In this episode, Jamey interviews Dr. Janice Walker, the CNO at Baylor Scott and White Health, where they delve into the transformative power of compassionate connection and innovation in healthcare settings. They explore how the industry is being reimagined and transformed by leadership approaches, technology advancements, and human experiences. They uncover strategies to prevent and mitigate workplace violence to enforce a culture of respect and ensure the well-being and security of individuals everywhere. For more engaging episodes and insightful discussions visit: https://www.amnhealthcare.com/amn-insights/elevate-care-podcast/
In this episode, Jamey interviews Dr. Janice Walker, the CNO at Baylor Scott and White Health, where they delve into the transformative power of compassionate connection and innovation in healthcare settings. They explore how the industry is being reimagined and transformed by leadership approaches, technology advancements, and human experiences. They uncover strategies to prevent and mitigate workplace violence to enforce a culture of respect and ensure the well-being and security of individuals everywhere.
For more engaging episodes and insightful discussions visit: https://www.amnhealthcare.com/amn-insights/elevate-care-podcast/
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TIMESTAMPS
(00:17) Introduction
(05:17) Prioritizing a Candidate Centric Experience
(14:09) Workplace Violence in Healthcare Settings
(19:47) Beneficial Support Structures
(25:00) Improving Healthcare Environments
(27:40) Leveraging Technology to Predict and Prevent Threats
(34:00) Compassionate Connection
(35:24) Janice’s Challenge
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ABOUT THE GUEST
Janice Walker is chief nursing officer (CNO) at Baylor Scott & White Health, the largest not-for-profit health system in Texas. The system’s integrated delivery network includes Baylor Scott & White Health Plan, Baylor Scott & White Research Institute, Baylor Scott & White Quality Alliance and its leading digital health platform, MyBSWHealth. Through 51 hospitals and more than 1,200 access points, including flagship academic medical centers in Dallas, Fort Worth and Temple, the system offers the full continuum of care, from primary to award-winning specialty care, as well as an array of virtual and in-home services.
As CNO, Walker focuses on pursuing excellence in every aspect of patient care through the advancement and integration of professional nursing practices.
Prior to her current role, Walker served in System nursing leadership at the hospital and division level and as chief operating officer at Baylor Scott & White All Saints Medical Center – Fort Worth. Previously, she was vice president/CNO at Texas Health Presbyterian - Wilson N. Jones (Sherman, Texas) and Freeman Neosho Hospital (Neosho, Missouri).
A Johnson & Johnson Wharton Fellow, Walker received her bachelor’s degree in nursing from Henderson State University, and both a master’s of business administration degree in healthcare management and a doctorate in healthcare administration from the University of Phoenix.
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Welcome to Elevate Care, the show where healthcare professionals, visionaries, and thought leaders come together to explore the limitless possibilities of healthcare innovation. I am your host, Jamey Dubke. Welcome to a journey where innovation meets humanity. Today I'm thrilled to welcome a luminary in the world of nursing and healthcare leadership, Dr. Janice Walker. As a chief nursing officer, Dr. Walker is at the forefront of shaping healthcare delivery. With her stewardship, Dr. Walker's vision and drive ensure the delivery of comprehensive care, from primary to award-winning specialty services, not to mention innovative virtual and in-home solutions. At the heart of her mission as CNO, Dr. Walker champions the pursuit of excellence in patient care, advocating for the advancement and integration of professional nursing practices. Dr. Walker's academic achievements are equally inspiring. A Johnson & Johnson Wharton Fellow, she earned her nursing degree from Henderson State University and holds both an MBA in healthcare management and a doctorate in healthcare administration from the University of Phoenix. Join us as we dive into a conversation with Dr. Janice Walker, a visionary leader whose dedication and expertise are transforming the landscape of healthcare. Dr. Walker, welcome to the show. Thank you, Jamey. What an amazing... kickoff announcement. I'm so humbled. Oh my gosh. Well, like you totally deserve it. Part of what we're doing here is really trying to bring humanity into the healthcare space. And so it's really important that people get to know your whole self. And so I know a fun fact about you is that you have a lot of people that like to call you mama J. That's right. So my grandbabies have given me that gift of a name and it's so precious and it means so much to me. So even some of my direct reports when they need me the most, they'll say, Mama J, I need you to call me. We have a problem. So Mama J is a very special name for me. I love that. Well, and as a beacon, right? You understand when you hear Mama J, you're like, oh, man, I absolutely need to send the bat signal, right? It's very personal. It's relationship based. If they know I'm Mama J, then I'm going to call them. Oh my gosh, that's awesome. Dr. Walker, our listeners are always inspired by the journeys of our professionals. Can you speak to the passion or the purpose to which fuels your work? Oh my goodness, Jamie. My fuel and my why comes from removing barriers so nurses can work and answer their calling every day to work not only at the highest part of their license, but to remove barriers. We are called to this