Kimberly Long 0:00

Hello, everyone. We are fortunate to have Dr. Cheryl Riking here with us. She's the Chief Nursing Officer at El Camino Hospital here in California. Welcome, Dr. Rinking.

Cheryl Reinking 0:12

Thank you so much for having me today.

Kimberly Long 0:14

Yeah, I am glad that we were able to get some of your time. I wanted to pose a few questions to see if we could get some of your expertise in some areas, but I wanted to start out first asking if you can walk us through your journey to executive level leadership and then outline some of the defining moments that might have shaped your trajectory.

Cheryl Reinking 0:33

That's a great question. And I've been here at El Camino Health for 38 years. And I started here at El Camino Health as almost a new graduate. I had six months of experience back in Illinois. And so I started on the night shift as a med search nurse 38 years ago. And then had opportunities to grow and develop at El Camino Health through the years. And one thing I would say that really were defining moments for me, were and what prompted me to get into leadership, I would say, is some clinical moments where I felt like potentially if I had more influence on decision making and on a practice in my organization, that some of those clinical difficulties, whether it be resources, workarounds we always have to do in nursing, if I had more opportunity to influence those outcomes, that perhaps it would make me more fulfilled as a nurse. Then I went and got my master's degree. And that was in the early 90s. And I began my first clinical manager role in 1994, actually. And then through the years had the opportunity to grow and develop at El Camino Health. And honestly, really translating those clinical values I had and the education I obtained to spread those across the organization and try to build trust in all the groups I interact with. That's really key, I think. The bedside nurses, union leadership, other C-suite peers, regulators. It's really the muscle I had to build over my career and my trajectory. And nobody actually teaches you that explicitly, by the way. You have to have your lived experience as a leader. And I had that here at El Camino. You know, I really feel blessed that I've been able to spin my career here, grow and develop here, build that muscle here so I could make a real difference here at El Camino. And honestly, how that's all culminated, I would say, is earlier this year in reaching our fifth magnet designation. That's really the cherry on top because what Magnet says to me is that we have put the structures and processes in place that are evidence-based that indicate we have the highest level of nursing care and patient outcomes. And we first got our first designation in 2005, and here we are all these years later, and we're up to our fifth designation. And it's really a real sense of pride, not just for my own journey, but for El Camino Health nursing in its whole life.

Kimberly Long 3:23

And you know that attests to your leadership and the ability to create a structure that is sustainable. And I commend you for that. And I celebrate you and the nursing professionals in your organization for the accomplishment of maintaining Magnet for sounds like over 20 years. That is phenomenal. In talking about sustainability and infrastructure, we have to work very closely with academia in order to sufficiently prepare nurses to function as nurse professionals in the healthcare setting. From your perspective, what are the greatest opportunities to strengthen the alignment between service and academia?

Cheryl Reinking 4:04

No, there is a bit of a competency lag we've noticed here at All Communal Health with the new graduate nurses. And the nursing curricula are, I think, still training nurses, at least from our perspective, that in a little bit of an old-fashioned way. And boy, our clinical practice environments are changing rapidly. And I really feel like with the pace of the acuity of our patients and the advanced age of our patients, so incredibly complex. The technology, the pace of needing to understand the coordination of care for our patients, that's just really rapidly changed over the last few years. And I think if our academic partners and our health systems did more partnering around some of those areas of how can we practice, help academia prepare these new graduate nurses through their curricula to be more prepared. We understand, can't be fully prepared, to face these complex care environments that they're going to be facing when they graduate. And of course, the second thing I think about is the use of data. I think that's another way we could partner with our academic partners. And that is we have a plethora of data here at hospitals, operational data, turnover data, quality data, patient experience data. And, you know, I think what academia has is they have research rigor. And often service hospitals are looking for someone who can help them with looking at their data and helping to identify opportunities for improvement and doing research together. So that's where I think we could partner more too with academia is how can we work together with this data so that our academic partners were kind of providing us with that research piece while we help to continue to prepare their students in facing the healthcare environment that they are going to be facing when they graduate. And I just think that would be something we could work on together and improve, not only helping the hospital to achieve its goals and partnering there, but also the new students where we could help them prepare even more for this complexity that the new graduates are going to face.

