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Special Nurses’ Week Edition

This month, we pay special tribute to Crozer-Keystone nurses with coverage of special events and awards that celebrate the nursing profession and the exceptional skill and success of our nurses in providing the very best care for our patients every day.

Center for Nursing Excellence Newsletter (May 2008)

In This Issue...

Walk in a Nurse’s Shoes Day: CKHS Administrators Appreciate Nursing Skill and Challenges

Do not judge any man until you have walked two moons in his moccasins.  -American Indian Proverb

Almost 40 Crozer-Keystone administrators learned about the daily challenges and rewards of nursing while participating in the system’s first “Walk in A Nurse’s Shoes Day,” held on April 23 and 24. Amazed by all that a nurse accomplishes each day, the administrators were also greatly impressed by the depth of compassion, dedication and professionalism shown by the nurses in caring for their patients and ensuring their safety and satisfaction. Following are observations from some of the administrators who participated and some nurses who hosted them.

Administrators’ Appreciation

Stephen J. Boff

Vice President and Chief Corporate Compliance Officer CKHS

It was rewarding to see that the patients who come to the hospital receive high quality care from the nurses and other clinical staff whose services relieve their pain, cure their illnesses and repair their injuries. The nurses demonstrated high clinical competence and genuine caring for the patients and their families. They quickly established a good rapport with each patient, listened attentively and quickly addressed their problems. For patients who had trouble walking, the nurses provided wheelchairs or other assistance. As someone whose job is far removed from direct patient care, this was a good reminder of how the nursing staff really carries out the mission of the hospital.

Richard Bennett

Executive Vice President & Chief Operating Officer CKHS

Aside from a better appreciation of the complexities of the care environment and the chaotic schedule, I was most amazed by the teamwork displayed by the staff. It was spontaneous and genuine. I observed this repeatedly at the Shock Trauma Unit at Crozer and the ED at Taylor with all members of the care team contributing. I was also amazed at what good teachers my host nurses are. David Bullen at Crozer and Lisa King at Taylor took a great deal of time teaching, showing and sharing their experience with me. It made me so proud to know first hand the good work our staff does every day and to know that when things get rough, these dedicated nurses have a loyal, faithful team to help carry them through.

Vera Kunkel

Manager of Worker Compensation CKHS

Shadowing Dee Smyth, RN, in Maternity at Crozer was truly memorable and fun. The job of a nurse is very physical and demanding—I just didn’t realize how busy you stay at all times and all the details involved in providing excellent care. I learned that you do what it takes to give the patients the care that is required for their well being. No task is too small or big—whether it be helping a new mother get bathed, getting a drink for a patient or family member, or delivering specimens to the lab. Dee interacted with every patient with compassion, professionalism and enthusiasm. She demonstrated concern for the safety and well being of her patients and their babies, and spent time listening to their individual concerns and needs. The entire staff in the Maternity area worked as a team—helping each other when needed. I have great respect for anyone in the nursing field. It takes a special type of person to wear so many hats.  

William McCune

Vice President of Operations DCMH

Anne Marie Finley on 3 East is simply superb. Talk about the model RN – patient ID by the book each and every time, with a bit of added good humor; hand washing virtually every other minute (she does not really like Avagard); excellent with families needing a bit of service recovery; and talk about hourly rounding—Anne Marie practices 15-minute rounding! Please extend my thanks to Anne Marie and the entire 3 East team for so graciously hosting me. 

Calvin Little

Director of Social Services Crozer

On the adolescent psychiatric unit, the charge nurse was part of a team to give the children the best care, and the efforts of the nurse and the team were seamless. The charge nurse interfaced with nutrition, the psychiatrist, nursing staff, PCA, patient care secretary, social work and the children on the unit—and I was only on the unit for two hours.  While I was there, a six year old had a meltdown and had to be placed in the quiet room. The nurse coordinated the effort, but everyone pitched in. It was very rewarding to see such great team work.

