Through a number of innovative programs at Montefiore, nurses are taking a greater role in .... face-to-face classes ove
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Volume 2 Issue 1 Winter 2014
@ MONTEFIORE
Nursing Through the
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Giving Nurses a Voice in Decision Making
Preparing for Delivery Emergencies
From One Generation to the Next
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@ MONTEFIORE
IN THIS
Volume 2 Issue 1 Winter 2014
ISSUE
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GIVING
NURSES A VOICE
Nurses are sharing their ideas and playing a role in decision making through Montefiore’s Nursing Councils.
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Montefiore nurses hail from around the world and down the street.
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FACES
Delivering Better Outcomes. Simulations and planning are helping nurses prepare for labor and delivery emergencies.
10 The love of nursing is passed down from one generation to the next.
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Nurses Week Awards: Recognizing our outstanding nurses.
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VIEW
POINT Through Nursing@Montefiore, we highlight the support and comfort our nurses and nursing teams bring to patients and their families in our hospitals, in our clinics and in the community on a daily basis, as well as examples of experience and skill among our staff that continually advance the nursing profession.
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urses at Montefiore, with their unique bedside view, are perfectly positioned to lead the organization in improving patient care and elevating best practices. Through a number of innovative programs at Montefiore, nurses are taking a greater role in decision making and are directly impacting health outcomes and patient satisfaction. Nurses are driving high-impact initiatives such as Peripheral IV Bacteremia and CatheterAssociated Urinary Tract Infections Prevention at the Einstein Campus, as well as the Hospital-Acquired Pressure Ulcers project at the Wakefield and Moses Campuses. With the goal of transforming conventional models of care, nurses are encouraging new moms to choose breast-feeding over bottle-feeding, as part of the Baby-Friendly Initiative at the Einstein and Wakefield Campuses. Through the Early Mobilization Program on the Moses Campus, nurses are working to get patients out of their beds earlier to shorten hospital stays and improve outcomes. Moses nurses are also involved in the Patient Satisfaction Program, where different initiatives focus on improving the patient experience, such as call bell responsiveness and communications around patient medications. In this issue of Nursing@Montefiore, we highlight the critical roles nurses play in transforming care at Montefiore, beginning with a feature on the Nursing Shared Governance Council. Last January, Montefiore nurses formed six Nursing Councils that have become the centerpiece in our push toward shared governance. The Councils create a formal structure for nurses to voice their opinions and influence decisions related to patient care and nursing practice. The Councils span all aspects of nursing practice, from information technology and best practices to nursing education and recruitment. More than 100 nurses have stepped up to participate on these committees, which have already begun to make changes. Moving forward, we hope to see every unit represented in at least one Council. This issue also highlights the critical role of labor and delivery (L&D) nurses, and the intense training and comprehensive planning needed to improve outcomes for emergency births. In one program, nurses and physicians together rotate through L&D simulations to prepare for a range of possible emergencies—educating and improving communication among the entire team. In our Nursing Rounds feature, we tell the stories of “nursing families,” in which the passion for nursing has been passed down from generation to generation. I am thrilled with the impact nurses are having at Montefiore, and I look forward to the changes and improvements that the Nursing Councils will bring forth in the coming months and years. Your feedback and participation are incredibly important, and I urge you to come forward, either through the Nursing Councils, or to me directly, with your ideas. n Susan Green-Lorenzen, RN Senior Vice President, Operations Email:
[email protected]
www.montefiore.org/nursing
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GIVING
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THE 6 NURSING COUNCILS Professional Practice Council Best Practices/Clinical Impact Council Education Council Clinical Informatics Council Recruitment and Retention Council Shared Governance Council
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he nurses that file into the conference room at the Moses Campus on Council Day hail from different campuses with a wide range of experiences, but with the common desire to make their voices heard. “Montefiore is asking me what I think so I can be part of the solution,” says Beth Brodeur, RN, a five-year employee who works in the Pediatric Emergency Department at The Children’s Hospital at Montefiore. Ms. Brodeur is co-chair of the Best Practices/Clinical Impact Council, one of six Nursing Councils that launched last January as part of the Montefiore Nursing Shared Governance Council initiative. The five other Councils include Professional Practice, Education, Recruitment and Retention, Clinical Informatics and Shared Governance.
