The AAMC Nursing Blog

Several months after begining the New Graduate Internship here at AAMC, our new grads are well on their way to becoming seasoned nurses. With AAMC experience already under their belts–all of our new grads worked for AAHS while they attended nursing school–they hit the ground running.

And what a diverse bunch! Many have traveled the world with incredible stories to tell. Their experiences range from raising butterflies to riding elephants.

These highly motivated nurses are full of new ideas and fascinating dreams–one is (literally) dreaming about improving our lift initiative, while others are dreaming about the Ravens winning the Super Bowl. 

Please take a moment to stop and get to know this wonderful group of nurses! Above: (back row from left to right) Kristen Toulette (ED), Kathy Sowa (PCU), Lynn Canade (OBS), Mary Hall (MSU), Myisha Davis (OR ACP), Alyssa Finlayson (ONC). (Front row) Sherry Perkins (AAMC’s Chief Nursing Officer), Nicole Zentgraff (GSU), Shahde Graham Coker (PCU), Becki Derr (OBS), Brittany Foscue (MSU), Anna Drapalski (WSU), Lauren Shaffer (OR ACP), Ashly Waterbury (MB). Not shown, Rachel Fitzsimmons (L&D).

-Lisa Davis, RN

The teal ribbon signifies your support for ovarian cancer research

I have worked in OB/GYN for many years. I had experience with patients who were diagnosed with ovarian cancer and knew the symptoms well.

However, the signs and symptoms are very vague, easy to ignore, and likely to be mistaken for other less serious illnesses. I missed them. And I, like most women with ovarian cancer, was diagnosed at an advanced stage.

Were you aware that September is Ovarian Cancer Awareness month? Join me for a 5K Run/3K Walk to Break the Silence on Ovarian Cancer.

Date: Sunday, Sept. 12, 2010

Time: 8:00 a.m. – 10:45 a.m.

Location: Quiet Waters Park in Annapolis

Register at www.nocc.kintera.org/mdcentral

The Walk to Break the Silence on Ovarian Cancer is the sponsored by the National Ovarian Cancer Coalition (NOCC). Organized by local Chapter volunteers, this event celebrates our survivors, remembers those we’ve lost to ovarian cancer and increases awareness about ovarian cancer.

Registration fees include a t-shirt and access to all activities on the day of the event. Pledges and donations are welcome, but not required.

For more information on NOCC and ovarian cancer visit their website at www.ovarian.org or contact a very grateful survivor and AAMC colleague, Nancy Long.

-Nancy Long, RN, CRNP

I was driving home on Route 50, on the last leg of a three hour car ride. My little boy and I were singing “John Jacob Jingleheimer Schmidt” at the top of our lungs and I was thinking I could really use a coffee, when the cars in front of me began slamming on their brakes. Probably to stare at some car pulled over by the police, I thought, irritably. It’s taking forever to get home.

But it wasn’t a police car or a stalled out vehicle. It was an accident that must have happened just moments before–I didn’t see flashing police lights or hear sirens. As we drove closer, my heart started to pound. There was a vehicle overturned in the median. All my senses went into overdrive as we crept by: broken glass, a hissing radiator, the smell of exhaust and tire smoke, a woman covered with blood.

Photo by Paul W. Gillespie-The Capital (Aug. 22, 2010)

A few passers-by had jumped out of their cars and were doing their best to help at the scene. “Do you need a nurse?” I yelled out the window. Seems like the answer should have been obvious, in retrospect. Maybe I was hoping they would say, “No, go on, we’ve got it under control here.” But they didn’t. And so I parked my car on the shoulder, told my son to start praying for the people who were hurt. That I was going to lock him in the car and not to get out for any reason.  

As I approached the vehicle, my BLS training came back to me—I assessed the scene. A couple 20-something guys were holding two small children who had either been thrown or rescued from the overturned car. They had some minor injuries and were clearly in shock, but otherwise seemed stable. A woman, hyperventilating and covered with blood, was being cared for by a person who identified herself as a nurse—I wonder if she is one of ours? Another helper lay on the ground, reaching through the car’s shattered window, to gently hold the shoulder of the trapped, unconscious driver.  

