The day in the life of Craig Richardson, CPL

In this Episode, we talked to Craig Richardson about what he does in this new position as a CPL.  

Transcript

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Welcome to Nursing Together. I'm Michelle Hoen, your host and Tanner's Chief Nursing executive. Today we're gonna be talking to Craig Richardson, who is one of our CPLs or our clinical progression leaders, and he is going to be letting us know exactly what he does on a day by day basis, as well as kind of giving us a little bit of insight in regards to the CPL role. So welcome Craig. Thank you so much. For coming in today. Why don't we go ahead and get started by you telling me a little about you and how you got started. My name's Craig. I started out on four East back in 2016. Worked there for two years. I went to the float pool in 2018. I was an LPN during this time. Went back through the LPN to RN Bridge program in 2023 to 2024. Whenever I graduated from that, the CPL position was available. I really like to talk. I don't know if you know that about me or not, Michelle. I do. I really like to talk and I found out that this position would be leading these rounds to the interdisciplinary team, and that sounded interesting to me. It sounded like a little bit of investigative work chart reading, looking through patient orders, doctor notes, that kind of thing. Presenting it to a group. It's really, Craig, I think when we first talked about your bridge program and you were in bed management, you've done a lot of great work in bed management. I think that is what really intrigued me with you with this position was you really got the idea of the Tetris that has to move from bed to bed And I think you were already doing pieces of that in bed management, looking at the charts and making sure. So just explain maybe how that's. The same but different. Yes. That was in about 2022 I believe. I cross-trained a bed management and like you said, it is like Tetris. Whenever I worked in there, I called it air traffic control for the hospital. There's a lot of moving parts that go into bed management that think a lot of people are not necessarily aware of, and part of that is chart reading. Part of that is you get a patient from the emergency department that's up for admission. You have to go through their chart, see where the doctor wants the patient, see what type of drips the patient's on. Their age, that kind of thing, see which unit is most appropriate for that patient. And I think that's where we started our journey. Even before Care Logistics came in to help us with Care Compass, we were starting to look at the whole right patient, right place, right time. And I think that was part of your air traffic control as you had to look at where do we stand, what do we look like? What is this patient really doing in the emergency department? When you got on in the role and you were looking at all of the different elements, tell me what one of your biggest challenges at the very beginning was. Oh gosh. Whenever I first started this role, I thought that it was going to be, obviously reading the chart, I didn't realize that I was going to have everyone's undivided attention to include physicians and for some reason for me to be such a social butterfly. It was a little intimidating in the beginning. You have this pressure to question the physicians. If there's something they say that, in my experience, working the floor as a nurse doesn't make sense to me. It's my job to be like, in my experience, we've been able to do this. Yeah. Sometimes the physicians are like, yes, you're right. And then. I think nailed it is one, trying to get those physicians on board to listen. Yeah. Is the hardest thing. I know one of the pieces of this is not just the rounding part of it, which is probably the most important piece. You get in there and you do your rounds, but once the rounding is over, walk through what the rest of that day looks like. Because I think a lot of times people think, oh, the rounds are over, and. The CPLs job's done that kind of guide us through what the rest of the day looks like. So I will guide you through a little bit of my whole day. Get here between seven and nine, depending on what unit I'm on. I'll read between 20 to 30. If you're in overflow, 40 to 50 charts, rounds take place generally between nine and 10 o'clock on every unit. During the rounds, whenever I'm talking with physicians, case management, physical therapy, I'm getting an idea of what barriers are keeping a patient here in the hospital. What's getting in the way or what has the potential to get an hour way right of this patient moving forward in their care or discharging from the hospital? And how do we resolve that after rounds? It is my responsibility to work in care advance. See what barriers I have with these patients call different departments, whether that be lab, radiology, nuclear medicine, the heart center, right. Those places. Yeah. Try to get things coordinated for the patient, find out why they aren't happening or in the timely manner that we thought they have.'cause there's a lot of things that come up in every department, right? Every patient is a little bit different and we don't always see the big picture and other departments can. So it's my job to follow up on those things. For the rest of the day. We recently got the service coordinators and the service coordinators are responsible for scheduling. So it's also my responsibility after rounds, see if any new orders have been placed for a patient to go down to have procedures. Got it. And be sure those patients are ready for the procedures. Be sure the patients have the appropriate IVs to go for a CT scan. Be sure consents have been signed, that kind of thing. The CPL is the go-to person on the unit. Yeah, for everybody, so I think that's been part of the confusion on what the CPLs do because you're nurses and sometimes they see you on the units and sometimes they don't. But when they do see you on the units, their automatic assumption as you should be able to help in patient care. Correct. Forgive me some scenarios in which the reason why we don't want you guys. You know, 100% in the patient care world. Right. What could that do to delays or possible snags if for some reason all of a sudden you're trying to help coordinate patient care on the actual physical unit? I do get that quite often, and I don't mind helping for small things on the unit, but when it comes to larger things, I feel like that might pull us away from being able to follow up with that patient care. Right. If you're on a big unit like four East. Yeah. One West specifically, right?'cause one West is