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Hello, everyone.
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I am very fortunate to have Dr.
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Daniel Danielle Gable with us this morning.
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She is the CEO of Ventura County Medical Center and Santa Paula Hospital.
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Welcome, Danielle.
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Thank you, Kim.
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So great to be here.
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I'm so excited to have this opportunity.
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So thank you for considering me.
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Absolutely.
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I wanted to inquire with you on your perspective on a few things.
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The first one is can you walk us through your journey to the executive level position and the defining moments that shaped that trajectory?
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Absolutely.
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I think I had kind of a uh atypical path to nursing.
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Nursing wasn't something that I, you know, grew up wanting to do.
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I actually don't have anybody in my family who works in healthcare.
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My dad is an economist and ran a trade association.
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And growing up, he was like, you know, you should do business, you know, and that kind of thing.
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So it was sort of indoctrinated in that way.
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So I went to college and majored in economics of all things at Berkeley.
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And um wasn't like it didn't really resonate with me.
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I didn't like feel passionate, but I thought that was kind of appropriate for my age, you know, and station in life.
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And so I took a job at Enterprise Reniper, which has a really interesting and well-known management training program.
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And I thought, hey, you know, it's going to teach me some skills, maybe get me into some business and operations, and I'll see if that's something I want to do.
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So I worked my way up there for a few years.
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It was reflecting back, it was a defining moment in my leadership journey in the sense that it taught me a very important lesson, which is leaders need to roll up their sleeves and understand and experience all aspects of the business.
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They have a business model that I really, really admire, which is you start in your, like I would be in a business suit, I'd be washing cars.
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You'd wash cars, you worked with the car washers, you learned how to, you know, do park everything tactically on the lot.
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Then they taught you how to work at the desk and, you know, rent cars.
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Then they taught you how to pick up customers.
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And then as you worked your way up, you had to take a big exam in order to be promoted.
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And then they taught you all the accounts receivable, all this stuff.
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So it was super helpful.
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But um, you know, I was doing that for a while.
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My husband got into business school at UC Irvine and it was sort of a dividing opportunity for me to say, hey, what do I want to do?
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I knew I didn't want to work for an enterprise forever.
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And a friend of mine, her older sister, had just gone back to school to become a nurse.
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And she and I were always very similar.
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And so um my my friend said, you know, you should talk to my sister.
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I think you'd really like nursing.
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And I was like, nursing?
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You know, but I talked to her and something inspired was super interesting.
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And I came back to Enterprise on during my last week and I said to one of my colleagues, you know, I'm thinking about doing this.
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And much to my surprise, she said, I'm gonna do it too.
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Let's go.
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So she went to nursing school at Samuel Merritt, and I did my prereqs in Southern California, and then I went to Western University of Health Sciences because they have a master's entry program.
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We went through it different places, but went through it at the same time, and I never looked back.
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That was my journey into nursing.
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I think, you know, I started as an ICU nurse at Cedar Sinai.
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I think at that time, because I had some business background and some sales, you know, some expertise and operations, I kind of got earmarked early to be a charge nurse and then and a preceptor.
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So that happened to me probably my first two to three years of practice.
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And then I became kind of a permanent charge nurse.
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And then there was an opportunity for the assistant manager.
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And then I, you know, I did that.
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When I was at the assistant manager level, um, we got a new nurse manager in the neuroICU who has become one of the most influential mentors and friends in my life.
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She really identified something in me that she felt like I was cut out for progressive leadership.
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And that started a journey where I kind of followed her quite a bit.
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So uh at one point she was running all of nursing operations at Cedars, and she tapped me to open an observation unit where I got to create it from scratch, open my hire my own staff, which was wonderful.
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And then she ended up getting a job as the chief COO, but the main person at Cedar Sinai Marina Del Rey Hospital.
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And she brought me over there.
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Um, and I started as an executive in operations, and then I became the CNO there.
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And we worked together for many years.
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Very defining moment.
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Her name is Joanne Laguna Kennedy.
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She's a proud ACNL member and a dear friend.
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So that was a major influence.
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And I had a hard time leaving, I had a hard time leaving Cedars and leaving her, but had an opportunity to come work in a pub in the public sector for a county hospital.
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It was something so far from what I had been doing, but something that felt so right.
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One of the challenges I had in some of the other organizations where I worked was I didn't feel like it wasn't as impactful as a population that was completely vulnerable and would not get health care otherwise unless we existed.
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And I really loved that.
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So I came over here and um was this the chief nurse executive for our hospitals until about a month ago, and then got promoted to be the CEO, which um I still pinch myself.
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Really, really I'm very lucky.
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I think another defining moment was just a conversation I had a couple of years ago with my boss, who's now one step above me, where he said, you know, what's what's your vision?
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And I said, I don't know.
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I'm open, you know, I love being a leader, I love the county, I love the patience.
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And he was like, Okay, well, I think you should be the CEO.
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So I said, Well, you have a few years, aren't you gonna keep working?
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You're not gonna retire yet.
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And he was like, Of course, we have a few years.
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And then he it was on nobody's bingo card that he was gonna get promoted.
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Just a series of events happened, and so here I am, about two years earlier than I thought.
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Well, congratulations.
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And you know what?
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I can say they know talent when they see it.
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Well, thank you.
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That's very, very kind of you.
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It's been a journey and I'm learning so much.
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There's something, you know, new and exciting every day.
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Nurse leadership and CEO leadership are very different.
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Yeah, absolutely.
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Now, here's another thing.
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So recognizing that we have a workforce that we need, from your perspective, what are the greatest opportunities we have to strengthen alignment between service and academia?
