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.”

Susan is the only clinical nurse to have won a Fulbright Grant, a Washington Mandela Fellowship and a national Magnet Nurse of the Year Award. She said her Tanzanian patients have many questions about HIV treatments and are curious about the different treatments available in the United States.

“Being a nurse gives you credibility,” she said, “as does being trained in patient education in the UW Health HIV/AIDS Clinic.”

Susan retired from her full-time work in the UW Health HIV/AIDS Clinic but continues to work as a per-diem nurse. Her nursing achievements are more amazing considering she didn’t earn her nursing degree until the week she turned 40. She was busy raising three children and it took her more than five years to graduate, although she did graduate top in her class.

“I think being a UW Health nurse is an honor and being able to represent the UW School of Nursing all over the world is a big honor,” she said. “I so strongly believe in the Wisconsin Idea and that the education you get from the school could benefit the whole world. You have knowledge that can save lives everywhere.”

The African connection started when she and her husband, Tim, climbed Mount Kilimanjaro. “The guides knew I was a nurse and said, ‘Come back and help our people,’ ’’ she said. “And when I came down off that mountain, I knew I could do anything.”

Susan first started working with AIDS orphans in Kenya. As they lived into adulthood as HIV-positive people, she saw the need for the sexuality education curriculum she developed. Her work moved to Tanzania as the security situation in Kenya worsened.

Over the years, she’s watched proudly as the global health students she’s introduced to Africa have gone on to earn degrees and become nurses, physicians, physician assistants, therapists and public health professionals. She was even able to introduce some of her grown children and grandchildren to Tanzania, where she is known as “Mama Susan.”

All heart in Rwanda

A group of nurses on the Cardiothoracic Surgery and Transplant Unit also have a strong bond with Africa after traveling to Rwanda as part of Team Heart. This volunteer group was founded by a Boston nurse who visited Rwanda and found a hospital ward full of young people whose hearts had been damaged when untreated strep throat progressed to rheumatic fever and heart valve damage. The group has been going to Rwanda to perform heart surgery since 2008.

Recently, though, the focus has shifted to building sustainable cardiac care in Rwanda, and that is where the cardiothoracic nurses come in. Nurses Alexa Callahan, BSN, RN; Mikayla Kohls, BSN, RN; and Bella Penniston, BSN, RN, have all traveled to King Faisal Hospital in Kigali to teach their Rwandan colleagues the fine points of caring for patients following heart surgery. Bella said she did international nursing work in India as a student and was thrilled to have the chance to go to Africa.

“The biggest difference is how young the patients are,’’ Bella said, noting that she was caring for teenagers with heart issues in Kigali, compared with the retirement-aged patients more common in Madison. She also enjoys working with Team Heart members from as far away as Iceland and Australia, noting that despite their different backgrounds, “health care is a universal language.”

Cultivating professional growth

When Aniqueka and Josh Ernst, BSN, RN, pursued their DNP degrees, they experienced the leadership culture from a new lens.

“UW Health nurse leaders have provided me with substantial support throughout my doctorate studies,” said Josh, who serves as a clinical program coordinator for the Telestroke Program. “With this experience, I learned from various leaders within the organization, and I will take their advice with me wherever I go.”

In one of Josh’s practicums, Melanie Hankes, BSN, RN, nurse manager, UW Health East Madison Hospital Emergency Department, showed him how to overcome unique department challenges by coming up with creative and innovative solutions. “Teamwork is essential and expectations are high,” he continued. “There is always a sustained commitment to our patients, staff and the community. It is nothing short of inspiring.”

What stands out most for Aniqueka is having leaders who believe in her.

“They see my potential, and no one has ever made me feel I was reaching too high or dreaming too big,” she said. “I’ve been supported by every leader I’ve interacted with, confirming my decision to get my DNP.”

Aniqueka said she’s received the same advice from many leaders: Stay curious and keep asking questions. One takeaway came to light when she saw the work that went into establishing the Internal Discharge Lounge that was quickly operationalized by nurses and nursing leaders to help free up inpatient beds.

“I’ll never forget when Michele McClure (chief nursing officer for University Hospital) said, ‘Don’t let perfection get in the way of progress. We didn’t get it perfect, but we were off to a good start,’” Aniqueka said. “That realistic approach — acknowledging the need to evolve — really stuck with me.”

Another notable moment was seeing the humility of the leaders.

“They are down-to-earth and want to hear from frontline nurses to learn how best to support them,” Aniqueka said. “It’s all about teamwork and willingness to have conversations to try and make things better for everyone.”

---

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

---

It is essential that every patient who enters a UW Health hospital or clinic feels that they’re in a diverse and inclusive environment that fully supports their care and healing journey.

The same holds true for employees: Feeling confident that their work environment is supportive allows them to thrive and provide the best care possible.

To build on our commitment to becoming a diverse, inclusive, and antiracist organization, UW Health has made it a priority to embed diversity, equity and inclusion (DEI) as a foundational competency and strategic priority throughout the organization.

