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Careers at UW Health

UW Health RNs shine on international stage

UW Health RNs shine on international stage

In celebration of UW Health Wisconsin receiving its fourth Magnet designation in 2023, a group of UW Health RNs and leaders from Wisconsin and Illinois attended the 2023 international Magnet Conference where this incredible achievement was recognized among 13,000 nursing peers from 27 countries.

At the conference, UW Health nurses shared an impressive quality improvement project and gave two impactful presentations—one of them receiving a standing ovation—further demonstrating that UW Health nurses are true experts and international leaders.

Nailed it! Shared governance presentations wow audiences
As part of the educational sessions offered throughout the Magnet conference, UW Health shared two presentations that highlighted impressive elements of how UW Health got to where it is with its effective and evolving shared governance structure.

UW Health director Sarah Brzozowski on stage presenting at the Magnet conference
Sarah Brzozowski (podium right), UW Health Director, Magnet & Nursing Excellence, presented at the national Magnet conference alongside Pamela Blabaum (podium left), UW Health Nursing Program Coordinator-System Strategy, on how UW Health has been using data to optimize our shared governance structure and culture.


“Using Data to Optimize Shared Governance Structure and Culture” was presented by Sarah Brzozowski, PhD, MBA, BA, RN, NEA-BC, Director, Magnet & Nursing Excellence, and Pamela Blabaum, COTA, Nursing Program Coordinator-System Strategy. Sarah and Pam shared how essential is it to leverage shared governance in today’s work environment, by bringing direct care nurses and leaders together to make decisions and drive outcomes. In addition, they showed how UW Health has optimized its shared governance council structure to enhance the confidence and influence of nurses throughout our organization.

“Structural Empowerment through Nursing Unit Councils”was presented by Mark Ravis, BA, RN, PMH-BC, MDiv, Care Team Leader, Inpatient Psychiatry, and Sarah Brzozowski, who touched on the nursing shared governance structure at UW Health, the need to optimize unit councils, how to tackle improvements and opportunities from multiples angles, as well as outcomes and next steps.

Both presentations were extremely well-received with nurses from across the nation and world, asking multiple questions after each session. One nurse who attended the Structural Empowerment through Nursing Unit Councils presentation felt compelled to share some positive feedback, stating:

“You guys rocked this presentation. This is the best session I’ve attended. Your work is really impressive.”
 

In addition, the founder of the shared governance accrediting body The Forum for Shared Governance, Dr. Robert Hess, was in attendance at the conference promoting the book he co-authored with Dr. Diana Swihart titled “Shared Professional Governance: A Practical Approach to Transforming Interprofessional Healthcare,” which includes a contribution from UW Health authored by Sarah Brzozowski and Mark Ravis, who shared important work that was done at UW Health on assessing the health of our councils (chapter 7). This is just another example that shows UW Health is doing amazing work in the shared governance arena!

Demonstrating quality improvement through mentorship
Nursing colleagues from the General Internal Medicine Unit (F6/5) at University Hospital shared their quality improvement project—“MASKing During the Pandemic: Mentoring and Sharing Knowledge”—that was designed to foster a culture of mutual support and growth among registered nurses (RNs) and nursing assistants (NAs) through the creation of a mentorship program called MASK (Mentoring and Sharing Knowledge). Through this innovative work, the unit paired RNs and NAs during the six-month program that resulted in improved NA skills and knowledge, maximized teamwork, increased job satisfaction and enhanced employee engagement. 

Demonstrating quality improvement through mentorship
Nursing colleagues from the General Internal Medicine Unit (F6/5) at University Hospital shared their quality improvement project—“MASKing During the Pandemic: Mentoring and Sharing Knowledge”—that was designed to foster a culture of mutual support and growth among registered nurses (RNs) and nursing assistants (NAs) through the creation of a mentorship program called MASK (Mentoring and Sharing Knowledge). Through this innovative work, the unit paired RNs and NAs during the six-month program that resulted in improved NA skills and knowledge, maximized teamwork, increased job satisfaction and enhanced employee engagement. 

UW Health Nurse Stacy Schrimpf (left) and UW Health Nursing Assistant Holly Adams (right) proudly represented UW Health and the F6/5 quality improvement project titled “MASKing During the Pandemic: Mentoring and Sharing Knowledge” at the 2023 Magnet Conference.

Conducting Non-clinical Graduate Nursing Rotations at UW Health with a Preceptor (Practicum, Residency, Mentor)

  • This resource is for students interested in doing a non-clinical rotation (also known as Practicums or Residencies or Mentorships) with a preceptor as a part of an MSN or DNP program with a leadership focus.
  • Go here to determine the process for additional tracks for nursing student projects or rotations.
  • All nursing graduate students (regardless of UW Health employment status) who would like to complete a non-clinical rotation with a UW Health preceptor (also known as mentor) for academic credit must follow the steps listed below.
  • The steps outlined here are requirements for UW Health. There may be additional requirements from the student’s academic institution. It is the student’s responsibility to find out about additional requirements from their academic institution.

All the steps must be completed before the nursing student can begin spending hours with their preceptor as part of their rotation or participating in UW Health activities as a student. These steps ensure the student is onboarded and has completed required competencies.

Step 1. Nursing student notifies their academic institution’s Clinical Placement Coordinator

  • The nursing student needs to start this process by notifying their academic institution’s Clinical Placement Coordinator to let them know of their desire to complete the student rotation at UW Health.
  • The academic institution’s Clinical Placement Coordinator will ensure that an Affiliation Agreement is in place between the student’s academic institution and UW Health. If an Affiliation Agreement is not in place, it is the responsibility of the academic institution’s Clinical Placement Coordinator to complete this process. For additional guidance with this process, the school’s Clinical Placement Coordinator should reach out to NursingStudentAcademicProjects@uwhealth.org.
    • Affiliation Agreements may take 3 to 6 months to be completed. It is strongly recommended that the student inquire about this detail early in the process.
    • Signing a new Affiliation Agreement is at the discretion of UW Health.