The purpose of the Councils is to create a formal structure that gives voice to nurses based on the understanding that they, being closest to patients, are in the best position to influence decisions related to patient care and nursing practice.
The purpose of the Councils is to create a formal structure that gives voice to nurses based on the understanding that they, being closest to patients, are in the best position to influence decisions related to patient care and nursing practice. Nurses at Montefiore have always collaborated, but they didn’t have a formal structure that provided a consistent, monthly forum for staff nurses to come together with nursing leadership to participate in nursing practice decision making. According to the research, shared governance is a key element in nurse satisfaction and nurse retention. “Whenever you have more control over your environment, it makes for a happier person,” says Ms. Brodeur. “I have a lot on
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my plate—I work full-time, am a single mom and am on the board of an active charity— but I volunteered for the Council because I looked at this as an opportunity for my opinion to be heard,” she says. The turnout has been strong and positive. Councils have between 15 and 40 nurses, all who volunteered to attend meetings on the third Thursday of every month (some come in on their day off to attend). “Ideally, we want a volunteer from each unit to sit on a different committee so that all units are represented and you have a wide breadth of experience sitting in the room,” says Ms. Brodeur. Each Council is chaired by a staff nurse who is supported by a co-chair from management. The staff nurse typically runs the meetings, which are structured as a roundtable to encourage open, lively conversation that allows issues to rise to the surface. In the months since they were launched, the Councils have been crafting their charter statements and identifying their goals, and several have begun to make changes.
The Council also serves as a way for the bedside nurse to bring issues to the attention of management. Already, the Council has identified an issue that occurs in almost every unit: How do nurses care for a patient who is hospitalized for a medical reason, but also has a mental diagnosis?
Professional Practice Council In the more than 25 years that Sophia Gonzalez, RN, has worked as a nurse at Montefiore, she has experienced many changes in the profession. “In the past, when new policies were put into place, you wondered, who made these decisions?” says Ms. Gonzalez, who works in Telemetry/ ICCU on the Moses Campus. “The nurses in the hospital now can contribute to decision making that affects us,” she says. Ms. Gonzalez jumped at the opportunity to join the Professional Practice Council, and then volunteered to be co-chair. “I wanted to be able to have a part in keeping the integrity of our nursing practice,” she says. The Professional Practice Council was created to help ensure that the delivery of nursing care reflects current evidence-based practice. It is responsible for developing and implementing nursing care initiatives to achieve compliance with the Magnet Recognition Program.
At a recent Council meeting, the nurses tackled their first issue—how to delegate—which one nurse had brought to the table. “A lot of nurses were having problems delegating to ancillary staff members,” says Ms. Gonzalez. Some newer nurses felt it was difficult to delegate to associates who have been at Montefiore longer. They weren’t always getting a positive response. “They wanted to do it in an effective manner, without feeling they were overstepping their authority,” says Ms. Gonzalez. Between meetings, Council members studied the literature. At the next meeting, they shared the evidence and provided an article to all the nurses on the Council, who in turn took it back to their units. The article stressed the importance of working as a team and making sure the person you’re delegating to feels like a part of the team. It also emphasized the importance of being sure the person you’re delegating to has the skill and experience to perform the task. “When you’re delegating, you’re actually transferring responsibility of a task while being accountable for the outcome,” says Ms. Gonzalez. Actions like these have been encouraging to nurses on the committee. “It’s important for us to be heard, to be valued and to feel that we’re instrumental in carrying out the mission of the hospital,” says Ms. Gonzalez.
Best Practices/Clinical Impact Council At a recent meeting of the Best Practices/Clinical Impact Council, a nurse at the Wakefield Campus brought up a disagreement that occurred on her unit. She had a patient who was incontinent, but the physician felt an indwelling catheter wasn’t warranted. The nurse was going to use a Texas catheter, otherwise known as a condom catheter. The physician didn’t want her to use that either, but the nurse manager thought that they should. It turns out, when they checked, there was no policy on the device. One of the key roles of the Best Practices Council is to conduct research reviews on all existing policies and procedures to make sure they’re up to date. Once a year, the policies and procedures in the nursing manuals are reviewed. “But some of the policies that we have are supported by evidence that is several years old,” says Ms. Brodeur. When they identify more current evidence, they’ll present it to the committee responsible for that procedure review. In the case of the Texas catheter, there was no policy. After the nurse brought it to the Council meeting, the team reviewed the research on Texas catheters and sent out a recommendation to the committee responsible for reviewing catheter procedures. A final decision has not yet been made.
www.montefiore.org/nursing www.montefiore.org/nursing
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The Recruitment and Retention Council has several goals—to develop mentorship programs for new hires and established staff and to recognize nursing associates, spearhead events for Nurses Week each May, and work to improve the well-being of nurses.