On telemetry, the main challenge for the nurse—a daunting one—is to get it right, every time. I was impressed by all the checks the nurse undergoes to ensure that the medications administered are the right ones, and that a prompt response is made to patients with any monitor irregularities. Patient safety was an overwhelming theme in the practice and procedures of the nurse I followed.

Mary Moser Grimes

Director of Quality Review DCMH

Linda McKillop, RN, in the nursery is the consummate professional! It was obvious that the new moms were easily able to dialogue with Linda and felt confident about caring for their babies after her interaction with them. 

Joan Marino

Director of Performance Improvement Crozer

The nurses in the Short Procedure Unit really enjoy what they are doing and that was evident in their interactions with the patients. The patients were treated very well. Their requests never seemed to be an inconvenience for the staff. 

Elizabeth Jaekle

Vice President, New Business Development CKHS

I had an absolutely memorable experience personally (who doesn’t want to help bring babies into the world?), and also professionally. Cathy Kazanjian, RN, in Crozer’s Labor and Delivery was a terrific proctor—patiently answering my questions and a role model in compassion and caring with the patients and families. The morning was busy and as anyone who has juggled many plates at once knows, it is a special art form to not break your stride while carrying a third wheel.

Nancy Young

Director of Risk Management Crozer

While shadowing Denise Phillips, RN, in the Burn Treatment Center, I was amazed by the number of departments and people involved in patient care: respiratory, pharmacy, residents, radiology, transport nurse, social work, housekeeping and burn techs, as well as nurses. I witnessed a great coordinated effort in maneuvering all the equipment that needed to go with a patient to CT scan. I also saw the challenges of dressing changes and keeping track of so many intravenous drips. Finally, I was impressed by how warm it gets under the gowns and other paraphernalia worn for infection control!

Gene Zegar

Vice President of Human Resources CKHS

At both Crozer-Chester Medical Center and Taylor Hospital, it was rewarding to see how compassionate and caring the nurses are regardless of the circumstances, no matter how sick the patient. Although the challenges were different at each hospital, I was struck by how sick the patients are and how many of them are on monitors. I was also impressed by the resulting level of constant activity around the nurses’ station.

Diane L. Beatty, RN, MSN, OCN

Director of Nursing Taylor

In the Rehab Unit, I followed Susan White, RN, and observed how she was able to quickly and efficiently prioritize everything that needed to be done for her five patients, deliver medications, and perform a nursing assessment on all of her patients in time for them to get to their scheduled therapies. Susan’s interactions with her patients were always kind and reassuring, even though some of her patients were not having a good morning and told her so. It was clear that Susan was very aware of all of the patient safety and infection control goals and initiatives.  

Brian Pfister

Administrative Director, Support Services and Process Crozer
I definitely gained a greater appreciation of the day to day working environment of our nurses, as well as the superior level of care that is consistently provided to our patients. The interactions I witnessed between nurses and patients on 1 West at Crozer just reinforced my knowledge of our nurses’ dedication and the support that is extended to our patients and their families each day. The nurses were always cordial, regardless of the patient’s attitude.  Call bells were answered promptly regardless of what the nurse was doing, or where they were at the time, illustrating the concern around patient safety. As many times as I witnessed the nurses going in and out of rooms, time and care were always given to hand sanitizing, and gowning up for those patients who were in contact isolation.

MaryAnne Spallucci

Vice President of Finance CKHS

Spending the morning with very busy, caring nurses on 2 South at Crozer reconnected me to what our business truly is about – caring for our patients. My nurse was very attentive to both the physical as well as medical needs of all of her patients. As for patient satisfaction, each patient was asked if they had pain or discomfort.  For infection control, the nurse put on a fresh pair of gloves each time she interacted with a patient. She also used the hand sanitizer each time she left a patient’s room.  For patient safety, all meds were double checked before they were brought into the patient.  Each time meds were given, the patient was asked his name and birth date.  The patient’s wristband was double checked before the meds were administered.  These examples are just a few of the many instances each day where nurses are embracing CKHS goals. The nurse who hosted me, Stephanie Wilps, helped me to understand how satisfying it is to be a nurse.

