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.

One Patient’s Special Graduation

Aditya “Dity” Vishwanathan was preparing to graduate with his bachelor’s in business from UW-Madison in May 2017. Struck with an unexpected hospitalization, he was unable to attend the long anticipated ceremony.

Both parents – his mother from Delaware and his father from Portland – traveled to Madison for the graduation along with Vishwanathan’s sister, aunt and uncle.

“Dity’s mother and father are first generation in their family who moved to the U.S. from India,” states Kirstin Reinke, BSN, RN, cardiac intensive care. “They were incredibly proud of their son for graduating college and accepting a full-time position with an accounting firm in Chicago.”

Vishwanathan’s father, Arun, who has his PhD, was always unable to afford his own cap and gown for any of his graduations. So, it was especially important to him that his son walk across that stage.

“I wasn’t bummed about missing my graduation,” stated Vishwanathan. But the staff on the cardiac intensive care unit knew that he and his family would appreciate some type of recognition for his accomplishment. Little did they know, it would come in the form of an actual ceremony.

“We are all college graduates and know how memorable it was to walk across the stage and be handed our diplomas,” continued Reinke. “We told his mother and father that we were planning a little surprise for Dity and the rest of the family. And it ended up being an all day effort because Dity was unable to walk in the morning.”

The ceremony preparation mimicked that of legitimate event planning, as Reinke and nursing colleagues made a graduation cap out of a cardboard box, covered with black construction paper – topped with an official Bucky Badger – and tassel made of rubber bands. “Honors cords” were also created using festive necklaces from the unit’s prior Nurses Week celebration, and to make the event extra special, Vishwanathan’s room was also decorated.

When Reinke walked Vishwanathan out to the inpatient cardiology unit, all staff working that weekend cheered as the graduation cap was placed on his head.

The family was able to take photos and unit staff walked them back to cardiac intensive care, where another colleague was playing pomp and circumstance, and a “diploma” was handed to him.

“There wasn’t a dry eye between his mom and dad,” said Reinke. “And once Dity got back to his room, he felt the emotion as well.”

The unit also arranged for a cake and “champagne” to be waiting when he and his parents returned to his room.

“The family was very thankful and actually kept the graduation cap we made,” continues Reinke. “It was a team effort from both units and I could not have made this happen without everyone’s help!”

One week after the ceremony, Arun and Vishwanathan were full of appreciation as they shared with Reinke their memories of the ceremony that took place.

Arun wrote: “We are exceptionally grateful for everyone’s creativity, compassion and support during this challenging time. Your team not only took wonderful care of our son, you also gave us an unforgettable graduation ceremony beautifully orchestrated by everyone on the unit. You made a very pleasant interlude to a not-so-nice situation.”

UW Health Employees Respond to National Crises

When we reflect on 2017 as a nation, it was undoubtedly a year with a continuous drumbeat of tragedy. From devastating hurricanes hitting Texas, Florida and Puerto Rico, to the mass shootings in Las Vegas and Texas, most Americans felt helpless as they watched news feeds and wondered what they could do from afar.

At UW Health, it didn’t take long for several staff members to rally and fly into action.

Hurricane Irma

This fierce tropical storm entered the Florida Keys and moved north, devastating most of the state. Once the extent of the damage was reported, Safety and Emergency Management staff for UW Health approached senior executives with an idea to assemble a team to help contribute to the relief efforts in the south.

It didn’t take long for the idea to get approved and after discussing the needs, it was determined that a team comprised of Registered Nurses would be ideal for providing any necessary care to victims and helping with other volunteer efforts.

Within a couple of days, 75 UW Health RNs indicated they were ready and willing to make the trek.

Due to the overwhelming response, a selection process was implemented based on how many RNs UW Health could realistically send to Florida – factoring in schedules and patient care needs. The resulting UW Health team included six nurses from ambulatory, education, emergency services and inpatient areas, including: Donna Clift-Prew, BSN, RN; Holly Hatcher, RN, Jennifer Kooiman Mohr, MSN, RN-BC; Josue Maldonado, BSN, RN; Chadd Siebers, BSN, RN; and Michele McClure, MSN, RN.

When the team departed in September, they arrived in Naples, Fla., and traveled to one of four Medical Special Needs Shelters (MSNS).

