By Steven Brittain

Special to NurseWeek

Seton Hospital Nursing Congress

As healthcare facilities across the country struggle to find and retain the most highly
qualified nurses, the shared governance model practiced at the Seton Family of Hospitals
in Central Texas continues to provide a distinct advantage over the competition and serve
as an invaluable recruitment resource.
When current chief nursing officer Joyce Batcheller, RN, MSN, CNAA, arrived at
Seton nearly 13 years ago, she found an intricate system of hospitals with a nursing staff
that was in desperate need of organization and voice.
The Seton Family of Hospitals, centered in Austin, TX and the surrounding areas,
includes five urban acute care hospitals, two rural hospitals, a mental health hospital,
several strategically located health facilities that provide medical care for well patients
and three primary care clinics for the uninsured. The Seton Family of Hospitals is the
leading provider of healthcare services in Central Texas, serving an 11-county population
of 1.4 million. Four out of every ten overnight patients in the region receive their care at a
Seton facility.
It was imperative that a nursing staff so large be allowed to work together in a
true shared governance environment so that decision-making and collaboration included
nurses at all levels.
Batcheller was the perfect person for the job. Having implemented a full shared
governance model at her previous leadership role at Inova Fairfax Hospital in Virginia,
Batcheller, who has worked in nursing for more than 30 years, hoped to instill the same
philosophy at Seton.
“I wanted to bring the same principles we had implemented in Virginia to Seton,”
she said. “I wanted staff input in developing hospital-wide solutions. I wanted a way to
bring the best of the best together from each site within the Seton Family of Hospitals so
that we could standardize policies, procedures, equipment and anything else pertaining to
our nursing staff across the spectrum of our institutions.”

A governing body is born

In May 1996, Batcheller’s brain child became a reality when the first meeting of the
Seton Nursing Congress took place. More than ten years later, the Nursing Congress is as
strong as ever and is a vital component of hospital operations, Batcheller said.
“We have staff members who were involved with the Congress on the very first
day who are still as involved as ever,” she said.
Seton's Nursing Congress, which can have anywhere between 55 and 60 members
at a given time, offers the nursing staff a monthly forum to talk about professional and
clinical issues, provides a mechanism for their input and feedback and helps generate
opportunities for the nursing staff to develop leadership skills.
According to Batcheller, the Congress evaluates and advances nursing practice
with the goal of meeting or exceeding patient-care expectations, and achieving successful
patient outcomes. It is sponsored by the Nursing Executive Council, and also includes
eight specialty-nursing councils and two support councils, which work together to
address clinical and professional practice issues; network-wide consistency of nursing
practice; research and regulatory compliance; standardization and cost efficiencies; and
nursing quality assessment and improvement.
The Nursing Executive Council - chaired by the chief nursing officer - is
comprised of lead nursing directors, and the chair and vice-chair of the Nursing
Congress. The Council is responsible for the strategic planning and oversight of the
Congress, and holds an annual retreat to establish goals and develop improvement
strategies for the nursing division.
Through the Nursing Congress, staff and leaders work together to continuously
improve communication, work environment, patient safety, orientation and professional
development.

Free exchange of ideas

Pamela Novak, RN, has been a nurse for the past 27 years and currently works in the
Endoscopy department at Seton Medical Center in Austin. She also serves as the current
chair of the Nursing Congress. The most engaging aspect of the Nursing Congress,
Novak says, is the environment of open communication and the free exchange of ideas
that it has created.
“Obviously the Congress has been a huge resource to the nursing staff, but I think
it’s become just as much of a resource for our administration,” Novak said. “All lines of
communication are open and it has led to our nursing staff having no fear of
management. They know that people are listening, and though every idea might not get
acted upon, at least there a forum in which to express them.”
Novak added it’s not uncommon for the chief executive or the chief financial
officers to attend the monthly forum. In addition to the regular CNO update at each
meeting, the presence of additional executive leadership provides the nursing staff insight
into what the administration deals with on a daily basis.
“It’s further proof that the administration at Seton values our opinions and won’t
hesitate to engage the staff members who work on the frontlines,” she said.
Just as important as having access to executive leadership is simply having access
to one another, says Courtney Payne, RN, CCRN, a critical care nurse at Brackenridge
Hospital, Seton’s trauma-specific facility in Austin.
In a hospital system as large as Seton, there are nurses who cover every specialty
and who know the industry inside and out, she said. The Nursing Congress ensures that
nurses from all of Seton’s hospitals are exposed to this expertise and can see how the
decision-making process affects everyone. Attempting to establish a network-wide view
of Seton instead of simply site-specific ones is vital to the success of the Congress, she
said.
“We have so many specialties working together that it’s impossible for you to not
be in a mode where you are constantly learning something new from your colleagues,”
said Payne, who served as chair of the Congress in 2005. “It allows us to make policies
that benefit everyone and develop plans that are the best for the patients because we’ve
considered the entire spectrum of care. We’re broadening the horizons of our nurses and
giving them such considerable control of their own practice. Giving your staff resources,
information and contacts with people from backgrounds they normally wouldn’t get to
work with benefits everyone from the nurses themselves to the patients in the hospital.”
Recruitment and retention
Perhaps the largest benefit Batcheller says she has seen from implementing the Nursing
Congress is the positive effect it has had on nurse recruitment and retention. Seton has
established relationships with several nursing schools to allow young professionals in
training and prospective employees to come to sit in on some of the monthly Nursing
Congress meetings.
“We’re eager to get up and coming nurses familiar with the Congress as early as
we can,” Batcheller said. “We want them to see what they can be a part of by joining the
Seton Family of Hospitals. Once nurses are hired, we try to get them involved
immediately. Most are required to attend if not a Congress meeting, then at least one of
their unit council meetings. We want them to know that they are integral parts of the
system and not just faces in the crowd.”
The 2002 American Organization of Nurse Executives survey took an in-depth
look at the current nursing shortage and found that 83 percent of those surveyed believed
improved working environments would be helpful in curbing the shortage, more so even
than better wages (79 percent). The survey also found that 70 percent of those asked
agreed a higher status for nurses in the hospital organization would be effective in
correcting the shortage.
Batcheller believes the Nursing Congress addressed these issues at the source by
empowering Seton’s nursing staff and by placing them in a conducive, academic-style
setting that fosters growth.
“We hold values and respect in very high regard at Seton and I think our culture is
fully embraced in our nursing staff. This can be seen in our levels of employee retention,
our ability to attach the best and brightest new nurses and through the recognition that
several of the largest institutions in the Seton Family have received,” Batcheller said.
The nursing services at Seton’s four urban acute care hospitals have received the
coveted Magnet Award—the highest level of recognition that can be awarded to nursing
services in healthcare organizations. The American Nurses Credentialing Center (ANCC)
awarded Magnet designation to Brackenridge Hospital, Children’s Hospital of Austin,
Seton Medical Center and Seton Northwest Hospital. These four Seton Healthcare
Network hospitals became the 61st through 64th facilities to receive this award in the
United States.
“I’m extremely proud of the work we’ve accomplished via the Nursing Congress
and the positive atmosphere it continues to bring to Seton,” Batcheller said. “The Nursing
Congress will continue to grow and evolve as the hospital system itself continues to
grow. I believe we’ve created model of leadership that future generations of Seton nurses
will carry on for decades to come.”