Terry Lynch

Director of Patient Relations Crozer

Lisa Zeglen, RN, began the morning on the Crozer PACU by cluing me in on her “internal narrative” for what she does and how she does it, which was very interesting. I have always sensed a tight, professional spirit in PACU and I felt fortunate to have seen it in action. In PACU, most interactions are with other employees and physicians. They rely on Rose Robb to help them interact with the families, and it was rewarding to see how diligent Rose is in providing this service. We were able to speak to two of the three patients Lisa cared for post-operatively that morning.  Even though they were a bit hazy and in pain, our interactions with them made it clear that the PACU team does a nice job in comforting and caring for our patients.

Lisa’s commitment to CKHS goals was also clear. One anesthesiologist provided medication when handing off the patient that Lisa eventually and properly discarded. Lisa took time to make it clearer to me what the competing interests and issues are –efficiency, practicality, financial impact on the patient, and the areas around the “grey edges” of a nurse’s day that appear from the outside as innocuous, but are potential accidents waiting to happen. I saw Lisa’s commitment to safety when we took on a MRSA patient and implemented some added precautions—and saw tension here, too, as the chart accompanied the patient from the OR at the foot of the bed.

Joan Meighan, MSHA, CPHRM

Director of Risk Management DCMH

It was so very clear that the nurses on Taylor’s 3A nursing unit work as a team and everyone is committed to patient care.  The staff took the initiative at every opportunity to be proactive to ensure patient safety and service excellence. The day reinforced my respect for nursing and all healthcare providers. 

Rick Graham

Corporate Director of Worker Compensation CKHS

Charlotte Scott, RN, interacted effectively with her patients on 2 North at Crozer, and did excellent service recovery with one patient in particular who was clearly having some satisfaction issues.

Jo-Zetta Shawl, RN, MHA, CNAA-BC

Director of Nursing and Clinical Support Services Springfield

I found it most rewarding to have a chance to get back to patient care which is near and dear to my heart.  I was in the ED, and I have tremendous respect for the challenges the ED nurses face.  It can be hard to remember all the documentation they are required to do when they are backed up with patients who need immediate attention, such as those with chest pain. Truly what they would like to do is spend more time with the patients, and it can be frustrating when some of the documentation, such as medication reconciliation, takes them away from the bedside. 

It was rewarding to hear that the nurses are very excited about moving into a new ED at Springfield. They are very proud that they had a lot of input in the design and flow of the new ED. It was important to them that we asked them for their opinions and acted on them.

Linda Ramsey

Asst. Vice President of Claims, Insurance & Risk CKHS

I think this should be an annual event or at least every two years. It benefits us to see the pressures the nursing staff faces every day. I asked both directors and the manager in my unit to participate because I thought it was such a great idea, and they all came back with very positive feedback. I was hosted by Debbie Quballa on Crozer’s ACE unit with a four-patient assignment. They were short an aide that day and I was glad for the opportunity to help with bed baths and provide other assistance.

Debbie really excelled in implementing CKHS goals such as infection control. Two of her four patients were on infection control contact precaution. She gowned and gloved each time before going in the room and required me to do the same.  She was very observant about making sure that call bells were in reach and gowns and gloves were used at all appropriate times.

Nurses’ Observations

Cathy Kazanjian, RN

Labor and Delivery, Crozer

Meeting Liz Jaekle and having her shadow me was great. Before she came, I wondered what I could show her since she was not a nurse. When she came onto the floor, she had her greens on, and instantly conveyed a readiness to help and acceptance of me. We had a delivery and watched the acuity increase as the morning wore on. Liz helped the whole time, interacted with patients, and was sweet to all. I think the nicest part of “walk in my shoes” was just sharing ourselves with each other. She could see who I was, and I could see who she was. A natural supportiveness occurred. Thank you for the opportunity, I appreciated it.            