I was an ER nurse for many years and when trauma patients rolled in, I felt in control, prepared with my emergency drugs, my gloves and IV supplies, my team. Here, there was a man offering me a roll of paper towels to staunch the blood of the victims. This was much different than anything I had ever experienced.

“Does anyone have a first aid kit?” Three appeared, I couldn’t tell you from where. I started barking orders: “You! See if there are gloves in the kit. You! Get the kids away from the vehicle. You! Put this cold pack on his head. Stabilize his neck like this.”

One pair of gloves were handed to me and I gave them to the nurse caring for the bleeding woman.

I smelled gasoline. Someone yelled, “This is gas leaking, people. Get away from the car.” For a moment, I let myself wonder what would happen if the car exploded. There were still two people trapped inside and about ten helpers surrounding the vehicle. No one budged. Not even the man lying on the ground, holding the shoulder of that trapped, unconscious driver. I was in awe of the bravery of these people.

It had probably only been about five minutes, but it seemed like much longer. I heard sirens in the distance and ran to move my car so the ambulance could pull in.

I found out later that seven people had been in the vehicle when it lost control. According to the news, they were all airlifted to a shock trauma center. The cause of the accident was not known.

This experience affected me profoundly. Among other things, it made me wonder how often this happens. As nurses, we don’t just offer care inside the walls of a hospital. What about you? Have you had to respond to an emergency situation? Did it change you? Has it affected your nursing practice? Tell us about it here.

-Monica Mewshaw, MSN, MPH, RN

What Is The DAISY Award?

The DAISY Award is a nationwide program that rewards and celebrates the extraordinary clinical skill and compassionate care given by nurses every day. It was established by the family of J. Patrick Barnes, who died of complications of the auto-immune disease, Idiopathic Thrombocytopenia Purpura (ITP), at the age of 33. DAISY is an acronym for Diseases Attacking the Immune SYstem.

During Pat’s eight week hospitalization, his family was awestruck by the care and compassion his nurses provided—not only to Pat, but to everyone in his family. One of the goals they set in creating a foundation in Pat’s memory was to recognize extraordinary bedside nurses who make an enormous difference in the lives of so many people.  

Do you know a bedside nurse who deserves recognition?

He or she should consistently meet the following criteria:

•  Demonstrates critical thinking and decision making skills

•  Offers compassionate care to patient and families

•  Establishes a special connection with families through trust and emotional support

•  Focuses on meeting patient and family goals

•  Educates patients and families

•  Is committed to the profession of nursing

If selected, the DAISY Award Honoree will be recognized at a public ceremony in his or her unit and will receive a DAISY certificate and award pin, as well as a hand-carved stone sculpture entitled A Healer’s Touch. Everyone in the unit will celebrate with Cinnabon^® cinnamon rolls – a favorite of Patrick’s during his illness. The Barnes Family asks that whenever and wherever nurses smell that wonderful cinnamon aroma, they stop for a moment and think about how special they are. 

Nominate an AAMC Nurse for The Daisy Award

Please access the electronic nomination, saved as T:\Daisy Award\electronic Daisy nomination form.doc, then forward to Lil Banchero at lbanchero@aahs.org  Hardcopies of the nomination form are also available on your unit.

Looking to contribute your skill set and time in the community? The Commitment to Community Initiative is seeking three nurses to support the first aid tent at Ride for Shelter, a family fun bike ride and annual fundraiser sponsored by the Friends of The Light House Shelter.

Date:                     Sunday, Sept. 26, 2010

Time:                     12:00 p.m.-2:30 p.m.

Location:              Severna Park: Jones Station Road Park-n-Ride

To learn more about the event, visit the Ride for Shelter website.

If you’re interested in volunteering, please contact Misa Ewing at mewing@aahs.org.  Thank you for your service!

Joanne H. Ebner, RN, BSN, COHN-S is a Cancer Prevention Nurse at AAMC. Her article, focusing on the importance of smoking cessation, even after a cancer diagnosis, was published in the July edition of the Oncology Nursing Society’s (ONS) newsletter, Prevention/Early Detection.

