On Oct. 18, 2018, at 11:30 a.m., the Magnet Commission for the American Nurses Credentialing Center (ANCC) called Beth Houlahan, DNP, RN, CENP, UW Health Senior Vice President and Chief Nurse Executive, who was anxiously waiting with a room of approximately 300 UW Health colleagues, to announce that UW Health has once again, been re-designated as a Magnet® organization.

This is very exciting news for UW Health and its patients, considering that the Magnet re-designation application process gets more rigorous each time an organization re-applies, every four years. Fewer than 10 percent of all registered hospitals in the United States receive Magnet designation or re-designation.

Jeanette Ives, Erickson, DNP, RN, NEA-BC, FAAN, Executive Committee Member for the Commission on Magnet Recognition, ANCC, delivered the exciting news to Dr. Houlahan, congratulating her and the organization, and making a point to call out some of UW Health’s impressive exemplars.

In an emotional speech following the announcement, Dr. Houlahan stated, “I’ve worked for many other organizations and I have to say that UW Health – our nurses, staff and faculty – are simply the best. Thank you for all you do.”

Other leaders shared the same sentiment, thanking all UW Health teams for all they do to make UW Health Magnet.

What is Magnet?

Magnet designation is the most prestigious title a health care organization can achieve for nursing excellence and quality patient care. UW Health is one of 10 Magnet organizations in Wisconsin and one of 448 in the world.

In simple terms, Magnet is a big deal for patients and families – knowing they will receive the highest level of care at a Magnet hospital. For health professionals, Magnet shows that UW Health is set up for excellence. This leads to a sense of pride among faculty and staff in working here, and even more pride in contributing to our vision of providing Remarkable Healthcare to patients and families, near and far.

NPs Bring Peace of Mind and Better Outcomes

83-year-old Shirley Ward takes a deep breath as nurse practitioner Elaine Makarowski listens to her lungs. But the checkup didn’t happen in a clinic. It happened in assisted-living facility Waunakee Manor, where Ward lives.

Makarowski, NP, is one of 10 UW Health nurse practitioners who provide care for patients at 19 long-term care and rehabilitation facilities throughout Dane County. The goal of the program is to take primary care services to skilled nursing facility (SNF) residents so they don’t have to leave for care.

That’s important to Ward.

“It means a lot because otherwise I’d have to go across town (to a clinic),” said Ward.

Makarowski said Ward is one of 550 assisted living, long-term care facilities and rehabilitation facilities residents who benefit from the service.

“It provides a picture into her life and the lives of other patients. This is their home. So I get acclimated and get to know them,” explained Makarowski. “My days are flexible. So if a patient needs care, I can find time to see them almost immediately.”

The nurse practitioners say the program reduces stress, improves resident and family satisfaction, increases safety and provides continuity with nursing facility staff.

NPs stay connected and in contact with residents’ UW Health primary care physicians and specialists to deliver care that utilizes both physicians’ and nurse practitioners’ skills and expertise.

Makarowski, who provides care at two of the 19 facilities, said care for both short-term and long-term residents runs the gamut.

“We deal with everything from acute issues and end-of-life discussions to managing prescriptions and hospital orders to make sure they’re correct and clarified,” said Makarowski. “We also ensure safe discharges from SNFs to either home or assisted living, advocate for patients by attending care conferences and many other things.”

The care is identical to the care provided in clinic and that improves patient outcomes, said Makarowski. The NPs have full access to x-rays, ultrasounds and laboratory services.

“Since we get to know our patients very well, we can identify even subtle changes that may indicate a change in condition,” said Makarowski.

UW Health has found that bringing these primary case services to SNF residents has not only reduced emergency department visits and hospital readmissions, it has saved at least $2 million in readmissions.

The program started 20 years ago with one nurse practitioner and has now grown to 10 NPs. And assisted-living residents like Shirley Ward continue to count the program as a blessing.

“It makes me feel great,” said Ward. “I can’t even explain it.”

Inpatient Staff Lives Up to the Promise

From the time that UW Health at The American Center was merely an idea, the goal has been to create and sustain a truly patient- and family-centered culture in which healthcare addresses the needs of the whole person.