Lisa Zeglen, RN

PACU, Crozer  

Terry Lynch observed the variation in types of patients I take care of and how I plan my care accordingly. In the PACU, he saw how our number of patients at any given time ebbs and flows depending on how the cases break from the OR. I think he enjoyed seeing the different personalities of our staff and all the different gifts we bring to the table. Our unit gets along amazingly well and I think he got that. He also got to see the many different types of MD’s we deal with each day. I believe that you need to walk a mile in a nurse’s shoes to have a true appreciation for what we do and who we are. After 24 years, I still love what I do. I think Terry got that, too.

Patricia M. O’Donnell, RN

Operating Room, Taylor

Kris Creighton, AVP of Operations, said she was enlightened by the identification process of the patients, the labeling of medications and solutions on the surgical field and the process of insuring that consents are timed signed and dated. She felt the empowerment nursing has to “hold things up until the doctor signs the papers.” Kris was also surprised at how awake and alert a patient was after having a carpal tunnel released. 

Barb Hewitt, RN

3A, Taylor

DCMH Director of Risk Management Joan Meighan found the team unity and team work on 3A to be exceptional. She commented that the nurses’ dedication to patients is remarkable. She was also amazed at the amount of walking that the nurses do! As a result of this experience, Taylor’s 3A nursing unit is hopeful that the executive branch will have a deeper understanding of the workload faced by nurses on a daily basis, and that they will see the correlation between nursing workload and impact on patient safety and well being.

Monica Engberg, RN

5 Oncology, DCMH

DCMH Director of Human Resources Susan Delaney enjoyed the opportunity to interact with my patients and me, and was amazed by the number of times we needed to travel up and down the hallway! It was great to have an administrator like Susan interested in what we do on the unit every day.

Brenda Giovenello, RN

Transport Nurse, Taylor

This experience provided Janice Perry, Assistant Vice President of Clinical Services, with a better understanding of the complexity of the nurse’s role and responsibilities in providing care in multiple diagnostic areas and settings.

Anne Marie Finley, RN

3 East, DCMH

Bill McCune, DCMH Vice President of Operations, arrived promptly at 8am, dressed ready to work in scrubs as 3 East is a large isolation unit. I had six patients, and some student nurses were on my team. Bill never left my side. He observed all my interactions with the patients, families, physicians, coworkers and students.  He was most impressed by how we follow nursing protocols with patient ID,  HIPAA,  isolation and hand washing, order clarification and medication administration. Bill commented about how “sick the patients really are on the med-surg floors.” He saw and heard firsthand how much care most of our patients and families need, how paperwork and documentation can sometimes be the last thing you do for your shift, and how all members of the health care team interact. 

Lynda Heile, RN

GI Department, Taylor

The more that senior administration understands our roles and responsibilities, the more they can facilitate the work we do.  

Kathy Menig, RN

OR, Springfield

I was shadowed by Springfield Hospital President Gwen Smith. She was impressed by the complexity of the process involved in bringing a patient to the OR and all the steps involved in preparation for surgery. This hands-on experience increased her awareness of how hard the staff on the front lines works to accomplish the multi-faceted, complicated process of caring for our patients.    

Heather Chambers, RN

ICU, Taylor

Eric Dobkin, M.D, CKHS Vice President of Quality and Patient Safety, found it enlightening to see the many protocols and procedures in the ICU such as MRSA surveillance, insulin protocol, and the frequent oral care required to reduce the incidence of VAP. He was impressed by the amount of work required to place every new ICU patient into isolation for six to eight hours until they have proven negative for MRSA. He also observed areas where our computerized charting program could be improved for efficiency, which would enable the nurses to spend more time with the patients.

