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During my second round of Chief Nurse Officer interviews at Children’s Hospital New Orleans, I was fortunate enough to be interviewed by a group of clinical nurses. The nurses shared an unwavering commitment to the organization and a deep desire to see organizational change. I have been fortunate enough to work for some amazing organizations and benefitted from talented professional mentors, so I was familiar with organizational characteristics that I valued as a nurse. On the ride to the airport after my interviews, I used my phone to do a search on culture change and healthcare. I quickly surveyed the resulting titles and ordered a couple of books from Amazon. A week later I received an offer and accepted the position. The start of a remarkable journey was just around the corner.

January 1, 2017 was my first day as the Chief Nursing Officer at Children’s Hospital New Orleans. I was excited to get started! I reflect on my first few months and realize that I was completing high-priority tactical issues: get positions approved, reorganize the new graduate training program, and order needed equipment. I also wore scrubs and visited all clinical sites on all shifts. I wanted to ensure I was focusing on the needs most important to the frontline team members who were delivering patient care. I am attaining a Doctor of Nursing Science degree at Louisiana State University Health Sciences Center with a research focus on the nursing professional practice environment impact on pediatric acute care outcomes. My interest in the nursing professional practice environment guided much of the work as a nurse executive.

One weekend, I read one of the books I purchased a few months ago and was struck at the similarities between the fictional organization depicted in The Florence Prescription and the actual organization of Children’s Hospital New Orleans. I brought the book to one of my Senior Directors to read and, based on her enthusiasm, I decided to use the book as the foundation for my first nursing leadership retreat. The outcome from that retreat was to initiate two actions highlighted in Building a Culture of Ownership: The Pickle Pledge and “Proceed Until Apprehended.” Decorated pickle jars started showing up on the patient care units—one unit even created a pickle tree—and team members started reminding each other to focus on solutions and to halt toxic emotional energy. “Proceed Until Apprehended” was a frequently used rallying cry as staff sought to solve workplace issues. Children’s Hospital New Orleans was moving away from a command-and-control management style to an organization that embraced transformational leadership and supported staff to be their best selves as they worked to meet the needs of our patients.

In the backdrop of the culture work we were doing in nursing, Children’s Hospital New Orleans was also going through executive leadership changes. It was the perfect intersection of opportunity and timing when our new Chief Executive Officer, John Nickens IV, ...

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