The most recent Press Ganey Guardian of Excellence Award confirms that UW Health at The American Center is living up to the promise.

In November 2017, UW Health at The American Center received the award, given to organizations that sustain performance in the top five percent of those surveyed during the year. To qualify, organizations must perform at that 95th percentile during all reporting periods in the award year. UW Health at The American Center was recognized in the “Patient Experience” category for inpatient care.

Delivering a high-quality patient experience involves managing many diverse components of that experience. Vicki Hill, vice president of clinic operations at The American Center, says that the work begins with data: monthly Press Ganey results are shared in the daily unit huddle and posted on the “huddle board.” Teams discuss the findings and use process-improvement tools to identify and address problems and measure the outcomes.

For example, data showed that more than six percent of specialty clinic patients at The American Center did not have their medical records available for the provider when the patient was in clinic. That resulted in an inefficient workflow and dissatisfied patients. A team including RNs, NPs, schedulers and management identified where the problem was occurring and the root causes underlying it, such as a lack of a central location for hard-copy records.

After implementing three changes in the workflows of schedulers and RNs, the team checked the results, which showed that the number of patients missing information related to their appointment had dropped to zero.

Hill said that transparency about Press Ganey results has prompted several successful improvement projects across teams. The commitment to continuous quality improvement reflects the overall idea behind The American Center site: Well before the building was even designed, groups of patients and family members offered ideas about what it should provide, how it should be laid out and what kind of services and amenities patients would appreciate.

The UW Health Patient and Family Experience Promise sums up the approach. Its three simple principles – listen with compassion, communicate effectively and treat patients with respect – encapsulate what patients and families should be able to expect from UW Health.

“Our staff is continually focused on the well-being of our patients as exemplified by their individualized, compassionate care,” says Senior Vice President, Chief Nurse Executive Beth Houlahan. “When providing our patients with an excellent experience, our staff is always mindful of meeting their needs relative to their mind, body and spirit.”

UW Health and UnityPoint Health – Meriter Partnership

Today’s healthcare industry is changing at a dramatic pace, often propelled by mergers, acquisitions and partnerships allowing healthcare systems to provide care and services to larger regions of consumers.

These changes can seem confusing and complicated to the average person, and even to those who work in healthcare. Concerns can arise about potential depersonalization of care, resulting with patients feeling like they might be treated as a number, that they won’t get to know their provider(s), or that they’ll feel shuttled around.

Fortunately, Christine Schmidt, RN, a patient representative with Meriter, can attest that UW Health and UnityPoint Health-Meriter refuse to let that happen as a result of their joint operating agreement (JOA) and are determined to make it smooth and seamless for patients. A defining goal of the joint operating agreement is to ensure that the right care is provided at the right location.

“I meet with anyone who gets transferred to Meriter from UW Health as part of a pilot to see what process improvement might be needed,” says Schmidt, who’s been in her patient representative role for four years after serving as a labor and delivery nurse for 32 years.

“Medical and cardiac patients over the age of 60 are the main populations that have been transferred from the emergency departments (EDs) at University Hospital and East Madison Hospital. Transitioning these patients to Meriter allows us to place the right patient in the right setting where the care they need can be best provided.”

Since the implementation of the pilot in 2017, Schmidt has met with nearly 40 patients.

“Patients have been extraordinarily kind about the transitions and say that their transfers were smooth,” says Schmidt. “Not one complaint has been voiced.”

This positive feedback reassures Schmidt and leaders of both organizations that the JOA is proving successful in this area, thus far.

“The most important piece of our partnership is to ensure that patient care is not disrupted or compromised in any way,” says Sue Rees, DNP, RN, CPHQ, CENP, Vice President, Chief Nursing Officer-Inpatient. “The work Christine and the service excellence group are doing serves as a great ‘pulse check’ for us, and we’re confident that this success will carry over into all areas of care that we provide jointly.”

Older adults are one particular patient population that Schmidt says “are handled with extra TLC at both UW Health and Meriter.”