The shelters initially housed close to 1,800 victims, but by the time the UW Health team arrived, the number of victims had been reduced to two. Rather than providing patient care, the UW Health team helped with demobilization of the shelter, which consisted of cots and supplies for more than 1,000 people.

The UW Health team joined several other nurses from across the US and were then dispatched to Tallahassee. The warehouse they worked in had sent out more than 10,000 ready-to-eat meals within the first few of days following the hurricane.

“It was my honor and privilege to be selected as one of six nurses to represent UW Health,” said Holly Hatcher, RN. “I absolutely believe in the power of giving back and we all learned so much on this trip – being flexible in a disaster recovery situation, emergency/disaster management processes, and more significantly – the importance of teamwork. I am so thankful for my managers’ support of the relief mission and for the opportunity to participate as part of the UW Health team. It was an amazing experience that I would gladly sign up for again.”

More Irma and Maria Missions

In addition to the Strike Team’s efforts, another UW Health nurse who is part of the Wisconsin National Disaster Medical Assistance Team (DMAT) through the Health and Human Services department experienced two back-to-back deployments.

Patty Scanlin, RN, NREMT-P, nurse care team leader for emergency services at UW Health at The American Center, also serves as the chief nursing officer for Wisconsin 1 DMAT. She joined 33 other members who were deployed to Hudson, Fla., along with other DMATs across the country.

“As soon as we arrived in Florida, we started providing patient care,” says Scanlin. “We had been up 36 hours. After that, we started working 12-hour shifts.”

In addition to helping care for 270 patients with often limited supplies and resources, some TLC was often needed for four-legged creatures, as well.

“The shelters stated that only service animals were to be allowed, but how do you keep hurricane victims and their very confused and anxious pets apart?” Scanlin asked. “We ended up allowing pets to be with their owners on the cots – there were more than 70. It was one simple act and a major stressor we could help remove for all of them – just by letting them be together.”

Scanlin recalls two instances where she and another team member helped care for pets.

“One anxious Labrador literally scratched the end of his nose from being frantic,” Scanlin said. “Another, older dog had an accident in his kennel so we gave him a bath.”

In addition to managing the furry friends amidst the chaos of patient care, Scanlin said there were more unexpected stressors that they had to contend with as well.

“DEA agents took us to our first shelter where there were also police and the National Guard. They were there to make sure everyone was safe,” Scanlin said. “The agents and police were all very vigilant and fortunately, I felt extremely safe. None of us needed to worry about these things on top of the hurricane destruction and victims in need of medical attention.”

Another unexpected concern that arose was when they realized that one particular hospice patient was close to death.

“One thing we didn’t set up for was where to place deceased bodies,” Scanlin said. “Fortunately, one of the members of our team was part of D-MORT (Disaster Mortuary Response Teams). He was able to find a room that had a locked door and would be designated as the on-site morgue. Thankfully, we never had to use it.”

Scanlin spent 11 days in Florida, returned home for two weeks and was deployed again for 16 days to Puerto Rico to assist with Hurricane Maria victims. Notification of each deployment came last minute, which Scanlin says is fairly common – often learning about them at night – and having to get on a flight the next day.

“I always have a bag ready to go,” she says. “At work, I feel guilty for leaving on such short notice, knowing that my coworkers and manager are burdened with my work. But I couldn’t have a more supportive team. I vividly recall telling my supervisor, Bridgett Schaeffer, that I would be willing to move to a staff nurse position if that would be better for everyone. Bridgett just looked at me and said, ‘No way – I support you 100 percent!’ – which was really nice to hear.”

Another comforting aspect Scanlin has appreciated throughout her mission work is knowing that her mental health and that of every DMAT member, is always supported.

“Each of us is followed up with by a mental health professional after every deployment, to make sure our re-entry into life and work back home is going well,” Scanlin said. “We have also formed amazing friendships among our teams, so it’s nice to know we can connect on Facebook anytime … and send each other silly Snapchats on occasion.”

Las Vegas Shooting

Just when the country thought it had witnessed more than enough destruction among storms and fires, an unimaginable tragedy took place in Las Vegas.