The Council also serves as a way for the bedside nurse to bring issues to the attention of management. Already, the Council has identified an issue that occurs in almost every unit: How do nurses care for a patient who is hospitalized for a medical reason, but also has a mental diagnosis? Nurses not on the psychiatric ward may not know how to best handle a patient’s behavior caused by a psychiatric disorder. The Council plans to address this issue further in the next meeting. “We’ve had only three meetings, and we’ve already identified two significant issues,” says Ms. Brodeur. “We are all feeling really good about it and starting to see how our efforts can affect our practice and, in turn, affect our patients,” she says.
Education Council Joining Montefiore a little more than a year ago, Theresa Bauman, RN, of the Emergency Department at the Wakefield Campus, felt that more could be done to communicate the education opportunities available to nurses at Montefiore. She knew there were hundreds of courses to choose from, but, says Ms. Bauman, “A lot of the nurses aren’t aware of the offerings.” Ms. Bauman, who volunteered to be a member of the Education Council, also believes there are unmet and emerging learning needs. The goal of the Education Council is to promote the educational opportunities that are already available to nurses at Montefiore, such as the classes offered on The Learning Network, as well as to create new learning opportunities. “We are trying to get a better understanding of what nurses are interested in and what would be most helpful for everyone,” she says. For example, it came up at one meeting that many of the classes are computer-based, but some nurses prefer
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face-to-face classes over online learning. Another goal of the committee is to place nurse educators in all units in order to provide ongoing instruction on new equipment and new processes. The Council has met only twice and is still working on the charter and its goals. “We’re discussing the goal of having a certain percentage of nurses involved in education opportunities, such as gaining advanced credentials each year or pursuing higher degrees,” says Ms. Bauman.
Clinical Informatics Council The Clinical Informatics Council is one of the most popular, with roughly 40 members from a range of disciplines and units. Lora Smith-Johnson, RN, of the Telemetry Unit at Moses Campus, joined because her manager thought she’d have a lot to contribute— she has been involved with CIS (computer information system) rollouts and training and has been designated as a “super-user.”
“A lot of the nurses aren’t aware of the offerings.” “Whenever you have more control over your environment, it makes for a happier person.“
“We are trying to get a better understanding of what nurses are interested in and what would be most helpful for everyone.”” “The nurses in the hospital now can contribute to decision-making that “The nurses in the hospital affects us.” now can contribute to decision making that affects us...” “We’ll prioritize the issues that seem to affect the most nurses and work on those as a committee.”.”
The bylaws define the goals of the entire initiative: Councils should participate in decision making that affects patient care and professional nursing practice, provide recommendations and reviews of policies and procedures, communicate progress and decisions of the Councils to all associates, and offer a spirit of collaboration.
The Council will focus on the integration of technology and healthcare processes to improve patient care. It will ensure that clinical applications and nursing documentation reflect the standard of care and evidence-based nursing practice, and will evaluate patient outcomes data to provide recommendations in order to enhance patient care through the use of technology.
Recruitment and Retention Council Kathleen Reilly, RN, previously a nurse recruiter and now in the Emergency Department at Wakefield Campus, volunteered to co-chair the Recruitment and Retention Council. “I always like to be involved in the process of retaining nurses,” says Ms. Reilly, who has been at Montefiore for 21 years. The Recruitment and Retention Council has several goals. It plans to develop mentorship programs for hires and established staff and programs for recognizing nursing associates, spearhead events for Nurses Week each May, and work to improve the well-being of nurses. At the last meeting, the members were asked to go back to their units and speak with their staff about what their most pressing issues are. “We’ll prioritize the issues that seem to affect the most nurses and work on those as a committee,” says Ms. Reilly.
“We’ve had only three meetings and we’ve already identified two significant issues.”
