Open To Work
Debra L. Risser
Transformative Nursing Leadership
Custer,SD
Summary
**Purpose-Driven:** Enhanced patient outcomes and caregiver development by aligning care provision with organizational mission, vision, and goals through strategic initiatives and evidence-based practices.
Overview
28
28
years of professional experience
1
1
Certification
Work History
Resident Care Manager
Fall River Health Services, Seven Sisters Living Center
02.2025 - Current
- Oversight of Memory Care, Activity Program, CNA/CMA Scope of Practice
- Resident care planning, compliance with CMS guidelines, and operational initiatives
- Directed CNA Program and Mentor Program
- Served on and facilitated committees: QAPI, Safety, Medication Safety, Golden Cup, Interdisciplinary Teams, Leadership, Oasis Leadership Orientation, Caregiver Recognition Planning
- Oversight of scheduling, payroll, position control, hiring, and performance management with coaching focus
- Strategic Initiative Development and implementation sustained
- Directed CNA Program and Mentor Program
- Competencies to validate competence
- Increased caregiver recognition (WOW’s, completion of CNA and Mentor Programs)
- Revised CNA, CMA, Activity, and Nursing Orientation checklist and pathway
- Created and initiated caregiver huddle to improve communication and safety
- Standardized leadership orientation
- Resident and caregiver rounding by leaders
- Staffing and task revision to improve resident care
- Operational achievements
- 100% pass rate and certification for the CNA Program
- Mentor Program decreased CNA and nursing turnover
- Improved caregiver engagement scores
- Earned 4 Star Rating from CMS 2025
Staff Development
Fall River Health Services
04.2024 - Current
- Provided opportunity to lead and define new position of Staff Development Coordinator responsibilities
- Committee involvement: Synergy Squad, Service Excellence Advisor, LEAN Process Improvement (Recruitment & Onboarding), QAPI
- Strategic Initiative Development and implementation sustained
- Complete revision of orientation checklists and competency verification processes for Med Surg, ED, and Long-Term Care, RN, LPN, CNA, CMA, Paramedics
- Complete revision of CNA program to include didactic and simulation experiences. Currently directing CNA Program operations
- Created and currently teach Mentor Program
- Designed reward and recognition programs (CNA, Mentor)
- Initiated and teach Psychological Safety
- Created nursing/paramedic/CMA, CNA competencies for Med Surg, ED, and Long-Term Care
- Operational achievements
- Patient-centered orientation checklist and onboarding decreased length of orientation, increased caregiver feedback regarding support and confidence
- 100% pass rate and certification for the CNA Program
- Mentor Program decreased turnover rates
- Increase in caregiver engagement
Nurse Manager – Acute Care, ED & Primary Care
Monument Health Custer Hospital & Clinics
12.2020 - 01.2024
- Operational performance management of Critical Access Hospital, Emergency Department, & multi-site Rural Health Clinics
- Position control and hiring process
- Patient and caregiver rounding
- Compliance with regulations
- Facilitated or member of committees (shared governance, CLABSI, CAUTI, Safety, QAPI, Health Informatics, Nursing Operations, Leadership)
- Performance management of 60 caregivers (RN, LPN, CNA, ED Tech, Clinical Assistants, CMA)
- Strategic Initiative Development and implementation sustained
- Outpatient infusion & wound care workflow modification
- Rapid Response process in all locations
- Standardized triage processes
- Standing orders and standard operating procedures in ED, Medical-Surgery, Outpatient and Clinic settings
- CRN leadership development
- Preceptor standard work
- Competency for nursing and support roles
- Patient-Centered Onboarding Pathway and competency validation increasing caregiver competency and decreased length of orientation
- Tiered safety huddles initiated in all settings
- Clinic workflow training, and escalation processes for EPIC in baskets
- Clinic schedule revision, standardized nurse rooming and pre-charting processes
- Quality Dyads created
- Medical Director and Nurse Manager – operational and communication focus
- ED Physician and RN – STEMI and Stroke
- Clinic Physician/Hospitalist and RN – standing orders and standard operating procedures
- Nurse Manager and CRN – patient acuity
- Pharmacy and Outpatient RN – infusion management and services
- Pharmacy Director and Nurse Manager – implementation of Pharmacy Tech role and IV/med compounding room
- Operational achievements
- Increased physician RVU from 10-14 to 20-28
- Increased inpatient and ED Press Ganey scores, earning 2023 Guardian of Excellence Award
- Increased caregiver engagement from 39th percentile to 87th percentile
- Expanded outpatient infusion services, revenue increase from 1 million to 6 million in 3 years
- Partnered with Pharmacy to introduce Pharmacy Technician role in care delivery
- Implemented Respiratory Therapy Services
Clinical Nurse Manager – Emergency Services
Monument Health, Rapid City Hospital
03.2015 - 12.2020
- Operational performance management of Level II Trauma/Stroke Center with census of 120–150/day and 147 caregivers
- Ensured regulatory compliance (CMS, Joint Commission)
- Facilitated and member of quality committees (Nursing Operations, Patient Experience, Health Informatics, Disaster Management, CLABSI, CAUTI, QAPI, Trauma, STEMI, Stroke) supported budget prep, and advanced process improvements
