Nurses Week

In celebration of nurses’ voicesIn honor of National Nurses Week 2018 (May 6 to 12), this special section of American Nurse Today

celebrates nurses’ voices.

The article by Debra Walker, PhD, MSN, MEd, RN-BC, offers strategies for increasing happiness. In the

article titled “Don’t wear high heels to an evacuation,” a team of nurse educators shares how they went

from “nonessential” to “essential” personnel during preparations for a hurricane. And David Foley, PhD,

MSN, RN-BC, MPA, embraces the importance of nursing theory and encourages other nurses to “adopt a

nursing theorist.”

All-Pro Nursing Team AwardsThis section also features American Nurse Today’s first annual All-Pro Nursing Team winners. We invited

teams from around the country to tell us why they’re an all-pro nursing team. The judges—including nurses

and editorial staff—reviewed and analyzed 42 submissions. All had compelling stories to tell about how they

worked together to help individual patients, develop research projects, and design and implement process

improvements within their organizations. After much deliberation, the judges declared the coordinators of

patient placement and staffing team at Boston Children’s Hospital as the winner. You can read their story,

and those of the three runners-up and six honorable mention teams, in the following pages.

American Nurse Today applauds the inspiration, innovation, and influence of nurses.

All-Pro Nursing Team Award winner:Coordinators of Patient Placement and Staffing, Boston Children’s Hospital

28 American Nurse Today Volume 13, Number 4 AmericanNurseToday.com

An unsettled air of anticipa-tion hung heavy over SouthCarolina Lowcountry inOctober 2016 as anotherlate-season hurricane threat-

ened. Televisions everywhere blaredwith constant and changing weatherupdates. Working at an acute-carehospital on the east coast added yetanother dimension to the unease.Patients questioned us, staff asked ifwe’d heard anything, and leadershipcontinued to meet in emergencymanagement planning sessions. Thequestion: Leave or stay?

A full patient evacuation was un-precedented at our hospital, so noneof us knew what to expect. Our fa-cility is a tertiary care teaching hos-pital that provides high-level qualitycare—cardiology, neurology, pri-mary, and mental health care—toover 70,000 veterans. We knewabout the master plan for an emer-gency evacuation, but evacuating149 beds, including 16 intensivecare unit beds and 20 long-termcare beds, was hard to visualize.

The evacuation question becamea drumbeat after weather reportswarned that our city was predictedfor a direct hit. Reporting for workmidweek in the nursing educationdepartment proved an educationalop portunity for us. After all, whoneeds education during an evac -uation?

Essential vs. nonessentialpersonnelOur department consists of fivenurse educators and one manager.Two educators were new to the de-partment but not new to our facili-

ty; they were staff nurses on ouracute medicine units. The remain-ing three were seasoned nurse edu-cators. As members of nursing edu-cation services, our primary dutiesrevolve around nursing students,nurse trainees, professional devel-opment, and community engage-ment. We fall under the realm ofnonessential personnel, right?So, naturally, it was justa matter oftime

beforewe would be giventhe green light to go home.

Our newer nurse educators hadspent their entire nursing career atthe bedside and had always beenon the “essential personnel team.”When faced with the possibility ofinclement weather that warrantedan extensive stay, they’d alwayspacked overnight bags and headedto work. The idea of not being es-sential seemed surreal to them.

One nurse’s storyI (Gant-Clark) had no doubt thateveryone in the department was onthe same sheet of music. As a nurseeducator, I know I have many re-sponsibilities, but I never imaginedthat evacuating patients to anotherfacility in preparation for a hurri-cane was part of my job. So I wassurprised when one of the new ed-ucators arrived in scrubs. With a

raised eyebrow and a side-ways glance, I asked,“Why are youwearingscrubs?”She re-

sponded, “Why aren’t you?”as she looked incredulously at myprofessional attire and heels. I as-sumed this newest faculty memberwas confused by her new educatorrole. However, when we got ourorders to assist in all evacuation efforts, including patient care, shegave me a smug smile.

The message from our chief nurseand nurse manager was clear, “Weare all essential today!” My initialthoughts of disbelief and pride for“paying my dues” were quickly re-placed with pride at being an es-sential nurse as our team got to workproviding exceptional care for pa-tients and their families regardlessof the circumstances because, asnurses, we are leaders.

By mid-morning, I had kicked offmy heels and was working alongsidethe head of the emergency pre-paredness command, delegatingand managing patient flow. We

Don’t wear high heels to anevacuation

Lines between essential and nonessential personnel blur during a crisis.

By Vanessa Gant-Clark, MSN, RN; Janice Skipper, MSN, RN; Kirstin Pennington, MSN, RN; Fharen Grant, MSN, RN, RN-BC-CNL; Erica Grate-Simmons, MSN, RN

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collaborated with all members ofleadership, the emergency pre-paredness team, managers, staffnurses, pharmacists, nursing assis-tants, bus drivers, and the police.Although I wasn’t at the bedside,my clinical reasoning skills kickedin, including stocking buses withextra urinals, ensuring all buses hadan adequate bottled water supply,asking the kitchen to make extrabrown bag lunches, and delegatingthe appropriately licensed staff toeach bus based on patient acuity.

