With its two-time Magnet designation, the highest number of Beacon units in the country, and a very long waiting list of nurses wanting to work here (well over 400 at this point), HUP nursing is considered one of the best in the area. But this scenario is a far cry from what Victoria Rich, PhD, chief nurse executive, found when she came on board in 2002. The Health System was recovering from a near miss with bankruptcy. Significant staff cuts throughout had taken their toll. The hospital’s vacancy rate for nurses was 30 percent; the turnover rate was 25 percent.
“How do you raise morale in a nursing culture with double-digit vacancy rate and a high rate of contract nurses who were not invested in the organization?” asked PJ Brennan, MD, chief medical officer and senior VP for UPHS, at one of Rich’s many “farewell” parties. “You recruit a chief nurse with conviction, a passion for patient care, someone with a heart who cares about her people, and an uncanny operational knack.”
Rich’s first act was to set up direct lines of communication between her and her nurses, asking IS to give each a UPHS email address. Then, she worked with HUP executive director Garry Scheib –- and a generous donation from the Board of Women Visitors -– to create the Nursing Network Center. “I was slowly setting up the infrastructure –- building the frame for the house, so to speak–- so we could continue to move forward.”
Over the next several years, HUP nursing evolved under Rich’s steady hand. She partnered with Brennan to create Penn Medicine’s Blueprint for Quality, our mandate to improve patient outcomes and safety. An important component was the Unit-Based Clinical Leadership team, which she considers one of her top three accomplishments at HUP. “Everyone has to believe he or she has something to contribute,” she said. “This is the way care should be given – in partnerships with doctors, nurses, pharmacists … the entire health-care team. It’s the future.” Many hospitals around the country have since established UBCLs but “we were one of the first, absolutely.”
Another top accomplishment: HUP’s two consecutive Magnet accreditations which “embrace all the building we did and its sustainability.” Fewer than seven percent of all registered hospitals in the United States have achieved this recognition of nursing excellence.
Last but not least: hiring only nurses with a bachelor of science in nursing (BSN) degree. Rich was again ahead of her time when she did this in 2006. Today, all hospitals in the Philadelphia area hire only BSNs; 92 percent of HUP’s nurses have at least a BSN. In 2010, the Institute of Medicine issued a report on the future of nursing and one of its recommendations was that by 2020, 80 percent of all nurses must have a BSN. Rich has been chosen as a state leader working towards this goal in Pennsylvania.
Rich has always been a strong advocate for patients as well as nurses. Indeed, she led the way in creating the Patient and Family Advisory Council and also worked to develop HUP’s nursing cultural diversity committee. “She has helped move all of us to always ask, ‘What is the right thing to do for the patients and their families?’” Scheib said.
Not surprisingly, Rich has received recognition from many national and international groups for her leadership in nursing. “Victoria is a visionary,” Scheib said of his colleague and friend. “Her legacy here will be the outstanding care our patients receive.”
Rich may be leaving her position at HUP but she is far from retiring. She’ll continue teaching in Penn’s School of Nursing and will also serve as a consultant for the American Nurses Credentialing Center, helping health-care facilities obtain Magnet designation. Still, “I can’t imagine not being here. This is my family. I’ve never felt like this in any other place.”
When Victoria Rich leaves her position as chief nurse executive later this month, she’ll take with her some very special memories:
- PJ Brennan, MD, sending her flowers every year on Nurses Day.
- Rounding with Bernie Johnson, MD, (HUP’s former chief medical officer who passed away in 2009) and Al Black, chief operating officer at HUP.
- Holding the pep rally for the first Magnet accreditation. “There was so much excitement in what we were doing.”
- Chuck Aitken, assistant executive hospital director, getting the huge fish tank from the ED waiting room for the Nursing Renewal Center. “It doesn’t get any better than someone doing that for you.”
- “Seeing the smiles on everyone’s faces” at HUP’s six Magnet Galas, which have contributed approximately $250,000 to outreach efforts. “They were all such wonderful celebrations.”
Other accomplishments during Rich's 12 years at HUP included establishing advanced practice shared governance and HUP nursing shared governance and having all clinical nurses in navy blue uniforms to help patients more easily identify them.
"I want to thank the many people I've worked with over the years," including Tamika Patton, Pat Wren, Diane Corrigan, Sally Sapega, Mona Matson, Ralph Ciampa, George HIckenbach, Bernie Dyer, Mia Gonzales, Rick Demers, Mike Restuccia, Barbara Hoehn, Joe Forte, Chuck Aiken, Mike Soltys, Tonita Bell, Craig Loundas, and Brooke McDonnell.
Photo caption: Victoria Rich (c.) with the staffs of Rhoads 3,6,7 and Dulles 1 at one of the many "farewell" parties held for her.