“The elderly patients say they feel so taken care of, which is reassuring to hear,” says Schmidt. “They are typically fragile and there is some extra kindness involved in getting them from point A to B very carefully, and in the best way possible. Not one older patient has ever said ‘this doesn’t feel right.’ There literally have been no questions, no qualms.”

Throughout the pilot, Schmidt recalls some instances when little things seemed to matter most.

“There was a 94-year-old patient who was very particular about her hair,” Schmidt said. “She misplaced her Velcro rollers in transit, so I ran out to purchase some for her. She was thrilled.”

Schmidt also comments that one particular gentleman was extremely appreciative of the nightshift nurse who wrapped him “extra tight” in a blanket when he couldn’t seem to get warm.

In addition, it’s communicated to patients that the transfers are not billed to them in any way.

“We let them know that UW Health and Meriter are picking up the tab,” says Schmidt. “These little things and the extra special treatment seem to be the most appreciated.”

Future plans for Schmidt include meeting with infusion patients, to see how services can be improved, given the recent move of some infusion services from UW Health to Meriter.

“Change can be difficult,” says Schmidt. “The key is to continuously review our processes and improve the patient experience to ensure the care each person receives is seamless. Our hope is to make it better than ever before.”

When someone is diagnosed with cancer or another commonly known disease, the natural reaction is sympathy. Sadly, that same reaction doesn’t always result in the case of eating disorders. There is often a stigma surrounding them – a tendency to not view them as “real” sicknesses or diseases – and often times, to not want to talk about it.

Nurses and other care team members on the P5 unit at American Family Children’s Hospital are working hard to make sure that stigma does not exist.

Windy Smith, MSN, RN, nurse manager of P5, explains how her team is caring for patients with these very real disorders that present very real physical issues.

“We have a specific list of criteria for an eating disorder admission, which includes symptoms such as vital sign instability, rapid weight loss (in a two-week period of time), heart rate below 50, body temperature below 96 degrees, heart electrical disturbances, electrolyte imbalance and actively refusing food,” Smith explains. “When we see a patient who’s presenting with these symptoms, they are admitted with the goal of getting them medically stabilized. Having an eating disorder is an extremely dire matter and disease. It can affect vital organs and often lead to death, if untreated.”

Smith’s team on P5 developed a specific protocol for eating disorder patients, which has resulted in getting each patient medically stabilized before they are transitioned to their next phase of treatment, which includes cognitive behavioral therapy at an eating disorder center.

“Food is a huge stressor for this population,” continues Smith. “We work with each patient and feed them slowly to increase calories, because their body isn’t used to having those nutrients. If calorie consumption happens too quickly, it can cause serious electrolyte imbalances which can be fatal.”

Smith states that the medical stabilization process can take approximately 2-3 weeks. During that time, food is viewed as the patient’s “medicine,” which is incredibly regimented during their stay.

“These patients have an extreme aversion to eating – it’s very stressful – and the goal is to medically stabilize them to transition to their next phase of care,” Smith says. “Every aspect of their care plan while they are here needs to be well orchestrated among the primary medical team, psychiatry, nutrition, culinary services, the nurse and others on the care team.”

Because of the extreme stress and anxiety associated with food for these patients, they are often assigned a patient safety attendant (sitter) to make sure they don’t exercise, purge or hide food.

“We also started using video monitoring for this patient population,” Smith explains. “A nursing assistant still sits with them during meals, which is a high-anxiety time, and video monitoring is used during other times to ensure that our patients are safe. Another benefit of video monitoring is that it allows nursing assistants to tend to other duties that require their hands-on expertise.”

Smith explains that the RN serves as the point person for the patient and family and coordinates all of the elements of care, to ensure seamless delivery of care to the patient and family. The RN also coordinates a lot of the “behind the scenes” interactions with the multi-disciplinary team, to establish a consistent and standard approach to care.

“The nurse is the hub of care for these patients and needs to create a therapeutic relationship with the patient and the family to help them through this extremely challenging time,” says Smith.