- Budget oversight, FTE management, Position Control
- Developed, taught and advanced process improvement across multiple departments
- Strategic Initiative Development and implementation sustained
- Facilitated and led operational redesign of 32-bed Emergency Department
- Created and defined processes for Vertical Care and secure behavioral unit
- Created and taught Critical Care Trauma Lead and Patient Flow Coordinator roles
- Standardized nursing handoffs, communication boards, CRN leadership development, and preceptor programs
- Defined Stroke Alert Pit Stop Process
- Revised OB standards of care and documentation in ED
- Created standard operating procedures (rooming patients, triage, boarding patients, diabetic care)
- Modified STEMI Process
- Defined and initiated Sepsis Alert
- Facilitated Team (inpatient and ED) electronic handoff process
- Defined and initiated cross departmental shadowing at onboarding
- Complete revision of interview process
- Created caregiver immersion scenarios to improve patient experience
- Created and taught CRN leadership development and preceptor program
- Defined and initiated bedside nursing report and standardized process in ED
- Assisted with design and initiated ED communication boards
- Operational achievements
- Successfully operationalized workflows in new ED (trauma, vertical care, triage, behavioral health pods)
- Critical Care Trauma lead improved orientation, competence and decreased length of orientation
- Patient Flow Coordinator improved arrival/departure/inpatient unit transfer times, increased efficiency in door to doctor times and stabilized staff assignments
- SOP’s standardized care, improving orientation and efficiency
- Decreased door to CT times for Stroke Alerts
- Decreased door to cardiac catheterization times for STEMI
- Improved physician response times and intervention implementation
- Improved patient experience and caregiver engagement scores
Clinical Resource Nurse
Regional Health, Rapid City Hospital
09.2013 - 03.2015
- Delivered holistic emergency and trauma nursing care; proficient in ACLS, PALS, TNCC, NRP, NIHSS, STEMI protocols
- Mentored new caregivers, served as mentor
- Daisy Award Recipient
- Managed staffing, patient flow, acuity, safety monitoring
Patient Care Coordinator & Inpatient Manager
Greater Regional Medical Center, Creston, IA
01.1998 - 01.2013
- Operational performance management of Medical-Surgery, ICU, Labor and Delivery, and ED units in unionized critical access hospital
- Payroll and budget oversight
- Ensured regulatory compliance
- Policy development and review
- Facilitator and member of Executive Medical Staff, Board of Trustees, QAPI, Leadership committees
- Caregiver education, development and succession planning
- Disaster management
- Direct patient care, preceptor and mentor
- Strategic Initiative Development and implementation sustained
- Managed staffing, schedules, patient flow, acuity and utilization review
- Lead for strategic initiatives and process improvement (caregiver 1:1’s, rounding, huddles)
- Revised staffing plan and schedules to mitigate overtime
- Collaboration with physicians for triage process for ED and Clinic
- Created education for charge nurses to better manage patient acuity and flow
- Collaboration with quality for admission criteria and discharge planning
- Operational achievements
- 100% staff retention
- Modified staffing and schedules to decrease overtime
- Decreased length of stay
- Decreased overtime
- Triage process improved patient arrival to appropriate level of care
- Improved appropriate level of care with utilization review
Education
ADN - undefined
Southwestern Community College
Skills
Nursing Leadership & Operational Performance
Emergency, Critical Care, & Acute Care Management
Rural Health Clinic Operation
Direct Patient Care
Press Ganey & Patient Experience Initiatives
Regulatory Compliance (CMS, Joint Commission)
Labor Relations and Collective Bargaining with Unionized Workforce
Process Improvement (LEAN, QAPI)
Strategic initiative planning and implementation
Hardwiring and sustainability
Performance Coaching & Mentorship
Policy Development & Implementation
Scheduling, Payroll, & Position Control
Budget oversight
Interdisciplinary Collaboration
Electronic medical records
Epic Med/Surg/ED/Clinic settings
Point Click Care
Meditech
Certification
ACLS, PALS, NRP, NIHSS, ENPC, STEMI, Stroke & Trauma Care, Lean Yellow Belt
AWARDS
Exceptional Nurse Summit Award Nominee (2025), Service Excellence Advisor Summit Award Nominee (2025), HX Guardian of Excellence Award | Emergency Department | Monument Health (2023), Leading Star Award (2021), DAISY Award Recipient (2014), DAISY Nominee (2020)
Accomplishments
Achieved HX
Work Preference
Work Type
Full TimeLocation Preference
RemoteTimeline
Resident Care Manager
Fall River Health Services, Seven Sisters Living Center
02.2025 - Current
Staff Development
Fall River Health Services
04.2024 - Current
Nurse Manager – Acute Care, ED & Primary Care
Monument Health Custer Hospital & Clinics
12.2020 - 01.2024
Clinical Nurse Manager – Emergency Services
Monument Health, Rapid City Hospital
03.2015 - 12.2020
Clinical Resource Nurse
Regional Health, Rapid City Hospital
09.2013 - 03.2015
Patient Care Coordinator & Inpatient Manager
Greater Regional Medical Center, Creston, IA
01.1998 - 01.2013
ADN - undefined
Southwestern Community College