Some issues that were discussed at the first two meetings included: nurse to patient ratios, how to adjust schedules to ensure appropriate coverage when nurses call in sick or are on leave, and developing a more comprehensive orientation process for new nurses. The Council also plans to work with the Montefiore Healing Arts Program to develop relaxation and stress management classes for nurses.
Shared Governance Council The Shared Governance Council provides oversight to the other five Councils and is writing the bylaws for the Montefiore Nursing Shared Governance Councils. The bylaws define the goals of the entire initiative: Councils should participate in decision making that affects patient care and professional nursing practice, provide recommendations and reviews of policies and procedures, communicate the Councils’ progress and decisions to all associates, and offer a spirit of collaboration. That spirit was reflected in the enthusiasm of staff nurses attending their meetings on Council Day. n
Delivering Better Outcomes: How Obstetrics Nurses Prepare for Emergencies Maternal/Perinatal Patient Safety Officer, Montefiore, and delivery is happening using a hemipelvis simulator and lifelike simulated fetus. After the delivery, the team debriefs, analyzing how their behavior affected the outcome. The observer, Dena Goffman, MD, Director of Maternal Safety & Simulation, Division of Maternal Fetal Medicine, Montefiore, and Assistant Professor, Obstetrics & Gynecology and Women’s Health, Einstein, also provides feedback, and everyone walks away with an idea of what works and what they could do better. OB Nurses play an integral role in labor and delivery. They are in the unique position of being the point person for the care of two patients—the mother and the fetus. Nurses need to quickly identify emergency situations, such as signs of fetal distress or hemorrhaging in the mom, and bring those issues to the physicians. In emergency situations, the coordination they provide, the information that they relay to the physicians and residents, and their handson care, are critical to the delivery’s success.
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izette Rivera, RN, a new obstetrics nurse at Montefiore, is assisting a mom in active labor when, sensing delivery is imminent, she calls for a resident. Ms. Rivera relays the pertinent information— the mom is 36, the baby large, about 4,000 grams. Her first baby, Ms. Rivera reports, was 10 pounds. As the delivery progresses, the baby’s shoulder becomes stuck—dystocia— and the resident calls for the attendings. Within minutes the room is filled—three nurses, two attendings, one resident, the pediatrician, a pediatric nurse and an anesthesia resident. The baby is successfully delivered, but needs resuscitation, and within
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moments of the placenta being delivered, the mom turns pale and says she feels dizzy and nauseous. She’s hemorrhaging. The room is noisy; everyone is talking at once, but then one attending’s voice rises above the rest and asks for quiet. She reviews the case aloud, the mom is given intravenous (IV) fluids, Pitocin, oxygen and uterine massage, and the bleeding stops. The crisis is averted—the mock crisis, that is. The delivery room is in the Ruth L. Gottesman Clinical Skills Center at Einstein Campus, the “mom” is an actor, played by Colleen Lee, MS, RN, Montefiore’s
In 2006, Montefiore began running simulations of labor and delivery (L&D) emergencies to provide ongoing training for the whole team. They have practiced
“Simulations have helped the obstetrics nurses beyond belief,” says Maggie Tierney, RN, who has gone through three simulation workshops. “In an emergency you could freeze, but this gives you practice in what you should be thinking about and communicating to the others on the team,” she says.