Step 2. Student identifies UW Health preceptor

  • Once the nursing student receives verification that there is an Affiliation Agreement between the academic institution and UW Health, they should then find a preceptor.
  • The nursing student must establish a preceptor for their rotation by identifying a UW Health employee. The student should discuss their preceptor identification with the academic institution’s Clinical Placement Coordinator and the course instructor to determine appropriateness.
  • The student should work with their preceptor and discuss the student’s academic requirements for the rotation to ensure the preceptor and organization can meet their needs. The student and preceptor should create a plan to complete rotation.
  • The student should review the preceptor requirements and restrictions below to be sure that they select someone who meets their rotation needs.
  • If the student cannot determine a preceptor, the student should email NursingStudentAcademicProjects@uwhealth.org for help with finding a preceptor.

Carefully read and follow the requirements and restrictions of a preceptor.

Requirements of a Preceptor

A preceptor of a DNP student at UW Health will be overseeing the DNP student’s practice while they are in the walls of UW Health. Although requirements of all academic institutions may vary, a preceptor at UW Health must meet the following minimum requirements:

  • A bachelor’s degree in nursing*
  • Must be in a UW Health position that requires an RN as a minimum qualification. *

Preceptor Restrictions for UW Health Employees

  • The UW Health preceptor cannot be the employee’s paid supervisor or manager.
  • The student’s rotation cannot take place at the same location where the student is a paid employee.
  • The student cannot complete their rotation hours during work hours; the student work must be completed on unpaid time.

*If the student is conducting a rotation outside of nursing, a non-nurse preceptor may be permitted. The preceptor should confirm their appropriateness with the UWH Clinical Placement Office by emailing NursingStudentAcademicProjects@uwhealth.org

Step 3. Student works with their Academic Institution’s Clinical Placement Coordinator

  • Once Steps 1 and 2 are complete, the student should inform their academic institution’s Clinical Placement Coordinator so that they can place a rotation request in myClinicalExchange (MCE).

Step 4. Upload documents on myClinicalExchange

  • Once the student’s rotation has been entered by their academic institution’s Clinical Placement Coordinator and approved by the UWH Clinical Placement Office, they will receive an email prompting them to upload documents into myClinicalExchange.
  • The student must complete the required documentation upload and training to be compliant with the student requirements.
  • Remember that this step must be completed for all nursing students, regardless of what academic institution the student attends and whether they are employed by UW Health.
  • Students will know that they are compliant in myClinicalExchange when they see the green thumbs up in the system.
  • Steps 1 thru 4 must be completed at least 4 weeks before the planned start of the student’s rotation

Step 5. Obtain appropriate UW Health access

  • Students will receive emails from their academic institution’s Clinical Placement Coordinator and myClinicalExchange about obtaining appropriate UW Health access and a UW Health student ID badge. Once the student receives this email notification, this is the final step of this process and indicates that the student on-boarding process is complete. In coordination with their UW preceptor, the student may begin their rotation.
  • Students should wear their student ID badge and always use their student login when performing student specific work.

How soon should students start this process?

  • It is recommended to start the process at least 8 to 12 weeks before students are to begin their project.
  • Steps 1 thru 5 must be completed 4 weeks before the first day of the student’s rotation. For example, if the rotation is to start at the end of January, Steps 1 thru 5 must be completed by the end of December. Therefore, the student should start the process in October or November.
  • Step 5 must be completed before the nursing student can begin spending hours with their preceptor as part of their rotation or participating in UW Health activities as a student.

If students have questions, who should they reach out to?

Questions should be directed to their academic institution’s Clinical Placement Coordinator who will reach out to UW Health key stakeholders as needed. Students should remain in close communication with their academic institution’s Clinical Placement Coordinator.

Remarkable teamwork, remarkable outcomes

Nurses are known for their clinical expertise, compassion and humility as well as a deep appreciation for their care team members. That’s why UW Health RNs often refer to nursing as a “team sport”— to recognize the hard work of their peers and the resulting positive patient outcomes.

Ross’ surprise reunion with his nurses

Following a harrowing car crash in 2020, Ross Kopfer spent more than 60 days at University Hospital fighting for his life. In 2022, Ross was interviewed about his experience and expressed appreciation for his nurses. Little did he know that all his nurses were around the corner to surprise him after his interview, which made for an emotional reunion.

Patient Ross Kopfer is forever grateful for the nurses who he says saved his life: Trauma and Life Support Center nurses Dave Schambow and Jennifer Milz (far left), Trauma and Surgical Unit nurses Lisa Pine (embracing Ross), Kelsey Spaith-Hilton (behind Lisa), Jessica Fall (center) and Vanessa Gates (third from left).

Kingston’s inspiring journey

When Tommy Wragg received the news in 2018 that his son, Kingston, had a rare condition at 3 months old, he never imagined the unbelievable journey that lay ahead at American Family Children’s Hospital.

When a kidney transplant was inevitable, Tommy helped manage an extensive medial protocol for several months to support Kingston while his body had time to grow. Complications arose a year later, requiring hospitalization for two years until Kingston was finally ready to receive his transplant in June 2022.

After a two-year hospital stay, Kingston Wraggs and his dad, Tommy, received a grand send-off from the care team members at American Family Children’s Hospital in June 2022.

Tommy, who has been a single dad since Kingston was 10 months old, was touched by the endless compassion they received along the way from nearly 40 nurses and care team members from the Pediatric Nephrology Program, Pediatric Transplant Program, Pediatric Intensive Care Unit, Child Life services and others.

“Kingston’s relationship with his nurses is where everything came full circle,” he said. “He was no longer lacking a mom. They became family.”

Tommy says the endless comfort and care Kingston received from his nurses was remarkable.

Teamwork results in new life for a young mother

At 37 weeks pregnant, Darlene was infected with COVID-19. She declined rapidly, doctors delivered her baby and she was admitted to the ICU at UW Health SwedishAmerican Hospital in Rockford, Ill., where she spent two months.

