Karen Ripper, BSN, MBA

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Most nurse executives' résumés list a number of experiences in different hospitals or healthcare institutions. This innovative leader has been able to pursue her education, accept new challenges, and advance in her career within one system. All of her nursing profession has been practiced in her hometown and the community where she grew up. Her long-term attachments to the organization and community have enhanced her experiences as a nurse leader.

KS: You've held a variety of roles within your system. What was your first nursing position there?

KR: Actually, my first job at Martin Memorial Medical Center wasn't as a nurse and it wasn't an actual paying job. Do you remember a hospital program called candy stripers? I was one of those teenage volunteers. I had visited my mother when she gave birth to her seventh child and, even at that age, was offended by the lack of sensitivity from some of the staff. I thought, “I could do this better. I could make a difference for these OB patients.” So, I went to an ADN program and, in 1975, started as a newly graduated registered nurse in med/surg. A year later, I transferred to obstetrics, and 4 years after that, I was the director of the OB unit.

KS: You accomplished a goal set at 15! But you didn't stop there. Please share your career progression with us.

KR: Sure! In 1990, I was fortunate to be on the leadership team when we opened another hospital, Martin Memorial South. Five years later, I was named the administrator for that campus. In 2000, the system's chief nursing officer retired. I was promoted to that position and then also became the administrator for Martin Memorial Medical Center.

KS: The system obviously believes in promoting talent from within. You stated your original nursing degree was an ADN, but I see that you have other professional designations. Did you obtain those while working as a nurse?

KR: Yes. I wanted to continue my education, so while I was working, I pursued my BSN, one course at a time. Then I went after my MBA and obtained my FACHE credential. I also got certified as a CNAA by the American Nurses Association Credentialing Center.

KS: Like many nurse leaders today, you have a master's degree in business. How has the MBA helped you?

KR: My MBA has helped me advance in my career. The education taught me what it takes to run a business, understand finance, HR, and the legal aspects of health and business. Frankly, it also gave me a voice at the table because, since the C-suite is dominated by male MHAs, the education gave me credibility. It prepared me to talk the lingo and to translate clinical and quality initiatives into the language of business. It also taught me to be more data driven and business results oriented.

KS: You're the model of continuing education for nurse leaders. Are you done with school, at least for awhile?

KR: No, I am headed back this summer to begin an MSN track in nursing leadership, and then one day my goal is to obtain my PhD so I can teach nursing.

KS: Since past performance is the best predictor of future success, I have no doubt you will meet those goals. So you've worked and continued your education at the same time. I assume you also have a family life?

KR: Yes, I have been married for 34 years and have a 13-year-old son. I think I have a pretty balanced life. When I was building my career, becoming a mom was not the priority. Now the enjoyment of being play counter for my son's Pee Wee football team on Saturdays is fulfilling and a priority. It is good for work-life balance to have a partner who understands career needs in addition to family obligation. My husband is most supportive in all my endeavors and is always there as an objective listener as well.

KS: What has been your most rewarding experience as a nurse leader?

KR: Opening our heart program. This community has yearned for local cardiac care so that patients would not have to continue traveling away from their support systems for that care. The community and Martin Memorial tried for 20 years to get a certificate of need. We didn't give up; we worked with the legislature, and finally we were able to get the CON approved. The governor and state representatives helped us. They realized how important it was to our community when the closest cardiac care hospital was 20 miles away. Construction of the building began in 2004, and I am proud to say we opened for business in August 2006. I was fortunate to be the team facilitator for the project.

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KS: How has the community responded, now that they finally have local cardiac care?

KR: It's been phenomenal. We've already touched 4,000 lives between our cardiovascular lab and our open heart surgery services. Our program is comprehensive, including a cardiac ICU, step-down unit, after care services, and cardiac rehab. The testimonials from patients and families are heart warming. One of our patients, a 28-year-old woman who suffered cardiac arrest a couple of times before angioplasty, speaks at community events about her experience with us and how we changed her life. She helps with our efforts to educate community members about the growing trend for young people to be victims of heart disease.

I, myself, had an experience with a family member who needed cardiac services 3 months before we opened our center. I saw firsthand what families go through when they can't get local care. That experience intensified my enthusiasm and pride in our center.

KS: What a gift to your friends and neighbors to not have to travel for care at such a stressful time in their lives. How did you recruit cardiac care nurses into the community?

KR: We didn't! We knew it would be difficult to recruit experienced nurses down here, so we grew our own. A year and a half before the first patient care, we partnered with Munroe Regional Medical Center in Ocala, Florida, to educate our staff. We selected nurses who volunteered from our OR and ICU because they wanted to learn this specialty. They traveled to Ocala for training and spent time training in the cath lab as well. The Ocala Heart Institute physicians and PAs led our surgical program in Stuart, as well as Munroe, so it was a seamless learning experience. The director of our unit came from another hospital with experience as a charge nurse. She's been a spark plug for the program because of her concern for people, which has been pivotal to our success.

KS: I understand that many hospitals in Florida experience wide swings in census depending on the season. How do you manage to staff for your patient care?

KR: Like other Florida hospitals, we close nursing units in the summer, and we import travelers in the winter. We have a MASH, otherwise known as a per diem pool. These are nurses who work more in the winter and take time off in the summer because of the seasonal difference. Incidentally, MASH stands for Martin's Answers to Special Hours. Our vacancy rate is only 4%, and because of our university affiliations and our residencies in the OR and Critical Care.

KS: Your concern for patients and staff is obvious to me. Is your organization on the Magnet journey?

KR: We are! We're laying the foundation for Magnet right now. Our staff is predominantly educated in associate degree programs; 30% of the nurses have BSNs, and we are in the process of offering all staff nurses education on nursing research. We've affiliated with Florida Atlantic University, have employed a nurse researcher, and started a nursing research fellowship program.

KS: Please elaborate on that.

KR: To sow the seeds for nursing research, we've conducted classes on what nursing research is and how to write a research abstract. After the classes, we solicited abstracts from the staff. Ten were submitted, and three were chosen through a double-blind selection process to be implemented. The three nurses whose abstracts were selected now receive 10 paid hours a month to pursue their studies. This is paid for through our philanthropy program.

KS: Donations to hospitals are often earmarked for capital projects. Philanthropy for nursing research programs is intriguing. Can you tell us more?

KR: We've received several major gifts from community members earmarked for nursing because donors have been touched by our nurses. We have a nursing endowment that funds our residencies for critical care and OR. Frances Lanford, a performer who sang with Bob Hope, left a trust to pay for resources needed by nurses. She knew that patients would benefit when nurses had funds for patient care and quality. The Chrysanthemum Ball Committee, which sponsors one of our big annual fundraisers, is considering dedicating this year's funds to nursing as well. They would specifically like to fund IT projects or projects that our nurses, as a group, feel are needed. It's great that so many of our patients and supporters know that nursing is front and center at Martin Memorial.

KS: Do you have any future projects planned right now?

KR: Yes, we will be opening a freestanding emergency room in September and are seeking a CON to open another hospital. And, as mentioned earlier, we are in pursuit of the Magnet designation. So much energy comes about when nurses become ever more empowered and gain control over their practice.

KS: You and your nursing team have obviously earned the appreciation of your community. Do you have any thoughts to share with your colleagues on how that kind of support could be elicited elsewhere?

KR: Yes. We all need to believe in the power of nursing. We are the voice for patients and their families at their most vulnerable times. We must sustain our passion for nursing and never lose our compassion and caring. Patients and communities will respond to that kind of professional commitment because great nursing is what they want and what they need.