Stephanie Miller, BSN, RN, CPN, practices on P5 and recently cared for one particular eating disorder patient, Anna Gille, who was admitted twice for anorexia, a disease that Smith says has the highest mortality rate of any mental health diagnosis. In addition, Smith notes that there is also a high risk of relapse with any stressful time in the patient’s life – therefore, ongoing therapy including individual, family, and nutritional therapy is essential to success.

“When Anna was initially admitted, her mother was so appreciative that we treated her anorexia as a real disease,” Miller said. “Their family wasn’t getting that response at other places. We didn’t let the stigma of anorexia and mental health be part of her care.”

Miller says that when she works with patients fighting eating disorders, she often tries to find ways to connect with them, to look beyond the disease and get to know the person.

“It wasn’t long after meeting Anna that I saw past the meals being refused and the high anxiety during nutrition discussions to discover a kind-hearted girl,” Miller said. “As we built trust in each other and created a therapeutic bond, Anna was able to talk to me about her passions and feelings. Some days were harder than others, but with the trusting relationship Anna and I established, we were able to find ways to make the days less difficult.”

Miller explains that as meals and calories increase in the patient’s plan of care, the anxiety and distress do, as well.

“Eating disorders can make it difficult for patients to understand that the medical team is trying to help them and that nutrition is what their bodies need,” Miller continued. “During this time, a trusting relationship is especially important. As tube feedings would run, Anna would paint my nails or we would play games to make the time pass. The protocol is very specific and regimented, but when it was allowed, we were able to find things to do that Anna enjoyed – such as getting her hair done, playing the piano, or going to see the Pet Pals therapy dogs.”

“It was wonderful to learn what a fighter Anna is and to watch her progress while taking care of her,” Miller said.

Anna’s mom, Jennifer, shared the gratitude that she, Anna and their entire family felt about the care Anna received.

“We cannot say enough about the phenomenal care our daughter and family received at American Family Children’s Hospital,” Jennifer Gille said. “The entire care team collaboratively developed an individualized plan to most effectively help our daughter. They listened, they cared, they changed the plan when it was not working and they kept strategizing a plan to be effective. We always felt the support and the concern for each one of us and truly believe that our daughter is still with us today because of the knowledgeable, dedicated team for which we are forever grateful.”

Innovative Role Connects Children’s Hospital and School of Nursing

Last May, the University of Wisconsin-Madison School of Nursing and American Family Children’s Hospital ventured into uncharted territory by jointly hiring the very first pediatric nurse scholar, a position that reports to both organizations with the goal of accelerating the translation of nursing research into clinical practice.

After an extensive search, Anne Ersig, PhD, RN, was selected as the best person to help both organizations innovate through the typically lengthy process of identifying practice challenges and implementing evidence-based solutions.

Fortunately, the children’s hospital and nursing school are not new to collaboration. Over the years, many nursing students, preceptors, nurses, researchers and administrators have worked together to mutual benefit. These successes led to an academic practice partnership, signed by the dean of the School of Nursing and chief nurse executive at UW Health in 2016, to formalize the collaboration and generate new opportunities to improve nursing education, facilitate research and advance nursing practice.

The pediatric nurse scholar position is a key part of that strategy, intended to leverage and align the vast clinical and research leadership that exists across both organizations.

From the beginning, Ersig has seen her role as one that spans the two nursing worlds so that information and insights can flow back and forth, experiences in practice can raise research questions, and research findings can inform and improve practice.

“I don’t need to be involved in everything, but my goal is to facilitate these types of things,” she says.

Ersig came to Madison from Pennsylvania, where she served as a nurse researcher at the Children’s Hospital of Philadelphia and as an assistant professor at the University of Iowa-College of Nursing, where she earned her PhD and pursued research on the genomics of chronic stress and anxiety.

As the pediatric nurse scholar, Ersig splits her time between her clinical colleagues and her research peers and students.

Q. What appealed to you about the pediatric nurse scholar position?

A. I missed the academic environment and I wanted time to pursue my own research. Yet I also love nursing practice. This is an opportunity to connect the two. I can help build a culture of scholarship and inquiry on the clinical side and advance science and nursing research on the academic side.