Darlene continued to decline and her care team worried that she wouldn’t survive. But she continued to fight and it was determined she needed a lung transplant. Only one program would accept her: The UW Health Lung Transplant Program.

Over the next four months, a comprehensive team of caregivers worked to get Darlene strong enough to be eligible for transplant, which finally happened in March 2022. Darlene returned home 10 months after she was first hospitalized.

“It was so rewarding to see how someone as sick as she was, make it through,” said Brittany Schappe, BSN, CCRN, Cardiothoracic Surgery Unit at University Hospital. “She could finally go home, and she came out stronger.”

“I had so many wonderful caregivers,” Darlene said (pictured with husband, Lincoln, and kids) of the nurses, doctors, specialists, respiratory therapists, occupational therapists, physical therapists and speech therapists who cared for her. “And my daughters were the driving force behind my recovery.”

Performing a lifesaving procedure for the first time

In September 2022, the perioperative team at American Family Children’s Hospital received a referral for a fetal EXIT (ex-utero intrapartum treatment) procedure on a pregnant mom — something they had never done before, given that they rarely deliver babies.

“We had only heard about the procedure because Dr. Lobeck was heading a study to get a fetal program started,” said Aimee Muchie, BSN, RN, manager, perioperative services. “The procedure is needed when a baby is having developmental issues with its airway due to a blockage. If the baby is born with no intervention, it is not able to breathe.”

The operating team would need to perform a Cesarean section and meticulously control the bleeding to allow the surgeon to go into the uterus, take out the baby’s head, neck and one extremity, with the anesthesia team placing lines. The otolaryngology surgeon would then establish an airway while the baby was still attached to the mom.

“We hadn’t received any education, so we had about seven weeks to plan, order the correct instrumentation and determine what to expect,” Aimee said. Pressure mounted when they received word that the baby was having trouble and the procedure would take place two weeks earlier than expected. “We had to make it happen. If we weren’t ready, the baby would be delivered normally and likely die.”

Aimee said their team got “in the zone,” and performed the procedure successfully. The baby was then transferred to the neonatal intensive care unit (NICU). Both Aimee and Inna Lobeck, MD, pediatric general surgeon, attribute the success to the exceptional coordination orchestrated by the nurses and all teams — anesthesia, instrumentation, NICU, otolaryngology, perioperative — and all support services involved.

“It’s astonishing to think what we accomplished,” Aimee said, sharing that the team faced another fetal EXIT procedure just four weeks later and that it “went off without a hitch.”

When faced with performing a high-risk fetal EXIT procedure for the first time, several teams at American Family Children’s Hospital rallied together and saved a life

Check out more stories featuring the great work of our nurses in the 2022 Nursing Annual Report (pdf).


Innovative approaches to ED capacity issues

When health systems are overwhelmed with patients, as they have been across the nation for the past few years, academic medical centers such as UW Health feel the pinch even more than most. Patients continue to need care, so the challenge is moving them through the system as efficiently as possible without compromising quality of care or patient safety.

“As a regional referral center, we see the sickest of the sick,” said Jacinda Krueger, RN, a supervisor in the UW Health BerbeeWalsh Emergency Department at University Hospital. “So, in addition to the patients who walk in the door, community hospitals that are not able to care for highly acute patients send them to us. In addition, Dane County’s population is growing at a higher rate than any other county in Wisconsin.”

In just three years, combined emergency department (ED) patient volume (University Hospital and East Madison Hospital) has increased from an average of 234 people per day (October 2019) to 278 per day (October 2022) — a 19% increase. Incidentally, more pediatric patients (1,904) were treated in the ED in November 2022, more than any month in UW Health history, a likely consequence of the spike in respiratory syncytial virus (RSV) and flu cases.

Emergency department overcrowding is a hospital-wide challenge

In addition to new workflows that were created to improve patient throughput in the CareSTART and Flexible Care Areas in the UW Health BerbeeWalsh Emergency Department at University Hospital, a new registration desk was added in 2022. The desk was built with safety in mind for both staff and patients, and new workflows have resulted in nurses seeing patients immediately upon arrival.
Didi Buckley, BSN, RN, CEN (left), nursing supervisor, and Jacinda Krueger, RN (right), emergency department (ED) supervisor, worked closely with ED care team members to get the new CareSTART and Flexible Care Area up and running to help alleviate capacity strain in the University Hospital ED.

Patient crowding in the ED is usually a sign that the entire health system is stressed.

When there are no beds available throughout the hospital, patients who need to be admitted must either be moved to temporary holding areas in the hospital, moved to hallways on inpatient units or remain in the ED taking up treatment spaces.

These patients, referred to as “inpatient boarders,” are cared for while they wait, but the situation is far from optimal. In recent years, ED staff at both UW Health hospitals in Madison have worked to creatively address the space problem while also continuing to ensure that the sickest and most vulnerable patients are given highest priority in the queue.

Lower-acuity patients, such as those who have pneumonia or influenza, are often seen in a special part of the ED, treated and discharged or admitted directly from the front end of the ED. These areas — known as CareSTART and the Flexible Care Area at University Hospital, and the Expedited Care Area at East Madison Hospital — are overseen by a physician and advanced practice provider team.

Despite having only 58 ED rooms at University Hospital, staff have increased bed capacity to more than 80 patients through use of flexible treatment areas and converted hallways.

“With the record volumes we’ve been seeing, we’ve expanded our ability to care for patients by adding additional treatment spaces and evaluating which patients can be treated in chairs,” said Didi Buckley, BSN, RN, CEN, another ED supervisor at University Hospital. “This helps us reserve beds for the patients who truly need them,” she said.

East Madison Hospital Emergency Department ‘borrows’ adjacent space

Jackie Payne, BSN, RN, care team leader, triages a patient in the new Expedited Care Area at East Madison Hospital, which was created to evaluate patients as soon as possible and get them where they need to be.
Jackie Payne, BSN, RN (left), and Melanie Hankes, BSN, RN (right), collaborated with emergency department (ED) and perioperative colleagues to create new spaces to help alleviate overcrowding in the ED.

