Amber Bratton started missing HCA Houston Healthcare almost immediately. After all, it was the place that gave her a job right out of nursing school. It’s also where she honed her skills in childbirth care, and it’s where she forged lifelong friendships. Perhaps most importantly, it’s where she felt supported. HCA Houston Healthcare gave Bratton a voice, and on her first day at a new job, she realized she no longer had that voice.
“The first day I stepped foot in another hospital, I knew I didn’t belong there,” she says.
Fortunately, she had a chance to return. Bratton kept in touch with the nurses and doctors she was proud to call colleagues, and just a few months after leaving, she returned to HCA Houston Healthcare and never looked back. As a Labor and Care Delivery Director, she has spent the last year-and-a-half managing the care of countless Houston mothers. And, because she has a voice, she’s been able to do it all during a pandemic.
Bratton’s story is a testament to the tight-knit community cultivated at every HCA Houston Healthcare facility. Because the family of hospitals is committed to equipping and empowering every nurse who walks through the doors, they were prepared for the pandemic and each of its surges. The team at HCA Houston Healthcare is proof positive of that commitment.
“We made adjustments to ensure our nurses could be resilient, and a big part of resilience is taking care of yourself,” says Lisa Greer, director of clinical education at HCA Houston Healthcare. “We want every single one of our nurses to know you are not alone. You have a voice.”
When Greer was beginning her career, nursing was, in her words, “very task-based.” As such, nurses were given the skills they needed to succeed that day. It was fine training, but compared to today, there wasn’t nearly as much focus on each nurse’s career. Now, at HCA Houston Healthcare, nurses like Bratton can join specialized programs for working in the ICU or helping mothers deliver their babies. Furthermore, while engaging in the specialty of their choice, each nurse can learn from a seasoned mentor. It helps that the family of hospitals is home to a program called Specialty Training Apprenticeship for Registered Nurses, most commonly known as StaRN.
The StaRN program, which is overseen by Greer, has been key to the care HCA Houston Healthcare has provided its nurses during the pandemic.
“We have a team solely devoted to nursing residents for the first year, year-and-a-half of their career,” says Greer. “My team follows them and keeps in close contact, constantly making sure they have what they need to succeed.”
To that end, Greer’s team meets with nurses in the StaRN program once a week just to see how they’re doing. These meetings also help the nurses see how they are progressing, and through in-depth conversations, nurses just beginning their career learn how to navigate any challenges they may face. However, that compassionate support doesn’t stop when nurses graduate from the StaRN program. Greer’s team keeps in contact with the nurses they mentor, offering one-on-one meetings, classes, and other opportunities for professional growth.
None of this changed during the COVID-19 pandemic. Sure, many meetings went virtual, and the leaders of the StaRN program followed strict safety protocols to keep everyone safe. If anything, Greer and her team focused even more on the care they provide their nurses.
“Self-care was a major theme of 2020,” she says. “Topics like ethics, time management, stress management, and self-care have always played big parts in our program, but this past year, self-care became even more important. This is our family, and we believe we have a moral obligation to make sure every member of our family has everything they need to be healthy.”
At the start of the pandemic, Greer and her colleagues witnessed firsthand how people across the world were rallying around nurses and other healthcare professionals. Strangers were bringing meals to hospitals, and in practically every corner of the world, nurses were being hailed as “heroes.” Over time, as pandemic fatigue set in, this outpouring of support eventually waned. Yet, according to Greer, her nurses’ passion is still strong.
That’s largely because of the support provided by programs like hers. Nurses at HCA Houston Healthcare aren’t just given time to rest; they are actively encouraged to take it. Alongside their fellow leaders in the Gulf Coast and throughout the Houston area, Greer and her team foster a culture where taking time to pause and take care of yourself and your loved ones is not a rarity, it’s the norm.
“I have a lot of nurses who tell me they never needed the ‘hero’ label,” Greer says. “They say, ‘I’m not a hero; I’m just doing what I was called to do.’ I like to think we play a big part in sustaining that passion.”
Likewise, Greer is quick to refute the narrative that nurses are in some way “broken.” Amidst reports of nurses leaving the profession, she is proud to be a part of a program—and an entire family of hospitals—that centers the nurse’s experience every step of their career.
“Nurses are not broken,” she says. “They’re tired, of course, but they’re not broken. We’re still here. We’re still a strong, loving family.”
And in this particular family everyone is heard. Specifically, HCA Houston Healthcare has implemented shared governance: nurses are part of councils, and as such, they have a say in how the hospital is run.
According to Kelli Nations, HCA Houston Healthcare’s chief nurse executive in the Gulf Coast Division, those councils played a key role in implementing COVID-19 protocols that kept nurses safe and comfortable.
“In the first six months of the pandemic, when everything was new to all of us, we used those councils as a touchpoint to see if everything we were doing was working,” Nations says. “It’s an amazing way to both get feedback and make sure nurses are actually heard, every step of the way.”
Throughout the pandemic, leaders like Nations have gone “behind the orange line,” meaning they walk into the care units where their nurses are performing duties. Every time she crosses that line, Nations is amazed by what she sees.
“Everyone has played a big role during this pandemic, but the nurse is the one who has been by the bedside,” she says. “They are responsible for organizing the multi-disciplinary teams that have saved so many lives.”
Both Greer and Nations have been the recipient of outstanding mentorship, and both of them have paid it forward. By Nations’ estimation, she has been a formal or informal mentor to as many as 50 people (“I like to think I have played some role in helping them be successful and getting where they are today”), and she continues to play an active role in HCA Houston Healthcare’s multiple leadership development programs.
But even after decades in the profession, Nations insists she learns just as much from her mentees as they learn from her. If anything, that’s been even more true during the pandemic.
“Every time I go behind the line, I see people changing lives,” she says. “That’s one reason why we’re so supportive of our nurses: because they inspire us.”
Together, she says, “we can have a lifetime of impact.”