Caring September 21, 2006 - mghpcs.org...zLynda Tyer-Viola, RN Quality & Safety .....12 zSafe...

Inside:Ben Corrao Clanon Award ...... 1

Jeanette Ives Erickson ............ 2The Institute for Patient Care

Fielding the Issues .................. 3Documentation andCommunication

Lean Equipment ManagementSystem ................................. 4

SummerWorks Program .......... 5

Service of Remembrance ....... 6

New Leadership ...................... 7Thomas Burke, MD

Clinical Narrative .................... 8Sheila Pallotta, PT

Clinical Nurse Specialist ...... 10Lynda Tyer-Viola, RN

Quality & Safety ................... 12Safe Hand-Offs

Food & Nutrition ................... 13Ingredients Room

New Graduate Nurse in CriticalCare Graduation ............... 14

Educational Offerings ........... 15

Neuroscience Units Investingin the Future ..................... 16

CaringCaringSeptember 21, 2006

H E A D L I N E S

Working to

MGH P

O

gether to shape the futureatient Care Services

n Friday, September 8,2006, Christine D’Anto-nio, RN, became the 20th

recipient of the Ben Cor-rao Clanon Memorial Scho-

larship Award. The scholarshipwas established in 1987 by ReginaCorrao and Jeff Clanon in memoryof their son, Ben, to recognizeNeonatal Intensive Care Unitnurses who demonstrate exemp-lary practice, a commitment toprimary nursing, and advocacy forpatients and families.

Nurse manager, Peggy Settle,RN, spoke of the special relation-ship between parents and primarynurses and the ability of nurses toteach parents to care for their ba-bies in the daunting setting of anintensive care unit. Said Settle,“Christine exemplifies what itmeans to be a primary nurse.”

D’Antonio thanked Corrao andClanon for supporting the award.Said D’Antonio, “I’ve only been anurse for four years, but I’ve learn-ed so much from my colleagues.

NICU nursing can’t be taught in aclassroom. It’s learned from the experi-ences we gain every day in a uniquework environment. I’m blessed to workwith such a talented group of people.”

Corrao and Clanon thanked NICUstaff for their continued compassionand shared a poem written by Ben’ssister, which began:

People do not miss their entrances,They step into our lives precisely

when they shouldAnd leave them in the same

beautifully scripted manner...

D’Antonio receivesCorrao Clanon Award

—by Mary Ellin Smith, RN, professional development coordinator

Ben Corrao Clanon Award recipient, Christine D’Antonio, RN (secondfrom left) with (l-r): Peggy Settle, RN, Jeff Clanon, and Regina Corrao

September 21, 2006September 21, 2006Jeanette Ives EricksonJeanette Ives Erickson

Jeanette Ives Erickson, RN, MSsenior vice president for Patient

Care and chief nurse

The Institute for Patient Careadvancing clinical excellence throughcollaboration, education, and researchs the depth andscope of our prac-

tice continue togrow amid a chang-

ing healthcare landscape,it’s essential to maintaina clear and focused vi-sion for the future. It wasthat future vision thatfirst led me to the idea ofcreating the Institute forPatient Care at MGH. Asyou can see by the dia-gram below, the Institutefor Patient Care is com-prised of existing (andsoon-to-be-created) cen-ters as well as a number

A of programs and initia-tives geared toward ad-vancing clinical excel-lence, inter-disciplinarycollaboration, education,and research.

My vision for theInstitute is that it will bea central entity linkingdisciplines and profes-sions within Patient CareServices to foster team-work, share best prac-tices, and bring an in-formed, inter-disciplinaryapproach to patient- andfamily-centered care.Rather than allowing our

good efforts to becomescattered and disconnect-ed, the Institute will en-able us to integrate com-petencies, evidence-basedpractice, quality-improve-ment, and infomatics intothe delivery of patient care.