Similarly, East Madison Hospital saw demand at its ED grow by 19% between Fall 2021 and Fall 2022, continuing a trend of double-digit, year-over-year volume growth. Staff at East Madison Hospital are also creatively addressing overcrowding by making efficient use of adjacent spaces.

“Within our Universal Care Center, we’ve been able to ‘borrow’ space from the pre- and post-surgical area adjacent to the ED,” said Melanie Hankes, BSN, RN, nurse manager of the East Madison Hospital ED.

Hankes credits Lindsey Lehner, MSN, RN, CNOR, director of perioperative services at East Madison Hospital, and Samantha Madsen, MSN, RN, manager of pre/post/PACU at East Madison Hospital, for being an accommodating neighbor by making certain pre- and post-surgical beds available to ED patients when Lehner’s unit volumes decline later in the day. Similar to the steps taken at University Hospital, East Madison Hospital also prioritizes its 16 emergency beds for the sickest patients.

“Certain patients are evaluated in our Expedited Care Area to reserve our beds for those who truly need one, while sending home others who can be safely treated without being taken to a bed,” Hankes said.

While ED crowding is unlikely to significantly diminish anytime soon, UW Health staff are encouraged by early signs, despite knowing that much work still needs to be done.

“Most people are pretty reasonable and understanding,” said Jackie Payne, BSN, RN, care team leader in the ED at East Madison Hospital. “Despite the growing volumes, our door-to-doctor wait times have remained stable. Of course, we would love to see wait times go down but the steps we have taken prevented them from increasing.”

Guest services staff add calm

Knowing how stressful an ED trip can be even during less crowded times, ED staff have gone out of their way to manage expectations by informing patients about the new procedures to handle higher volumes more efficiently.

“Communication with patients as they enter the waiting area goes a long way toward keeping stress levels in check,” Buckley said. “We are also grateful to Guest Services for extending its Guest Ambassador Program to the ED at University Hospital.”

A longtime hospitality hallmark of the Surgical Waiting Area at University Hospital, guest ambassadors — conspicuous by their bright red shirts — warmly greet patients and family members, help familiarize them with the surroundings and provide a much-appreciated sense of comfort and reassurance.

“We’ll provide a blanket if someone is cold,” said Stephanie Bracken, Guest Services supervisor. “We’ll escort loved ones to the visitor waiting area down the hall, take people to the cafeteria or accompany them to their car when it’s time to leave. The goal is to enhance the guest experience in a stressful situation for both patients and loved ones.”


Check out more stories featuring the great work of our nurses in the 2022 Nursing Annual Report (pdf).


Innovative response to capacity crisis

Nurse manager Amy Marver, MSN, RN, reviews the after-hospital care plan with a patient in the Internal Discharge Lounge that was quickly stood up by nursing and coordinated care teams to free up hospital beds for patients in need

When a significant uptick in emergency department (ED) and inpatient volumes occurred at University Hospital in fall 2022, considerable strain was placed on care teams and system capacity.

To ensure that patients were getting the care they needed in a timely fashion, UW Health nursing and coordinated care teams flew into action by reimagining how they could continue caring for the community.

As a result, they quickly stood up an Internal Discharge Lounge that opened Oct. 13, 2022, as a small test of change to move patients who were ready for discharge to a safe place while freeing up inpatient beds for ED patients and transfers.

“Inpatient care teams were initially provided information about the lounge process,” said Connie Allen, MSN, RN, director nursing operations support, who helped coordinate the effort with frontline nurses, clinical nurse specialists, nursing education specialists and coordinated care colleagues. In addition, guidance was given to staff and providers on applying a new lens to consider each patient as a possible candidate for the lounge.

“The coordination of efforts throughout our ED and inpatient units to raise awareness was outstanding,” Connie said.

Becky Lovett, BSN, RN, care team leader and diabetes resource nurse for the General Internal Medicine Unit, was the first staff member to send a patient to the internal lounge.

“I had been in communication with the patient’s nurse, and together, we determined that the patient was eligible for transfer to the lounge,” Becky said. “The patient’s ride wasn’t coming until 4 p.m. that day and we got her to the lounge by 11 a.m. Connie was there and two of our nurse managers, Troy Betts and Amanda Toberman, escorted the patient to the lounge, which was so wonderful and kind.”

Becky admitted to hiccups along the way, but remembered wise words from the University Hospital CNO, Michele McClure, who said: “Don’t let perfection get in the way of progress.” And they didn’t.

“The communication and collaboration were seamless, as everyone pivoted left and right to make it happen,” Becky said. “Everyone worked together to figure it out as we went along. Being nimble is so important. We got a lot accomplished — the lounge was a fantastic idea.”

This innovative approach complements the existing External Discharge Lounge, located at the Best Western InnTowner hotel, which has been serving as a transitional option for University Hospital patients and families.

“We were extremely pleased to see the success of this effort in helping free up inpatient beds to ensure patients were receiving the right level of care at the right time,” Connie said. “Although our capacity issues continue to be concerning, this key improvement helps curb the strain.”

A few members of the team who sprang into action to set up and staff the Internal Discharge Lounge (left to right): Kyla Schoenwetter, DNP, RN, ACNS-BC, CCRN, clinical nurse specialist; Brittani Reinhardt, MSN, RN, CCRN, nursing education specialist; Amanda Toberman, BSN, RN, nurse manager; Nancy Leistner, MHA, RN, former director, coordinated care; and Tammy Wymer, MSN, RN, CCM, outcomes manager

Check out more stories featuring the great work of our nurses in the 2022 Nursing Annual Report (pdf).


We couldn’t do what we do without them

While their responsibilities are different, the staff who support nurses and patient care have some things in common: they appreciate the trust the nurses have in them, are compassionate in caring for patients, and they find even the smallest task rewarding. Another common thread they share is that nurses rely on them and appreciate the invaluable support they provide, which allows them to focus their energy where it’s needed most.

