Well, we are in the seventh inning stretch here, my friends. Thank you so much for being here. So we've talked a lot today about teams and the dynamics of teams and how we do this. And there are critical team members of our team, our nursing team members, right? And how we move and function with our nursing colleagues and how we recruit and build that nursing team is so pivotal to the success of our GI centers that I wanted to spend just a little bit of time talking about that high-functioning nursing team. And as a practicing nurse myself, you know, what it means to be a nurse and the tenets of nursing that we should all drive our nursing practice towards in our GI centers. And so again, no financial relationships to disclose. And so to hearken to my home here, Go Blue, I think about it always as the team, the team, the team, right? We have to have careful consideration about the teams that we build and the elements that they bring together. But at the end of the day, if we have a high-functioning team who is in tune with each other, the things that we can do just drive so much great success. And I have to give my child credit because he did pick the team picture that was on there. He told me I couldn't post a football picture. So when we think about the team, though, right, what those elements that we've heard today, the things that really drive us, unity, camaraderie, collaboration, trust, open communication, psychological safety, defined roles and accountability, those are all elements that come to the team. But when they're put together in a way that they intermingle and that they are dependable with each other, you really do have a perfect dance. You should be able to watch your unit function as operatic performance, realistically. So in context, what drives nurses? And in hope that we are all here, nursing or provider, because we care about our patients, because the patient is our North Star and we are driven to do the right things and caring for health and well-being. The American Nurses Association, as well as other practice groups, including SGNA, really do focus on the safety of the patient, the quality of care, the collaboration that gets us there, and the care delivery that we are each able to bring with our unique backgrounds. And so nursing has very deep tenets of practice in it. But just as we heard in the last conversation where we talked about evidence-based medicine, nursing is really anchored in evidence-based practice also. And so as we think about those high-functioning teams in our GI areas, really anchoring to what is best practice and what are the things that drive us forward in the care of our endoscopy and GI patients, and how we use those best practice tenets, how we use those quality indicators, how we use those quality improvement programs and projects that we've just spent so much time talking about to drive our practice forward. And that's really where nursing comes in. And that is a basic tenet of nursing practice. And so the scope and standards for nursing are to ideally work up to the top of their licensure, whether it's a registered nurse, an LPN, a master's prepared nurse, a doctorally prepared nurse. Everyone in that scope and span has things that are within their realm of control and expertise that they can do to bring to the table to enhance that care of the GI patient within our practice. So building that nursing team to drive your practice is really critical. So careful consideration of the needs of the practice, careful consideration of your regulatory requirements, your state requirements versus national, and very importantly, the skills and the personality potential that comes together with each of those. Your nursing and your support team should really be a ballet of congruence. And whether we're talking about the roles of each person that comes to the table and how we define them, or we're talking about what it looks like to interact with our partners in care, clerical, physician, housekeeping, anesthesia, we have to bring our best selves to that, again, and what we know best. So when we build those teams and we think about the things that we need in our practice, the collaboration between your nursing leader and your medical director, your other partners, really understand what the needs are of your unit and of your department. What do we want it to look like? Define those roles and responsibilities because that is going to help us drive a high-performing and high-functioning team. Your recruitment strategies are really important. Making sure people understand when they're interviewing and wanting to come and join your unit that you have a high-functioning team, that you have expectations of performance, and making sure there's alignment early on, that they identify that that is something that they want to be part of so that you're not bringing people on board who don't want to be part of what excellence can look like. We want to make sure that we foster training and development and that we have very clear plans about what onboarding looks like and continuous learning looks like. We want to know that we have compliance and safety at the forefront. Whether you're a joint commission, whether you're another regulatory body, your internal regulatory work, your state work, do we have safety and regulatory in hand with our staff and can they speak to it? Are they able to identify what that means for our patients? Your nursing team is going to be great partners if you have clinical engineering, and sometimes they are your clinical engineers, for your equipment and your technology because they are the ones in the room really troubleshooting live in the moment with you. Making sure that we have the environment that's going to foster that team to move them forward in collaboration and partnership. As we think about how we train that team for excellence and even how we maintain the excellence in that team is really clear goals and clear vision and making sure that they're in alignment with the entire department. Establish that shared vision that we've talked about earlier and making sure that it's