The underlying philo-sophy of the Institute isrooted in the core com-petencies articulated bythe Institute of Medicine(IOM) in 2002. They are:

Provide patient- andfamily-centered care;identify, respect andcare about patients’

differences, values,preferences, and needs;relieve pain and suffer-ing; coordinate contin-uous care; listen to,

inform, communicatewith, and educate pa-tients; share decision-making; and advocatecontinued on next page

The Institutefor Patient Care

Programs/InitiativesCollaborative Governance

Clinical Recognition Program

Credentialing

Organizational Evaluation

Culturally Competent Care Curriculum

Leadership Development

Visitor Program

Simulation

Awards/Recognition

Workforce Development

The Knight NursingCenter for Clinical &

ProfessionalDevelopment

The Max & EleanorBlum Patient & Family

LearningCenter

The Yvonne L. MunnCenter for Nursing

Research

The Center forInnovations in Care

Delivery

Goals for the Institute:Foster an environment of clini-cal inquiry and experiential learn-ingPromote team learning to opti-mize safe, effective, culturally-competent patient care; createan environment that promotessafety for patients, families, andstaffParticipate in the developmentand evaluation of organizationalinitiativesSupport the development of adiverse current and future work-force

Goals (continued):Enhance the relevance of researchas it relates to public healthSupport research that advancescare that is safe, effective, andevidenced-basedProvide leadership for innovationsin learning for staff, patients, andfamiliesDevelop, implement, and evaluateprogrammatic initiatives that im-pact staff-development and or-ganizational effectivenessMake innovations visible throughinternal and external publicationsand presentations

September 21, 2006September 21, 2006Fielding the IssuesFielding the IssuesNew documentation

and communication modelQuestion: What’s goingon with the Documenta-tion and Communicationproject?

Jeanette: The Documen-tation and Communica-tion Project began inFebruary of 2006 whenwe identified opportuni-ties for improvement aswe prepared to automateour documentation sys-tems. The Documenta-tion and CommunicationProject Team meets regu-larly and has developed aplan to implement changeson two pilot units, Bige-low 14 and White 8, thismonth. The plan is tostandardize documenta-tion within and acrossunits while shifting ex-pectations about commu-nication within units.

Question: What is driv-ing these changes?

Jeanette: As we stand-ardize practice in prepar-ation for an automateddocumentation system, itis important to retain ourability to hear the patientand family’s perspectivesand be able to use thisknowledge to optimizeoutcomes. Patient careand nursing practice needto drive the design, so thegoal is to enhance prac-tice before moving toautomation.

Question: What will bedifferent?

Jeanette: A care-deliverymodel comprised of acare team and care leaderwill ensure continuity ofcare for patients over thecourse of their hospitali-zation. The care team isaccountable for achiev-ing optimal patient out-comes and enhancing the

patient and family exper-ience.

We value documenta-tion that reflects nurs-ing’s contributions tooutcomes of care. Cur-rently, valuable informa-tion is communicatedverbally but not docu-mented in the patient’srecord. New strategiesinclude changing thenursing assessment to thenursing data set, elimin-ating admission notes,and writing goal-orientedprogress notes that re-flect the synthesis of careprovided.

Question: Will shift re-port change?

Jeanette: Report will bea transfer of written infor-mation (progress notes,the data set, the patientproblem/intervention/outcome sheet, treatment

record, and flow sheet).After the in-coming nursereviews the documenta-tion, there will be anopportunity for dialoguebetween the nurse com-ing on duty and the nursegoing off duty to clarifyany questions. Bothnurses will meet with thepatient to ensure a seam-less transition of care.

Question: How will theDocumentation and Com-munication Project berolled out to the rest ofthe hospital?

Jeanette: Once initialfeedback is obtainedfrom the pilot units, ad-justments will be made,and four more units willadopt the program inNovember. More unitswill be added periodical-ly until all units are usingthe new documentationand communication mo-del.

Prior to implementa-tion, unit leadership willreceive information tohelp staff prepare for the

change. Members of theproject team will meetwith staff prior to roll-outto review documentationchanges. During the firstweek of implementationmembers of the team willbe on hand to supportstaff.