Dawn Cleary, medical assistant

Dawn Cleary, MA

When Dawn Cleary walks through the door to perform her duties as a medical assistant (MA) she feels respected by her colleagues.

“The nurses and other providers are always willing to help, they’re easy to approach and I am always learning from them,” Dawn said.

Dawn became an MA in 2015 after working for years in a completely different field at another area employer. She went back to school, drawn to help others through health care.

“There is always something to do, and I get to interact with patients and make connections with them and the other staff,” Dawn said.

Among her tasks as an MA at the Odana Rd Clinic, Dawn prepares exam rooms and patients for examination, takes vital signs, documents allergies and medications, assists with minor procedures, performs EKGs and bladder scans, administers vaccines and other injections, keeps track of forms, responds to MyChart messages and processes prescription refill requests.

Dawn also helps train students and new employees or use her expertise on a larger project.

The daily structure provides stability, but every day is different. “The most difficult part of the job is responding to unexpected clinical and administrative emergencies while maintaining professionalism and patience,” Dawn said. Most importantly, Dawn looks forward to going to work. “While some days are rough, I remember I can’t control everything, and I have a great team of people around me who support each other.”

Don Mai, nursing care partner

No two days are the same for Don Mai. As a nursing care partner his work has varied from delivering meal trays to holding a 6-month-old baby, from playing card games with a 20-year-old patient to sitting with a middle-aged patient in the emergency department (ED).

“I enjoy my job because I get to help our staff with the smallest things that can make their days easier, such as turning over rooms in the ED, running things to different locations in the hospital, answering phone calls and call lights and restocking supplies on the unit,” he said.

For most of the shifts, Don experiences something new often with a new care team in different departments. “This is extremely exciting and motivating for me as I get to learn new things about the medical field,” Don said.

Don is channeling that experience and applying to medical school in 2023 to advance his career.

Naomi Massey Haas, health unit coordinator

Naomi Massey Haas

After many years working as a health unit coordinator (HUC), Naomi Massey Haas continues to learn something new almost every day. “I frequently run out of time to delve further into my never-ending wish list of opportunities to improve our workflow and processes,” Naomi said.

Naomi works at American Family Children’s Hospital on P5, the Pediatric General Medicine/Surgical Unit.

“A health unit coordinator serves as a bridge between a unit’s nursing staff and colleagues across UW Health,” Naomi said.

Through communication and quick problem-solving skills, HUCs anticipate the needs of team members providing direct patient care. “We have a go-with-the-flow attitude and need to be quick on our feet to support the team as patient conditions change rapidly,” she said.

Naomi credits leaders who encourage the HUC team to share ideas about improving workflow and increasing efficiency. “We get to apply our diverse skills, create new work processes and collaborate across disciplines, which results in engaged individuals on the team,” Naomi said.

“We focus on patient safety and confidentiality while working with our nurses to provide patient- and family-centered care by establishing connections between our patient families and UW Health’s incredible variety of resources,” Naomi said.

Nick Moorehead, certified nursing assistant

Nick Moorehead, CNA

As Nick Moorehead worked his way up to a senior role in environmental services supporting the surgery team at University Hospital, he got a close-up look at the inner workings of what it takes to help nurses and other providers with patient care. “I am a person who loves to help others whenever I can,” Nick said.

His experience combined with his attitude made it an easier transition when Nick made the career move about a year ago to work as a nursing assistant (NA) after completing the internal UW Health program for nursing assistant certification.

Among his duties, Nick assists patients with personal hygiene, repositions them in their beds and takes their vital signs. Primarily working with orthopedic and medical patients at East Madison Hospital, he finds a way to connect with them, ensuring they are comfortable during their stay. Nick’s patients share their appreciation for his “can-do” attitude and his ability to brighten their day with his smile, even through the mask.

“I am motivated by knowing I can come into work to help different patients and their families through the tough times of being in the hospital,” Nick said.


Check out more stories featuring the great work of our nurses in the 2022 Nursing Annual Report (pdf).


Frontline focus on improvement

Within a large academic health system like UW Health, collaboration is an important element of our culture. It keeps the organization moving forward and allows staff and providers to share in both the work and rewards. When it comes to improvements, an identified gap or dissatisfier is followed by a plan for how to improve the issue. In these instances, frontline nurses are often the visionaries who ignite the change.

Improving post-hospital education for transplant patients

Jay Klamer is happy that the new patient educational videos will benefit transplant patients and his nursing colleagues.

When Jay Klamer, BSN, RN, started working on the Transplant Unit at University Hospital, daily patient and family education sessions were held in the nearby family lounge.

“It was great because transplant patients and their support people would attend along with nurses and pharmacists,” Jay said. “The sessions were very useful because the patients and families could interact with the care team and ask questions.”

Unfortunately, that changed in early 2020 with the onset of COVID-19 pandemic. The transplant teams could no longer use the lounge, so they moved to nurse-to-family and nurse-to-patient models, which weren’t as effective.

“When there is one person instead of eight providing the education, it takes less time away from patient care. Providing all the education at discharge takes a lot more time and is very challenging for the person managing the discharge,” Jay said of the resulting strain on nurses. “It was equally difficult for patients who weren’t getting their post-hospital care education needs met because everyone was doing it differently.”

That’s when Jay knew there was a better way to help patients and his nursing colleagues.

Jay Klamer, BSN, RN

The first attempt to fix the issue involved patients using iPads to attend a daily virtual class led by a clinical nurse specialist or nurse.

“Consistency was still a challenge and support people would often miss it due to COVID visitor restrictions,” Jay said. “So, I took a closer look at how much we were missing and wondered how we could fill in the gaps.”

Jay recalled that pharmacy had a similar issue and subsequently changed their class to a video format, which provided more viewing flexibility for patients. He realized this same approach would help transplant patients receive the education they needed, while greatly helping nurses from a time perspective.

Jay standardized the video content and engaged key colleagues, including clinical nurse specialists Gwen Klinkner, DNP, RN, BC-ADM, CDE; and Jess Viste, DNP, RN, ACNS-BC, CCTM.