My colleagues were scatteredthroughout the facility. While I wason the loading dock, our nursemanager was at the emergency de-partment entrance assisting with theevacuation of our mental healthward. She commented later that thepatients boarded their buses in anorderly fashion with smiles on theirfaces, likely enjoying the change ofscenery, sunshine, and fresh air asopposed to their windowless lock-down ward. She said that keepinga smile on her face as other per-sonnel left and said, “Have a great

weekend” or “Drive safely” wasdifficult because her Folly Beachcommunity had already been giv-en a mandatory evacuation order.She had come to work thinkingshe’d be dismissed but found her-self doing something she felt ill -equipped for.

The calm after the stormEventually, everyone on the nurseeducator team eased into their vari-ous temporary duties, includingbathing and feeding the nursinghome residents, packing their per-sonal belongings, and transferringthem to stretchers in preparationfor their bus ride to our sister hos-pitals in Augusta, Columbia, andDublin. Although some patients re-quired reassuring, most were calmand appeared to enjoy the change

of routine, as did my colleagues. Hurricane Matthew arrived as

forecast 3 days later, and all patientswere settled and far removed fromharm’s way. Our departmental after-action review proved to be very en-lightening as we reflected on ourdifferent points of view and emo-tions on the morning of the evacua-tion—guilt for not being prepared tostay or evacuate with the patients,fear of the unknown, false expecta-tions, and a sense of purpose andintrinsic reward while performingbedside nursing care. Overall, thisexperience made me appreciate myrole as an RN even more. My skillsand knowledge don’t depend on myenvironment or equipment but onmy passion for my patients and theirwell-being. Nursing is a part of me;it’s not just my job. A nurse is anurse, heels or no heels.

The authors work at Ralph H. Johnson VA MedicalCenter in Charleston, South Carolina. Vanessa Gant-Clark, Kirstin Pennington, Fharen Grant, and EricaGrate-Simmons are full-time faculty for the VA Nurs-ing Academic Partnership; Janice Skipper is theirnurse manager.

The message was

clear, “We are all

essential today!”

supportive • compassionate • collaborative • here to stay • engaged • autonomous • inspiring • proud • teamwork • professional • transparent • respected • resilient • dedicated • amazing • authentic • caring • patient-centered • excited supportive • compassionate • collaborative • here to stay • engaged • autonomous • inspiring • proud • teamwork professional • transparent • respected • resilient • dedi-cated • amazing • authentic • caring • patient-centered • excited • supportive • compassionate • collaborative • here to stay • engaged • autonomous • inspiring • proud • team-work • professional • transparent • respected • resilient • dedicated • amazing • authentic • caring • patient- centered • excited • supportive • compassionate • here to stay • engaged • autonomous • inspiring • proud • team-

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Benjamin Franklin wrotethis about the unalienableright to happiness delin-eated in the U.S. Constitu-tion: “The Constitution

only gives [you] the right to pursuehappiness. You have to catch ityourself.” Do nurses really have tochase or discover happiness? Whatdoes happiness mean to you? Anddo you remember the first time youfelt that you achieved happiness?

Meaning of happinessSome researchers describe happi-ness as a state of accepting thatwhat happens in life is necessary tobeing human. Life is a series of ex-periences that develop our charac-ter, behavior, and skills for living.Previous beliefs about happinesswere based on achieving success—working hard, finding a great job orposition, losing weight, driving anew care, and having money in thebank—but recent studies in positivepsychology indicate that happinessdefined by material gain or successisn’t sustainable. Happiness fuelssuccess, success doesn’t fuel happi-ness. In addition, evidence supportsthe connection between the mind,body, and spirit and that happiness

is strongly related to health. Some-thing as simple as smiling slowsyour heart rate during stressful situ-ations and can lead to a happier,positive attitude in you and thepeople around you.

Social psychologists have been re-searching strategies to increase hap-piness and well-being after discover-ing that when positive thoughts andactions replace negative ones, thebrain becomes more active in areasof creativity, motivation, resilience,and productivity. Happiness strate-gies are based on theory and re-search that examine the characteris-tics of people who profess to behappy. In light of challenges manynurses encounter both professional-ly and personally, these strategiesmay help you in your pursuit ofhappiness. The first step is pursuingmeaningful, substantive happiness.

Pursuit of happiness Scientists and researchers call ourdaily routine of plans, tasks, en-deavors, projects, and ambitions“goal pursuit.” When a goal is ma-terialistic with possible negativeoutcomes, anxiety and unhappinessovershadow achieving the goal. Ifthe goal is realistic, flexible, cultur-

ally valued, and authentic, the goalmay or may not be achieved, butthe pleasure and satisfaction of justpursuing it can be meaningful.What you learn while working onthe pur suit of a valued goal canlead to increased opportunities andthe mindful satisfaction of beingchallenged. A perfect example iscompleting a nursing program anddeveloping a sense of purpose andresponsibility as a nurse.