Spotlight on:  DCMH Nursing Spectrum Award Nominees

Nursing Spectrum magazine and Nurses Week have created a national program for recognizing extraordinary contributions that nurses make to their patients, each other and their profession.  Congratulations to the nurses nominated by the Delaware County Memorial Hospital Nursing Staff and Nurse Management Council for the 2008 Nursing Spectrum Excellence Award in the following categories:

Advancing and Leading the Profession

Maureen DePrince, RN, stroke coordinator, has shown great leadership in advancing DCMH on its journey to become a Joint Commission Certified Primary Stroke Center. She has educated nurses, physicians and ancillary support personnel on the stroke program and collaborated with other organizations to obtain and share information related to stroke care education. Recently, DePrince took on a new role as champion of the nursing units’ Service Excellence initiatives. In this role, she has involved staff nurses in developing solutions for improving nursing satisfaction as well as customer satisfaction.

DePrince joined DCMH in 2001 as one of the hospital’s first graduate nurses focused on critical care nursing. First as a critical care nurse and now as the stroke coordinator, she keeps current on issues, shares her clinical expertise, acts as a role model and consistently demonstrates leadership in nursing.

Clinical Care

Flossie Hogan, RN, CCRN, is an extraordinarily dedicated nurse, an excellent clinician and a wonderful role model for others. She is knowledgeable, professional and caring and always strives to give her patients the very best of care.  A veteran nurse with over 25 years in Critical Care, Hogan serves as the Intensive Care Unit representative on the Nursing Education Council. She readily accepts new challenges and is always looking for ways to enhance her nursing skills and improve patient care. 

Management

Kathy Manuel, RN, MSN, ONC is a 33-year veteran of DCMH. As nurse manager of the Oncology Unit, she has fostered collaboration with the oncologists, encouraged a large percentage of her staff to achieve certification and assisted the staff in development of shared governance through a Unit Council.  Once the council was functional, she stepped aside to give the nursing staff the autonomy they desired. Manuel also implemented a process for outpatient chemotherapy administration making the treatment process as smooth as possible. 

A member of Oncology Nursing, Manuel stays at the leading edge of her profession by attending clinically relevant conferences, monitoring nursing research and keeping abreast of national standards affecting oncology nursing. A strong proponent of education, she has served as a great role model for her nursing staff by returning to school for her bachelor’s and master’s degrees in nursing. 

An extremely professional, compassionate and gifted individual, Manuel is able to quickly manage any situation on her unit. Patients are her number one focus, and all unit decisions are based on these questions: “How will this affect our patients?” and “Will it improve the quality of care they receive?” 

Mentoring

Jeanne Stanton, RN, BSN, CNOR, CRNFA, is an exceptional role model for all nurses in the OR. She takes the time to educate fellow nurses and to explain procedures to her patients, calming any fears they may have. As a surgical assistant in the OR, she explains the procedure being done, anatomy and pathologies, and she is always available to mentor others in best surgical practices. She is kind, thoughtful and considerate of her co-workers and patients. A member of the Association of Perioperative Registered Nurses, Stanton is always willing to help others, lending a hand before you can ask.

Teaching

Patricia LaPorta, MS, BSN, RN, CCRN, BC is a veteran in critical care and education who came to DCMH a few years ago as a nurse educator. In just a short time, she has helped to develop, educate, monitor and implement changes on a hyperglycemic protocol in the Critical Care Unit. Throughout this effort, she has provided intensive education and continuous staff support.  She has arranged for guest physicians and nursing professionals to present information on glycemic control to all staff and physicians at DCMH and currently, she presents a lecture on glycemic control each month. She also teaches at the system-wide Critical Care course monthly. Exceptionally bright and articulate, she captures the staff’s attention and presents information in an organized, informative and interesting manner. She has a unique ability to see situations from a number of perspectives.

In addition to her glycemic control efforts, LaPorta has developed and implemented programs for VAP and CVC line infections and provided related education to the staff. She has worked diligently to educate staff on evidence-based practice. By remaining current on the most recent studies, she brings progress to the profession, allowing nursing to provide the safest care known.