in alignment with your organizational vision and mission. Making sure your team members all understand their roles and their roles as nurses in achieving that goal. What they uniquely bring forward as a nurse in this practice space. Making sure that we have diverse team composition and that they know the skill complexities that go into it. As we think about our GI centers, we could have LPNs that are supporting our prep and recovery of our patients. We have our registered nurses that are providing procedural care and that critical care element in our pre-op and recovery areas. We've got our CNAs that are doing support staff. What does everyone's role and scope look like? If you have APP providers in there, what does their complement help with the provision of care and how do we make sure that everyone's role is defined and everyone understands that working together gets us to excellence and efficient practices and quality standards and best patient care? It's important to have strong leadership. We talked early this morning about a leader versus a manager. Leaders really do have vision and they're able to convey that. The nurse leader, the physician, medical director in partnership, you need people in those roles that can motivate. There's nothing better than a physician and a nurse leadership team in partnership who are conveying a shared message and vision because that really does drive your team forward. You have to be in lockstep. I often say we will disagree behind a closed door, but out in public, we are going to be on the same page. That's how we move these teams forward because we are moving together forward towards a very clear vision. We want to emphasize things like servant leadership and how we grow and develop these teams. I'll give Dr. Schulman great credit. She's a very empathetic leader who uses emotional intelligence. It was wonderful to hear her speak on that because she really does sit and spend the time to listen to the teams and then come back and talk about what that means and how that looks for moving them forward. That is truly how we move these teams forward. Those healthy team dynamics, you have to have them. What does open communication look like in your team and how that drives excellence? If there is trust and we have a shared expectation of communication with each other and that it's respectful communication, we are going to advance faster because we are going to believe in each other and we're going to have that trust there. We're going to collaborate. We're going to encourage teamwork. We're going to know each other's roles so that we are able to pick up when one doesn't have 100% to give or is busy taking care of another critical situation. We have a clear pathway for conflict resolution. What does it look like to disagree respectfully and how do we advance that? We're going to encourage active listening. We're going to get to excellence. We're going to get to high functioning teams by having active listening together and how often we come back to have those team meetings and to talk about these things and to talk about process improvement and quality improvement. Before I get to this one, as we think about nursing in itself, you want to think too about the qualifications of your team. What do you need people to bring to the table? You need people who are coming in perhaps that have experience to fill a gap where you've lost a senior player on your team or you have a great and excellent team and you're interested in bringing in someone new who's never been in endoscopy before. You have to be able to define those things and define what that opportunity within your team looks like because you're going to bring in new folks and either have the bandwidth within your team to train or you're going to need someone that can hit the ground running with you. Examples of excellence that get us to that high functioning training, strong orientation, ongoing learning and education, simulation labs and doing dry runs, particularly in procedures and cases that aren't done frequently. Maybe it's something that's a once in a lifetime procedure that your facility's never done before with complex advanced providers. Doing those simulations, doing those dry runs to make sure that your team can function in a very orchestrated fashion is going to advance your safety and your collaboration before you even start touching that real patient. And so when you're in a high functioning team, you can generally recognize that there is a sense of reduced workload because everybody knows that everyone else is doing their part in this. There's going to be a sense of efficiency because you're a well-orchestrated team. There's going to be improved quality of care because this is something you do repetitively. It's something that you do together with each other consistently with that trust and that confidence. You're going to have improved patient outcomes. And we're going to see reduced burnout, reduced burnout on our provider team, reduced burnout on our nursing team. Because when you have a high functioning team and you know that everyone is coming together for a shared purpose and they're coming together with the same objective, day in, day out, whether they've been there, you know, six o'clock in the morning and starting the first case or it's 11 o'clock at night and you're there on call. When you have that high functioning team, when you can drive that high functionality, you're going to see improved performance and you're going to see higher value and higher staff satisfaction, which ultimately drives your higher patient satisfaction. And so it's a lot of hard work to drive those high efficiency and high performing teams. But those who stay, those who work towards distinction, they have a clear vision, right? Those who innovate and they motivate and they're part of advancing the care. Those who find the work that speaks to their passion, because those are the people we want on our teams. Those are the people that will be champions in these areas. Thank you.

nursing teams

GI centers

evidence-based practice

patient care

leadership