Rather than focusing on the fin-ish line—“I’ll be happy when I get the promotion and a salary in-crease”—remember that happinesslies in the journey. Steps taken inthe pursuit of happiness, such asparticipating in wellness programs,reading self-help books, and attend-ing wealth and happiness seminars,have value, but the key ingredientsof positive psychological well-beinginclude mindfulness, physical health,spiritual well-being, and connec-tions with others.

Strategies for happinessSeveral proven strategies increasehappiness in the brain’s prefrontalcortex, the part of the brain that’sresponsible for emotions.

The meaning of happinessStrategies for pursuing and obtaining happiness.

By Debra Walker, PhD, MSN, MEd, RN-BC

30 American Nurse Today Volume 13, Number 4 AmericanNurseToday.com

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jobs.nyulangone.org

Dedicated. Innovative. Tireless.During Nurses Week, we’d like to extend special thanks to our nursing colleagues around the world. We are inspired by your commitment, expertise, and accomplishments. We’re also especially proud of the devoted nurses at NYU Langone Hospital—Brooklyn as well as the Magnet®-recognized teams at NYU Langone’s Tisch Hospital and NYU Langone Orthopedic Hospital.

32 American Nurse Today Volume 13, Number 4 AmericanNurseToday.com

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MindfulnessWe all find ourselves thinking about what we need todo next. Rather than giving our full attention to the pa-tient in front of us, we’re thinking about the patient weneed to care for down the hall. The result is reducedproductivity and feelings of unhappiness. Learning toslow down and focus on being present can lead to in-creased efficiency and happiness.

Meditation is one way you can learn to focus yourmind. Research shows that regular mindfulness medita-tion can increase the happiness in the brain and perma-nently rewire it to more positive function. Taking just 5minutes to breathe slowly and deliberately, not countingor holding your breath, is one of the most effectivestrategies to help you redirect negative thoughts and re-focus on the present moment. You can practice shortmeditations at home, at work, or anyplace you feel your-self becoming stressed. Sit in a comfortable position, fo-cus on your breathing, and then bring your mind’s atten-tion to the present. When your thoughts drift to eventsof the past or concerns about the future, gently guideyourself back to the present and your breath.

Physical healthTaking care of yourself through diet and exercise canhave lasting benefits both physically and emotionally.For example, exercise releases pleasure-inducing en-dorphins that boost your mood, improve motivation,decrease stress and anxiety, and reduce depression. Itcan also increase the development of new neurons inthe brain that have been damaged by stress and anxi-ety. And when eating five servings of fruits and vegeta-bles every day and exercising (walking, yoga, playingwith your kids) for at least 30 minutes a day threetimes a week become a part of your lifestyle, youbuild a foundation for long-term happiness.

SpiritualityScientific evidence shows that people who have religiousor spiritual beliefs are happier than those who don’t pro-fess any type of spirituality. They perform acts of kind-ness and exhibit empathy and compassion. With orwithout a formal religion, spirituality offers protectivequalities that can help us sustain happiness throughoutour lives. And when practiced with a community, spiritu-ality provides the support of others during difficult times.

Connections with othersSpending time with friends and family is the numberone source of happiness. That means maintaining awork/life balance that gives you time to connect withother people. Rather than pursuing the purchase of anew car, which will give you only fleeting happiness,make time for a family vacation or a regular walkingroutine with your best friend, which will provide youwith experiences that enrich your life.

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Lasting happinessSustained happiness can’t be found in material pur-suits. Instead, focus on the journey of your life—thegood and bad—with mindfulness and in the companyof friends and family. Make your physical health a pri-ority and incorporate a sense of wonder about theworld through religion or spirituality. The result will bea life of happiness that supports you through challeng-ing times.

Debra Walker is an assistant professor at Indiana Wesleyan University in Marionand Thomas Edison State University in Trenton, New Jersey.

Selected referencesAchor S. The Happiness Advantage: The Seven Principles of PositivePsychology That Fuel Success and Performance and Work. New YorkCity: Currency; 2010.

Chittister J. Happiness. Grand Rapids, MI: William B. Eerdmanns Pub-lishing; 2011.

Corliss J. Mindful meditation may ease anxiety, mental stress. Har-vard Health Blog. Updated October 3, 2017. health.harvard.edu/blog/mindfulness-meditation-may-ease-anxiety-stress-201401086967

Kubzansky L, Viswanath K, eds. The Science of Happiness: New Dis-coveries for a More Joyful Life. New York City: TIME; 2016.

Lyubomirsky S. The Myths of Happiness: What Should Make You Hap-py, but Doesn’t, What Shouldn’t Make You Happy, but Does. NewYork City: Penguin Press; 2013.

Seppala E. The Happiness Track: How to Apply the Science of Happinessto Accelerate Your Success. San Francisco: HarperOne; 2016.

Use these strategies to create sustainable happiness.

• Connect socially. Spending time with family andfriends is the most important thing you can do to behappy, so create a good work/life balance.

• Be mindful. Appreciate the present moment and findtime for daily meditation.

• Tend to your physical health. Health and happinessare strongly connected, so exercise regularly and eathealthy.

• Be spiritual. Whether religion-based or not, spiritualityoffers a foundation for happiness.

• Spend money wisely. Rather than spending money onmaterial things, spend it on experiences—family vaca-tions, activities with friends, a mindfulness retreat.