“I could not have gotten this far without the help from Gwen and Jess,” Jay said, noting that Gwen ensured the language was at the appropriate medical literacy level and helped with scripting, while Jess provided the core educational content and reviewed everything for accuracy.

Although creating the videos has taken more time than Jay anticipated, he is excited to help patients and nurses once all videos are accessible via MyChart and uwhealth.org. “We have robust written versions of our materials, but there are limitations. Having this education available on video improves access for all patients and will help everyone in the long run.”

Pre-admission discharge planning is a win for patients

During a test of change to help reduce avoidable days a patient may spend in the hospital, case managers called patients with planned surgeries to gather information and anticipate discharge needs prior to their stay.

It’s safe to assume that no one wants to be hospitalized longer than necessary. Unfortunately, there are instances when patients are medically ready for discharge but unable to leave for an outlying reason, such as needing long-term care and a nursing home bed is not available. These are referred to as “avoidable days” and cause a ripple of dissatisfaction for patients ready for discharge and those in need of care. The cost also adds up.

Outcomes manager Katie Meicher, BSN, RN, identified an opportunity to address this preventable issue with improvements to case management workflows.

Katie Meicher, BSN, RN

“It had been hypothesized that discharge planning before scheduled surgical admissions would provide several benefits,” Katie said. “It could reduce avoidable days as well as the number of patients turned away, while improving patient satisfaction, outcomes and hospital capacity issues,” Katie said.

To put things in motion, Katie conducted a test of change on a subset of vascular surgery patients who met the criteria of having a planned surgery. Prior to admission, they were called by a case manager for an initial interview to gather information pertinent to discharge planning, and to help set reasonable expectations for the length of stay and anticipated discharge needs. Case management was then able to start pre-admission discharge planning.

“The results were astonishing,” Katie remarked. “Not only did the six-month test of change reduce avoidable days by greater than 90%, we discovered an unintended benefit — there was more time to reprioritize patients who were urgently admitted but had at least 24 hours before going to the operating room.”

With the prioritization of those patients, the vascular surgery case manager was able to begin discharge planning pre-operatively, thereby reducing avoidable days in that population by greater than 90% as well. The estimated annual financial impact of this intervention was a reduction in cost of $245,813 with a projected reduction of over $3.1 million annually once scaled across surgical services.

“Follow-up survey data also revealed that the patient experience had been overwhelmingly positive regarding the reduction of avoidable days and improved patient communications,” Katie said. “With further reduction of avoidable days, we project that bed availability will increase, benefitting patients in need of quaternary care.”


Check out more stories featuring the great work of our nurses in the 2022 Nursing Annual Report (pdf).


Nursing informaticists tuRN ideas into action

In health care, innovation is key to keep pace with the ever-changing landscape. Health care systems must be increasingly nimble, have a steady influx of innovative ideas and most importantly, teams that can execute those ideas.

Enter our esteemed nursing informatics colleagues, otherwise known as the “wizards behind the curtain” who wield their expertise to turn those ideas into action and progress.

At the intersection of nursing and technology, this expert team of nursing informaticists keeps nursing at UW Health moving forward. Pictured (left to right): Chelsey Langer, Becky Kohler, Linda Xiong, Sandy Vergenz, Courtney Olson, Jason Laseman, Brooke Ramsay, Vicki Bentley, Christa Westenberger, Wendy Wittwer, Jade Lee. Not pictured: Andi Kyser and Brenda Wendle.

One of the first to integrate two unique systems

When nursing informaticists Jade Lee, Chelsey Langer and Sandy Vergenz were presented with an innovative idea from inpatient nursing staff, they saw a prime opportunity to improve patient safety and nursing satisfaction.

The idea pertained to the nurse call system (Responder 5) on inpatient units that provides dual alerts after a patient pushes a nurse call button: flashing lights outside the room that help nursing staff quickly identify the location and an alert/call to the unit desk that any care team member can answer to see if help is needed.

The innovative integration of Responder 5 and AvaSure now provides visual alerts to nurses at the unit desk and in the hallways, improving nurse response time and reducing the chance for patient injuries.

On units where constant observation cameras (AvaSure) are located inside patient rooms, the lack of visual alerts when an alarm was activated presented a challenge.

“Offsite video monitor technicians alert nurses to distress in those rooms by sounding an alarm and calling the unit desk,” Lee said. “The techs also were having to quickly multitask—speaking to the patient in the room while calling the unit desk — hindering nurse response time, which was exacerbated when there were multiple cameras in use on the unit.”

Langer added: “Based on what we knew about Responder 5 capabilities, we thought it made sense to align that function with the AvaSure cameras to help nursing staff quickly identify the patient room via a visual message on the nurse call console at the unit desk and initiating lights outside the patient room.”

When it was confirmed that the integration was possible, technicians from AvaSure and analysts from UW Health Unified Communications and the Health Link Inpatient teams were consulted for the Health Link (electronic medical record) build. It was a long and arduous process, but the nursing informaticists were a driving force and committed to making it happen.

Instead of moving to a pilot phase, the team “tested the heck out of it,” Lee said, adding that they went with a “big bang” approach and launched the integration on 23 of 31 units at University Hospital, American Family Children’s Hospital and East Madison Hospital. The remaining eight units will be integrated once they upgrade from Responder 4 to Responder 5.

“This was a wonderful collaboration that has improved patient safety and nurse efficiency by closing the gap on that critical window of time from when the observer sets off the alarm to when the nurse enters the room,” said Vergenz, who added that the icing on the cake was threefold. “Not only was UW Health one of the first health systems to make this type of integration possible, the reward of improving patient safety and nurse satisfaction is invaluable.”

Streamlining a process boosts patient and nurse satisfaction

Having a surgical procedure is stressful, so when Kerry Martin, MSN, RN, nurse manager, Thoracic Unit, University Hospital. saw an opportunity to improve the patient experience and streamline the workflow, she took action.