postpartum hemorrhage, eclampsia, shoulder dystocia, breech vaginal deliveries, emergency cesarean sections and neonatal resuscitations. Such complications are common at Montefiore, which tends to treat pregnant women with co-morbid conditions, such as obesity and diabetes, and those who may not have had access to prenatal care. “Simulations have helped the obstetrics nurses beyond belief,” says Maggie Tierney, RN, who has gone through three simulation workshops. “In an emergency you could freeze, but this gives you practice in what you should be thinking about and communicating to the others on the team,” she says. The simulations allow experienced nurses to practice what to do in emergencies they don’t see that often, while new nurses take on primary nurse roles, which they’re less likely to experience in a real emergency, when more senior nurses typically step in. The simulations educate nurses on the roles and expectations of the physicians, encourage team building among nurses and physicians, and provide a safe and supportive environment in which to voice questions and to learn. “It’s a great place to practice because you’re not in the hospital environment where you’re stressed out. It’s very relaxed, but it feels real at the same time,” says Brenda Badolato, RN, an L&D nurse at the Wakefield Campus and a 16-year Montefiore veteran. L&D simulations, held monthly, typically include six to eight staff—a resident, attendings, nurses, anesthesiologists and pediatricians. The team rotates through two stations or simulations during a half-day training session. As a simulation progresses, the observer calls out issues that arise, and the team must react. At the end of the
simulation, the observer and the associates debrief, offering positive reinforcements and recommendations. Just weeks after participating in a simulation of a hemorrhage last year, Candice Castro, RN, an L&D nurse at the Einstein Campus who has worked at Montefiore for 27 years, took a phone call from a man whose wife was 36 weeks pregnant and bleeding. From the sound of his voice, Ms. Castro knew it was serious, and told him to drive to Montefiore immediately. “We were expecting a placental abruption, and we had just practiced this, so we knew who to call and what to do; we had a room set up, the high-risk obstetrician was ready, the neonatal team was ready,” says Ms. Castro. The patient was delivered without incident within 30 minutes of getting here. “The communication was excellent,” she says. Improving communication is a top priority of the simulations. Failures in communication
during births are a leading cause of infant death and injury, according to The Joint Commission.” The simulation helps us practice what we have to communicate, that we have to give a full report when the resident comes in,” says Sandra Sturridge, RN, an L&D nurseat the Einstein Campus. Nurses also practice delegating jobs within the delivery room, such as saying to another nurse, “I want you to do the recording.” Practicing alongside doctors from different campuses also helps nurses feel more comfortable when they are placed with the doctors in a real delivery. “The outcomes are so much better, without a doubt,” says Ms. Castro.
High-Risk Delivery Coordination In some cases, simulations are conducted for a specific case, as part of a relatively new initiative called High-Risk Delivery Coordination. Many of the pregnant women who come to the high-risk service at Weiler Hospital have other health problems, such as diabetes, obesity, heart disease, immunological disorders or blood disorders, which increase their risk of complications during a delivery. In some cases, the fetus has a known anomaly, such as a heart defect, that requires immediate surgery after delivery.
Diane Collins, RN, a neonatal intensive care nurse at Weiler Hospital, has been part of this coordination for a number of births in which the infant had a known heart defect. When she is expecting such a birth, she meets with the Obstetrics nurses and the various doctors on the team to coordinate exactly what is going to happen during the delivery and immediately afterward. “For babies that need to go to the pediatric cardiac catheter laboratory, we have a small window of about 15 minutes to stabilize the baby before he or she goes in,” she says.
About once every month or two, the L&D nurse manager has to coordinate the delivery of high-risk women, which requires the cooperation and teamwork of a long list of departments hailing from different campuses of the Medical Center—Maternity, MaternalFetal Medicine, Adult Operating Room (OR)/ Post-Anesthesia Care Unit, Respiratory, Cardiology, Adult and Pediatric Anesthesiology, Pediatric Intensive Care Unit, Neonatal Intensive Care Unit (NICU), Neonatology, the Pediatric Catheterization Laboratory,Social Work, Pathology and Radiology, as well as Admitting, Facilities (for moving equipment), Security and the Blood Bank.
To make that happen, coordination is key. She makes lists of all the equipment needed, including warming beds, cardiac monitors, blood oxygenation monitors, IV pumps and backup medications for any number of possible emergencies. A day before the delivery, she arranges to send over the equipment from the Einstein Campus to the Moses Campus, where the delivery has to take place because the Pediatric Cardiac Catheter Laboratory is located there. Before the birth, the neonatal team will do a simulation together.
Administrative nurse managers from the main OR, L&D and the NICU are responsible for getting all the nursing staff, supplies and equipment in place. At the meetings, they walk through what needs to be done logistically and which equipment and instruments need to be coordinated and transported. “We speak about all the issues that can arise and how we plan to handle them, so we know in advance whether the baby would need blood or be intubated,” says Ms. Collins “That way, we can be all set up ahead of time, rather than having to call down for blood during the delivery, for instance.” “Since we’ve been coordinating like this, it has gone so smoothly; we all work together—doctors are waiting, even the elevators are waiting,” she says. During the last high-risk delivery the team handled, they got the baby to the Cath Lab in just nine minutes, says Ms. Collins. “It’s a huge thing to organize, and I’m very proud of the way we all prepare for this and make it happen on the day of delivery,” she says. n
THE HIGH RISK DELIVERY COORDINATION TIMELINE
Receive notification from obstetrician of a high-risk patient.