• Be resilient. Learn the art of bouncing back from adversity.

• Give thanks. Gratitude is linked to happiness. Take timeonce a day to think of one thing you’re grateful for.

• Be positive. Some experts say you can “fake it till youmake it”; smiling and engaging in positive behavior canhelp you become more positive even if that’s not howyou initially felt.

• Live a meaningful life. Connect with goals that havemeaning to you and find joy in the journey.

Happiness strategies

This National Nurses

Week, we thank our

nurses for their

dedication to

excellence, our

patients and

each other.

One week is simply not enough to recognize

the difference our nurses make every day. As the

most comprehensive academic health system in

Georgia with seven hospitals (including three

Magnet®-designated hospitals) and more than

200 clinic locations, our nurses are redefining

clinical care.

The future of nursing is at Emory Healthcare.

All that’s missing is you.

EEO/AA/Disability/Veteran Employer

Visit emoryhealthcare.org/careers

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I recently spent one summerworking as a clinical instruc-tor in a course that required12-hour experiences on avery busy inpatient floor. As

any clinical instructor, student, orfloor nurse knows, clinical dayscan be long, confusing, and oftenchaotic. Each day I met many won-derful nurses—some had been inpractice for years and others wererecent graduates. In either case, itwas a pleasure pairing them withstudents who would benefit fromtheir knowledge, skill, and experi-ence. As we spoke throughout thefirst few weeks of the clinical ex-perience, we couldn’t help butcompare notes on our own experi-ences during our prelicensure andgraduate programs. And as is oftenthe case when a group of nursescome together, the conversationdrifted easily from topic to topic,including how much nursing prac-tice, medical equipment, and es -pecially nursing education haschanged. One nurse shared several“used to be’s” and was proud thatshe could still calculate I.V. driprates with the help of hertrusty watch with a sec-ond hand and providemedications as accu-rately as any pumpon the market.

While eatinglunch with severalinstructors, stu-dents, and facultyone day, I was sur-prised to learn howmany seemed un-comfortable at the

mere mention of nursing theory.This aversion seemed to be deeplyrooted in bad experiences with thesubject during their education. Iwas a bit puzzled by this; nursingtheory was one of my favorite cours-es during my master’s in nursingprogram. As our capstone courseassignment, each student wrote a30-page paper that fully exploredthe origins, philosophy, and practi-cal applications of a selected nursetheorist. I chose Betty Neuman, cre-ator of the Neuman Systems Model,which had deeply impressed me asa holistic, systems-based approachto patient assessment and care.

Taking a chanceWhen I was in school, the internetwas much less developed than itis today and wasn’t viewed as avery credible source of informa-tion. None theless, I typed “BettyNeuman” and then “Neuman Sys-tems Model” into the search barand was surprised when her con-tact information appeared in theresults. I took a chance, called thenumber, and was completely sur-

prised when Betty Neuman herselfanswered the phone. I also was sonervous that I nearly hung up, butI rallied to introduce myself as agraduate student researching hermodel. Dr. Neuman was incrediblygracious and spent the next 45minutes sharing anecdotes on herinternational travels and how shefelt her model lent itself to interdis-ciplinary collaboration and care.

Dr. Neuman asked me about mypaper, and I told her I’d be pre-senting it to the class in 2 weeks. I will never forget her response: “Idon’t suppose you would want totake me to class, would you?” I as-sumed she was joking and laughedsoftly. But after she told me shelived only an hour from the class-room and was actually consideringhaving someone take her to myclass on the night of my presenta-tion, I realized that she was seri-ous. After a bit more discussion,she admitted that the plan mightnot be realistic but offered to ad-dress the class via teleconference.As approved by my instructor, Iquickly made the arrangements

with the university’s technolo-gy department.

Show and tellOn presentation day,with the whole classand instructor watch-ing, I nervously dialedthe phone to start theteleconference and wasso relieved when Iheard Betty Neuman’sdignified voice. She

Rescuing nursing theoryAdopt a nurse theorist today.

By David Foley, PhD, MSN, RN-BC, MPA

INSIGHT BLOG

34 American Nurse Today Volume 13, Number 4 AmericanNurseToday.com

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http://www.childrenshospital.org

36 American Nurse Today Volume 13, Number 4 AmericanNurseToday.com

was extraordinarily generous withher time and spent more than anhour talking not only about hermodel but also about her thoughtson nursing theory in general.

At the end of the evening, thereality sunk in that I actuallybrought a real nurse theorist toclass, albeit virtually. The experi-ence was so fulfilling that it instilledin me an admiration for nursingtheory and its application to dailypractice. I’ve always been amazedwhen some nurses show apathy—or outright aversion—to the subjectof nursing theory. Many say thatthey find the subject to be dry oruninspiring or that it invokes apainful memory of a paper or pres-entation that resulted in a less-than-desirable grade in nursing school.

Incidentally, my professor gaveme a “B” on my presentation be-cause she said that Betty Neumandid the presenting for me. Despitemy mild objections, I knew furtherprotest would be futile, so I quick-ly reconciled myself to the gradeand celebrated what I instinctivelyknew was a milestone experiencein my nursing education. After all, I brought Betty Neuman to class,and that somehow made the “B”seem quite tolerable.