Springfield Earns 2008 VHA Leadership Award for Clinical Excellence

Springfield Hospital was one of only 49 hospitals in the United States to be honored for meeting or exceeding national performance standards for clinical care in the prevention of ventilator-associated pneumonia. The hospital’s Acute Care Center had no cases of ventilator-associated pneumonia for 12 consecutive months.

This prestigious honor was made possible by the commitment to excellence of Springfield’s physicians, nurses and staff members.

VHA is a national alliance of more than 1,400 not-for-profit hospitals and more than 21,000 non-acute health care organizations nationwide.

Magnet™ FAQ

What are the 14 Forces of Magnetism?

Third in a series.  In the next several issues, we will summarize each of the Forces. These are qualities that nurses find attractive in their place of employment.

Force 7: Quality improvement

There is a process that improves the quality of care delivered within the organization. Patient care nurses participate in the quality improvement process and perceive it to be effective.

Force 8:  Consultation and resources

Knowledgeable experts, particularly advanced practice nurses, are available for peer support and consultation within and outside of the nursing division.

Force 9:  Autonomy

The nurse is permitted and expected to practice autonomously, consistent with professional standards. Independent judgment is expected to be exercised within the context of a multidisciplinary approach to patient/resident/client care.

Remember, we are on the “Journey to Nursing Excellence.” If you have an amazing story that illustrates these qualities or you have a suggestion as to how we can better demonstrate these qualities, please e-mail them to zanet.lester@Crozer.org.

Executive Endings

Nancy Bucher, RN, MSN, CNAA-BC

Chief Nursing Officer and Vice President
Crozer-Keystone Health System

A few weeks ago, I had the pleasure of spending time with three Crozer-Keystone nurses during our first “Walk in a Nurse’s Shoes Day.”  My experiences strongly reinforced what I have always known . . .  Crozer-Keystone nurses are dedicated, compassionate and highly clinically competent, not to mention extremely nice people. This is true not just on special days like this one, but every day of the year.

I had the opportunity to work with Rebecca Stevens, RN, a 36-year tenured nurse in the Crozer Intensive Care Nursery, as she took care of an extremely low weight, very fragile 24- week gestation baby on a ventilator. Becky demonstrated so much love, compassion and incredible skill in the way she cared for this tiny neonate. You would think after doing this for as many years as Becky has that it would be old hat, but this was simply not so. Becky and all of the NICU nurses were so very caring and protective of these infants. They never leave them. No one even took a break. They are also so supportive of the parents. The nurses encourage bonding and do a great job of preparing the parents to take these tiny bundles of joy home. They also are very watchful of the social issues that might potentially affect these kids.

I also spent time in Crozer Pediatrics with Janet Byrne, RN, who spent 20 years as an ED nurse and is now taking care of pediatric patients. She is a tremendous child advocate, and cares for these children so lovingly and competently. I was very impressed by her ability to coordinate the care of three 3-month old babies and one active 7-year-old. I am challenged just by caring for my 3-year-old and 5-year-old grandchildren, and they are not sick!

The next day, I went to Taylor Hospital and spent time with Kathy Lally, a young, enthusiastic and very professional RN. She effortlessly provided high quality care to four patients with very diverse diagnoses. It was very rewarding to watch Kathy motivate one woman to make up her mind to stop smoking by sharing her own personal experience. 

I’m especially pleased that many of my fellow Crozer-Keystone administrators had the opportunity to “walk in your shoes” and see for themselves why I am so proud to be associated with each one of you. Their comments in this special edition of our nursing newsletter reflect your professionalism and commitment to our patients. It’s very clear that you are the heart and soul of our hospitals, and we are very proud and grateful for the noble way in which you do your work and carry out our mission.

Nursing Excellence: Influencing practice, quality of care and professional development through inquiry and innovation.