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After surgery and an extended stay in the trauma center, the patient was supposed to finally be in the clear. Then his heart seized up. Wasting no time, the staff at the HCA Houston Healthcare facility leapt into action. They rolled the patient into the intensive care unit (ICU), where Karen Irwin supervises a team of top-tier nurses.

“The surgeon opened him up right there at the bedside,” recalls Irwin, a nurse with more than 35 years of experience. “All of my nurses were there, handing off blood and medication. It was a team effort.”

And precisely because of that team approach, something happened that never would have occurred early in Irwin’s career.

“The surgeon turned to the nurses and asked, ‘What do you think? Is there anything else we can do?’” she recalls.

It may seem small, but interactions like that are indicative of HCA Houston Healthcare’s distinctive, caring culture. The network of hospitals focuses on amplifying the voices of nurses and equipping them with everything they need to do their jobs well while keeping happy and healthy. The result is a one-of-a-kind atmosphere where the staff, the physicians, the patients, and their families all have the best experience possible.

“Too often in healthcare we forget that the patient is someone’s mother or husband or child,” says Jenn Bowman, HCA Houston Healthcare’s division vice president of patient experience. “The service we provide isn’t just about a number on a survey or checking the box on this activity; it’s about how we take care of the individual.”

That word—“service”—is at the core of everything Irwin does as a nurse. Irwin is an often soft-spoken person, but her eyes contain years of stories—some moving, others profoundly sad. She’s the kind of person who, when she’s talking, you listen.

When Irwin started her first job as a nurse at a hospital in downtown Houston in 1985, she took on the role because she wanted to give back to her community. A lot has changed within her profession in the last three decades, but her commitment to service remains.

“When I started my career, the doctor did this, the nurse did that, and we didn’t talk much unless we had to,” Irwin says. “But that’s not the way it is anymore. The doctor–nurse relationship has changed for the better.”

“The service we provide isn’t just about a number on a survey or checking the box on this activity; it’s about how we take care of the individual.”

Jenn Bowman, MBA, BSN, Vice President of Patient Experience

At HCA Houston Healthcare facilities, Irwin says that relationship is now much more of a collaboration. Physicians, nurses, nutritionists, and specialists all convene as one team dedicated to the patient’s healing.

That collaboration has been immensely valuable throughout the pandemic, when it’s arguably been more important than ever to give patients and their families the most accurate, detailed, and up-to-date information as quickly as possible.

“Patients have a much bigger voice than they used to have,” Irwin says, “and they want their hospital stay to be highly interactive. We listen to that. We want them to be comfortable and knowledgeable about everything we’re doing—and to achieve that, we have to work together.”

Irwin is quick to point out that nurses have some impressive innate abilities: They are caring, of course, and they also have a unique gift that allows them to know when they are in the right place. That’s how Irwin knew she was a perfect fit for the ICU after a single shift in 1985.

Some seventeen years later, it’s also how she knew HCA Houston Healthcare was the perfect home for her.

“HCA Healthcare is special,” she explains. “The nurses really do have a voice, even if you are new to the team.”

In fact, Irwin says several of the newer nurses have played a key role in helping their hospitals remain resilient throughout the COVID-19 pandemic. Those nurses have advocated for safe group mixers and get-togethers outside of the hospital setting, which in turn have given all nurses a chance to relax and debrief from their tough schedules.

Irwin also notes that the network’s model of shared governance makes a big difference. Nurses are part of the same committees as administrators, which gives both parties a say in how HCA Houston Healthcare’s hospitals are run. And while the hospital system is eager to give each of its nurses plenty of influence, it also strives to equip and empower all nurses at each stage of their careers. The network prioritizes promoting from within: Irwin knows two nurses who started their careers at patients’ bedsides and are now chief nursing officers (CNOs).

“It’s one thing to say, ‘We support nurses,’ and it’s another to actually walk the walk,” says Kelli Nations, HCA Houston Healthcare’s chief nurse executive in the Gulf Coast. “We believe that true support means making sure everyone has the tools they need to do their jobs to the best of their ability.”

“We believe that true support means making sure everyone has the tools they need to do their jobs to the best of their ability.”

Kelli Nations, HCA Houston Healthcare’s Chief Nurse Executive in the Gulf Coast

To be sure, those tools include robust tech and data. But if you ask Jenn Bowman, who has been a nurse for nearly fifteen years, one of HCA Houston Healthcare’s greatest assets is the way it encourages nurses to be their authentic selves.

Bowman spends a lot of time with the young nurses who are part of the Specialty Training Apprenticeship for Registered Nurses, known as StaRN. Alongside her colleagues, Bowman helps these novice healthcare workers organize their days and become more efficient.

“I didn’t have that when I was starting my career,” Bowman notes.

During one of those conversations about efficiency, a nurse named Peter approached Bowman.

“What can I say to a family member when someone is dying?” he asked.

Bowman told the nurse that he was exactly right; they could not and would not save every single patient. But that’s why, Bowman said, it is important to be yourself.

“It’s okay to sit and cry,” she told Peter. “It’s okay to sing or pray. You can have amazing tools at your disposal, and our nurses do, but you always have to have a heart for people. That’s something every member of our team has.”

In her 36 years of nursing, Irwin has seen plenty of loss. Recently, Irwin and her team lost a 33-year-old woman with whom they had grown close.

“She had been here for a long time, and I developed a connection with her husband,” Irwin says. “I hope that made a difference.”

Whenever she experiences a loss like that, Irwin is quick to turn to her team, who she says is always there for her and every other nurse.

“That’s how we’ve made it through this pandemic,” she says. “Yes, you have bad days and you lose people, but you also have good days. You save people.”

That includes the trauma patient mentioned at the start of this story. After the surgeon turned to his nurses to ask what they thought, the team assembled a plan. Then, together, they got to work saving the man’s life.

“We’re always a team,” Irwin says. “It’s a special place to be.”

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