Define and clarify each team’s responsibility.
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2 Mobilize multiple department teams to plan the delivery.
Perform a series of checks and balances to make sure that all personnel, equipment and locations are ready to go.
Day of delivery: Recheck details, making sure everyone understands their roles.
Debrief after the delivery to discuss how the team can perfect the process.
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4 Run through a high-risk delivery simulation with all participating teams.
6 Day prior to delivery; Send over equipment from Einstein to Moses Campus, and double check equipment and backup equipment.
8 All teams report for delivery.
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FACES Montefiore nurses hail from around the world and down the street. They enhance our world-class team, bringing new skills, enthusiasm and innovative ideas to our patients and the Medical Center as a whole. Here, we offer a glimpse at a few of the professionals who have come on board recently:
Kathleen McCarthy, RN
The Children’s Hospital at Montefiore
Kathleen McCarthy, RN, a 2012 graduate of Dominican College, works in the Infant Cardiology Unit at The Children’s Hospital at Montefiore. The best part of the job, she says, is watching children who have been in the hospital for a long time get better and go home. Ms. McCarthy, who hails from Rockland County, was an emergency medical technician (EMT) before she studied nursing. But interacting with nurses made her realize she wanted to spend more time with patients, “being the comforting face that they see,” as she puts it. On her days off, she still works on the ambulance as an EMT, as well as putting in time at a local police department, helping out with female prisoners. She is also currently enrolled in the Pediatric Nurse Practitioner Program at New York University.
Holly Pearlstein, RN
Montefiore Wakefield Campus
Holly Pearlstein, RN, feels a personal connection to patients and their families. When Ms. Pearlstein was 17, her father was diagnosed with cancer. It was a formative experience that, filled her with compassion for the cancer patients she met. Eventually, she realized she wanted to pursue patient care, and returned to school for a degree in nursing from New York University. Ms. Pearlstein is now a nurse on 6 East, Wakefield Campus, and enjoys both teaching patients and helping make their lives a little brighter. “It’s not easy being a patient in a hospital,” she says. “I know that. It’s the little things at the end of the day that the patient is going to take home. It’s going to depend on maybe just a pillow that I can get for them.” Away from work, Ms. Pearlstein enjoys playing tennis and hiking and is currently planning her wedding.
Nathana Fisher, RN
Montefiore Home Care
Nathana Fisher, RN, likes to say that she did not choose home care nursing—it chose her. She was working with mentally disabled patients in a New York State group home when a friend connected her with a part-time job as a Montefiore home care nurse through an agency. Six months later, she had a new full-time career. “It’s so personal,” Ms. Fisher says, “You go in the patients’ homes. You get to know their tendencies, and to see their lives.” Ms. Fisher, who is originally from Jamaica and studied at Borough of Manhattan Community College and Lehman College, focuses on wound care, spending between half an hour to two hours with a patient during each visit. She recalls one patient who was on home care for two years and had frustrated other nurses by not following the necessary recovery steps. “In six months, everything was fine,” she says proudly. “I got her to do what she was supposed to do. It was all about me talking to her, listening to her, and treating her how she wanted to be treated.” Ms. Fisher has a four-year-old son, who “has a busier schedule than I have,” she says. When she is not treating patients, she is taking her son to soccer, music, church and other activities. www.montefiore.org/nursing www.montefiore.org/nursing
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THE PASSION that many nurses have for their job can plant a seed in their children. At Montefiore, at least 19 daughters and sons have followed in their mothers’ footsteps and become nurses themselves. Nursing@Montefiore spoke to four families about what and who influenced them—in some families, nursing goes back generations.