work. And with the burdensome. aspect of this work. There are barriers, there are issues, there are confrontations, and so I'm called to help remove those barriers so they can bring their best self to work or to the environment every single day. I love that. Thank you so much for having a heart and a passion. I know as our nurses and clinicians, they come into this wanting to serve and wanting to be able to provide the best care for our patients. So thank you so much for championing that work. Absolutely. Dr. Walker, with turnover rates being a significant challenge in healthcare, can you discuss the trends you've observed in recruitment and retention, especially during the post pandemic period? Certainly. So we're a different organization. I think all across the nation, everyone is different. We have to go after talent in a very crisp, agile fashion. We are competing for the same type of talent and we have to create environments that are very cultural based. to remove barriers and have that glue of retention that staff and talent would say, you know, that is the very best place to work. And in order to do that, we've had to completely rebuild how we think about and how we go after talent. And what we call is more of a candidate-centric model versus an employer-centric model. So work-life balance is very important. Different shifts are very important. what I bring to work every single day, and do I have leaders that are there for me? Are they really, really helping me remove barriers? Are they being transformational in their style? Are they, do they understand the work I do every day? Thank you for sharing that. I think when you think about all the different generations that are in the workforce today, especially the millennials and the Gen Zers, they are looking for different staffing models, right? And so, I love the fact that you are being proactive in thinking about how do you go back or go away from this very rigid model to only like only having one way to operate to now understanding that there are needs and work-life balance. I'm very thankful for the Millennials and the Gen Zers who are bringing that to the forefront because that's something that some of the different generations. don't necessarily always appreciate or maybe just never wanted to address or felt shame or maybe anxiety about bringing that up. So I'm glad that you're addressing that. So thank you for doing that. Since you mentioned prioritizing a candidate-centric experience, how does that contribute to addressing these challenges? So for any talented candidate, they have 10 to 15 offers waiting on them. Wow. It's just the world we live in. So we have to understand our processes. We have to understand the barriers that we have created ourselves. We have to make them frictionless. We have to work as a team to understand the way we went after talent pre-pandemic. It's not how we're going after it today. Pre-pandemic, in my current organization, we were rich with applicants. That talent pool has dried up. So we have to be innovative and creative about how we go after talent. And we've learned so much as an organization coming off of this pandemic that we did some of those hoops that our candidates had to jump through. We created them ourselves. And we had to pause, back up, think from the candidate's viewpoint, how does that feel that it took so long for you to call me back? Maybe you really don't want me. or you're asking me to come in for interviews when the rest of your competitors are okay with virtual. So just really forward thinking that what we built pre-pandemic is not working right now. And except for any of the team members to raise their hand and say, hey, have you ever thought about A, B, and C, we reworking it? think when you think about A, B, and C, is there a way we could make it smoother? So we did that and we allowed freedom and anyone bringing raising their hand and saying I heard from a particular candidate that someone else reached out to them quicker let's explore how we can do that too. That's awesome. So gone are the days where you're able to wait for five days in between interviews. Oh, they've left the building. Exactly right they've accepted that offer. I love the fact though that you guys are introducing that virtual interviewing piece because obviously we're now all accustomed to being in front of Zoom or being in front of cameras and so there is a comfortability that we have with that and that gives us access to talent across the globe where we would not have previously been able to have that. So I love that you guys are being aggressive with that. How is that changing the mindset of the candidates when they come in? Is there anything that... that they're looking for differently now than they were maybe even pre-pandemic? So one of the things that we explored doing that during the pandemic we found ourselves so stretched for actual recruiters. Okay. That we explored models of hooding clinicians, kind of a blended team effort, to sprinkle some seasoned clinicians and nurse manager leaders and CNOs that could really speak the language. of the environment. So now I would say to you we are one team related to recruitment and nursing operations. So we can speak of the urgency to fill these roles. We can speak for the different talent we're shopping for. So we cross blended operations with recruitment and I will tell you the candidates see the difference. We also have nurse ambassadors. that if we have a candidate that can't commit, and really our recruiter feels like, I just need someone that can speak the language. We call up the nurse ambassador, they're on the phone with the candidate, and they seal the deal. Wonderful, so it's like you're creating that mentorship or community before the candidate walks in the door. Absolutely, and