Grisel Fernandez-Bravo makes running a hospital from home sound easy.
The 1985 FIU nursing alumna works out of a spare bedroom in her role as chief executive officer of Memorial Hospital Miramar in Broward County. In the days since much of the country transitioned to remote operations, she has directed the setup of a triage tent in her facility’s parking lot (where as many as 350 people come daily for coronavirus testing), authorized the establishing of a wing of “negative pressure” patient rooms to isolate the infected, and rolled out training and protocols for maternity staff in the event of a pregnant woman presenting with COVID-19.
Fernandez-Bravo’s current arm’s-length leadership doesn’t sync with her usual hands-on, roll-up-your-sleeves style—the CEO has often been spotted on site in nurse’s scrubs, a sign of her on-the-ground commitment to patient care—but complete isolation is doctor’s orders: Fernandez-Bravo is undergoing treatment for bone-marrow cancer and cannot afford exposure to the virus that has upended much of the world. Frankly, it would kill her.
“Luckily, I feel OK,” she says over the phone, her strong voice and upbeat tone belying any trace of the fatigue that accompanies someone in her severely immunocompromised condition. “It’s one of those things that you just have to push through.”
Fernandez-Bravo actually stepped away from duties in January when she began a nine-week course of treatment at Boston’s Dana Farber Cancer Institute. Her boss, an executive within the Memorial Healthcare System, of which her hospital is a part, covered for her during that time. She returned to South Florida during the first week of March, just as the region saw an uptick of virus cases, and has been fully back at the helm 24/7 ever since, albeit from home.
Every morning, weekends included, begins with a 7 o’clock call during which she goes over reports and gets details coming out of the incident command center. How many folks tested positive over the past 24 hours? How many were moved into critical care? How many beds remain available?
Other meetings have her interacting with physicians who serve on the hospital’s medical executive committee and with top-level administrators of the five other institutions within the Memorial Healthcare System.
And then there are those who report directly to Fernandez-Bravo and keep her connected day and night: the chief medical, nursing, financial and administrative officers who serve as the CEO’s eyes and ears while turning to her for guidance and decision making on every aspect of the hospital’s operation.
“As frustrating as it is for me personally because I can’t be there physically, I know that I have an amazing team,” she says. “We all work so closely together, we all know each other really well and what the expectations are during a time like this. As hard as it’s been, I can say that we’re doing extremely well.”
Also holding a doctor of nursing practice degree and an MBA, Fernandez-Bravo chalks up her ability to lead remotely in such an historically unprecedented time to her decades of working as a boots-on-the-ground nurse and, later, chief nursing officer, before ascending to her current position in 2016.
“Because I’m a nurse, I can do it with my eyes closed. Because I was an ER nurse, I know what the demands are and what happens in these types of situations,” she says. “As a nurse, regardless of what role I’m in, I care for patients. That’s what I’m doing. And because I happen to be a CEO, I also take good care of my employees,” she says of the 2,100 who work at the 178-bed hospital. “I make sure that they’re safe. I make sure that their needs are being met.”
Aurelio Fernandez (no relation), the CEO of Memorial Healthcare System, has no qualms about Fernandez-Bravo’s capacity to keep things running smoothly. He is himself a two-time FIU alumnus, having earned a bachelor’s in business administration in 1974 and a master’s in health services administration in 1985, and recognizes her ability to rise to the challenge.
“She is a valuable player, and we’re not going to let her down,” Fernandez says of making accommodations as necessary to keep her in charge. “She's got good people that she relies on, and we will support her.” Currently quarantined himself after testing positive for the coronavirus (he feels fine, he says), Fernandez knows what dedicated professionals with years of experience can accomplish even under the worst of circumstances.
“Her being a clinician, she focuses on patient quality outcomes, and that has contributed to the positive results” both now and throughout the years, he says. Fernandez adds that under Fernandez-Bravo’s watch, her hospital has maintained its coveted “A” hospital safety grade from the national organization that rates institutions on preventable errors, accidents, injuries and infections. That succeess he attributes to her.
And while staying physically away does not jive with Fernandez-Bravo's preferred way of conducting business, she knows better than most the consequences of not heeding all precautions. While her own case is extreme, that of her 27-year-old son should serve as a warning to society’s seemingly heartiest.
“This is a kid who was very healthy, who was a college athlete and is in great shape,” she says of the recent law school grad, who was nearly hospitalized with COVID-19 but has since turned the corner. “He has never been this sick in his entire life. It just crushed him. It was unbelievable.”
Of her own situation, she remains hopeful.
“It’s not curable, but it’s treatable,” she says of the cancer. Her treatments will continue over the next several months, and she takes strength from a family that “has been more supportive than I could ever ask for.” (In addition to her son, she has a daughter who is a nurse at Joe DiMaggio Children’s Hospital).
The opportunity to lead in such a doubly difficult time also keeps her going.
“It means a lot to me that I’m able to do this [job] and be a resource right now,” she says. “I have faith in God that he will help me through this. I have work and I have family. And so I have everything.” ♦