Question: How do weknow the new system isbetter than the old one?

Jeanette: A research pro-tocol was developed tolook at pre- and post-implementation respons-es of staff and patients.And staff on the pilotunits will participate infocus groups to give feed-back about the changesand the implementationprocess.

If you’d like moreinformation about thenew documentation andcommunication model,contact project managers,Rosemary O’Malley, RN,(6-9663); Miriam Green-span, RN (4-3506); orMandi Coakley, RN(6-5334).

for disease-prevention,wellness, and healthylifestylesWork in inter-disciplin-ary teams; cooperate,collaborate, communi-cate, and integrate careEmploy evidence-bas-ed practice; integrateresearch into clinicalexpertise and patients’values for optimumcareEmploy quality-im-provement measures;identify errors and

hazards; understandand implement basicsafety principles; con-tinually understandand measure quality ofcare; and design andtest interventions tochange systems withthe objective of im-proving qualityUse infomatics; com-municate, manageknowledge, mitigateerror, and support de-cision-making usinginformation technology

Jeanette Ives Ericksoncontinued from previous page

Education, innova-tion, and influence don’thappen in a vacuum;much of our work willrely on new and existingpartnerships. It will beimportant as we moveforward to forge relation-ships with businessesand educational organi-zations that support freethinking and inter-disci-plinary learning.

We’re still in the earlystages of designing andcreating the Institute forPatient Care, but I cantell you it will continueto evolve and developover time as we obtain

more funding, implementmore programs, and iden-tify more areas for re-search.

It’s good that ourpractice and sphere ofinfluence continue togrow, mirroring the dy-namic nature of healthcare itself. The Institutefor Patient Care will helpus harness the knowledge,imagination, and spirit ofinquiry that have madeus a world-class institu-tion and keep our talentsand energies focused onthe areas where they’reneeded most. I’ll keepyou informed as we

move forward with thisimportant work.

UpdateI’m pleased to announcethat Mary Sylvia, RN, hasaccepted the position ofnurse manager for the JeanM. Nardini, RN, Hemo-dialysis Unit. I’d like tothank Tony DiGiovine, RN,for providing interim lead-ership, and I want to ac-knowledge the invaluablecontributions of unit-basedleadership and staff duringthe difficult months follow-ing Jean Nardini’s death. Iknow Mary will appreciateyour support as she assumesher new position.

September 21, 2006September 21, 2006

or the past year,staff from Patient

Care Services,Materials Manage-

ment, and Biomedi-cal Engineering haveworked to improve thesystems driving the care,management, and distri-bution of centrally-storedequipment. During athree-day seminar to kickoff this effort, the grouplooked at current equip-ment-management sys-tems to identify opportu-nities for improvement.They discovered a num-ber of practices that con-tributed to delays, dupli-cation of efforts, andinefficient circulation ofequipment. The multi-disciplinary team con-cluded they needed asystem that would ad-dress both the functiona-lity and accessibility ofequipment to ensure op-timal patient care.

The group met with ateam of consultants tolearn more about theLean Equipment Manage-ment system. The Leansystem is derived fromthe Toyota manufactur-ing philosophy that eli-minates waste at everyopportunity to ensure the‘leanest’ possible process.The group looked at whatwasn’t working in thecurrent system and soonpresented a new designfor equipment flow atMGH. The design waspiloted on four patient-care units in January,

2006, and two more unitswere added in April.

The pilot programsgave the team an oppor-tunity to look at the over-all process, study staffingissues, and refine supplylevels needed to supportthe demand for equip-ment on each unit. It alsoallowed the implementa-tion team to spend timewith staff hearing feed-back and promoting bestpractices. In August, theLean Equipment Manage-ment system was rolledout on five more units,allowing the team to fac-tor in elevator wait time.