so they know a name, they know the environment that they described. and they hold us accountable that really is the environment when I arrive. And so the brainstorming of nurse ambassadors came from our recruiters and then nursing operations made it happen. That's amazing. I love all that collaboration and understanding that no longer can we all sit in these silos and that the new unit of value is truly around the center of team instead of the individual. Exactly. That has to give you guys an advantage in the market, for sure. It's very prideful. Awesome. How important is the concept of leadership span of control in creating an environment that not only attracts, but also retains health care professionals? So that is probably the hottest topic you hear about today, coming off of this pandemic, when you look at the literature and the evidence. I'm part of two huge work groups that are really studying, and pausing, and describing. What does the future look like for Spana Control for nurse leaders? Both the American Organization of Nurse Leaders, AONL, the Academy of HMA, they are studying this as I sit here today. So I would say to you, within the next six months, they are going to publish some evidence-based, refreshed literature coming off this pandemic on what is the design of Spana Control. because it is vital to address retention. They go hand in hand. We could not expect that nurse leaders carry a huge span of control and produce the retention metrics that we need produced and not a revolving door of talent. It's all about bringing them in, very candidate-centric, and retaining them at the end of the day. The revolving door. needs to stop and span of control is front and center to making that happen. What are some of the current spans of control because it does feel very big and I've heard from some of our clients that anywhere between maybe 60 to 100 nurses per nurse manager. That's correct. And so where is the best practice? Who has the best evidence? proven by the outcomes of retention, patient satisfaction, hospital acquired infection, harm factors, the onboarding of the new graduate. Who has the best model and what does their span of control look like? And what supplemental ancillary support are surrounding that nurse leader in terms of educators, supervisors, clinical coaches? It's all the full package. But right now, The span of control is all the way from A to Z. No one really can articulate by the evidence and the literature and the strong research, where do we need to land that plane? Man, I can't imagine. I've done so many different organizational designs, and I don't think I've ever tried to organizationally design any manager that had more than 10. I mean, literally, I just can't imagine having the performance coaching, having just the one-on-ones, just the chickens. Relationship. Yeah. Like, just getting to know them on a human level, getting to know their family, right? Because when you come to work, you are creating a community and you're creating that dream team, right? Like, you have a team that you want to be surrounded by and your leader is the one who determines kind of... the end state, a lot of actual doctors right now are saying that your manager will actually determine your health. And that's because of all the stress and the cortisol that's exerted. So anybody who is dealing with any type of belly fat, you can actually thank a lot of your managers for some of that as well too. Right. And so let's not forget that front and center to being employee-centric and that great experience we want every candidate to have, we want the same for the leader. So you cannot address retention and recruitment without looking at leadership retention and recruitment. And they're shopping for the same thing that some of our employees are looking for. Work-life balance, being able to meet their calling, being able to be present and build those relationships. And if the span of control is too large, that is next to impossible to do for any human being. Yep, they'll feel set up to fail. And they'll leave. Yep, and we can't have that. That's right. Leadership certainly sets the tone for the workplace environment, which brings us to a pressing issue that leaders are currently grappling with, and that's workplace violence. Recognizing that the American Nurses Association reports that one in four nurses has been assaulted at work, what have you and your teams experienced with workplace violence? So before the pandemic, before we knew the word COVID, everywhere you turned in any nursing journal or any seminar, was sprinkled with this tone of workplace violence is out of control. So now let's watch what happened after the pandemic. You saw it less during the pandemic because of crisis mode. We were saving lives, we were scared to death, we had to know what we were dealing with. And so there was this stronger sense of what I wanna call respect to make it through, for the globe to make it through, right? So now that's calmed down. We've solutioned that. We know what the evidence exists to prevent that. So now we're back to the number one topic, workplace violence. And, Jamie, it is worse than ever. Constant abuse and attack on clinicians of all form, not just nurses, shootings in hospitals, shootings outside of hospitals. brutal attacks up to rape or sexual assault. And so that's why it is so important for us to talk about those incidents and learn from those incidents. You cannot not speak of them because that sets the tone that I'm not in the solution mode and I'm not looking at my data because at the end of the day, we have to be there for our staff and our leaders. So. Number one is not hiding it under a bushel, bring it out, talk about it in your communities, in the press, in the legislature background of our