Q. This is a new position. How did you spend your first few months here?

A. I scheduled “meet and greets” with clinical nurse specialists, nurse managers, nurse educators, administrators, leaders and teams comprised of nurses, physicians, social workers and therapists, to learn more about their respective areas and identify shared priorities and interests across the hospital to help form the basis for organization-wide projects and studies, and provide opportunities for connecting nursing faculty, researchers and students from the School of Nursing with projects and teams at the hospital.

I also took the time to work on my own line of research by meeting with multiple groups and individuals across campus whose expertise and interests align with mine. I view this as my first “pass through the buffet.” I sampled everything, and now I’m developing a list of priority projects.

Q. What are those priority projects?

A. I’ve identified three priority topics at Children’s Hospital that cross over unit and specialty boundaries. The first is transitions of care. The second is teamwork, collaboration, and interprofessional communication, education, and practice. The third is stress, burnout and resilience – in all groups, including staff, patients and families. The priority projects are those that involve one or more of these topics.

Q. Can you point to any specific projects within those topics that presented themselves as good opportunities for collaboration?

A. There are several. One physician mentioned an interest in using mindfulness to develop resilience on her team. I also heard from a nurse manager who saw her staff struggle with stress and burnout, and she, too, wanted to find ways to build resilience. The exact language was different from unit to unit, but the desire to develop resilience was a consistent theme across the organization.

We are moving forward with creating a work group to identify and evaluate evidence-based strategies that could work for the different groups. One of our DNP students, who is also a practicing RN at the hospital, will be joining that work group to represent nursing and, perhaps, to determine whether it could develop into a scholarly project, which is a requirement of the DNP program. Also, my own research deals with chronic stress and anxiety and I am exploring whether there may be some opportunity for me as well.

Another physician expressed an interest in interprofessional education, which we embrace and promote at the School of Nursing. That led directly to an opportunity for four undergraduate nursing students to shadow the interprofessional team in the Diagnostic and Therapy Center (DTC) while their assigned preceptor was on leave. This gave them the opportunity to observe care in a less well-known clinical area; their feedback on the shadowing sessions also highlighted the interprofessional collaborations among team members in the DTC and how essential those are to providing excellent care.

Q. Barb Byrne, vice president of clinical operations at American Family Children’s Hospital, has said that one of the goals of this position is to facilitate the dissemination of findings. In other words, she wants nurses to recognize they can drive change, find ways to do it, and then share what they learn so they can improve nursing practice and all of healthcare across the country and even around the world. This seems like a tall order. What do you think?

A. I agree with Dr. Byrne. If we find a way to improve care, we need to share it and share it widely. It shows commitment to all pediatric patients and their families, and it shows leadership in nursing and healthcare. But I believe it is also a fundamental aspect of nursing. Ultimately, the goal is to improve child and family health and wellbeing. One of the ways nurses do that is through direct patient care, patient-by-patient, family-by-family.

Another way is by disseminating our discoveries so that other health systems can learn from our findings and adopt evidence-based methods that work. The School of Nursing knows how to do that, and that is one of the things we bring to the partnership.

Q. Dean Linda D. Scott has described this position as innovative and forward-thinking. What do you think she means by that, and do you agree?

A. The position – and the partnership that created it – aligns with the National Institute of Nursing Research’s vision for the future of science that encourages more partnership between those who are experts in generating nursing knowledge and those who are experts in translating and applying it. This is where nursing – and all of healthcare – is headed.

Of course, translating research into practice is already happening, but it takes, on average (nationally), 17 years. That’s way too long!

While American Family Children’s Hospital and the School of Nursing may not be the largest clinical and academic institutions, they are just the right size to identify innovative research findings, implement and test them in practice, and then share what we find with others. This is how we’re going to advance health care in this country – through key alliances and partnerships between the clinical and academic setting.

Age is Truly a Number

At 81 years young, Marian Ehrenberg is the oldest nurse at UW Health in Madison, Wis. But don’t tell her that.