In 2022, a group of our nursing leaders collaborated with the DEI department to present a customized learning session for all nursing leaders. Entitled “DEI Tools Supporting Through Lived Experiences,” 22 directors and four chief nursing officers attended a half-day learning session while 73 nurse managers attended a day-long retreat.

“As nurses, we’re trained on a lot of things. It’s easy for us to talk to people about changes in health care, the newest vaccine or a new workflow, but for most people, it’s not so easy to talk about DEI,” said Lea Veltum, RN, General Internal Medicine Clinic Manager at 20 S Park St Clinic and 1102 S Park St Clinic.

She proposed DEI be the focus of the Nurse Manager Monthly Retreat. “Our hope was that more nurse managers would be comfortable integrating DEI learning with their nurses on a regular basis so that it becomes a core competency and part of how we talk about the strategic plan,” Lea said.

The learning sessions centered around DEI principles that are the foundation of the UW Health vision to be a leader in actively dismantling racism in ourselves, in our system and in our community. They included facilitated, small group discussions based on the real-life experiences of UW Health employees.

The nurses were coached on how to respond when an employee experiences a racial microaggression by using the LEADER Perspective: Listen and validate, express empathy and acknowledge harm, ask the employee what they need, do recognize the cumulative impact, ensure an antiracist and inclusive workplace and reach out to the DEI and Performance Management teams.

“I think for many it was very eye-opening. It was great to have difficult discussions and learning opportunities in a safe space,” said Tracey Abitz, DNP, RN, CTN-B, University Hospital director of specialty nursing services. “Intention does not equal impact—microaggressions are too common, but they can be interrupted. As leaders, we need to help change the language and the culture. Learning to speak the same language is helpful for leadership and transparency with our teams.”

In addition to DEI learning and professional development resources, the DEI department provides support to leaders who are looking for resources and tools to help their employees navigate concerns. The department also serves as a resource for Black, Indigenous and People of Color (BIPOC) and/or LGBTQ+ providers and staff to share their experiences at work.

“It’s so wonderful and supportive to have a resource like the DEI team,” Lea said. “Now managers can say, ‘I sat in that learning session, I know who to go to. I don’t need to react to this or solve this problem instantly. I can loop in other people and make sure that we do this right instead of just doing this fast’.”

---

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

---

Care team leader rounding improves satisfaction

Elevating the role of care team leaders (CTLs) on the 4th floor Medical Surgical Unit at East Madison Hospital has had an exceptionally positive impact on patients and employees.

“I want to empower people at the bedside to make decisions in the moment and be proactive. This impacts quality outcomes and patient satisfaction, as well as staff satisfaction,” said Kristen. “We are a growing hospital, so this was also a way to start succession planning and build leadership skills to ensure that staff members have opportunities to grow professionally when they’re ready.”

The hiring of a house supervisor a year ago to maintain the inpatient nursing operations of the hospital meant that CTLs such as Eden Larson, BSN, RN-BC, had more time for patients and staff. CTLs on the unit now round on patients each shift, something Eden says has made a world of difference.

“CTL rounding with the patients is a great way for us to support our nurses. They can see that we’re more available to them, and it’s a positive change for patients,” Eden said. “When a patient who’s had a dissatisfying experience can feel that they’ve been heard, it changes their outlook on their stay. And the nurse doesn’t have to feel alone when they have another person who can talk to the patient, really listen to them and address their concerns.”

Eden and Kristen feel a renewed sense of teamwork on the unit. “People really enjoy coming to work and say this is their work family,” Eden said. “Medical surgical nursing is not easy and most people don’t stay in this field for very long. I’ve been here for six years and I just love the people I work with. Morale has improved over the last year. People smile a lot.”

CTLs on the unit worked with the nurse manager and clinical nurse specialist to develop a standard set of questions for rounding based on patient satisfaction metrics. Since they began rounding in July 2022, there has been a dramatic increase in their top box scores:

• General hospital satisfaction rating increased from the 86th to the 93rd percentile
• “Staff worked together to care for you” rating increased from the 74th to the 92nd percentile
• “Response to complaints” rating increased from the 88th to 92nd percentile.

When asked about the increase in the scores, Eden said, “I think it was a little unbelievable. I initially thought it was wrong, and that it had to be a different unit.”

Kristen said, “It’s a validation that we’re doing something right and it just keeps pushing us forward.”

As she began nursing school, it never dawned on Tamara Kempken Mehring, MSN, RN, CNS-BC, that her future would be in clinical research.

“I fell into the world of clinical research nursing, as did most of my colleagues,” she said.

Decades later, Tamara is blazing trails as a leader in her field, confident she made the right choice. “There is a reason I ended up on this path — it’s been extremely rewarding,” she said.

For the past eight years, Tamara has been the clinical nurse specialist (CNS) on the Clinical Research Unit (CRU) at University Hospital. She leads a team through research protocol implementation while supporting the conduct of safe, ethical, compliant and high-quality clinical research at UW Health.

Tamara disseminates best practices as she fosters the specialty practice of clinical research nursing.

