Madelyn "Maddy" Pearson, DNP, RN, is relatively new to Brigham Health, but she has already helped lead nursing achievements at the Boston-based organization.
Dr. Pearson, who serves as CNO and senior vice president of clinical services, joined Brigham in 2017.
Since then, she's played a key role in Brigham earning Magnet designation, the top national honor for nursing excellence. She also helped establish a CNO Cabinet that allows staff, including nurses, to voice concerns and make suggestions about workplace issues, quality and safety.
Dr. Pearson came to Brigham after serving as regional senior vice president of patient care services and CNO of Mount Sinai Health System's downtown campus in New York City.
Here, she discusses her role at Brigham, describes challenges nurses face and discloses the most effective way to combat nurse bullying.
Note: The following responses were lightly edited for length and clarity.
Question: What is the biggest issue nurses face in today's healthcare environment?
Dr. Maddy Pearson: We face pressures to reduce lengths of stay and move patients through our system. We must balance this with ensuring that we deliver the highest quality, safest care, meet our patients’ goals to their satisfaction and maintain a practice environment that is robust, collaborative and comprehensive for our care teams.
Q: Many systems offer sign-on bonuses and other incentives to attract new nurses. What recruitment and retainment efforts does Brigham make?
MP: We have a newly licensed nurse program through which nurses spend quite a bit of time in orientation learning how to work in an academic medical center and getting an unbelievable amount of support along the way. They are also exposed to different opportunities you don't usually see at orientation. [This includes] going to an intensive care unit, going to an operating room and really learn[ing] the structures and processes of the hospital. It's not only how do you take care of patients but how do you become a team member, how do you participate in committees and clinical decision-making. It's a robust orientation.
Q: In your opinion, what is the most effective way to combat nurses being bullied?
MP: Being transparent and open and honest and calling it out when you see it. Helping our providers and clinicians understand the effects [of bullying] from an individual perspective, from a safety perspective [is important], because if a nurse or provider feels bullied, they are less apt to speak up when there's a safety concern. There's a lot of evidence to support that. So really being transparent and open and honest, calling it out for what it is, educating folks [about] the effects, and understanding the root cause of that to make people understand the implications of their decisions and behaviors.
Q: What is the best way to inspire nurse leaders?
MP: Help develop them [nurses] so they participate in structures and processes and committees and develop new programs, some of them outside their scope. That will also help them see the greater impact they can have on quality and safety and the work environment for our clinicians. When new nurse leaders see they can have an impact on any one of those, it feels good. They feel as though their participation and their head and their heart have had a big say in outcomes.
Then if you can tap into their passion as to why they became a nurse — why did they enter into this field? —try and bring out their passion — did you go into a certain area of clinical practice, or does quality drive you? — and then get them involved in those areas or processes, so they can help to advance the outcomes.
Q: Workplace violence and nurse safety are hot topics right now. How does Brigham ensure a safe workplace environment?
MP: This is something that is top of mind for everyone at the Brigham. We are always assessing and looking for opportunities to make improvements in collaboration with our security colleagues. It’s critical that we have a safe environment for patients, families and staff, while also ensuring that we are accessible to patients and families.
We also have a process in place called the "SAFE response," where if a clinician feels there is escalating behavior happening or they're not comfortable, they can call a safe response, which brings resources to the bedside. That could be their supervisor, a physician, a therapist, a security officer if needed, to work through what's happening and determine the resources we need to bring [in]. Do we need to have a patient care conference to try to address any potential escalations that come forward? Those processes, when pulled together, create a robust program.
Q: You led a hospitalwide effort to achieve Magnet designation. How did you go about this?
MP: When I got here, the sources of evidence had been submitted [for the] Magnet [designation], and we were waiting to see if they needed any more information to move toward the site visit. We got notification and then scheduled the site visit. My role was to help lead us toward preparing for that site visit, which was a celebration of nursing, the inter professional team and the care we provide. The appraisers have to go everywhere [in the organization] that nursing's practiced, and it's to validate everything we put in our application [about nursing care here].
It was a phenomenal experience. I kept telling our nurses and clinicians here, "It's really so much fun. You really get to shine." We had a group of clinical nurses who served as champions and truly engaged staff throughout the Brigham as we prepared for the site visit. It was a beautiful journey, and we got our call [about being chosen for the recognition], and we had a huge party with a confetti cannon and everything. I believe our Magnet journey was transformative for the organization because the nurses, the physicians the therapists, really rallied around each other and celebrated how we provide patient care. It's still very much top of mind here at the organization. It's still very much alive. We called it "Magnet magic," and we're still living and breathing that Magnet magic every day.
Q: What is one piece of advice you would give another hospital CNO?
MP: Hold true to your values and beliefs. I think engaging in dialogue at all levels of the organization is critical. Transparency of self, of data, of what we do well, where perhaps we have opportunity, and engaging clinicals in how we move forward as a team, in my mind are critical to our success.