Rescuing nursing theoryAs the years passed, I found myselfin the role of nursing instructor andtaught a class entitled “Nursing the-ory and professional practice” tofirst-year, first-semester nursing stu-dents. From the outset, I was deter-mined to present nursing theory inthe most positive light possible. Idemonstrated nursing theory’s rele-vance to both research and prac-tice, hoping that students who goon to pursue a career in bedsidenursing or graduate studies willhave some positive experiencesupon which to draw. Each semes-ter, I shared my Betty Neuman sto-ry and encouraged students to re-member to be as generous as shewas with sharing knowledge andexpertise with others. During en-counters with former students, I

was pleased when they told methat they remembered the story andfelt it impacted them in a positiveway, not only because of her gen-erosity but also because of hermodel’s power in identifying stres-sors and their effect on patients.

Encouraged by these and otherstories, I’ve engaged in a pursuit to rescue nursing theory from thegrips of boredom, dryness, and in-effective classroom experiences.How could I accomplish this goalin everyday life and nursing prac-tice? I adopt a nurse theorist of theday and encourage my students,graduates, and colleagues to do the

same. Adopting a nurse theoristeach day doesn’t mean spendingtime reading research-based articles(unless, of course, you feel a senseof passion to do so) or performinga recursive review of each of thetheory’s ba -sic tenets. Instead, cele-brate the essence of a different the-orist each day.

These efforts came to fruitionduring my recent long 12-hourclinical days with students. I hadn’ttaught medical-surgical clinicals ina while and hoped my students’hopeful eyes didn’t recognize myreticence. After a week or two of

establishing an organized routine,during preconference I informedthe students that we would beadopting a different nurse theoristeach week and to be aware of theessence of that theorist as we per-formed our daily nursing care. Asthe weeks passed, I was upliftedby the discussions we had aboutWatson’s Carative Factors, Leinin -ger’s view of transcultural nursing,consciously initiating an effectivenurse-client relationship in tributeto Pepleau, and yes, assessing ourpatients’ stressors per the NeumanSystems Model.

By the end of the long, hot sum-mer, I was surprised how effortlessand fluid our conversations andthoughtful reflection had becomeas we drifted from theorist to theo-rist. Even more exciting was thefact that the students carried onthese conversations with their as-signed bedside nurses, some ofwhom actually popped into theconference room during postcon-ference saying things like “I don’tremember nursing school beinglike this…there’s too much joy inthis room!” and sometimes simply“You’re the best.”

We weren’t the best, but wewere striving for excellence. Oneimportant way we did that was byremaining grounded in our nursetheorist of the day and channelingthe essence of the works of BettyNeuman and her many distinguish -ed colleagues.

I was invigorated by these clini-cal days and saddened when thesummer ended. But it really hadn’t.I continue to adopt a nurse theoristof the day and encourage you todo the same, even if for just a fewmoments of meaningful reflectionduring a brief hallway conversationor elevator ride.

A “B” indeed…

David Foley is an assistant professor of nursing atCase Western Reserve University in Cleveland, Ohio.

Editor’s note: Hear more nurses’ voices byreading entries for our Insights Blog (amer-icannursetoday.com/insights/) on theAmerican Nurse Today website.

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I was determined to present

nursing theory in the most

positive light possible.

I demonstrated nursing

theory’s relevance to both

research and practice,

hoping that students who

go on to pursue a career in

bedside nursing or graduate

studies will have some

positive experiences upon

which to draw.

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The 10 members of the coordinators of patientplacement and staffing at Boston Children’sHospital pride themselves on their patientand family focus and their willingness to goabove and beyond to do what’s right. And,

according to Suzanne Reidy, director of patient flowand staffing, they’re “jacks of all trades. We are thein-house supervisors on the night shift, and every-one looks to us first for advice no matter what’s go-ing on.”

All of these qualities are evident in the story thisteam shared as part of their submission for the Ameri-can Nurse Today All-Pro Nursing Team award. Here’sthat story in their words:

CM was a 2-year-old boy who was born with acongenital heart defect. He had two of the three sur-geries that were needed to correct his defect, but afterthe second surgery, he suffered from poor ventricularfunction and was placed on the list for a heart trans-plant and maintained on milrinone infusion athome.

In December 2016, CM was admitted to the hospi-tal for worsening heart failure. In March 2017, hesuffered a cardiac arrest and was cannulated to ex-tracorporeal membrane oxygenation (ECMO). He wason and off the transplant list because of sepsis andnew seizure activity. Both parents were with CM dai-ly, and they longed for a new heart for their belovedson. More months passed, and CM remained in thecardiac intensive care unit (ICU) on ECMO.

In early September, CM suffered a seizure and wasin status epilepticus; he needed to be intubated. Whenhe was extubated a few days later, he exhibited un-equal pupils and disordered breathing. A computed

tomography (CT) scan showed no new ischemicchange, but his neurologic status continued to deteri-orate rapidly. He was reintubated, and a CT scanwith contrast was performed. The scan showed abrainstem hemorrhage. The parents were present andgiven the grim findings.