Each day brings new opportunities and appreciation

“Much of my role is operationalizing a clinical research protocol in the clinical setting,” Tamara said. “Education and training are a significant part of my day-to-day, supporting nurses and other research professionals to be able to ensure fidelity to the research protocol while providing remarkable care to our patients.”

One moment she might be working with CRU nurses caring for patients, the next she’s collaborating with the interdisciplinary research team during the protocol implementation process.

Jessica Branson, CNS manager, says Tamara’s expertise in bridging the gap between clinical work and research helps both worlds better understand one another.

“It allows us to successfully provide a multitude and variety of studies to our patients on and off the Clinical Research Unit,” Jessica said.

“Tamara’s dedication to her unit, practice and profession is evident in everything she does,” said Tammy Kiger, MSN, RN, nurse manager.

“She heightens the visibility of clinical research nursing at University Hospital and has earned the respect of national and international colleagues through her incredible contributions.”

Collaboration and outcomes

The variety of work and collaboration with clinicians, researchers and patients keeps Tamara engaged and inspired.

“If we don’t carry out research protocols accurately, and ensure protections for human subjects, new treatments will not make it to market — new discoveries may not be made,” she said.

This was evident during the early days of the pandemic, when there weren’t standard-of-care vaccines or treatments for COVID-19. “We only had research and clinical trials. Today we have approved vaccines and treatments,” she said.

Being on that clinical research path was something Tamara never would have predicted, but it’s the trail she’s grateful to walk every day.

Michelle Hornung, BSN, RN, was looking for a creative outlet after working long hours as a trauma nurse. She found it online in Huntington Beach, Calif.: A 1969 Volkswagen Transporter that an old hippie used to haul surfboards to the beach. Picture a vintage VW van with its roof removed.

Her husband and father-in-law modified it so she could fill the rear with buckets of locally grown flowers, and the Crazy Daisy flower truck was born.

Michelle and Crazy Daisy became a bright spot at the Sun Prairie Farmers Market, and at local celebrations, where she offered a “build-your-own-bouquet” experience for bridesmaids, baby showers and corporate events.

“It was exactly the respite I needed from the trauma unit,’’ Michelle said. But funny thing, the flower truck eventually became a vehicle for sharing a breast cancer journey that would drive her to a new calling: Nurse navigator in the UW Health Breast Center.

First, a word on the truck’s name. Michelle’s team on the trauma unit already called her “Daisy” because of the amazing number of nominations she has received over the years for the DAISY Award that recognizes exceptional nurses.

“To date, I’ve had 20 nominations and one win,’’ she said. “And every one of them means the world to me, because they come from patients and families of patients.”

Michelle was 41, and had no family history of breast cancer, so when she found a lump in her right breast, she assumed it was a cyst. A mammogram, followed by an ultrasound and biopsy, revealed instead that she had Stage 2B triple-negative breast cancer.

“Never in a million years did I think I would be on this side of the hospital bed,’’ Michelle told her followers on Crazy Daisy’s Instagram and Facebook pages. Michelle said she initially shared her diagnosis on social media to let the flower truck’s fans know why she was canceling public appearances.

But she continued to share: her biopsy results, her chemo infusions, her lumpectomy and the day she had her head shaved. Some of her posts were brutally honest: crying ugly tears, struggling through brain fog and being plagued with the lingering taste of onions from the chemo. Others were funny. She dubbed her final eyelash “Lorraine the Lash,’’ a “tough old bird” who hung on long after all her other lashes fell out. And she showed off the daisy caps, T-shirts and goofy chipmunk costumes her nurse colleagues wore to cheer her up.

ADN to BSN career path

In addition to increasing the number of ADN RNs through the Nurse Apprenticeship Program, UW Health offers an ADN to BSN (Bachelor’s Degree in Nursing) career path through a partnership with UW-Madison School of Nursing.

The first cohort of six ADN nurses was enrolled in Spring 2023, with an additional 50 ADN spots set aside for the Fall 2023 semester.

Funding limitations preclude every UW Health employee who wishes to participate from being accepted for enrollment. Accordingly, ADNs from inpatient and ambulatory units with the highest number of ADNs will be among the first ones invited to apply for enrollment in the ADN to BSN career path.

“Regardless of degree or title, every employee who interacts with patients is essential to ensuring outstanding patient care,” Mork said. “At the same time, the literature shows that health care systems with greater numbers of BSN prepared nurses have been shown to have better patient outcomes. BSN educated nurses are also better positioned for leadership, teaching and quality improvement opportunities. The Magnet organization endorses the Institute of Medicine’s 80% BSN recommendation for nursing and has set up the program to drive organizations to reaching and maintaining that threshold.”

Community partners making a difference

Karina Rohrer-Meck, a nurse and clinical information leader at Epic, said her company is pleased to help UW Health champion new solutions to challenges such as the nursing shortage.

“UW Health and the University of Wisconsin have a long tradition of serving as beacons of support, advancement and excellence in our community, and innovative programs like these build on that tradition,” Rohrer-Meck said. “We are happy to help them champion new solutions to such important challenges.”

---

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

---