Nursing Executive: Interview with Myrna Allen, RN, MSN
Building a new hospital from the ground up
Chief Nursing Officer/Chief Operations Officer
Martin Luther King, Jr. Community Hospital (Opening Spring 2015)
Please give us an overview of your nursing career.
I started my career in Iowa as a diploma nurse, but have spent almost my entire career in California. I have a master’s in nursing administration from UCSF as well as a BSN and a bachelor’s degree in healthcare.
Clinically, I spent many years in perioperative services, from trauma and transplants to serving as an OR staff nurse. My responsibilities expanded into directorships of operating rooms and cath labs. I’ve also worked as a chief nursing officer (CNO) and chief operations officer (COO) in various healthcare environments.
Over the course of my career, I’ve received two official appointments from past governors of California. In the first case, I was appointed to the California Board of Registered Nursing. On the second occasion, I was appointed to serve on a committee charged with overseeing Medi-Cal managed care contracts and per diem rates for hospitals throughout the state.
I’ve run my own business as a healthcare consultant, working with 40 hospital clients on regulatory issues, Title 22 and state and federal regulations. I’ve also served as a healthcare industry lobbyist at the state level.
In between all of that, I’ve taken part in more than eight surgical mission trips to Mexico, Russia and India. I’ve been fortunate to travel with a physician group out of San Diego that performs cleft lip and cleft palate reconstructive surgery. Besides being very rewarding, it’s a reminder of how fortunate we are to have a healthcare system that provides care to one and all.
How did you come to be the CNO and COO of Martin Luther King, Jr. Community Hospital?
In 2012, I was working with a consulting firm that was brought in to provide input on plans being drawn up for the new facility. I came back to the hospital campus in April 2014 as a consultant and was offered a permanent position. The opportunity to serve as COO and CNO of a brand-new hospital was too good to pass up, so I accepted.
Due to my work as a professional consultant to hospitals, I’ve seen how successful hospitals operate, how regulation impacts them and how solid leadership is a key to success. I wanted to be part of that process and the ability to do so at Martin Luther King, Jr. Community Hospital allowed me to put all of these good ideas and processes in place. It was a clean slate.
What is it like to be involved in the creation of a brand-new hospital facility?
Many existing facilities open up new service lines, but we’re actually starting from scratch. The county built this wonderful new facility and the clinical team is designing the entire patient care process.
We’re going to be paperless when we open the hospital and we’ve built an electronic medical record system to make that possible. We’ve also had many best practices built into the medical records so that critical issues are addressed from the start, including patient satisfaction, infection rates, etc.
We’ve had a great talent pool from which to build our team and we’ve hired some very smart people. You can always find talented clinicians with good resumes, but what you really need are individuals who have passion for the art of nursing and excel at out-of-the-box thinking.
We’ve asked our staff, “If you were queen/king for a day, how would you do things?” From there, we’ve created our vision: to be a leading model of innovative, collaborative community healthcare.
How will you facilitate communication among the staff?
“Silos,” where everyone focuses on their specific area with little regard for the other parts of the system, are the worst thing that can happen within any organization. We have established multidisciplinary committees because in this day and age, you can’t make an independent decision without somehow impacting everyone else.
We’ve also partnered with UCLA and others so that we will have 24/7 physician coverage. That is a big draw for our nurses. Our hospitalists, laborists and intensivists will be available at all times, facilitating communication, collaboration and rapid response. We will also have a full complement of physicians staffing our emergency department.
How do you make the shift from a unit-based clinical mindset to that of a manager with C-level responsibility?
It all started in my perioperative work. Nursing care was evolving and I was in the appropriate place to pursue a master’s degree in nursing administration. That provided me with the broad educational preparation required to move successfully into management.
I learned how to understand and manage the financial side of running a department, a hospital or a large service line within a hospital. This also helped me to understand how contracting is handled with payer sources and how the finances are managed across an entire hospital, not just at the unit level. As nurses, we must be logical, thoughtful and flexible in this regard.
To me, it’s a matter of reframing your approach and learning to think broadly at the executive level rather than from the perspective of a single unit. Sometimes, you need to look beyond the clinical level to see the bigger picture. I wanted to expand my vision to include an understanding of the jobs that need to be created, the processes that must to be put in place and what best practices should be adopted in the facility.
How do you transmit the values of the organization to the people you hire?
I’m in a position to help create the culture and values of the organization from the ground up. Those values include caring, collaboration, respect, accountability and excellence. Our values are driving the interview process, the development of policies and procedures and the way we build the technology of the hospital. We review these values on a daily basis.
We looked closely at the talent pool and made sure that the individuals that we were going to hire could serve as role models for the best possible collaborative patient care the hospital could offer the community. We asked candidates, “Are you a caring person? Can you show respect? Do you strive for excellence?”
All of the staff members I’ve hired are committed to enacting best practices and a positive organizational culture.
How will you measure employee satisfaction?
We’re working on those strategies now and they will be in place by the time we open. We already have a plan for a dietary department that will be health-friendly. We have a walking club that meets at 3 p.m. every day and we’re putting other strategies in place as our staff comes on board.
We also have a large, Zen-style healing garden within the walls of the hospital. This is a place where patients, visitors, families and
We’ll be providing six or seven weeks of orientation and training for new staff. Before stepping onto the patient care units, our staff will know everything they need to succeed. They’ll have confidence in the management system and they’ll be able to see how things are functioning correctly. Plus, we have the opportunity to gather good ideas that will help all of us to succeed and thrive.
Employee satisfaction is key and we’re sure that the staff are going to be very happy working here. It is and will be a functional and beautiful place. We’re committed to staying cognizant of employee satisfaction and making sure that our processes are working for our employees and our patients.
Right now, we have 60 employees and we’ll have about 400 when we open in the spring.
How would you advise nurses who are interested in pursuing management and executive positions?
I would say that they should pursue a master’s degree if they want to compete for a job such as mine. This level of education allows you to perceive the broader picture of the healthcare industry. I also recommend seeking out a mentor when you land your first post-graduate management position. A mentor’s added guidance will steer you in the right direction; it is invaluable.
Can nurses without a master’s degree pursue management positions?
Yes, some nurses have a great deal of experience despite not having a master’s degree, which definitely counts. If you want every opportunity that could possibly be open to you, volunteer in areas that will serve you once you begin seeking positions in management and upper-level leadership.
I also recommend studying the regulations in our industry and state. California has many regulations governing the qualifications required of people who run hospital organizations. Understand the scope of practice and the parameters within which you’ll need to serve.
If you have an interest in moving up through the ranks of management, I recommend joining committees and getting exposed to other aspects of the organization. Committees involving budgetary issues, best practices, ethics and quality improvement are wonderful places to increase your understanding and involvement.
You can also choose to float to other parts of the facility in order to observe how various departments and units function. For some nurses, it’s just a matter of taking a chance and moving beyond their comfort levels. Be open to ideas; learn everything that you can; and broaden your base of skill, knowledge and experience.
What professional vision do you have for your future?
I’ve served in various chief executive roles and I know that I most love to serve in the area of operations. I’m a happy camper right now — this is such a wonderful opportunity for me. There’s so much to do and to learn.
What I love about my current position is that there are so many balls in the air. We have to make the right decisions; hire the right people; build a logical, flexible system; and maintain a sense of the bigger picture. It’s very exciting.
Lastly, I need to think about succession planning because none of us will be here forever. I can serve as a role model and mentor my own staff to be the leaders of the future.
Keith Carlson, RN, BSN, CPC, NC-BC, has worked as a nurse since 1996 and has maintained the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students at www.nursekeith.com.
This article is from workingnurse.com.