state capitals. We have to tell our story. It's no longer acceptable. I know in 32 states it's now a crime and in 38 states it's a felony. I can't imagine that it's not a felony in every single state. And so it really, it was shocking to hear that data. And you see that on the news all the time, right? You hear the reports and the stories. And I know you have dealt with that personally as well. Do you have any examples that you'd want to share? So I will tell a story because we learn as clinicians with storytelling. So I will tell the story of the tragic events that happened in the Dallas-Fort Worth market when a social worker and a nurse were killed at our. at one of our competitor hospitals and we knew pretty quickly that was unraveling. And so we were there for that hospital in the sense that it happened in a women's service unit and we were there in the sense in case they had to transfer patients. What we were not prepared for and now as I speak nationally I talk about being prepared for your competitor to call you in a dire state of need. or something you may not be prepared for what they're going to ask for. So we assumed Methodist was going to ask for transfers or maybe a sending some staff, which we would have gladly done. But they called and asked for us to take the assailant, the shooter, once he came out of surgery. So as a leader, myself and the chief nursing officer of that particular entity, our first reaction was, how can we possibly subject our own staff to caring for that individual. Then we went and spoke to the nurses. The chief nursing officer of my entity that was asked to do that, she asked her nurses. And her nurses said, bring him over here. The minute he's stable out of the OR, bring him over. It is the best thing we can do for Methodists right now is to help them care for that assailant. So we brought him. The press knew he was with us. I mean, I'm not telling anything that's not already there, but be prepared to help your competitor hospital solution anything they need. Because one day it will be us, and I will be reaching out to my competitor hospitals very unique in the ask and we're all in this together it's not okay in any environment and it's just a matter of time before we're all exposed to that so just think out of the box and what you can do for peer support for your other hospitals. Thank you for sharing that I it just makes me even emotional thinking about that experience I can't even imagine what was happening at Methodist as well as what was happening at your hospital as well too and I just as a I mean that has to be so hard to understand you're dealing with trauma and then you have and we call them competitors but obviously we're serving patients and we're serving humans so I love the fact though that and that's one of the great things about nurses right is they're willing to do anything for anybody. They have that servant heart and that's why we love our nurses and all of our clinicians. In your work with workplace violence governance, what kind of support structures have you found to be critical for staff who have experienced violence or aggression? So it's a full package. It's a full beginning to end of what we're here to do for our staff. So let me start at the front door of that. As we started to build some toolkits, some policy writing, some technology layered in, we knew that immediately that the incivility and the hostile environments have to start with us and how we treat each other. So in my particular organization in the Workforce Violence Toolkit, we start with incivility and mutual respect. And that it's not okay. to bring on new employees and treat them unkind. Anyone that starts a new job is unfamiliar with the environment and they need a partner, they need a colleague to help navigate with them. And it just shows the love and the compassion we have for each other and that we're glad you've joined our family and we're going to help navigate that. So incivility and bullying is non-negotiable anymore between any discipline. Physician to nurse, nurse to nurse, nurse to tech has to be called out unacceptable. So that started the journey. And then layered through there are some processes of non-tolerance actually discharging patients from care if we need to, how we escalate an incident and bring leaders to help support is embedded, all the way to data collecting. I'm going to talk about that for a moment. Okay. Data collecting is vital to understand what you're faced with. We data collect with infection rates. We data collect with retention rates. We have to data collect around violence. Not only for internal solution, but external knowledge. Whether it's with our legislators or our communities or our police forces, we have to collect the data. Healthcare professionals sometimes have a hard time and telling the story of incivility and abuse. Because we should have tough skin, right? It's part of the job, right? It's what we signed up for, but it's really not anymore when you're trying to improve a process. Data collection is important. So we constantly look at that data and if we see an entity that maybe is not reporting enough, we challenge them because they're not immune to what I'm talking about. And so data collection is crisp in order to build solutions. And I think we have penetrated that pause and I don't have time to write that incident report or I don't have time to call my leader. I'm just going to deal with it internally. No. We cannot create solutions without data. So that's part of the toolkit. And then I will tell you in my current organization, it's very, very important to have workforce violence updates for the staff to know what we're doing. It's one of our internal intranet sites that is constantly refreshed. Very much like when we went through the pandemic, we