Seeing the numbers of victims that resulted from the mass shooting, one nurse at UW Health thought there might be a way to support the health professionals who were working round the clock to try and save lives.

“People who go into healthcare tend to put others first and their own needs on the back burner,” states Shelli Horne, BSN, RN, surgical services nurse at UW Health at The American Center. “Seeing what was taking place in Las Vegas, we knew those hospital workers were working long hours and days, and we thought sending food — as simple as it sounds — would be one way to offer support.”

Horne and two colleagues put out a call for donations to the rest of the UW Health at The American Center team and within two hours, they raised an impressive $1,700 for University Hospital in Las Vegas.

“We sent 51 pizzas to the Level One hospital the first day and then the next day we sent subs to two other area hospitals,” stated Horne. “We also donated $440 to the victim relief fund.”

Shortly thereafter, Horne said the disaster coordinator at the Level One hospital called to thank them for their efforts and let them know how much the pizzas were appreciated.

“It was the least we could do,” says Horne. “And comforting to know our efforts helped in some small way.”

View Channel 3000’s coverage of this story

Local Needs

Amid the national tragedies, a few UW Health staff members remained mindful of responding to ongoing community efforts, such as the fight against hunger and domestic abuse.

“Our Inpatient Operating Room (OR) RN Unit Council wanted to raise awareness about hunger issues in the community we serve every day,” stated Sara Booth, BSN, RN, inpatient OR nurse.

On Sept. 14, one of the local Madison news stations, WMTV NBC-15, challenged the city to post pictures of people wearing orange, to #Orange4SHFB on its Facebook page. For every picture posted, several local businesses committed to donating 23 meals per picture to the Second Harvest Food Bank.

“I thought it was a fun way for us to make a difference and I was thrilled to see that 27 of our operating room colleagues posted pictures,” stated Booth, who helped spread the word about the TV station’s challenge. “It was so fulfilling to know that those simple photographs resulted in 702 meals to Second Harvest!”

And the inpatient OR didn’t stop there.

In an effort to create camaraderie in the workplace and support two local organizations, Booth stated that the Inpatient OR RN Unit Council hosted a food and materials drive called “Fill the Box, Feed a Soul.” As a result of the drive, the council voted on supporting two organizations located in Dane County: Middleton Outreach Ministry (MOM) – one of the largest food banks in the county; and the Domestic Abuse Intervention Services (DAIS) – whose mission is to empower those affected by domestic violence and advocate for social change through support, education and outreach.

“From Sept. 23 through Oct. 1, we divided our OR staff into 10 teams, and food and clothing items were collected for donation throughout the week,” states Booth. “At the end of the week, we weighed the donations from each team and determined first and second place winners to receive a pizza and ice cream party, respectively (through funds raised by the OR staff).”

After each team’s donations were weighed, the total amount of donations to MOM and DAIS totaled more than 600 pounds.

“We are so thankful for and proud of our colleagues who coordinated and contributed to local and national relief efforts,” stated Beth Houlahan, DNP, RN, CENP, Senior Vice President, Chief Nurse Executive. “Their efforts speak volumes about the type of staff we have at UW Health … remarkable.”

The ‘Missing Link’ Beyond Our Doors

The UW Health Transitional Care Program provides a very important service to a variety of patients in both the medical and surgical settings. Although each patient has a unique care plan, the goal is steadfast: prevent avoidable readmissions.

One way Laura Sell, MA, BSN, RN and colleague, Dani Edwards, MSN, RN, PCCN – who both serve as transitional care case managers – keep that goal front and center is by continuously looking at all sides of the care provided before, during and after each procedure, to try and find ways to improve it.

“The patients we work with have had a surgical procedure – typically an ileostomy – related to a colorectal disease of some kind,” says Sell. “Many of these patients are at a high risk for readmissions, so we analyze every step involved in their care and think, ‘What would I want if this were me?'”

It is this empathic viewpoint that allows Sell and Edwards to determine if enhancements can be made to the care plan or the way the care team communicates throughout the continuum of the patient’s care, including after they’ve left the hospital.

“There are many dynamics in play with these patients,” continues Sell. “Not only are they dealing with a physical appliance that they need to adjust to and learn about, there are dietary guidelines they need to adhere to. So, understandably, there can be a great deal of anxiety and angst associated with all of it.”