A Childhood Illness Inspires a Legacy of Nursing Mother: Alicia Kilayko, RN, Pediatrics, Wakefield Campus, 23 years at Montefiore Daughter: Kristine Kilayko, RN, Labor & Delivery, Wakefield Campus, 13 years at Montefiore Alicia: I was a sickly child growing up in the Philippines, and my parents always brought me to the clinic or hospital. The nurses were so kind, and I always thought I wanted to be like them. I went for my nursing degree in the Philippines, and got my first job in an intensive care unit (ICU) and later went into nursing education. But then I got married and had children and became a stay-at-home mom. Kristine: I remember when I was little, having cuts and bruises, and my mom would always be there comforting me and taking care of my injuries. She went back to nursing when I was about 10 years old. She didn’t talk about her job, but she just embodied what a nurse is. Alicia: I told my daughter, as a nurse, you are not going to be a millionaire, but you will be a millionaire in gratitude from your patients. It’s so satisfying seeing the kids we treat get better, crack a smile, and knowing that I make a difference in their lives. Kristine: I get the same feeling as my mom, that fulfillment at the end of the day, knowing your patients feel better and the family is content. I had one patient in the ICU who was intubated and sedated. I would sit and talk to her. When she was out of the ICU, I came in and introduced myself. She gave me a huge smile and said, “I know who you are, I remember your voice.” It felt so good to have made a difference for her.
Like Mother, Like Son Mother: Anne Brennan, RN, The Learning Network, 31 years at Montefiore Son: Thomas Brennan, RN, 7 South, Einstein Campus, Two years at Montefiore Anne: I would talk a little about my job at home. I worked on the night shift for 26 years. If we had a rough night, I would talk about what happened. Thomas: She would not stop talking about the job 24/7. I used to make fun of my mom and roll my eyes. When I was about 18, one of my high school teachers was in the ICU, and she brought me in to visit. It struck me for the first time how hard she worked—she
was performing 20 tasks in the span of a minute, on her feet the whole day. I had no idea how intense it could be and how much impact you can have on a patient. Anne: When I worked at the bedside, I got so much satisfaction out of helping somebody, even if it’s just allowing them to talk to you about what’s bothering them. Now I work in the The Learning Network and do onboarding of new associates. I like that “aha” moment when you’re explaining something to a nurse and she gets it, when the light bulb goes off. I feel like I made a difference for them, too.
Thomas: I’d love to carry on my mom’s legacy. She has such dedication and care for her patients, no matter what the situation. She’s so well respected at Montefiore. Anne: I think it’s great that there are more men in nursing today and patients are more accepting of male nurses. It changes the whole tone of nursing. Sometimes when he comes home, he’ll vent some frustrations, and I’ll listen and ask what happened and how he handled it. I try to just listen and not always offer advice.
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Giving Back to Montefiore for Generations Mother: Margaret (Margie) Rohan, RN, CMO, Yonkers Campus, Two years at Montefiore
I was so touched by the constant stream of her coworkers coming to visit her and the way I was treated as one of their own.
Sister: Eileen Deighan, RN, CMO, Montefiore Yonkers, 31 years at Montefiore
Eileen: For me, it wasn’t as much as my mother deciding that I’d be a nurse as my own experience. As a child, I had cancer, and I just loved one of the nurses who took care of me. I remember making a bargain with God that if I lived, I would be a nurse or a nun. We’ve had other tragedies as well. My son developed cancer and died in 2005, but Montefiore took loving care of him and continues to provide care for my daughter. I try to give back every day for all they’ve done for us.
Daughter (to Ms. Rohan): Christina Rohan, RN, Medical Surgery, Einstein Campus, One year at Montefiore
Margie: When we were little my mother, who was a nurse’s aide, told me and my two sisters that we’d all become nurses. We all did. But we went through personal tragedies in our life that really made Montefiore a home for us. My oldest sister, who was a nurse at Montefiore, was in a serious accident and suffered a traumatic brain injury. Montefiore rallied around us.
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Christina: Growing up, I wanted to be like my mom, who worked in the emergency room. I’d wait for her to come home and tell me about her patients and things that she saw. I was always impressed with the way she interacted with her patients and how much she knows. But my cousin’s battle with cancer also affected me. We spent a lot of time visiting him in the hospital, and I’d watch the way the nurses cared for him. There was one young nurse who was so good to him, and became a good friend to him. She was so inspiring and that’s when I knew I wanted to be a nurse. They did everything they could for us, and I try to be like that for my patients. Margie: I think what we’ve gone through as a family has made us more compassionate and more understanding of what it’s like to be on the other side, a patient or a family member of someone who’s sick. I try to treat each patient as though he or she were part of my own family.