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I'm glad that you asked me that question.
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Um, it's something that we were really lacking a few years ago when I came here.
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I think the first thing is making sure you have a really robust nursing pipeline program once they're graduated or near graduation that you have a nurse residency or transition to practice or whatever you call it.
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And in building that, like when we did it here, we brought in all the deanies and made sure that they all had input into what, you know, what they felt like their graduates might be lacking and meeting on the clinical side and, you know, kind of what what they thought their graduates were looking for in a place of employment.
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And that was hugely, hugely helpful for us.
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We maintain here in Ventura County, I think we're very blessed.
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Our local schools have a very tight collaborative where we meet quarter rate.
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We talk about not just regional clinical placements, but we also talk about issues where we're having trouble with placements, we're having, you know, any trends that we're identifying kind of across our disciplines.
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It's been hugely, hugely helpful.
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And actually now at this point, a lot of people call us from other counties saying, how can we do something similar?
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We're really in lockstep.
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We're really in lockstep.
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I think one thing that is really important when those two groups are working together is that we really place ourselves in the shoes of the other person.
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A lot of chief nurses and executives get frustrated because they think, like, why are the schools asking for so much of us?
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We don't have enough preceptors, we don't have enough space.
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And the reality is it's a result of the system and not of people's individual or personal preferences, and that we really owe it to ourselves as a profession to do whatever we need to do to help them get their placements and get people in the door because it's so, so important for the well-being of our profession.
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Um, I really treasure my relationships with the deans.
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They actually, I was, I um was so honored.
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They asked me to speak at the white coat ceremony at Cal State Channel Islands last year, which was so awesome, like a incredible opportunity.
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And then we consulted Petradyne, which is a really well-known university.
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They just opened some health sciences stuff, including a nursing undergrad, nursing graduate program, and now they're launching their DNP.
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And we consulted for them.
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It was awesome.
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Oh, those types of partnerships.
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I just absolutely love them.
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They're amazing and they get so much done.
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And because there's so much alignment or such need for alignment, I think what you're working with is amazing.
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Yeah, it's fantastic.
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We're really, really lucky, and I have a lot of great colleagues and role models to work with.
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So, you know, you had a lot of years as a chief nurse and now as a CEO.
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I know that they're frequently competing priorities.
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How do you navigate those?
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It's really hard.
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And I think, you know, under the current structure that we're dealing with in the healthcare system, with the impact of HR1, we're being asked to do even more with even less.
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And I think it really is important to stay aligned to what's your true North, you know, your North Star.
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I remember another mentor that I had earlier in my career, Dr.
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Linda Burns Bolton, uh, who's unfortunately no longer with us, but was an incredible icon to nursing.
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She always talked about connecting to your North Star.
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And I remember that at my core when I'm faced with two seemingly conflicting alternatives.
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What is really truly what is in the best impact of the community, the patient, and keeping that central to what we do.
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I also think you need to be the higher up you go in an organization, the more comfortable you have to be with creating boundaries and recognizing that sometimes somebody else's burning five alarm fire isn't yours.
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And you have to be careful not to get into that, you know, well, I have to solve every problem now.
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And then last but not least, I think you really got to rely on your organization's, you know, strategic plan and mission and vision and make sure that, you know, when you have competing priorities, you're ordering them in the order of things that align with your own strategic plan and the mission of your organization.
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Absolutely.
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And now, now that you are the CEO of a public facility, a public hospital, there are legislative things and regulatory decisions that'll be made that'll impact how you run the hospital.
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Absolutely.
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How do you think leaders can more effectively influence those legislative and regulatory decisions that impact nursing and health care?
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I think that's a really great question.
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And that's funny, when I was a newer manager and a newer nurse leader, uh getting involved in advocating was like the most intimidating thing for me.
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So I know a lot of us are not comfortable with that.
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But it, you know, the higher up you go up the food chain, the more important it is.
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I'm a tremendously firm believer in being involved in as many professional organizations as possible.
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Some of them do advocacy work and making sure that you are part of those efforts.
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I rarely turn down an opportunity to write a letter, visit with, you know, elected officials.
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In this role, I meet with the Board of Supervisors very regularly.
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I have the opportunity to bring to the forefront a lot of issues.
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Here in the public health system, you know, public hospital system, we're very engaged with CAPH.
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I do, they do a lot of advocacy and lobbying efforts on our behalf.
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So we're definitely involved.
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We have a seat at the table of multiple committees there.
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Though it's not an advocacy organization, I really want to attribute, you know, my participation in ACNL to a lot of my professional growth and understanding what it really means to be a nurse leader, what's really important, and networking with other people who are connected to all kinds of causes, big, big and small, that I may not have even known about, but that are important.
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I have had the opportunity to advocate quite a bit through those relationships as well.
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I think Kim, you know, a few years ago we decided um within the Healthy Work Environment Group at ACNL that we want to do some work on substance use amongst nurses, nurse leaders, and nurses.
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It's a it's a taboo, stigmatized topic that nobody wants to talk about, but it's real and it happens.
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And I would have never advocated for some of the changes that ended up getting to the table of the BRN actually, if I hadn't had had those connections with ACNL and a professional organization and met the right people.
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So hope that answers it.
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It sure does.
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And I want to congratulate you on your promotion to CEO as well as being elected president elect for ACNL.
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So Dr.
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Gable will be president for 2027.
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So thank you so much.
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Thank you.
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Thank you.
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Thanks for having me.
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Always good to see you.
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You too.
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Take care now.