As nurses, telling clients to quit smoking can be challenging. The difficulties associated with quitting tobacco are well known. Now imagine asking a client to quit smoking after he or she has been newly diagnosed with cancer. It may seem counter intuitive to begin counseling a client to quit once a diagnosis of cancer has been confirmed. New research, however, is shedding light on the benefits of quitting smoking even after a cancer diagnosis.

Most research up until now has focused on clients with heart disease who continued to smoke and rightfully so, because tobacco use is a major contributing factor to heart disease. New research studied the effects of smoking on the postoperative outcome of lung cancer surgery (Parsons, Daley, Begh, & Aveyard, 2010). Patients underwent surgery for primary lung cancer and were divided into three groups—nonsmokers, former smokers, and current smokers. Five-year survival rates were 56.2%, 40.9%, and 34.0%, respectively. Smoking was a significant factor affecting the postoperative prognosis of patients undergoing surgery for lung cancer. Deaths were not necessarily related to the lung cancer diagnosis but also included other diseases such as multi-organ failure, respiratory disorders, cardiovascular disease, and events related to surgery. This is not surprising news given that smoking impacts the body’s immune system and its ability to heal.

The health effects of smoking are far-reaching. Not only is it the main contributor to lung cancer (approximately 90% of lung cancers are associated with smoking) but recent research shows that continued use of nicotine impacts the treatment of lung cancer as well. In a study in the American Journal of Respiration, nicotine was found to cause lung cancer tumor progression and resistance to therapy. In other words, nicotine is protective of the abnormal cells.

To read more, click here.

They are complex, intense, and often bittersweet.

Although we use them in administering patient care every day, advance directives are often confusing to both the healthcare provider and the patient. 

Research is going on right here at AAMC to help improve the way we give care to patients with advance directives. And we need your help. Your participation in this quality improvement project can help us improve our knowledge about advance directives and patient rights, as well as develop a well-coordinated approach to our patient’s advance care planning preferences.

There will be two sample populations. One part of this study will be conducted with the health care providers in the perioperative areas, while the other will focus on the rest of our nursing personnel. 

Would you be willing to participate in this study? You will be asked to:

• Take an anonymous, 15 minute pre-survey prior to an education session. Survey available from Aug 23- Sept 6. No identifying information will be collected.
• Attend education session, “Too Much Quiet: Understanding Your Role with Advance Directives” on Friday, Sept. 10 from 11 a.m.-1 p.m. (Nursing Grand Rounds) or on Tuesday, Sept. 7 from 7:00 a.m.-8:00 a.m., both  in the H.S.I.   

• Take an anonymous post-survey about one month after attending the session. You will receive an email with a link to the second survey inviting you to respond between Oct 8-Oct 29. Again, no identifying information will be collected.

No identifying information will be collected. Your answers to this survey will be kept anonymous.   

Appreciation raffle gifts will be awarded.

Help make advance care planning a sweeter part of our patient’s hospital experience. For questions about the project, please email Catherine Rovaldi at crovaldi@aahs.org.  For questions about your rights while taking part in this study, call AAMC’s Research Integrity Officer at 443-481-1320.

The AAMC Commitment to Community Initiative is seeking school supplies to help local Anne Arundel County Elementary school students and Light House Shelter recipients with needed supplies for the upcoming academic year.

A variety of supplies are needed, including:

Those interested in collecting school supplies for their respective department or area should contact Alex Mickler at amickler1@aahs.org or 443-822-9387 to receive a collection box. School supplies will be collected from Aug. 9-19. Units should bring their collected donations to the Clatanoff Lobby on Thursday, Aug. 19 from 1-3 p.m.

Thank you for your generous commitment to help children in our community.

Commitment to the Community

Co-leads: E. Misa Ewing, Emily Groves. Committee: Joan Sadler, Debbie Sears, Deshirle (Dee) Rowel, Dana Garver, Michael Owens, Diane Frank, Virginia Mooney, Vicky Tallerico, Meg Hutchings, Mary Ellen Tuma, Sabita Persaud

• Planning tour of new Light House Shelter this month.
• Partnering with Junior League of Annapolis to collect back-to-school items for backpack distribution to local elementary schools and children at the Light House Shelter.
• Planning nursing assistance during Ride for Shelter, a Lighthouse Shelter fund raiser, on Sunday, September 26 at 12:00 p.m. at the Severna Park Park-n-Ride.
• Remember: Groups or individuals with community service projects looking for support–please contact “Community Service Initiative” via Outlook.

