Sentara CNO Discusses How to Lead a Resilient Workforce

Genemarie McGee, RN, BSN, MS, shares how she's helping to address nursing burnout and inspire resiliency at Sentara Healthcare and offers advice for future leaders.

Editor's note: This conversation is a transcript from an episode of the HealthLeaders Podcast. Audio of the full interview can be found here and below.

Sentara Healthcare is a nonprofit health system with more than 3,700 beds across 12 hospitals in Virginia and North Carolina. The organization employs more than 8,000 nurses among its hospitals, clinics, home health and hospice services, assisted living facilities, as well as the system's health plan, Optima Health, which has more than 850,000 members.

Genemarie McGee, RN, BSN, MS,  a registered nurse who serves as corporate vice president and chief nursing officer, oversees those nurses, along with the coordination of nursing care across the health system.

McGee was "bitten by the leadership bug" early in her career, and has held numerous leadership positions for Sentara, including vice president and nurse executive for Sentara Leigh Hospital, and director of Sentara Norfolk General's emergency department and Level I trauma center, Nightingale Regional Air Ambulance, and the ambulatory care clinics.

During the most recent HealthLeaders Podcast episode, McGee shared insights into her leadership background, discussed how she's helping address nursing burnout and inspire resiliency at Sentara, and offered advice for future leaders.

This transcript has been edited for clarity and brevity.

HealthLeaders: In your role as system chief nursing officer, how are you addressing burnout at the health system?

Genemarie McGee: We have been focusing on making sure that we are staffing as well as we can, which has been difficult over the past two years. We've tried to make sure our employees have the mental health resources they need online so that they can access them when they need them.

Here at Sentara, for about the past 12 years, we have had a strong nursing shared governance structure, and that shared governance structure serves to lift the voice of the bedside nurse. It also helps us to pay attention to what's important to our nursing staff. For me, that's part of ensuring that we're trying to stay in touch as much as possible and understand what they're doing. We're also encouraging our managers to be flexible on scheduling and getting people time off when they can.

The other piece is we have intentionally, each year, done what we call our staff engagement survey. Even during COVID, we went ahead and did that to get feedback from our staff. In November 2021, we had about 5,000 of our nurses across our system lean in and take that engagement survey.

There were some things going on with burnout across the U.S. before COVID, so a lot of our focus has also been on helping the staff to build resiliency. Resiliency seems to be kind of an overworked term, but I think that's important that they take what they've learned about themselves, about their profession, about our organization, throughout this pandemic, and learn from it. How do you take the good parts of what you learned? How do you make sure any habits that you may have been doing or participating in before that wasn't helpful and not carry that on?

[Recently I spoke] at a virtual research symposium, and encouraged the staff that were attending to look at resiliency professionally, but also personally. Do you have compassion for yourself? Are you kind to yourself? Are there some things you might need to adjust in your personal life? We've been through a rough two years, we've got a fatigued workforce, so it's giving them a message of hope, and moving forward, but also recognizing we've been through a tough time, and ensuring that people have the resources whenever and whatever they need.

HL: As you mentioned, burnout has been an ongoing issue. What other ways did you address burnout prior to the pandemic?

McGee: Before the pandemic, we had certain populations of nursing that it was a bit more difficult to hire for. As a system we started to focus in and figure out what could we do to ensure that we had appropriate staffing in those areas. It's also the reason we started, about seven or eight years ago, our own internal pool so that we had staff that were available, and actually knew what Sentara was expecting in quality, safety, and professionalism. If we had someone who was going to be out long-term, we could pull one of our "swap nurses" to assist at that facility.

The other piece is we have managing for daily improvement boards. Those are boards on every nursing unit that share some of our patient-sensitive measures and some other quality safety metrics. We also document if we have more staff members starting. That is how we keep that two-way communication going.

We also encourage and require that all of our leaders round throughout our facilities; our nurse leaders are rounding on their units, our administrators are rounding, engaging the staff, and checking up on the staff. That's part of our being a highly reliable organization. We found that that structure through COVID helped us to manage what we were seeing and what was happening.

A couple of things we look to make sure we are communicating: That the communication is two -way and that employees feel comfortable giving us feedback. That helps quite a bit around resiliency and engagement, which are the opposite of what we would call burnout.

HL: What other initiatives have you been leading for the health system?

McGee: I am the executive sponsor for customer experience across our health system, and that's something that's near and dear to my heart. It's important that we try and ensure that our patients and our families have a good experience. I always say that we are taking care of people at some of the most vulnerable times of their life; they may have been given some bad news, or they may have had an acute event occur. I even point out that having a baby, which is a very joyous event, is also a very stressful and vulnerable time for our patients in our family.

I work with our clinical effectiveness team to ensure we take the time to focus in on our quality results, but more importantly, on making sure that we are safe, that we follow our safety habits, and that we're highly reliable.

I also have responsibility for hospital case management. So, I am looking at transitioning patients and assisting their families as they're bringing them home or maybe placing them in another form of care.

I still sit on the COVID-19 team steering committee. We are still meeting two years later and will continue to meet.

I sit on the board for our local EMS system. We also have a degree-granting BSN college within our health system and I sit on that board, and then I also sit on the board for the Virginia Organization of Nurse Executives and Leaders. Some initiatives are internal and external, but all weave together.

HL: How would you describe your leadership style and how does your background as a nurse impact it?

McGee: I would hope that I have a transformational, coaching leadership style. I believe strongly that you can be an excellent leader and be compassionate and kind at the same time, but still hold people accountable for results. I do try and be as authentic as possible; what you see is what you get. I try not to be a person that surprises anyone.

And I like to empower nursing, but also recognize and encourage nursing to be a great partner to our health system. We are part of the health system and we need to partner with our health system and their strategic plan. I encourage us to be collaborative players in our system.

HL: What advice do you have for nurses in the workforce who may want to make the jump into leadership positions or into the C suite?

McGee: I would encourage anyone that has the drive and wants to be a nurse leader to sit down and talk to their current nurse leader. Talk to them about their role, what they like, what they don't like. I would also encourage anyone to shadow another nurse leader, something I offer to my own nurses. It's important that you see what a day in the life is, because there's many perceptions of what you may see about your nurse leader, but there are many things that they may do that you don't see.

I also encourage them to be a lifelong learner and to go back to school if you need to, to get your BSN or your master's. I also encourage that if you're going to go that doctoral route that you really think through and figure out why you might want to do that, and what you need to do.

I would also encourage people to interview other leaders to figure out what is your passion and what is your niche, and where do you want to be two years or five years from where you are currently.