“I don’t think I am anything special. I love my job and working with people. I enjoy my profession,” said Ehrenberg.

Her interest in medicine began as a child. She grew up outside Wisconsin Rapids, Wis. Her dad, 48 when she was born, unfortunately had health issues and she was exposed to many hospital visits as a child.

“He died when I was 12 years old. I saw the work done by the medical team and I admired the nurses. There weren’t a lot of opportunities for women when it came time for me to choose a career, and I went the nursing route at St. Olaf College and University of Minnesota graduating in 1962 with a BSN,” said Ehrenberg.

She worked to put herself through school before she began working as a nurse.

Having worked in several states and several hospitals, she has seen many changes over the years – but says although technology and medicine have come a long way, the core values of nursing are the same.

“We had to write everything down on paper and now we rely on the computer. There were also no monitors in the operating room when I started,” said Ehrenberg. “But the role of nurses is still the same.”

She spent the bulk of her career, 37 years, working as an emergency room nurse at Meriter Hospital in Madison. She retired at age 70, but less than six months later she joined the UW Health nursing team.

Ehrenberg works at UW Health’s Union Corners Clinic and fills in when they are short-staffed. She is in an outpatient setting and enjoys getting to interact with patients and her coworkers. The feeling is mutual: her colleagues threw her a surprise 81st birthday party. They feel she brings a very special energy to work.

She is one of seven UW Health employees working in their 80s and she has no signs of slowing down.

“You never know what life is going to throw at you so you can just be ready. I like to keep my mind alert and body active and this is a good way to do that,” said Ehrenberg.

An Operating Room Nurse’s Perspective

When a child needs surgery, it’s undoubtedly a whirlwind for parents. From clinic visits, to lab tests and phone calls, they arrive at the American Family Children’s Hospital on the day of surgery, anxious about nearly everything.

They sit in the preoperative holding area or up on the floor, waiting with their hungry (and probably cranky) baby or child. When it’s finally time to go back to the operating room, I go introduce myself to the parents as their child’s OR nurse. They will only interact with me for 5-10 minutes, but I will care for their child during the entire surgery, as if he or she were my own.

What happens back in the operating room is a mystery to most people.

Along with the surgeon and my nursing and anesthesia colleagues, we will perform something akin to a well-orchestrated dance.

Perhaps weeks ago, I coordinated getting special equipment or implants for the child’s surgery.

Perhaps I had multiple conversations with the surgeon and other physicians about special labs we need to draw or biopsy specimens we need to take.

I talked with the pharmacist about a medication earlier in the morning. I had a conversation with my surgical technologist about the surgeon’s instrument preferences. I talked with my anesthesia colleague about how we would position the child on the OR table.

I warm the room up, mostly to keep the child warm, thereby reducing the chances of hypothermia and postsurgical complications. But secretly, I do it for the parents’ comfort, too.

After the induction of anesthesia, we place IVs and possibly arterial lines. We talk about the need for blood products. I do a thorough skin assessment, and make judgments about how best to protect the child’s skin and nerves during surgery. I place a catheter, if necessary.

Our entire team positions the child under the surgeon’s direction. My anesthesia colleagues and I speak up if we see something that could potentially be an issue. We make sure the child is kept safe, warm and comfortable.

Finally, it’s time for the surgery to begin. Once we make an incision, my first instinct is to send a page to the parents to let them know everything is OK, because I I could see the worry on their faces.

After that, I keep an eye on vital signs, make sure the equipment is functioning properly, and anticipate problems before they arise. A good OR nurse has what we like to call “OR ears,” meaning we have one ear on the surgical field at all times, and hear the surgeon request something and are up to get it even before the surgical technologist has a chance to ask for it.

I make phone calls to make sure the nurses are aware of where the child will go postoperatively. I coordinate lab studies and pathology specimens. I electronically document everything that happens in the OR, from who is present in the room to medications used to the dressings we put on. I answer pages for the staff surgeons.

Occasionally, our intraoperative plan of care changes. We are ready to for those changes and can plan and execute them flawlessly. Data consistently show that patients who are cared for by certified nurses have better outcomes. I can proudly say that our OR nurses have a very high certification rate.