Staffing and Scheduling

Co-leads: Ann Marie Pessagno, Jill Smitley. Committee: Kristina Anderson, Karen Asplund, Lil Banchero, Sharolyn Bush, Evelyn Farkas, Anne Harnish, Sharon Hilder, Peggy Holston, Jackie Johnson, Nita Jones, Lisa Laking, Cheryl Lamon, Marianne McKiernan, Pat Mlynarski, Cathy Moir, Elise Morris, Deanette Readling, Joan Sadler, Jo Ann Shelley, Deb Swanner, Vicky Timerman

• Moving revised policies to policy review committee in Aug. Plan for implementation of approved policies in September.
• Collaborating with HR and AAMC directors to approve HR policies.

Cultural Diversity and Workforce Advocacy          

Co-leads: Sherri Morgan-Johnson, Shirley Faison Everette. Committee: John Bonaccorsy, Sedonna Brown, Anna Cortez, Keverne Gomar, Vilma Hardesty, Walter (Buddy) Holland, Miles Joebchen, Uyen Joebchen, Mary Ann Julian, Sandrine Larre, Jazmin Manlapaz, Sharon Mooney, Saisa Neel, Darlene Robinson, Alexis Rubin, Clover Springer, Marilou Turner

• Celebrating a successful Multicultural Festival, held on June 16, a celebration of our diverse AAMC family that incorporated multicultural education, song, dance, food tasting, and attire. Based on positive staff feedback, another festival will be held later in the year.
• Exploring Healthstream to ascertain how to incorporate diversity training through this system.
• Assessing need for culture-related questions in Alec nursing assessment—thus promoting cultural competence from admission to discharge.

Communications

Co-leads: Christine Frost, Monica Mewshaw. Committee: Chona Hamrock, Deb Keane, Juli Pastrana, Denise Schmitt, Anita Smith

• Spring/Summer edition of AAMC Nurse newsletter distributed to staff and community affiliates.
• Continue to use Nursing Blog to communicate with staff weekly.
• Began discussions to incorporate patients’ and families’ input in nursing communications.

Care Delivery Model

Co-leads: Katie Boston, Rita Linnenkamp. Committee: Carol Bell, Susana Bradbury, Michelle Donovan, Kim Dyson, Stephanie Thompson, Cathaleen Ley, Judith Loftice, Pat Mlynarski, Deanne Tearnes

• Promoted CaringBridge, a free Web site that “connects families and friends during a serious health event” as an avenue to share health updates and receive messages. Check it out at www.CaringBridge.org and pass on the information to your patients and families.
• Planning Grand Rounds on September 10 at 10:30 a.m. in the HSI: “Too Much Quiet: Understanding Your Role with Advance Directives.”
• Work in Progress: Hospital Wide Patient and Family Advisor Council by FY12.

Nursing informatics council (NIC)

Leads: Kathie Lester, Beth Cunane, Nancy Faust. Committee: Joyce Becker, Theresa Bosworth, Fannie Choy, Barbara Garn, Kira Gleeson, Susan Kozel, Brittany Metzger, Sumati Rao, Rachel Turner, Cynthia Vaughn, Angela Zazzera

• Planning a restructuring through new membership from each unit. Unit rep would be go-to person regarding Alec issues and any problems or questions.
• NIC tracer questions to be sent out to staff.

Professional Development       

Co-leads: Janice Drum, Sally Grimm-. Committee: Lisa Davis, Cindy Holsapple-Boone, Irma Holland, Michelle Lewis, Evelyn Rochlin, Mel Wagner, Denise Matteson, Jamie Dotson, Ruby Vlcej

• To schedule a presentation slot with the Board of Review, submit your Clinical Ladder Application to the Department of Clinical Education and Professional Development. A rep will contact you to schedule a meeting time.
• Board of Review presentations are held in the HSI—scheduled every half hour from 8:30 a.m.-12:30 p.m. on the following days: August 11, 26, September 7, 27, October 28, and November 10, 30

Stay tuned to hear more about our newest nursing initiative, Nursing Research, led by Cathaleen Ley and Jen Herzig!