leaders and quality roles. We need nurse leaders and regulatory infection control, telemedicine and technology. And we need to also keep them at the bedside and the inpatient areas. So that need just doesn’t go away. So how do we work together and how do we prepare nurse leaders so that they are able to support their staff so that we can minimize burnout as well. There’s leaders that we need an education. Duquesne has several of those really good at what they do. Nursing homes, senior communities, home care, insurance division, looking at healthcare disparities, also the international world. So, you know, as you look at the nursing rules are extensive, but even more so today, we need to have legislative voices. And I think that what the pandemic has done is really unit nurses around their legislative voice. So how do we now improve those roles? And who says that? I actually heard someone say the other day is why can’t we have a president that’s a nurse? When that be a change. So as we look at this, nurses are becoming leaders in lots of areas. And so we need to not only support the nurses on the front line, but also help them through this pandemic. So just like someone that goes off to war, we’ve lost a lot of patients in this country. And so this was a internal war for us. And so how do we help these nurses and other healthcare providers or the environmental service person or whomever we’re working with? How do we help them as nurse leaders get through this pandemic and be there on the other side of this to still care for our patients whether it’s at the bedside role or whether it’s in a leadership role, we’re needed in all areas. So teaching them how to manage that stress and being able to identify that host pandemic so that we can support them is really important.

– You and I talked earlier and you mentioned that you’re still doing the bedside work even though people probably say, you’re a leader you don’t need to do this, but you’re still willing to get there and get your hands dirty, so to speak. And I think that speaks to your leadership because I think good leaders will say that they won’t do it, they won’t ask someone to do anything that they themselves wouldn’t do. So how important is it for you to still stay connected and still be a helping hand even though you’re in a leadership level?

– I think it’s really always important as a nurse leader to remember what is like every day, but also listen to your staff, really sit down and listen to them and pay attention to both their verbal and non verbal because they’re going to tell you a lot, but I can tell you that, you know, when I would round on a unit and answer a call late, you know, I think that’s so important. It keeps me connected to the patients. So no matter what job I’m in, I’m always connected to how is this going to improve patient care and how’s it going to improve the nurses role? So both of those things are always in the forefront of my mind of every decision that we make. and every decision that I help to support is how do we improve patient care and how do we improve the environment and work for the nurse because both of those things will make us more successful in healthcare and prevent errors. We’ll keep nurses at the bedside and happy about what they do every day and have them see how important their job is.

– So obviously people who are looking at this program as a possible career track, they’ve got the expertise as these are advanced degrees but it’s also important for them to understand that beyond just what they know, they’ve got a lot to learn. So what’s great about the program at Duquesne it’s not just theory. It is about real world application. So how important is it for someone like yourself and other professionals to be a part of this? So it’s not just learning something out of a book but it’s really how things are going to be applied at once they can get in their role.

– I think that is really important that nurses maybe don’t have their end goal in sight, but know what the next step is. And knowing that you can look at this program and say, Hey I want to do this because it does allow me to learn the theory and the important pieces of what I need to know, but also allows me that ability to apply it and real world and to learn from key experts whether it’s through projects and activities that are built into the curriculum, or is through investigating and talking with individuals and networking with people that I wouldn’t have done if I didn’t go back to school. So when you’re looking at, how do I learn how to be the best leader I can, and to be visionary in my world it’s really that great combination of class and theory with real world expertise. And I think that Duquesne has really done that in this curriculum by listening to their partners and counting on their partners to provide that real world knowledge so that they build the right curriculum that allows the nurse to be successful as a nurse executive.

– So once our students come out of this program the big question for them is what are the job opportunities? We have seen some industries that have ceased to exist because of the pandemic. Obviously we know that the healthcare field is not one of those. However, they may be asking themselves is there only one position like yours in a hospital and what chance do I have to get a role like that if there were so few, so you expect opportunities that executive nurse leadership to grow and given that it will be a competitive field, what do you think students can do to set themselves up?