The issue? Patients coming out of surgery are understandably groggy and often want to be left alone. But a nurse needs to ask several questions to help care for them.

“Patients often ask ‘Don’t you have this in your computer already?’ or ‘Don’t you talk to each other?’ ” Kerry said. “Inpatient nurses know that having patients complete these questions at home before their procedure would be a much better process. It is just a matter of how that idea becomes a reality.”

Kerry submitted the suggestion — a pre-admission adult health assessment for surgical patients — to the UW Health Workforce Innovation Hub, an area on the organization’s intranet where staff can share innovative improvement ideas.

When Anne Mork, MS, MHCDS, RN, chief nursing officer of ambulatory services saw the submission, she immediately reached out to Linda Xiong, BSN, RN, interim director of nursing informatics, to make the idea a reality.

“We started with a test of change that involved care team leaders (CTLs) from University Hospital and East Madison Hospital, as well as first-day surgery RNs,” Linda said. “The goal was to have patients answer necessary questions in their optimal state, prior to surgery.” Three phases were involved:

  • Phase 1: CTLs called patients at home who had pre-scheduled surgeries and would need hospitalization afterward. They passed along the information to the pre-op nurse to avoid repeating the process when the patient arrived on the day of their procedure.
  • Phase 2: To optimize the pre-surgery downtime between nursing assessments and physician check-ins, patients in first-day surgery answered intake questions (on a hospital-provided iPad) that inpatient nurses previously asked after surgery.
  • Phase 3: Admission questions were moved to MyChart in advance of surgery as a pre-admission questionnaire.
During a test of change, care team leaders reached out to patients ahead of their scheduled surgeries to ask them questions while they were at home and feeling well.

To gauge effectiveness, the nursing informatics team implemented a time study that revealed a time savings of 14-16 minutes per inpatient, while it saved pre-op nurses from asking 7-8 questions. Linda and her team rounded on those units following the launch to see how things were going.

“Nurses were so happy to hear about the project and that part of their admission process was done,” Linda said. “They were literally high-fiving us at the unit desk, which was incredibly rewarding for our team, knowing that we helped remove a burden for them.”

“Being part of this test of change has been exciting,” Kerry said. “It’s really fun to see when your idea goes to actual implementation and then expands to other units.”

Linda credits the success of this implementation to having great partners like Kerry and Ashley Bishop, RN, BSN, manager of perioperative services as well as the pre-op and inpatient nurses who were involved.

“Having some of the questions already answered allows the pre-op nurses to focus more on what matters most: Preparing and comforting our patients for surgery,” Ashley said.

“This was the type of project we love working on, proving that ideas are seen and nurses are being heard,” Linda said. “It’s an exciting time for our team, showing how we contribute to remarkable health care.”


Check out more stories featuring the great work of our nurses in the 2022 Nursing Annual Report (pdf).


Providing the tools for lifelong leaRNing

Tricia Ejzak (center) and other UW Health surgical nursing education specialists recently created a centralized OR orientation where they teach core content and utilize the UW Health Clinical Simulation Program facility for a more realistic training environment.

Even with the constant changes in health care, UW Health nurses are endlessly knowledgeable and incredibly skilled. But where do they go for the learning and professional development that allows them to be so infallible? This is where the Department of Nursing Professional Development comes in. 

Nursing Professional Development includes more than 20 nursing education specialists who are responsible for clinical staff onboarding, professional development, new equipment, procedure and protocol training, and management of the prestigious Nurse Residency Program, which onboarded nearly 200 nurse residents this year.

Nursing education specialists work to ensure staff have the tools and education they need to be confident in their abilities to provide remarkable care and feel fulfilled working at UW Health.

“Mentorship and advocacy are the foundations of my practice as an educator,” said Molly Daniels, MSN, RN, CMSRN, nursing education specialist.

“We are champions for both the orientee and preceptor,” said Bianca Nelson, MSN, RN, CCRN, nursing education specialist. “Our job is to advocate for the nurse and tie education and professional development back to better patient outcomes.”

Tricia Ejzak, MSN, RN, CNOR

Tricia Ejzak, MSN, RN, CNOR, provided a closer look at her role as a nursing education specialist in the operating room:

Q: What does a typical day look like as a nursing education specialist?

A: Every day is different. As an NES in the operating room at East Madison Hospital, I am responsible for onboarding all new staff who will work in the OR. When someone starts, they spend their first week with me practicing skills and learning how to be safe in the space before moving on to work with a preceptor.

Since I work with the OR team, I monitor quality measures for surgical site infections and educate staff on opportunities for improvement. Another focus is continuing education. If there is a new procedure, new equipment or equipment that staff needs more experience with, I ensure they have the training they need. I also support staff with their professional goals and manage required trainings.

Q: It sounds like you also create process efficiency?  

A: Absolutely! A new sports medicine surgeon started doing a procedure with a risk of significant blood loss. In those instances, we use a Fresenius Kabi Continuous Autotransfusion System to collect and clean blood for reinfusion. In the past, for every procedure, a trained technician from University Hospital had to travel to East Madison Hospital in case we needed to use the machine. Knowing the process could be more efficient, I coordinated training on the Fresenius Kabi Continuous Autotransfusion System for eight of our OR nurses. Now, we have trained staff at East Madison Hospital.    

In addition, all the surgical nursing education specialists recently created a centralized OR orientation. We teach core content and utilize the UW Health Clinical Simulation Program facility for a more realistic training environment. With centralized orientation, we are more efficient and can now back each other up, when needed.

Q: How do you know what to focus on as an NES?
A:
We get direct requests from staff members and feedback from surveys. I work closely with OR leadership who inform me of any practice and protocol changes.

Q: What is the best part of being an NES?
A:
My job allows me to work with remarkable people in many different departments. I also enjoy being a part of the NPD team. Everyone is incredibly knowledgeable and supportive. It is tremendously fulfilling.  

