By Heather Duge

Since the beginning of 2023, Sheralyn Hartline, DNP, RN, CNEP, RNC-NIC, and Stefanie Tanner, MSN, RN, BCEN, have shifted into leadership roles as part of the opening of Cook Children’s second Medical Center in Prosper, Texas. Both nurses described opening a new facility as a unique experience – one that has challenged them and allowed them to think outside the box. 

“We are here to guide the ship, but the staff took ownership of our processes and ultimately provided the safest, quality care for our patients,” Sheralyn said.

Stefanie said it has been a year of robust learning.

“The community, market and population are very different in Prosper so it’s not just copying and pasting what is being done at the Fort Worth campus,” Stefanie said.

Providing the highest quality care and a one-of-a-kind experience is always at the top of their minds as they know people in Prosper have many options to choose from when looking at hospitals.

“As we enter new territory, it has been increasingly important to be involved in community events and build relationships with leaders in the region,” Sheralyn said.

Sheralyn, assistant vice president for Nursing and Patient Care, and Stefanie, director of Nursing and Patient Care, worked to create and implement processes to improve practices for 200 nurses across multiple departments at the Prosper campus.

“Our teams refined what is working well,” Sheralyn said. “We also found processes that we needed to take back to the drawing board."

One of the projects spearheaded by Morgan Cotton, Clinical Risk/Quality Improvement coordinator and Amanda Pulley, manager of Laboratory Operations, is the Emergency Department and Lab Specimen Integrity Project. The interdisciplinary team worked together to provide solutions for keeping specimen integrity.

Another project led by frontline staff called Difficult IV Access (DIVA) involved collaboration with child life specialists, Advanced Care Technicians and nurses to improve the process for IV placement and infiltrations. Now, a nurse from the DIVA team who is trained to place IVs in patients with difficult access can be called at any time.  

Sheralyn and Stefanie also have supported many educational opportunities on the Prosper campus such as the emergency nurse pediatric course, the trauma nursing core course and crisis prevention intervention, largely driven by clinical practice and advanced education specialist Lucinda Berent.

“It’s a huge plus for staff if they don’t have to travel to Fort Worth or elsewhere to get certifications,” Sheralyn said.

Previously at Cook Children's Medical Center - Fort Worth, Stefanie served in the Emergency Department and Sheralyn led the Level IV NICU. Their different perspectives complement each other well. The dynamic duo communicates with each other from the moment they wake up until going to bed.

“I am a thinker and Sheralyn is a feeler,” Stefanie said. “We are both very outgoing and truly love our jobs. It’s busy and some days are 10 to 14 hours, but when I’m collaborating with Sheralyn, it doesn’t feel like work. I feel like this is what I get to do every day and I’m lucky to get paid for it.”

Sheralyn agrees and says she is blessed to be able to go to a job and do what she loves all day. Her passion for our organization’s Promise is reflected in all that has been accomplished since the opening of the Prosper facility.

“We are so proud of the culture that the team has created in Prosper while using our Promise as the guiding compass,” Sheralyn said.

Ashten Fleming, DNP, RN, NEA-BC, is the newest member of the all-female team at the helm of the Cook Children’s Physician Network (CCPN). In January 2023, she stepped into the role of Assistant Vice President of Primary Care and Specialty Services. She joined Vice President of Primary Care & Specialty Services Veronica Tolley, MHA, as well as fellow Assistant Vice Presidents Tara Allen, FACMPE and Teresa Baker, FACHE. Together, the four women work to support primary and specialty care practices and CCPN. The network began in 1995 and includes more than 700 primary care and pediatric sub-specialty physicians with offices in Tarrant, Denton, Parker, Johnson, Collin and Hood counties plus West Texas.

Ashten’s specific role focuses on operational development and implementation of business strategies support for Cook Children’s providers and departments. In one recent example, she helped onboard a new specialty practice of physicians and staff, connecting them with all the resources they need. Growth and team building is one aspect of the role, in addition to supporting quality patient care, managing market trends that might affect the teams, and working in collaboration with the system and providers to integrate technology to support sound financial and patient care outcomes.

Prior to coming to Cook Children's, Ashten worked at Medical City Healthcare for ten years, most recently in an assistant vice president role.

“What I love about coming to Cook Children’s is the special culture it takes to deal with pediatric patients,” she said. “There really is something different here - the kindness with which we interact with each other is really a big thing.”

Ashten had always wanted to be a nurse -- she enjoyed working with people directly and meeting people where they were. She attended Southwestern Adventist University for her BSN, the University of Texas at Arlington for her MSN and the University of South Alabama for her Doctorate of Nurse Practice Executive Administration. But she always found herself in leadership roles, either as the charge nurse, clinical supervisor or committee leader. At her first job, her bosses told her she belonged in the director development program.

“I didn’t want that. I went home and prayed and I said ‘I didn’t want this for my career, so if you want me to do that, you’re going to have to do all these things,’” she said. “That prayer was answered very specifically and I said okay, ‘I heard you.’ And six months later, I took on my first director role and it’s gone from there.”

Since stepping into a leadership position, Ashten discovered she can advocate for patients and her clinical team on a higher level. Even if it is a different path than she envisioned, she now finds genuine joy in her role and the impact she is able to have.

However, she is quick to point out she doesn’t do it alone.

Working together in a “hive brain manner"

Ashten and her three colleagues at the head of CCPN work together to tackle the many aspects of the program. In addition to supporting primary and specialty care practices, they oversee aspects of the regional clinics, telemedicine, physician recruitment, off-campus multi-specialty centers, UCCs and Neighborhood Centers.

They work together in almost a “hive brain” manner, Ashten said. When they receive a more specific request, it's likely at least one of them has the insight needed to tackle it.

Together, they work to encourage a culture of empowerment, self-awareness and communication among CCPN staff. They round with their departments and talk to leaders and staff, asking them for insights and feedback. Ashten works hard to be accessible to her departments and their needs; recently, she got feedback from one of her departments that she was “down-to-earth and approachable,” which was “really touching for me because that is my goal.”

In February, the team gave a presentation at a Cook Children’s director’s retreat in which they encouraged leaders to assess teams for working strengths and working frustrations and understanding the role each person plays on the team.

“We need all the different types of leaders and team members, and make sure we put them in the right roles,” Ashten said.