After such a lengthy ICU stay, the parents requestedthat he be taken to the hospital’s garden for extuba-tion on a beautiful warm September afternoon. Myteam was called and asked if we could help expedite a garden visit for end of life. We quickly jumped intoaction. I called the security supervisor and explainedthe situation. The team was already en route to thegarden with the family, so we had to move quickly.We paged engineering to open the door because thegarden had just been renovated and wasn’t officiallyreopened yet. Because the garden is off a busy hall-way and intersects three other hallways, we requestedthat security block each hallway and reroute staffand families.

The staff moved CM to the garden and placed himin his parents’ arms. He was extubated and diedpeacefully. The family was so grateful for this, and wehope that they can find peace in having their wishgranted.

This team of nurses and other healthcare profes-sionals pulled together on a moment’s notice to fulfilla deeply meaningful wish for a young family. The suc-cess of their effort speaks to excellent communicationamong team members and the hospital, a high level ofresponsiveness, honed decision-making skills, and trueprofessionalism. All attributes of a cohesive and effec-tive nursing team.

Quick action grants afamily’s final wish

Coordinators of patient placement and staffing, Boston Children’s Hospital

Winner

When asked why she submitted the Children’sHospital Los Angeles pediatric intensive careunit for the American Nurse Today All-ProNursing Team award, Hui-wen Sato, RN, MSN,

MPH, CCRN said, “I wanted to share with a broaderaudience how nursing can be healthy and not full ofnegativity and bullying, even on the most chaotic andstressful of days.”

This team’s award submission highlights respect. Inresponse to the question, “Describe your culture ofprofessionalism,” Sato answered: “Our unit is knownthroughout our hospital for our exceptional managersand our strong teamwork. Our managers are support-ive, empathetic, and go out of their way to show praiseand both moral and practical support. We see our man-agers and core charge nurses treat one another andtreat us with respect, and it absolutely spills over intohow we treat one another at the bedside. We are ablame-free unit, so when mistakes are made, we focuson how to improve our patient care and resolve issues.We don’t focus on gossip or punishing people whomake mistakes. This is simply a part of who we are.”

The team’s staffing and assignments also reflect re-

spect. Patient assignments are made with the strengths,weaknesses, and skill level of each nurse in mind. “Wealso try to assign other nurses with appropriate skillsets in neighboring areas,” said Sato. “We want to en-sure that every nurse has the support they need if theyhave a particularly challenging or very sick patient.”

This multidisciplinary group of healthcare profes-sionals exemplifies teamwork at its best, working tocare for their patients and support each other.

Aimee Sharp, MSN, RN,CCRN, NE-BC, nursemanager of the intensivecare unit (ICU) at AnMed

Health, has a lot to be proudof, according to Jay Wright,MSN, RN, NEA-BC, director ofinpatient nursing for cardiovascular and critical careservices. “Aimee has done so much to develop a cul-ture of change,” said Wright. “With Aimee’s support,the ICU staff truly embrace evidence-based practiceand the staff is fully engaged.” And Sharp says of herteam, “We want to figure out how to make things bet-ter. I’m fortunate to have this group…what we have ispretty spectacular.”

In this multidisciplinary team’s entry for the All-ProNursing Team award, they described their effort to re-duce the incidence of hospital-acquired Clostridium

difficile (C. diff) in the ICU.They identified a lack of clearresponsibility for cleaningsome equipment in patientrooms. Some of the steps theteam took to solve this prob-lem included creating a check-

list that clearly defines what should be cleaned by en-vironmental services and what should be cleaned bynurses. In re-evaluating the way rooms were cleaned,the team found that using ultraviolet light therapy aftereach discharge or transfer didn’t seem to make a bigimpact on the C. diff rate. In response, they institutedbleach cleaning three times a week in all rooms. And,in coordination with the lab, the team created a C. diffvalidation form with strict testing criteria. The result ofall of their efforts was an 84% reduction in C. diff cases(from 19 in 2015 to 15 in 2016 to 3 in 2017).

38 American Nurse Today Volume 13, Number 4 AmericanNurseToday.com

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Pediatric intensive care unit, Children’s Hospital of Los Angeles

Multidisciplinary team reducesClostridium difficile incidence

Intensive care unit, AnMed Health, Anderson, SCSecond runner-

up

First runner-

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AmericanNurseToday.com April 2018 American Nurse Today 39

Dorothy Garrison, BSN,RN, nurse clinician atSentara Norfolk Gen-

eral Hospital, says thatthe “special care nurserystaff see each other asfamily.” And, based onthe team’s submission forthe American Nurse Today All-Pro Nursing Teamaward, they see their patients that way, too.

Debra (not her real name) was transferred to thehospital’s maternal high-risk quaternary care centerwhen her membranes ruptured at 32 weeks’ gestation.She hadn’t received any prenatal care after 18 weeks,and although she was 34 years old, she had the men-tal cognition of a 13-year-old. Debra’s daughter wasborn with respiratory distress and was placed on con-tinuous positive airway pressure, antibiotics, ther-moregulatory support, and tube feedings.