were constantly have data feed. So workforce violence has to be that front and center for any healthcare organization across this globe right now. You have to have a program, you have to have data feed, and you have to help the staff with solutions. Now, we may not always prevent every single incident, but we have to listen. and we have to be perceived as realizing what it looks like on the front line. Absolutely. I think it was startling when I read the statistics that 20 to 60 percent of the workplace violence incidents go unreported. Why are some of the reasons they would go unreported? Does it have a lot to do with the fact that they just don't want to stop or because there is kind of that stigma that it's just part of the job? I don't think they want to stop. Some of those inflictions of abusive behavior comes from fear of the unknown and absolutely panic and anxiety that I'm sick or my loved one is sick and you're not doing enough for them. So, as clinicians, we have to realize that that's the state that the family member and the patient are in right now, help them navigate it. But it's still not acceptable to be treated that way. So we're getting better. The whole nation's getting better about telling their story, but we can't stop because the solutions are not completely in place. As you mentioned, it's not a felony in every single state. It will be one day, but it's not there yet. Thank you. Thank you for sharing that. And given the OSHA guidelines for preventing workplace violence in healthcare, how do you see the role of technology in monitoring and improving safety in healthcare environments? It's evolving. all organizations are on, what technology can we deploy to make our staff members feel somewhat safer, what documentation can we put in the electronic health record for us to realize what we're dealing with, how can we all speak the same language about escalations, and then front and center is what and what are the pieces of the toolkit to navigate through that environment. And nursing school did, I never in my wildest dreams thought that we would have to have armed guards. that we would have to label patients based upon their behavior at the current state that we're up against a situation with, you know, some evidence-based tools of how you're assessing the patient and the family. Panic buttons. and alarms. We have them at my current organization, but I never dreamed going to nursing school that we would be in the situation we're in today, but we've got to keep talking about it. In order to bring solutions to the table, we have to speak about it. It's amazing because I don't think in any other industry, maybe TSA, where you're actually expecting to walk into the job and potentially be assaulted or be verbally abused or physically have to walk into that or clinicians walk into that environment. That is definitely a mind shift and I think it probably has some implications into people wanting to come into the option and so it's so important that we have those technologies and that all of our hospitals are utilizing the tools to help make sure that everyone gets to feel safe. And we're learning from each other. Healthcare systems are very good at sharing best practices. So we publish, on how we're going to solution this particular hot spot today because the solutions today will look different, you know, a year or so from now. That's how we're driven by evidence based practice and publications very much like I've already talked about with Spana Control. That's how we learn to navigate this pandemic. So we're our network community is very rich on this topic. I love that. I love that we can come together on this with the goal of zero preventable harm. Can you share some of the ways in which technology is being leveraged to predict and prevent potential threats to both staff and patients? I can. I can speak to evidence-based tools that are deployed. in nearly every electronic health record based upon assessments and trigger points. And then from that, what does your toolkit look like in terms of maybe a buddy when you deal with that particular patient or family or where you stand in the room between you, the patient and the door. Just different toolkits that are being built nationally to help the clinician know that that I'm about to go in a situation where an occurrence or a history of behavior is already present. So it's more about even just the situational awareness, like hey, how far away from the door am I? Right. And that must even now have implications on how you design floors of hospitals so that you can make sure that the patient is further away from the door than when the clinician enters. My gosh, this is getting really complex. It is very complex. Wow. Okay, as we look at the goal of zero preventable harm, this brings us to the importance of a positive work culture and the concept of joy at work. And you've already done a great job about talking about how we as humans should just really give each other respect. But let's talk about some of the psychological and emotional aspects of workplace safety. How does finding joy at work relate to the prevention of workplace violence? One of the things that I've found very effective, is storytelling related to incidents because we all learn. And we realize that we're not isolated in the workplace violence environment. And joy then starts to come back into your conversation that I'm not isolated related to what I just went through. So peer support is vital. coming off of an event, but preparing you for the next event. So joy and connection related to coming off of an event has to be swaddled, I'm going to use that word, with peer support around our nurses, our physicians, our leaders. Or joy starts to dissipate. When we go through tragic events, realize that