What does the newLean equipment flowlook like? Each unit hasa cart containing the mostcommonly used equip-ment (Propaq monitors,3M pumps, PCA pumps,Sigma pumps and feed-ing pumps). Equipmenton carts is visible, so thelikelihood of not havingequipment when neededis minimized. This hasresulted in fewer calls toCustomer Service.

Prior to implementingthe Lean managementsystem, equipment fre-quently spent more timein transit than being usedfor patient care. It wasdecided that the best so-lution was to have equip-ment remain on units atall times. Now, equip-ment is cleaned in theSoiled Utility Room by aMaterials ManagementLean associate. After

being cleaned, it’s re-turned to the Lean cart,ready to use. Each Leanassociate handles five orsix units, visiting eachunit every two hours. Sothe maximum amount oftime any piece of equip-ment is out of servicewaiting to be cleaned istwo hours. Units are cov-ered by Lean associatesseven days a week, from7:00am–11:00pm.

To enhance the Leansystem even more, Bio-medical Engineering hasmade some changes tothe way certain equip-ment is repaired to re-

duce turn-around time.Lean associates havebeen trained to performquick repairs on the unitto minimize the amountof time equipment is outof service.

Staff on units wherethe Lean program hasbeen implemented areextremely satisfied. Oneclinician wrote, “I lovethis plan. It’s terrific tobe able to go in the backroom and get clean, func-tional equipment... what-ever we need. I hope wecontinue this.” The LeanEquipment Managementsystem is a rewardingsolution for patients,staff, Biomedical Engin-eering, Materials Man-agement, and PatientCare Services.

The Lean EquipmentManagement system

Lean Equipment Management:a utilization success story

—by Dan Kerls, OTR/L, senior project specialist,and Ed Raeke, director, Materials Management

F

Systems ImprovementSystems ImprovementSystems Improvementoffers:

equipment carts on unitsLean associates assign-ed to monitor/re-stockunitsLean associates can berequested via pagercleaning and par levelstocking done on sitePlans are currently un-

der way to bring the re-maining inpatient unitsinto the Lean program, afew units at a time. Thisfall, senior project spe-cialist, Dan Kerls, anddirector of Materials Man-agement, Ed Raeke, willbegin to assess equipmentdemand and staffing is-sues in preparation forimplementation.

For more informationabout the Lean program,please contact Ed Raeke at6-3686, or Dan Kerls at4-3085.

Lean associate, Alberto Wilson, re-stocksLean cart on the Bigelow 14 Vascualr Unit


ith informationalpamphlets attheir sides and

hands-on experi-ence under their

belts, 15 MGH-TimiltySummerWorks interns leftthe Family and FriendsCPR training sessionswith enough informationto save a life. With thehelp of clinical educators,Roberta Raskin Feldman,RN, and Laura Sumner,RN, of the Knight Nurs-ing Center for Clinical &Professional Develop-ment, interns had an op-portunity to perform CPRon simulation manne-quins. Other MGH em-ployees certified as CPRinstructors volunteered tohelp. They were: TomHennessey of Police,Security & Outside Ser-vices; Karla Leegard,RN; Denise Lozowski,RN; Suzanne Newton,RN; and Richard Pino,MD.

On the first day oftraining, interns learnedadult CPR procedures,which consisted of pre-cise chest compressionsand breaths. Many parti-cipants commented onhow exhausting the pro-cess can be as they prac-ticed on life-sized man-nequins.

On the second day oftraining, participantslearned other safety inter-ventions, including theHeimlich maneuver (onadults and infants), andCPR for babies and smallchildren. The seriousness

of the class registeredwith students as theybegan to understand theimportance and conse-quences of being unpre-pared in an emergencysituation.

Says Dan Correia,SummerWorks coordi-nator, “This is just oneexample ofthe kind oftransferableskills we pro-vide as in-terns continueto ‘learn andearn’ through-out the sum-mer.”