In an attempt to ease this stress, Sell and Edwards look for gaps and themes that help them know exactly where to target their improvement work, and who to work with to get it done. Feedback from patients indicate that they are already impressed with the services provided by the transitional care team.

One particularly rewarding example involved a 69-year-old female patient who came to UW Health’s University Hospital for revision surgery after having been through several surgeries at another hospital.

When Sell met with the patient in the hospital, she talked through the transitional care-surgical brochure with the patient, explained the program and explained that she would be calling her for up to six weeks. The patient was also given Sell’s cell phone number so that she would call her directly with any questions she had.

“The patient took the brochure, raised it up and said, ‘THIS is the missing piece that the other hospital didn’t have.'”

“When I called her at home, she said she had been extremely tired and struggled with eating and drinking,” Sell said.

Upon Sell’s assessment, the patient was indeed dehydrated, as she suspected. She was directed to see her primary care physician that day for further care.

“What you do is so important,” the patient told Sell. “You even care about us after we go home.”

And the patient is exactly right, especially when it comes to Sell’s dedication to improvements. Here are a few of the most notable changes she’s been instrumental in moving forward:

• Creating a practice protocol to ensure consistent management of high output ileostomies across the continuum of care. They collaborated with colleagues at the Digestive Health Center to develop it and presented it to the unit nurses and to the Nursing Practice Council.
  
• Increasing awareness of diet and fluid intake and output among wound and skin, ostomy and home health nurses.
  “The nurses are now noting output, so it’s working,” says Sell. “There was only one patient readmitted in two years for an ill-fitting appliance. Most readmissions have been for dehydration, so this increased awareness is making a difference.”
  
• Surveying patients before, during and after their procedure, to see if they received enough information about their stoma, lifestyle, diet changes and appliance.
  
• Collaborating with pharmacy colleagues to develop opioid-tapering patient instructions.
  
• Working with the UW Carbone Cancer Center nutritionist to facilitate easy referrals via Health Link (electronic health record), for patients struggling with meeting nutrition requirements after surgery.
  
• Reinforcing consistent order sets for all consults on ostomy patients. Sell and Edwards helped make changes to the post-operative order sets so that no matter where a patient is roomed, they’ll have consistent order sets for all consults – nutrition, behavioral health ostomy care service and notify provider for ostomy output <500 in 8 hours or >1200 in 24 hours.

Sell and Edwards maintain their commitment to improvements and have a few new initiatives in progress and on the horizon.

“We recently succeeded in implementing a new process related to home health that’s needed for patients with ostomies over the holidays,” Sell said.

“Typically, home health staffing is low during this time, so if you have a patient that’s leaving during those times, home health care might not be available,” Sell explained. “As a work-around, we suggested that home health get ordered before the patient goes home (pre-surgery). It’s tricky because it’s not our workflow. So, we met with colleagues at the Digestive Health Center (DHC), presented the idea and hammered out the details, which resulted in the resource center finally being available to DHC just like it is to case managers at University Hospital. Home health referrals are now initiated before surgery.”

Sell and Edwards are also considering videos as another patient education option, and a better system for rehydration – outpatient option versus inpatient – among other things.

“Improving processes and patient care is intrinsic to our nursing practices and our program,” Sell says. “Seeing that these changes are making a difference in patients’ lives is beyond rewarding.”

Peggy Troller has been a nurse for 34 years – and she likes to make work fun.

“I would say I am the silly one on the unit. I am always for keeping things lively,” said Troller.

She has been at UW Health for four years working in the Transitional Care program. Although Troller may have a fun-loving attitude, she knows how to get down to business. She has created a program that is important to patients and quite personal to her.

Troller has been wearing hearing aids for 22 years.

“I had horrible ear infections as a child. Countless surgeries. My ear drums were basically shot by the time I was 9 years old,” said Troller. “I needed technology to catch up to me. When I was 35, I got hearing aids. I know what it is like to be hard of hearing and that helpless feeling.”

Transitional Care specializes in patients who are 60 years and older. Their job is to make sure patients have what they need to go home and not need to come back to the hospital. In short, the unit helps patients transition home successfully.