Keeping up our certification means taking many continuing education credits. We are abreast of the current practice recommendations and standards of care. All of this translates to safer care for every child.

As a tertiary care and Level I Trauma Center, we tend to see the most complex and challenging surgeries. We are very good at them, but I don’t perform my job in a vacuum. I have an amazing team of anesthesiologists, surgeons, surgical residents, anesthetists and nurse anesthetists, surgical technologists, nurses, and multiple types of support staff who are critical to a good outcome. We never take our jobs lightly.

I care for each child as if they were my own, knowing the parents can’t be there. I comfort each child if they cry when waking up. Sometimes I pick them up and comfort them like I know the mom or dad would. I rejoice in small victories for every parent and grieve deeply when life throws them a curveball and their child’s disease has progressed. Every once in a while, I go home and cry for them.

They likely won’t remember my name. And that’s OK. We’ve got this.

When his daughter Bethany was diagnosed with cystic fibrosis (CF) as a baby, Don Hawes was in his early thirties, working in the mailroom at Land’s End and holding down a couple odd-jobs on the side to make ends meet.

Don and his wife, Julie, learned quickly that their daughter’s treatment was complex, time-consuming and oftentimes confusing – especially for a young couple who, until then, knew next to nothing about the disease.

“I told my wife back then that she should become a nurse because she was so good with everything to do with Bethany’s CF,” Hawes recalls. “She told me, ‘Don, you’re not planning to climb any corporate ladders at Land’s End, so maybe you should go to nursing school.'”

And so he did. After enrolling in his first CNA class, Hawes took a part-time job at a nursing home in Dodgeville, in addition to his full-time job at Land’s End. His life was busy, for sure, but now he was committed to the goal and somehow found the time to take one or two classes each semester until he got into the nursing program at Southwest Tech in Fennimore.

Soon after becoming a registered nurse, Hawes learned from a colleague that UW Hospital in Madison was holding a job fair for nurses.

Hawes was hired at UW in 1997 into a nursing Medical Cluster that served four different units, caring for patients with a variety of conditions. Then, in 1999, Hawes took a permanent position on the Pulmonology Unit (D6/5), where he would work with patients living with CF.

Hawes and his colleagues quickly learned that his experience caring for his own daughter was invaluable, and over the years he helped educate countless patients and families who were new to the disease about the complexities of treatment, but also about the hard-won wisdom he’d earned from his own family’s experience.

But working on that unit was not always easy for him. Sometimes he knew too much. There were times, Hawes says, when he would come home after a particularly hard day at work – maybe a patient had died or one wasn’t taking their treatment seriously enough – and his emotions would get the better of him.

“I knew there were times when I would become way too strict of a father,” he says, referring to managing his daughter’s care at home. “But you can’t know the statistics, or see the consequences of not following the therapies as needed, and not become a little emotional.”

“The thought will occasionally cross your mind that you might outlive your child, and you can’t help but breakdown,” Hawes added. “But then you just have to realize that all you can do is move on and do your best going forward and to remind yourself that the future for CF patients looks better now than it ever has.”

After eight years on D6/5, then-cardiopulmonary transplant manager, Mary Francois, asked Hawes if he would consider becoming a lung transplant coordinator. He agreed, and continues to work there today, helping patients with CF and other diseases navigate the lung transplant waiting list and ensuring that they are well enough to receive the gift of life, should the opportunity arise.

It’s also a place he knows his daughter will likely eventually end up as well. Though she is doing pretty well right now, Hawes says she will likely be added to the lung transplant list in the next couple years, if not sooner.

And so Hawes, who felt so ill-prepared when his daughter was first diagnosed some 30 years ago, now has more than 20 years of nursing under his belt, and is as prepared as any parent could be to see his daughter through this next phase of their journey together.

The Inspiring Practice of One Remarkable Nurse

When you think of what a nurse embodies, the terms selflessness, compassion and clinical expertise most likely come to mind. For one UW Health nurse, these qualities seem to make up the very fiber of her being, which has translated into a remarkable practice that has impacted countless lives, near and far.

