My Specialty

Respiratory Telemetry Nursing, Doug Robinson, USC Arcadia Hospital

Leading a close-knit unit through the COVID-19 crisis and beyond

Male nurse wearing a mask and white coat addresses his team of nurses circled around him.

Doug Robinson, RN, MSN
Nursing Manager
4-North Respiratory Telemetry Unit
USC Arcadia Hospital

Please share with us the arc of your nursing career.

My journey began in the Seattle area. After I had some experience under my belt, I accepted a travel nursing assignment in the ICU, which brought me to Southern California.

After years of working in ICU, I ventured into medical sales, specific to the wound care market. I never really felt like I was selling because I had used the products in my own practice and was able to draw on my nursing experience and my experience with patient education. This part of the journey also allowed me to travel all over the country, including to Puerto Rico.

Eventually, I decided I wanted to pursue a graduate degree in nursing. Originally, I meant to focus my master’s degree on education, but because I found myself in many leadership roles throughout my career and found satisfaction in that work, I changed my focus to leadership.

Tell us about your unit.

The 4-North (4N) respiratory telemetry unit is a busy 40-bed unit that focuses on patients presenting with a primary respiratory issue. Many respiratory patients have multi-organ system failures and multiple comorbidities, like renal failure needing dialysis. It’s common for them to be on ventilators and have tracheostomies or gastric tubes. Thus, these patients tend to be high-acuity and need assistance with their activities of daily life.

What brought you to this particular unit and nursing specialty?

I was very familiar with the care of patients on ventilators, so this unit was a natural fit. And, honestly, throughout my career, I’ve always been at the right place at the right time.

How did the COVID-19 pandemic impact your unit?

My unit, 4N, was basically the epicenter for treating the COVID-19 medical-surgical population at USC Arcadia Hospital. It was a very challenging time for the staff. As the leader of this unit, I was committed to being visible and present with my staff and patients. Conducting daily huddles for both shifts helped all employees know they were supported.

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I’ve never been in a war, but you hear about the camaraderie that soldiers develop in the trenches, and I believe we had a similar experience with COVID-19. My staff excelled, and this ongoing emergency situation made the team very tight. Everyone looked after each other, feeling supported by the larger facility.

What is your philosophy or approach as a nurse leader?

I can always draw on the example of people who have been effective leaders for me. What’s important is showing that you genuinely care about your team, the patients, and the work. I’m passionate about patient care, and I lead from that perspective.

So many things come at us and our staff. I try to bring focus to specific things. For instance, this week we might focus on HCAHPS scores. You’re always spinning so many plates, but you must help guide staff to focus on what’s important.

Effective leadership builds teams and empowers staff to have a voice, and I encourage this on my unit. I look for opportunities to regularly recognize staff members for the great things they’re doing that impact our environment and patient care. Finding creative ways to recognize people for doing what’s right is so important.

What are characteristics that you look for in nurses who work on your unit?

Beyond appropriate education and clinical skills, one thing that’s very important is that someone be warm and engaging. I ask myself, “How is this person going to connect with patients and colleagues?”

As nurses, we think a lot about tasks, but what patients really want is to feel cared for. If you can find nurses who display emotional and relational intelligence, good communication, and a caring and compassionate personality, that goes a long way.

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What’s important to consider when it comes to nurse retention?

Anything we can do to foster an environment where staff members like and care about each other is crucial. Everyone needs and deserves a sense of belonging. Many of our nurses are established locally, which is part of the charm of this community. There’s a sense of family. The people on my unit who have stayed over the long term have tight relationships with one another.

Are there any emerging healthcare technologies that you are excited about?

Nurses should definitely be much more involved in the development and testing of new technologies. Many times, technologies and devices are developed by individuals who aren’t clinicians. When a new technology is introduced to the clinical environment and doesn’t quite work as intended, it disrupts the workflow and can result in nurses having to come up with workarounds that would have otherwise been unnecessary.

Nurses shouldn’t have to change the way they practice in order to make up for new technologies’ shortcomings. Instead, we need more nurse entrepreneurs and companies that involve nurses in the design and development right from the start. We’d end up with much better outcomes and save a lot of money, time, resources, and headaches for everyone involved.

Do you have any future career plans or educational goals you’d like to share at this time?

I don’t think so, but then I didn’t originally plan to go back for an MSN degree. You never know where your journey will take you, and opportunities arise all the time in nursing.

What do you feel is at the center of who you are as a nurse?

For me, it all boils down to people and relationships. I love feeling that I’m making a difference and helping, whether it be with a patient or with a staff member’s career development. Like any leader, I can get caught up in scheduling and other minutiae, but I really like to have the opportunity to be present and visible on the unit with my team.

The other day, I went in to see a patient during my rounds, and she told me that she had come back from a procedure and was feeling nauseous. I made the simple offer of a cup of peppermint tea, and I could tell she really appreciated that caring human touch. I could have just checked her off my list, but it felt good to take the time to connect authentically. After all, that connection is what nursing’s all about.


KEITH CARLSON, RN, BSN, NC-BC, has worked as a nurse since 1996 and offers expert professional coaching at www.nursekeith.com.


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