Independent Paths to Caring Mother: Vinel Lynch Malcolm, RN, Medical Unit at Moses Campus, 24 years at Montefiore Daughter: Tara Malcolm, RN, Medical Surgery, Moses Campus, One year at Montefiore
Vinel: When I was 13, growing up in Jamaica, I witnessed a motorcycle accident. The kid was lying on the street and I wanted to help, but there was nothing I could do. I felt so helpless. I kept harboring that feeling of wanting to help, and that transformed me into who I am today. I see my profession not as an noun but as a verb, doing something to help others. I didn’t want my daughter to go into nursing just because I was a nurse. It has to be a calling; you have to have that inner desire to do it. But she chose it on her own. Tara: My mom really loved and enjoyed nursing, and that was part of the reason I became a nurse. But part of it was seeing the care my brother got when he was sick with sickle cell disease. He was in and out of the hospital. The staff treated him like he was their own child, and that really influenced me. My mom tried to discourage me from becoming a nurse. She had worked very long hours and didn’t want that for me. But I have fond memories of her coming home and sharing stories with us. She truly loved what she did, and I love it too. I love to get to experience something different every day. Nursing is a continual learning, growing process, and I get to make a difference and encourage people to feel better. There was one patient, a 23-year-old guy, with cancer, and he was our bundle of joy. For some nurses, he was like their son, for others, a nice companion, for others a kid brother. That really stuck out for me, how caring everyone here can be. n
Montefiore is a Family Affair A lot has changed in the 20 to 30 years since their parents started nursing, but these nurses who were inspired by their mothers’ work have all experienced the same love of the job that their mothers talked about over the years.
111 East 210th Street Bronx, New York 10467
NURSES WEEK
Montefiore recognized our outstanding nurses during last May’s National Nurses Week. For the third consecutive year, associates were asked to nominate fellow nurses whom they thought exemplified excellence in professional nursing and who embodied the Montefiore standards of excellence. Nurses were nominated for different categories and had to demonstrate the characteristics that are essential to nursing care in those roles. This year, nurses and nursing teams were nominated online, and a committee selected the 39 winners. The nurses were honored at three special events at the Wakefield, Moses and Einstein Campuses. The winning nurses were notified in advance and invited to bring their families and friends. Each was presented with a framed award certificate and a bouquet of flowers. The directors of nursing at the various Campuses presented the awards and shared poignant comments from the nurses who nominated them.
AWARDS
Name and Award Type n Anne Brennan Nurse Educator
n Jasmine Moya Novice Nurse
n Judy Nebel Nurse Leader/Manager
n Casilda Adames Novice Nurse
n Lyndon Nuqui Licensed Practical Nurse
n Marjorie Linton Registered Staff Nurse
n Kristin Prisco Novice Nurse
n Sandra Martino Registered Staff Nurse
n Patricson O’Neal Career Achievement
n Ngoclan Ha Registered Staff Nurse
n Samantha Napolitano Registered Staff Nurse
n Gilbert Jumpp Patient Care Coordinator
n Candice Castro Registered Staff Nurse
n Hyacinth Charles Patient Care Coordinator
n Susan Carter Patient Care Coordinator
n Kathleen Hart Patient Care Coordinator
n Nora Averilla Patient Care Coordinator
n Pio Paunon Nursing Research & Evidence-Based Practice
n Corey Williams and the Einstein ED Nursing Team Nursing Team
n Elena Bertolino Nursing Research & Evidence-Based Practice
n Alex Bux Nurse Educator
n Balwant Persaud Licensed Practical Nurse
n Lisa LaFalce and the Klau 4 Nursing Team Nursing Team
n Diahann Barthelemy and the SICU Nursing Team Nursing Team
Recognizing Montefiore’s Outstanding Nurses
n Stephen Ferrara Advanced Practice Nurse n Joy Mitchell Nurse Educator
n Jeniece Trast Nursing Research & Evidence-Based Practice
n Christine Croke Career Achievement
n Mohamed Yasin Nurse Leader/Manager
n Ketty Floyd Nurse Leader/Manager n Jael Brooks Licensed Practical Nurse n Ria Anderson Novice Nurse n Franciou Philippeau Novice Nurse n Paula Smajlaj Registered Staff Nurse n Mumtaz Duymun Charge Nurse n Ronette Shaw Charge Nurse n Farley Villarente Nursing Research & Evidence-Based Practice n The Wakefield Pediatric Nursing Team Nursing Team n Elizabeth Dolan Career Achievement