Debra was discharged while her daughter remainedin the hospital. Because Debra had no family in the

area, she spent a monthat the Ronald McDonaldHouse across the street.During that time, thenurses on the team helpedher with many of her ba-sic needs, including foodand assistance crossing

the busy street; they also communicated with theRonald McDonald House staff to ensure that she wasable to do her laundry and properly store her breastmilk.

In addition, the staff helped Debra prepare to gohome with her baby. They taught her about propernutrition, safe sleeping habits, the importance of med-ical follow-up, and coping mechanisms.

“When Debra’s baby was discharged, there wasn’t adry eye to be found,” said Garrison. “But that wasn’tbecause of fear. It was because we knew in our heartsthat Debra was going to have the skills, resources, andability to care for her child.”

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All in the familySpecial care nursery team, Sentara Norfolk

General Hospital, Norfolk, VA

Third runner-

up

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Honorable Mention Awards

Perioperative team, Fox Chase Cancer Center,

Philadelphia

The Fox Chase Cancer Center perioperative team no-ticed delays in getting patients to surgery. After in-

vestigating, the team realized that blood wasn’t get-ting to the operating room (OR) fast enough to startthe case on time. They collaborated with pre-admis-sion testing to complete blood type and screening atpresurgical testing (for procedures that require trans-fusions). The preoperative staff now orders the prede-termined units of blood the night before, and on themorning of surgery, preop communicates with theblood bank to ensure that the blood units are readybefore dispatching transport for retrieval. Delays causedby blood being unavailable in the OR refrigerator de-creased significantly.

Cardiac stepdown unit, GeisingerWyoming Valley Medical Center,

Wilkes Barre, PA

The most significant outcome of the cardiac stepdownunit at Geisinger Wyoming Valley was a 58-year-old

woman who was admitted with an ejection fraction of9% after cardiac arrest postcoronary artery bypass graft-ing. She received a left-ventricular assist device as des-tination therapy. After weeks of therapy, the patientwas evaluated for transplant. She was on and off thetransplant list because of a fractured femur and hospi-talization for pancreatitis secondary to gallbladder dis-ease. After recovering from a cholecystectomy, the pa-tient received her transplant. The team will alwaysremember her and how she touched their lives.

Heartingale Squad, Lakeland Regional Health,

Lakeland, FL

The Heartingale Squad at Lakeland Regional Healthpresented its quality improvement mobility project,

“Pre- and postoperative noninvasive nursing interven-tions to decrease pulmonary complication in theacute care setting,” at the March 2018 American Nurs-es Association Quality and Innovation Conference.The outcomes of the project include decreased inci-dence of pneumonia, oxygen dependency, acute res-piratory distress requiring higher-level care, and de-creased readmission rates within 30 days of dischargedue to pulmonary complications.

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Scalp cooling task force, Memorial Sloan Kettering,

New York City

This team designed a program to bring scalp cool-ing to clinicians and patients throughout Memorial

Sloan Kettering. Scalp cooling limits chemotherapy-induced alopecia. In March 2017, the team success-fully launched scalp cooling services across all outpa-tient units treating women who have breast cancer.And in December 2017, the team switched vendorsfor a more streamlined process that also saves pa-tients money.

Charge nurse team, Moses Cone Surgery Center,

Greensboro, NC

This team rose to the challenge when its assistantdirector was out for several months because of ill-

ness. Some nurses created the staffing schedule andapproved vacation and time-off requests. Others be-came more involved in the hiring process, interview-ing applicants and making job offers. They collabo-rated with the executive director (who approved thetemporary leadership transitions) to ensure that thecenter remained focused and able to offer exception-al care to patients and physicians. Everyone on theteam has a renewed appreciation for the assistant di-rector’s leadership contributions to the center, andthe challenge strengthened and united an already ro-bust team of nurses.

Surgical oncology team, New York-Presbyterian/ColumbiaUniversity Irving Medical Center,

New York City

In collaboration with the unit council, manager, clin-ical nurse specialist, and patient services administra-

tor, this surgical oncology team made huge strides inimproving its quality outcomes and patient experi-ence. They set goals in January 2017 to improve theirquality scores and executed them throughout theyear. From 2016 to 2017, the team saw a 90% de-crease in cases of Clostridium difficile, a 53% reduc-tion in falls, a 60% reduction in catheter-associatedurinary tract infections, and a 32% decrease in aver-age length of stay. •

Honorablemention

Boston Children’s Hospital 300 Longwood Ave, Boston, MA 02115(617) 355-6000 • 404-licensed-bed pediatric hospitalChildrenshospital.org/career-opportunities As a teaching hospital of Harvard Medical School and a fix-ture on the US News & World Report Honor Roll, our reach isglobal and our impact is profound. Join us, and be part of aplace where big things happen every day—and where everysingle member of our team contributes to saving and heal-ing the children in our care. Discover how your talents canchange lives. Yours included.