Nursing Education and Professional Development 2022 at UW Health

Ambulatory: Clinical Staff Education DepartmentInpatient: Nursing Professional Development Department
Staff onboardedClinical staff: Registered nurses (RNs), medical assistants (MAs) and other clinical roles: 280
Non-clinical: 829
Online orientation: 734 employees
Ambulatory nurse residents: 13
Registered nurses: 524
Nursing assistants (NAs): 318
NAs hired through the NA Apprentice Program: 61
Age-friendly partner: 2
Student nursing assistants: 63
Nurse residents: 203
Nurse externs: 28
Personal safety observer: 1
Nursing care partners: 74
Anesthesia technicians: 2
Surgical technicians (STs): 7
ST travelers: 2
Nurse resident cohorts2 with 432 hours of education provided, including 52 lectures from content experts and 15 skills sessions7 (increased from 6 to accommodate hiring more nurse residents sooner)
Staff trainedRetrained all primary care staff in COVID vaccine reconstitution and administration

Conducted 75 N-95 trainings for specialty care clinics
Critical Care class: 111
Intravenous Ultrasound class: 81
Preceptor workshop: 202
Advanced Preceptor workshop: 28
Peripheral IV class and roadshow: 165
Nurse Resident (NR) IV skills: 147
Inpatient Trauma class: 80
Nursing assistant professional development: 68
Basic Arrhythmia class: 218
Continuous Renal Replacement Therapy Advanced User course: 54
Adult Stroke class: 35
Maternal mock code training to improve care and outcomes for pregnant patients: 56 RNs
Non-violent crisis intervention (NVCI) Initial class: 54
NVCI Refresher class: 28
Annual competencies/validation tools created for the staff-driven competency processComprehensive staff-driven competency packages for RNs: 9
 
Shifted medical assistant focus to CEU/educational opportunities
Competencies: 65
Validation Tools: 130
Education requests completedCompleted Health Link (electronic medical record) Nurse Decision Support Tool rollout to primary care sites. Offered 180 hours of on-site triage support, 16 trainings and 12 Q&A sessions in addition to offering WebEx messaging RN support, Monday–Friday, 8 am–5 pm to nurses using the new tool.In partnership with the Nursing Education Council, established Nursing Professional Development Days.
Other notable accomplishmentsCompetency management
January 2022: Released competencies covering approximately 1,000 staff members as part of Annual Staff-driven Competency.
Improved electronic process to make system more user-friendly for end user. Educators relieved managers of validation method checking and competency completion responsibilities.

Evidence-based practice
Held 24 Introduction to Triage and 7 Advanced Triage classes. Piloted one Nurse Extern cohort with 10 scheduled for 2023.
Perioperative nursing student shadow experience
Spring 2022 collaboration with the University of Wisconsin-Madison School of Nursing to host nearly 50 Bachelor of Science in Nursing students for a perioperative shadow experience from First Day Surgery to intraoperative to Post-Anesthesia Care Unit.

Revised Nurse Resident (NR) Orientation
Added more hands-on skills and specific breakout sessions for pediatrics and surgical services. Goal was to provide NRs with more basic skills to help reduce the amount of teaching help needed from the nursing education specialist and reduce the preceptor workload on units.

Check out more stories featuring the great work of our nurses in the 2022 Nursing Annual Report (pdf).


Evidence-based mentorship program

To help support new-to-practice nurses, Kelly O’Connor (pictured) created an evidence-based mentorship program on the Pediatric Medical/Surgical Unit at American Family Children’s Hospital.

In 2015, when Kelly O’Connor, BSN, RN, CPN, started working at American Family Children’s Hospital, she noticed some personal challenges.

“It was really difficult to transition from being a student nurse to a new-to-practice nurse,” Kelly said. “As a student, you receive a lot of support. As a new nurse, there is a gap period after orientation with your preceptor until you feel confident on your own. You may feel alone and don’t yet have those authentic connections with other nurses for support.”

Kelly thought it was just her, until she started seeing those same challenges with other new nurses.  

Knowing this may be more than a coincidence, Kelly did some research. It turns out, those common experiences of fear, disillusionment and overall stress felt by new-to-practice nurses are real and described as transition shock.

“I learned that transitioning into nursing is often traumatic, and new nurses may be fearful at work throughout their first year,” Kelly said.

She also found that there were distinct developmental stages that new-to-practice nurses went through, and that nurse mentorship programs helped ease those transitions.  

With her research in mind, Kelly approached Élise Arsenault Knudsen, PhD, RN, ACNS-BC, nurse scientist who leads the Nursing Research and Evidence-Based Practice (EBP) Programs, about starting an EBP project focused on supporting new-to-practice nurses in her unit.

“To help retain new, bright nurses, we need to develop a culture that accepts and embraces them,” Kelly said. “A mentorship program is a first step in creating a positive loop: New nurses who are accepted, appreciated and guided will eventually offer the same acceptance, appreciation and guidance to new nurses who come after them.”

In 2022, Tessa Martin, BSN, RN, CPN, nurse manager of the Pediatric Medical/Surgical Unit where Kelly currently works, made the decision to include the mentorship program in the onboarding process for all new nurses on the unit. After the initial 14-week orientation where nurses are paired with a preceptor to learn the ropes, the new nurses are matched with an experienced frontline nurse mentor. For the next seven months, in addition to support on the unit, mentors and mentees meet outside of work for one hour each month to informally discuss any fears, concerns or highlights the new nurse wants to share.  

Furthermore, Kelly created mentorship resources and worked with Tessa to distribute information about the program to staff and nurse residents.

“In addition to the mentor/mentee relationships, we created a visual management board in our conference room that staff can reference at any time,” Tessa said. “We also posted the new nurse development stages that Kelly identified through her research and have our mentor/mentee pairs printed on cards to show their progress through the stages.”

“The mentorship program has become incredibly successful. Our job is really hard, and this program helps acknowledge those feelings and supports new graduates through those evidence-based struggles.”

Kelly O’Connor, BSN, RN, CPN

Check out more stories featuring the great work of our nurses in the 2022 Nursing Annual Report (pdf).