I might not be in trouble 24 hours, 48 hours, or 72 hours after the event. I might be troubled. after the event. We're humans. We're tough. We're cold and we have thick skin. But we are humans and when incidents occur in our life, professionally or personally, we have to have resources or the joy evaporates. So just make sure in any environment that you have a swaddling program and the DNA of the in that environment supports the clinician. Awesome. We know that nobody gets to be their best self by themselves, and so it's that partnership and it really even goes back to when you're talking about the spans of control from a leader's perspective and what does that team dynamic look like? When they go to their leader or if there are support structures, is it welcomed or is it something that they feel isolated and that they feel like they have to handle on their own? and you think about what we're trying to bring back into the profession, what are some of the barriers that are preventing some of this joy from entering into the workplace or into the into building the communities within the hospitals? So one thing that comes to mind that I love doing is succession planning and equipping leaders with something new every single day to help them be there So any all organizations must have programs that are continually fed with investments and tool kits and aspects for leader development. Leading today is totally different than leading before the pandemic. So we've got to pause and we've got to have strong programs. to constantly build our leadership infrastructure. that can promote joy in the workforce. I think we're all connecting the dots back to span of control, what a transformational leader really looks like, building the relationships, growing our own, how do we produce the next tomorrow's leader, and what does that look like? And joy in the environment is front and center to their toolkit. Absolutely. Humans crave that progress. Yeah, yeah, like everybody needs to see that I'm progressing or I have opportunity. And when we think about that word development, formally, we used to think about it as a ladder. And now it's very much a lattice. Oh, you better believe it. And so now, like when I'm talking to clients about their talent planning or succession planning, it's a lot about, well, how do we help create new opportunities for them? Like what if there's a rotational program, right, where they can go try out different if you think about some of the skills of the future, prompt engineering and everything with AI and chat GPT, which is a really fun tool to go play around with until you start asking about medicines. I read a story the other day that said, don't ask about medicines. And then I tried it and I was like, man, that could be kind of dangerous. But there's gonna be a ton of new skills of the future and we have to really make sure that our development plans, our succession planning is built around that. So I'm glad you guys are doing that. You advocate for compassionate connections among health care staff. Can you tell us what you mean and how has this improved workplace culture and patient care outcomes? Compassionate connection is being present, developing that relationship for someone I'm caring for at this moment. It not only fills my cup up as a clinician, it keeps my joy brewing and I have to have the time in the process built that I can connect. or I will burn out and I will burn to a crisp. So, Compassionate Connection is really, really published in the literature, especially by experienced companies, Presgani, others, that it is real and you have to pause not only for your new graduate, but maybe your seasoned nurse on how do we connect with who's in the bed or who's sitting across the exam table. And it's not just for the clinician, for the housekeeper that goes in the room, the access service person that goes in the room. We are here to care for you in a very frightening time and compassionate connection has to be part of my daily purpose and calling. I'm just not task oriented. I have to connect. Yeah, so whether you're the CEO or you're the janitor, you have to have that mindset. Awesome. Alright, Dr. Walker, if you could challenge our audience to take one specific action or adopt a mindset shift based on today's conversation, what would that challenge be? To be present as a leader, to crave continual learning, to fill your cup up with relationships and fellowships. and networking every single day. You never know where God is gonna lead you in this world. And you never know when you need to dial a friend. So where's my connection? Where's my purpose? And connecting the dots, that network community is powerful. And without it, you as a leader start to burn out. And so learn something from everyone you meet every single day. Awesome. Mama J, thank you so much for sharing with us today. I hope you all connect with Mama J on LinkedIn. Are you on Instagram? I am not, I'm on Facebook and LinkedIn. Okay, LinkedIn folks. If you don't do Facebook, that's totally fine, but definitely LinkedIn for sure. Thank you for joining us today on Elevate Care. We hope you enjoyed this episode. If you found this podcast valuable, please consider liking, subscribing, and leaving us a review on your favorite podcast platform. Your feedback means the world to us and helps us to reach even more listeners just like you. You can learn more about our show on our website at amnhealthcare.com and follow us on social media to stay updated on new episodes and the ever-changing world of health care. Thank you for being part of the Elevate Care community. Until next time, keep elevating health care and remember that together we can create a brighter, healthier future for all. Special thanks to AMN Health Care for making this show possible.