– When I talked to new graduate nurses they say they want to be a chief nursing officer someday and that’s a great aspiration and that’s a great role. And you can have lots of experiences that will help you through that. However, as you mentioned there are a limited number of roles to that. So what is your passion and how do you connect your passion to be a leader in that world? So it could be a chief operating officer. We actually have within our health system, we have at least two or three nurses that are chief operating officers not just chief nursing officers. We have home care and hospice president that is a nurse. We have a president of, one of our hospitals who is a nurse. So the rules are there for you and for your taking and so what you need to do is actually build whatever area that you like and aspire to. You can grow and be a leader in that world. So it could be, we actually, our chief quality officer is a nurse. So all of those roles exist. You just have to decide how your career path is going to allow you to get there. So going back to school getting experiences and your area of expertise, both of those two things will help you continue to grow and have that vision of what you envision health care to be in the year, maybe 2030. So think about that and how you can move in those directions.

– That’s a great lead into the question I was about to ask. So if you think about everything that’s been accomplished in the medical field over the last year, it’s really nothing short of amazing, whether it’s kind of a removing the red tape that enable us to be more robust with telehealth. And of course, being able to develop a vaccine in such a short amount of time, but once things start to slow down and we get a tighter grip on this pandemic, there is going to be a new normal where you’re going to have to figure out what’s happening in the field and be able to adapt and adjust and be able to lead out of that. Going forward, you mentioned 2030, what is the medical field going to be like? But going forward, what do you expect to see as becoming part of the new normal?

– The new normal leads us with some things that are going to stay the same. And so the new normal one thing that has on change and will not change as we move into the future and for nurse executives is that you need to lead people. And so people are going to be important no matter what role you have, whether you’re at the bedside, whether you’re in a middle management kind of role or you’re the nurse executive, you need to lead people and you need to work with people. So building those partnerships and engaging staff, being able to keep staff on the front lines and how do you do that? How do you support them? How do you support their development? How do you help them grow and to have a voice? So nurses and other members of the team need to heal through this process. And so they need to be able to see hope for the future. So nursing executives really need to provide that hope for the future. So leading people, being that person that is able to see that there is a new normal, and that we’re going to do well and how do we do that together is really important. So they look to that nurse executive for that direction. So I think that’s one thing that won’t change. One thing that will change though, is really that nursing executives need to have an enhanced focus on getting involved in the government and advocacy road work and being that voice for nurses and patients. Physician have done that really well for a long time. Pharmacies has done that for a long time and very well. Nurses tend to just sit back. This is our time to have a voice and to be active in those roles. There are still states that don’t have nurse practitioners having full practice authority. We should have both practice authority in all of our states. Why is it that some states don’t and how do we get them to move forward? How do we have the president put nurses on committees not just positions. So we need to be able to have a voice and to begin to change the future together.

– You’ve talked so much about passion. Someone could look at your very impressive resume and all of the letters at the end of your name but going back to that passion at the end of the day what makes you so fulfilled in your job because when people are looking at the executive nurse leadership program and obviously there is a career but it has to be more than a career for them. So what really drives you?

– I really think that there’s a lot of things that drag me sometimes that it really is that one nurse that says, thank you you’ve made a difference in my career. You helped me to get that leadership role and to support me and guide me to take that next step. It’s having those partnerships that can help me get a job done. So when I need help or support, whether it’s internally or externally, I have a lot of people that I can call colleagues that will help me get the job done and to make a difference for patients. I think it really all falls into helping our communities and helping our patients every day. So it’s not a day-to-day thing that I see as actually seeing it for a big picture and saying, you know making Pittsburgh a great place to live in. It is all because we have great healthcare and so that and great jobs and so we as nurses are a part of that world, and that work that happens every day

– And finally for students looking into the executive nurse leadership and health management track. What advice do you give to them as they’re getting ready to make that decision

– Start, start by taking a class, enrolling, get involved and before you know it, you’ll be engaged and moving forward and you’ll be done and you’ll be looking for your next job in your next role. And so it took me a little while to get started to be honest with you with school, I kept thinking of waiting for the best time, and there really wasn’t a best time. There was always something else. So I decided just to start and see where it took me. So, and I haven’t stopped since. So I think it’s just getting started and taking that first step. So take a chance and check it up.

– I appreciate you taking the time with us. I know you’re incredibly busy, probably always but especially right now in the times that we’re in and so thank you so much, Dr. Larkin for sharing your insight with us.

– You’re welcome, its been my pleasure.

– Duquesne University’s online Executive Nurse Leadership and Healthcare Management track has offered at various different levels including masters and doctoral degrees and post-master’s certificate. To learn more, you can visit our website and get in contact with our enrollment advisor team today.