Children’s Hospital Los Angeles 4650 Sunset Blvd., Los Angeles, CA 90027CHLA.org • 323-660-2450 • 300 + bedsChildren’s Hospital Los Angeles is ranked sixth in the nationfor clinical excellence on the 2017-18 U.S. News & World Re-port Honor Roll of children’s hospitals. The hospital hasearned Magnet® recognition from the American Nurses Cre-dentialing Center since 2008. CHLA is one of America’s pre-mier teaching hospitals, home to the Versant™ RN Residencyin Pediatrics and affiliated with the Keck School of Medicineof the University of Southern California since 1932.

Children’s Mercy Kansas City 2400 Gillham Road, Kansas City, MO 64108816-234-3587 • childrensmercy.org/ • HResources@cmh.edu367 bedsChildren’s Mercy Kansas City has received Magnet® recogni-tion four consecutive times for excellence in nursing services.Children’s Mercy nurses are national leaders in helping ad-vance pediatric nursing and how it’s practiced in KansasCity and around the world. Learn more about nursing atChildren’s Mercy by visiting ChildrensMercy.org/Nursing.

Contemporary Forums 151 Innovation Drive, Irvine, Ca 92617(800) 377-7707 • contemporaryforums.com/Having hosted more than 350,000 medical professionalsover the past 35 years, Contemporary Forums is the leaderin continuing medical education. We serve educational con-tent in a variety of formats including live event conferences,OnDemand and Streaming in order to suit the needs of to-day’s medical professionals.

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Emory Healthcare 550 Peachtree St NW, Atlanta, GA 30308404-712-4938 • emoryhealthcare.org/careers nursing.careers@emoryhealthcare.org2,104 bedsAs the most comprehensive academic health system in Geor-gia, Emory Healthcare nurses are integral members of high-functioning interprofessional teams that are transforminghealth care and advancing medical discoveries. We are dedi-cated to the health of our community and proud to be theonly health care system in Georgia with three Magnet®-designated hospitals: Emory Saint Joseph’s Hospital, EmoryUniversity Hospital, Emory University Orthopaedics & SpineHospital.

University of Louisville School of Nursing 555 S Floyd StreetLouisville, KY 402021-502-852-58252301 S Third StreetLouisville, KY 40202online@louisville.eduuofl.me/ananurseThe University of Louisville's RN to BSN degree is offered100% online in 8-week terms. Students take 31 credits ofcore coursework, and earn 30 credits (tuition free) uponcompletion of their professional nursing portfolio. Focus on one course at a time and save more than $14,000 in tu-ition.

Memorial Sloan Kettering Cancer Center mskcc.orgLocations in New York City, Long Island, New Jersey, andWestchester, NYMemorial Sloan Kettering Cancer Center has devoted morethan 130 years to exceptional patient care, innovative re-search, and outstanding educational programs. We are oneof 47 National Cancer Institute–designated ComprehensiveCancer Centers, with state-of-the-art science, clinical studies,and treatment. The collaboration between our physiciansand scientists is one of our unique strengths, enabling us toprovide patients with the best care available as we discovermore effective strategies to prevent, control, and ultimatelycure cancer. Our education programs train physicians andscientists, having impacts on cancer treatment and biomed-ical research around the world.

White Plains Hospital 41 East Post Road, White Plains, NY 10601wphospital.orgMegan Haefner, RN, MSN •WPHRNResumes@wphospital.org292 bedsWhite Plains Hospital is a growing organization with keyclinical areas including maternity, Level III NICU, two car-diac catheterization labs, free-standing cancer facility, ortho-pedics, five new operating suites and two of the latest da Vinci® Xi™ robots for minimally invasive surgeries. WhitePlains Hospital is a member of the Montefiore Health System.The 292-bed hospital is fully accredited by the Joint Commis-sion and earned Top Performer for Key Quality Measures® in2015 and 2013. WPH received Magnet® recognition in 2016from the American Nurses Credentialing Center.

NYU Langone Health 550 First Avenue, New York, NY 10016212-404-3618 • nyulangone.orgNYU Langone Health is a world-class, patient-centered, inte-grated academic medical center, known for its excellence inclinical care, research, and education. Included in the 200+locations throughout the New York area are five inpatient lo-cations: NYU Langone Hospital—Brooklyn and the Magnet®-recognized Tisch Hospital; Rusk Rehabilitation; NYU LangoneOrthopedic Hospital, Hassenfeld Children's Hospital at NYULangone. Also part of NYU Langone Health is the Laura andIsaac Perlmutter Cancer Center, a National Cancer Institute–designated cancer center, and NYU School of Medicine. Formore information, go to nyulangone.org and interact with uson Facebook, Twitter, YouTube, and Instagram.

South Nassau Communities Hospital One Healthy Way, Oceanside, NY 11572877-SOUTH-NASSAU(877-768-8462)Southnassau.org455 bedsWelcome to South Nassau Communities Hospital. We are anaward-winning, 455-bed, acute care, not-for-profit teachinghospital located in Oceanside. Our dedicated staff serves theentire South Shore, from the Rockaways in Queens to theMassapequas and beyond. And we offer quality, compassion-ate care on our main campus in Oceanside, plus nine othersatellite facilities in the region. Some people call us the best-kept secret on Long Island, though we rank among the bestfor the health care we provide.

AmericanNurseToday.com April 2018 American Nurse Today 43

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