Hear firsthand from one of our most accomplished nurses, Susan Gold, BSN, RN, ACRN, about her inspiring and impressive 26-plus-year nursing career.

You came into the nursing profession in your 30s. What was your reason for making a career change?

SG: Growing up with very limited resources it took me 20 years to graduate college! When we moved to Madison and our youngest was two, I decided it was time to finish my degree. The nursing profession was something to which I always felt drawn. It’s what matched me. My parents raised me and my seven siblings with the philosophy that a life well lived is a life that made a difference. I have continued that philosophy by raising a teacher, a doctor and a police officer. It took me five and a half years, but it was absolutely the right decision and I became a nurse the weekend before I turned 40.

How did you come to focus your practice on infectious disease and immunology?

SG: I began my nursing career working inpatient with pediatric oncology patients. When I moved to the Teenage Clinic I also began working with the Pediatric Infectious Disease physicians.

When was your first trip to Africa and how did you initially get involved with caring for and educating teenagers there about HIV?

SG: My first volunteer stint in Africa was to Kenya in the fall of 2003. I was assigned to Nyumbani Children’s Home. This is an orphanage for more than 100 HIV-positive children. It was then that I realized how little the adolescents knew about HIV, reproductive health and prevention of transmission. Since they were starting to receive antiretroviral (ARV) medications instead of preparing to die, they needed to prepare to live long healthy lives. My Fulbright Scholarship gave me the opportunity to evaluate a curriculum by teaching classes that cover those issues.

You’ve received two extremely impressive honors in recent years – the Fulbright Scholarship and Nelson Mandela Fellowship. How have these affected your practice and life?

SG: First, these awards demonstrate the commitment UW Health makes to nursing and nursing research. In addition, they have allowed me to reach nearly 1,000 African adolescents and more than 70 UW undergraduates who accompany me on my trips. They gave me time to develop relationships that resonate in my life every day. I have learned in my practice to do more with less and to never forget the power of nursing. The foundation of my nursing practice in Swahili is “tuka sawa.” We are all the same.

In addition to your outstanding contributions to the practice of nursing and HIV awareness, you’ve done some other amazing things, such as climb Mount Kilimanjaro in Tanzania. Where do you get your remarkable drive?

SG: I have tried to live my life with no “should haves.” I am so grateful for everyday that I am healthy and loved and able to do what means the most to me. I really want no regrets and to know that I always did my best and took advantage of every opportunity  that came my way, or knowing I worked hard to develop each one.

Your colleagues were sad to see you retire from UW Health in December 2017. Are you truly done nursing?

SG:  I will never be done nursing! I will be coming back to the clinic to work per diem. I will continue my nursing work in Africa for the foreseeable future, bringing UW undergraduates with me twice per year. I just returned from another trip to Tanzania on January 3, bringing the total number of students I’ve taken to Africa to 72 who have helped me with my project, Talking Health Out Loud

What’s been the most rewarding part of your job, or what has a ‘good day’ looked like?

SG: A good day is knowing that I’ve made the unbearable a little more bearable… that I’ve learned something that makes me a better person and a better nurse…that every patient and family that I’ve interacted with knows that when you arrive at UW Health, you will find light, hope and human kindness.

Magnet® Nurse of the Year

To top off a truly remarkable year and nursing practice, Gold, who retired in December 2017, was named Magnet® Nurse of the Year for Exemplary Practice by the American Nurses Credentialing Center. Gold said she felt “honored and reminded, again, why University Hospital is the best place to be a nurse.” She also stated that her award was a reflection of all the support she’s gotten over the past 26 years from nursing colleagues, managers and nursing leaders.

Nelson Mandela Fellowship

Gold says receiving the Nelson Mandela Fellowship, which was a direct outgrowth of the work she did related to her Fulbright Scholarship she received in 2007, was an incredible honor that she was “proud and humbled” to receive. The fellowship allowed her to travel to Kenya in March 2017 and continue cultivating her impactful HIV educational program and the collaboration between U.S. and African healthcare professionals.