Four years ago, she realized there was a gap in resources for those who were hard of hearing. There was also a gap in understanding the communication needed for patients with hearing aids. She wanted to become an advocate and put a plan in place.

So she started a program where she would have extra batteries or supplies on hand to clean hearing aids for those in need.

“Often times when you go to the hospital, it’s in a rush or not expected. So you don’t always have extra hearing aid batteries with you. And the saying goes, ‘your hearing aid knows when you leave with no extra batteries because that is when they die,'” said Troller.

She also understands how hearing is critical in the medical process.

“I know what it is like,” she said. “If your hearing aid goes out and you aren’t able to hear, it can be scary. People don’t look directly at you and you can’t hear what they are saying. You end up not talking because you are afraid of how loud you will speak. It is a huge barrier when you are in a hospital setting.”

So, if someone’s hearing aid goes out or he or she needs help, she is there on the unit.

When the program started, Troller needed a way to get attention. So, of course, her fun- loving personality took over.

A crown, wings, and a wand make up the “Hearing Aid Fairy” costume for Troller.

“I actually just had some of the costume around in my office,” she said. “I try to stand out so people know we offer help and it makes people laugh.”

She would put on the costume when asking patients if they needed a change of battery or when she walked to different units. Troller stood out and got her message across.

Troller doesn’t wear the costume as much these days because the program is established, but she still puts it on from time to time. She also has received some grant money to buy the batteries. The program has been a success and she also wants to raise awareness.

“I am an advocate for the patient. That is why I went into nursing. I wanted to help people. It’s important for providers and medical professionals to understand how to communicate with someone who is hard of hearing,” she said.

“They shouldn’t shout in their ear or talk to the back of their head. They need to have a face-to-face dialogue. Also, it’s OK to ask if their hearing aids need new batteries or cleaning. That can make all the difference.”

Troller plans to continue the program and her fun approach are all part of an important message.

“It can be frustrating and uncomfortable if your hearing aid is not working,” she says. “So I try my best to make the patient experience as good as possible.”

The DAISY Award is a worldwide program that rewards remarkable care, clinical skills and extraordinary compassion in nursing. It is given to outstanding licensed nursing professionals in more than 2,000 health care facilities worldwide.

Award history

The award was established in 1999, by the family of J. Patrick Barnes, who died at age 33 of complications of Idiopathic Thrombocytopenic Purpura (ITP). Having been touched by the remarkable care demonstrated by nurses during Patrick’s illness, the Barnes family made it their mission to recognize exceptional nurses with the DAISY Award.

DAISY Foundation website

DAISY Award recognition

Each DAISY Award recipient is recognized with a certificate and a hand-carved stone sculpture entitled “A Healer’s Touch.” Additionally, the recipient’s team receives cinnamon rolls — a favorite of Patrick’s during his illness — with the sentiment that the heavenly aroma will remind them how special they are and how important their work is. The recipient’s unit receives a banner to hang in their unit for the month.

Daisy Award recipients at UW Health will personify our remarkable patient and family experience. They will consistently demonstrate excellence through UW Health values of innovation, integrity, compassion, accountability, respect and excellence.

DAISY Award winner spotlight: Kristin Powell

Nurse Kristin Powell received a heartfelt hug from Tamra Burkhamer, a grateful family member of a patient who nominated Kristin for a DAISY Award for the remarkable care and extraordinary compassion she provided to her mother during her time at University Hospital. Kristin received the award in front of her unit teammates and the patient’s family.

“Kristin will always be remembered by us as an angel here on earth. We couldn’t have asked for anyone better to take care of my mom (and us)! Kristin is a phenomenal nurse, a beautiful person and an extraordinary asset to University Hospital and the hematology/oncology unit,” Tamra wrote in nominating Kristin for the award.

“Whether she realizes it or not, Kristin made a huge difference to all of us and there is no way that we could ever thank her enough. I hope this nomination for the DAISY Award at least lets her know just how very important she was in our lives and how fondly we will always remember her and the compassionate care she provided for all of us.”

How to nominate an extraordinary nurse

DAISY Award recipients personify the remarkable patient experience at UW Health. Patients, patients’ families or visitors can nominate a deserving nurse by completing an online nomination form.

Contact us

(608) 890-9466

NursingRecognitionCouncil@uwhealth.org