Kimberly Long 6:29

Oh, that is absolutely factual. I agree with you 100%. And, you know, with everything that's going on with healthcare and changes and reimbursement and things like that, along with what you just described, we have so many competing priorities. How do you, in your experience, navigate those?

Cheryl Reinking 6:49

Yeah, it's really a challenge, competing priorities. And no, in my world, what I try to prioritize the most is our workforce. And because if we don't have a top-notch workforce, everything else follows that. Patient outcomes, joint commission, regulation, compliance, all of those kinds of outcomes and initiatives are can't happen without a really solid workforce. So that's always what I've been prioritizing in my organization. And I've done a lot around retention this past number of years. And I'm proud to say that we've done many things over the past few years. And I really think this is a way in which we know that cost is so important, like you said, Kimberly, and containing costs, and there's changes in reimbursement. But again, what I like to say to my leaders is that look at I think that if we invest in our workforce, everything else will follow. And that's why this focus on turnover. Now we have brought our turnover down over this past year to 4.4%. And nationally it's still 17.7%. Now we've done this through a lot of ways, but you can you imagine how much cost that's saved on turnover? We know how much it is to turn over a nurse in the state of California. And so really retaining nurses is essential to containing costs and investing in our nurses. And that's why I was able to bring in a nurse retention specialist here at El Camino, whose role is to help us to retain our nurses and build career paths for our nurses so they stay at El Camino. And we've seen our since 2022, our turnover rate drop by 60%. And honestly, I think it is because of our nurse retention specialists and some of the things she's doing, but also other investments we've made into our nursing workforce, like creating transition programs for change of specialty. And shared governance is so essential to ensure the nurses have their voice from the bedside all the way to the boardroom and that their voice is heard and that they have opportunity to have input into practice changes and having those structures in place where nurses can really be leaders on their units and make changes. That's my dream, and that's what I had dreamed of 38 years ago. And I'm really proud to see it coming to fruition.

Kimberly Long 9:18

That is phenomenal. And you mentioned the nursing voice. Now we have a lot of legislation and regulations that impact nursing and healthcare that really don't have the nursing professional voice there. How would you recommend that we can more effectively influence legislation and regulatory decisions that impact nursing and healthcare?

Cheryl Reinking 9:46

I've learned a lot about this from our government relations officer here at El Camino Health. And it all starts with data, of course. When we want to impact our legislature, we can't just say, well, we feel like this should be different. We know that's where we have to start. And you can't walk into a legislator's office without some real facts backed up by evidence. It's just like our profession, of course. But also we need a coalition. It's not a single voice, it's not a solo voice. And so that's why I really try to get the nurses that I interact with to belong to professional organizations that have the voice for us, like ACNL, like AONL, like our California Hospital Association colleagues, and all of those professional organizations who can gather that data, aggregate it for us, represent nursing, and take it to the hill and represent us. And I do have to say that I did have an opportunity to influence legislation most recently. Our government relations person who represents us at El Camino Health and in the CHA said, Cheryl, there's this new legislation about ratios and fines and things like that. So he came to me and he said, and this is what the language is right now. What do you think? And I said, you know, I think this can be different and it would have more meaning for us. And I explained what my thoughts were. And believe it or not, they accepted that into the bill. So that's where I felt like he took some expertise, some subject matter expertise, built that into the bill, took it back to the CHA, where they helped create that and make those changes that got adopted in California. So there's a great example of subject matter expertise. It's very helpful. And as long as you have the structure in place to get your voice, get nursing's voice, get your voice heard, boy, great things can happen.

Kimberly Long 11:51

Oh, that is just phenomenal. And I I again want to commend you for all of the success that you've realized and how you made your dream and aspiration about nursing manifest at El Camino Health. Thank you so much for taking the time to share all of that with us. And I just want to express my personal appreciation for you sharing your expertise and experience with us today. So thank you so very much.

Cheryl Reinking 12:17

Oh, thank you. It was a pleasure to be here. And I'm just so happy to share my story and some of my thoughts with the rest of the nursing leaders in California.

Kimberly Long 12:26

Thank you.