a big, busy unit. Yes. If I'm doing too much and I'm away from the computer too much. Can't keep up with what's going on with these patients. We use secure chat a lot. A missed message. Yep. 15 minutes might sound like only 15 minutes, but if that doctor needs an answer in. The next five minutes. Five minutes and I missed their message. Or even if the timeframe to get that patient into a test was the next 10 minutes and you were away for 15. We just lost that time block. We get that patient down. There was, that happened to me. I was assisting with something. Someone down in surgery messaged me, asked me a question about the NPO status of a patient, and they were like,'cause we have 12 o'clock for this patient. I read the message at 11 58, 11 59. I messaged them back and then it took them five to 10 minutes to respond. Right. I almost got the patient an extra day stay in the hospital'cause it was very important that they get down in a very timely manner, and I know that. I know that it seems almost disingenuine like for nursing, right? What does it really matter if a patient stays here an extra day or we're taking good care of'em? It's not really about the patient care, it's about, and it's not even necessarily that patient that we're trying to get through the system. It's the 16, 20 patients down in the emergency department, patients that we're trying to free up in overflow.'cause unless you've worked in overflow or in the emergency department atmosphere in general, it's the wild West down there. Right? If you're a patient, you're admitted to the hospital, no one wants to stay in that environment longer than they have to. It's stressful down there. It's funny that you say that,'cause I was sick just recently and I was telling my husband, I was like, it takes a lot for me to think about the emergency department. And I said, I'm really not feeling good. I might have to go to the ed. And he's like, okay, do we need to go? And I'm like, no.'cause then they'll admit me and I'll be in a hallway bed. But yeah. Uh, that is always. A thought that I have in mind because of my experience in the flow pool. I worked at overflow was the big place that I worked and I know while they received good care and overflow, that's not a place that anyone wants to stay. So something that's going through my head constantly as I'm doing my job throughout the D day, I keep the, the ed track board pulled up, keep an eye on the admissions that are coming in, keep the eye on the number of patients that are in CDU. Yeah, because I'm. Constantly thinking. We always have patients and I think inpatient nurses maybe don't quite understand that the ED is an open door. The inpatient, once they're done, if they got 32 beds. And 32 beds are filled, they're good, and they can't get any more patients, but the emergency room just keeps piling up and so does the CDI think that's why it is so important for this particular position. I just wanted to make sure that nurses understood that with this role, it's not about why aren't you doing your job, right? That's not what the role of the CPL is, but the role of the CPL is to push and to make sure that we are. Effectively and efficiently moving that patient through the system in the most appropriate way. Yeah. I've also found on units, usually the bigger units that need the extra set of hands. This week I just happened to be on four A and I've been working with Tori, and Lydia Frees up the assistant nurse manager a lot for them to not have to be conscious of the discharges that they have. If I'm there, it's my responsibility to. Do the nursing home discharges. Be sure all that information gets faxed over in a timely manner. Yeah. Also frees up the assistant nurse manager to be able to focus on that unit of notice benefits and getting the patients out. That being my responsibility and also the assistant nurse manager, not having to focus so much on. This assistant nurse managers could be doing other things other than the discharges. You could get ahold of the discharge nurse. Right? Not every day, but there's a good part of the days that we have a discharge nurse. If they can't get to that person, that could be something that you could coordinate and say, Hey, can you come up here and discharge this patient so we can go ahead and get'em out and get'em moving? So that just happened right before I had to call Dale. It was lunchtime. The family member came up to the nursing station and said, Hey, my husband. He's getting a little stir crazy. Yeah. He's been ready to go for three days now, and he's only been here for four. I can do the paperwork here at the desk, but I'm the only person manning the desk. Right, right. So I was like, wait. Dale's here today. She's a discharge nurse. I'll get her to come up and she did. The patient was out in 20 minutes. Yeah, and I think that really makes a difference, not only to the patient, but also to our nurses. And they don't have to worry about doing it. They could be going to lunch or like you said, if they're trying to get their meal for the day that they haven't gotten, regardless of what time it is. Is there anything else you wanna talk about with this role or make people aware of, to make sure they totally understand? Because I want this role to be. Looked at as a tool and not as a hindrance or an obstacle for them. One thing that I want people to remember about the CPO role is that while we may not be involved in direct patient care, we are here for support and we are here to help you any way that we can. I'm here to be a resource for you. If you have a question, charge nurses and at the station resource nurses and at the station. Don't be afraid to ask us for help. Yeah, usually whenever I'm on these units, I sit right beside the charge nurse so that the doctor has one place to go visit. So I'm usually, it probably annoys the assistant nurse managers, so they like a little shadow over'em. And I don't mean to be a bother, but I need all the information I can tell. Be sure these patients get through their hospital staying. Just don't be afraid to approach us. Yeah, if we're able to help, we'll help you. And if we're tied up doing what we're doing, then. Just, you can. Thank you, Craig. I appreciate you coming on and I look forward to making sure this continues to be a role that we look at as a asset and not anything else. You guys have already been such a foundation for efficiency and I really appreciate you. Perfect. All right. Have a great day. Yeah, you too. All right. Thank you so much for listening to Nursing Together. We look forward to speaking with you again next week. Until that time, remember to keep your head up and keep reaching for the stars.