Saint Thomas Healthcare Transformation through Nursing Servant Leadership

Ascension Saint Thomas nurse, Stephen Vastola, was on his way to a relaxing Sunday lunch date with his wife and toddler when the family stopped at a Hermitage-area waste management facility to pitch some half-empty paint cans. Stephen spoke casually with an employee before turning to leave when the employee fell three-feet from the trailer ledge where he sat. No one else was around. Stephen’s wife called for help and dialed 911. Stephen’s 11 years of nursing experiencing kicked in instinctively. He checked the stranger’s pulse—nothing. Stephen began hurriedly performing CPR. He counted 30 seconds before the unconscious man was breathing again. Stephen asked the man his name and performed other basic memory tests as an ambulance arrived. The man survived, thanks to the courage and quick thinking of a local nurse.

In honor of National Nurses Week (May 6 th – 12 th ) Ascension Saint Thomas is proud to honor America’s 4 million registered nurses and our more than 3,500 nurses. We are also celebrating our newly-launched Nursing Transformation Unit and considering how the field is evolving due to increased emphasis on hearing and valuing the voices of individual nurses.

In 2018, leadership at Ascension Saint Thomas held a series of “town hall” meetings at our hospital facilities across Tennessee. Nurses stood up, told their stories, and expressed their ideas for improved policies and practices. One key takeaway was that the nursing care model has remained stagnant as other aspects of the healthcare industry have been positively influenced by cultural shifts like the principles of shared leadership—the idea that members across an organization’s hierarchy deserve to be heard.

With the feedback from these town hall meetings, Ascension Saint Thomas leadership developed a pilot program called the Nursing Transformation Unit. The interview model for the pilot program prioritized behavioral-based questions aimed to thoughtfully select the first cohort—15 nurses and seven nursing technicians positioned from 17 of our medical surgical units from all of Saint Thomas Health to make up our Transformation Team at Saint Thomas West.

The program launched in October 2018 after all cohort members completed comprehensive orientation sessions designed to equip them with organizational tools and an understanding of process design. New team members were encouraged to seek out inefficient processes, ask questions, and look for creative solutions. On a rotating basis, each team member was responsible for overseeing the application of different interventions of focus – flattening the leadership hierarchy.

Moving forward, team members are responsible for collecting data to assess whether the intervention was successful or requires further iterations.

The goal is for each member of future cohorts to learn process improvement techniques that he or she can take back to his or her respective unit to foster progress and innovation across Saint Thomas.

At Ascension Saint Thomas, our vision is to foster both career development and holistic growth. We support nurses as members of our healing community, but also as individuals with perspectives and experiences that matter to leaders across our organization. Stephen Vastola did not wake up on a Sunday morning earlier this spring expecting to save a life. The fact that he did is just one testament to the reality that being a nurse with Ascension Saint Thomas is not simply a job—it is a lifestyle, a leadership role, and a calling.