At times,training waschallenging,but the impor-

(Photos by Daniel Correia)

Student OutreachStudent OutreachMGH-Timilty SummerWorksinterns gain life-saving skills

—by Roytel M, MGH-Timilty SummerWorks intern

W tance of the informationkept everyone focusedand on track. Some in-terns commented thatthey felt a sense of reliefin knowing they possess-ed life-saving knowledgeand techniques. Uponcompleting their training,they felt better informed

about the real practice ofCPR as compared to theglamorized version theyhad seen on television.

Said one intern, “Theinformation we got willbe useful in any situationwhere someone needshelp.”

The MGH-TimiltySummerWorks Programis a career-explora-tion/sum-mer em-

ployment program thatoffers eighth gradersgraduating from TimiltyMiddle School paid in-ternships at MGH duringthe summer.

For more informationabout the MGH-TimiltySummerWorks Program,contact Dan Correia at4-6424.

Photos clock-

wise from top

left: Laura Sum-

ner, RN, guides

SummerWorks

intern, Nateaha,

through exercise

in infant CPR;

Roberta Raskin

Feldman, RN,

coaches intern,

Yeriseli, in adult

CPR; Sumner

and Raskin Feld-

man with interns

(l-r): Yeriseli,

Nateaha, Roytel,

and Crystal

(seated)


n Monday, Sep-tember 11, 2006,the MGH Chap-

laincy and hos-pital administra-

tion offered a service ofremembrance commemo-rating the events of Sep-tember 11, 2001. Theservice incorporated read-ings, music, prayer, andreflective thinking toacknowledge the contin-uing despair and worldchanges that have occur-red since that day fiveyears ago.

The days after Sep-tember 11, 2001, taughtus that we need eachother more than ever. Just

RemembranceRemembrance

as our International Med-ical and Surgical Re-sponse Team (IMSuRT)traveled to Ground Zero,following the attackes onthe World Trade Center,the MGH communitycontinues its ongoingmission of deliveringcompassionate care.

Speaking to the gath-ering, Mike McElhinny,MDiv, director of theChaplaincy, said, “Wethe survivors of Septem-ber 11th have an obliga-tion to those who died touse our talents to restorea sense of hope.”

Senior vice presidentfor Patient Care, Jeanette

A service of remembrance:five years later

—by Mike McElhinny, MDiv, director, MGH Chaplaincy

O Ives Erickson, RN, andsenior vice president forHuman Resources, JeffDavis, participated in theservice. Said Ives Erick-son, “It was justfive years ago thatwe shared the sad-ness that engulfedour world. Wereached out to ourcolleagues in NewYork and to thosewith whom wework at MGH. Wecared for those wholost their lovedones and in so do-ing, became a dif-ferent institution, adifferent commu-

nity—a community witha global mission.

“Today, our hearts areone. We have re-affirmedour commitment to im-prove the lives of thoseseeking our care and towork toward a betterworld. In the face of ad-versity, we are a unitedteam, caring for all who

need our knowledge,skill, and services. Fiveyears later, our spirit andcommitment are strong.As we honor those whodied and suffered loss onthis day in 2001, I wishyou all peace and person-al happiness. Thank-youfor all you do... for peo-ple and for MGH.”

Members of the MGH Chaplaincy lead attendees in a service of remembrance.Above, senior vice president for Patient Care, Jeanette Ives Erickson, RN, and senior

vice president for Human Resources, Jeff Davis, address the gathering

(Photos by Paul Batista)


homas Burke,MD, has accept-ed the position of

director of theMGH Center for

Global Health & DisasterResponse.

The Center for GlobalHealth & Disaster Re-sponse was establishedearlier this year to buildon our long history ofproviding humanitariancare to victims of diseaseand disaster around theworld. That history and agrowing demand for ex-pertise in global healthprompted MGH to createa formal center to sup-port this important work.

In his role as director,Burke will position theCenter for Global Health& Disaster Response tobe able to respond tointernational disasters,provide knowledgeablecare for widely variedpopulations, and main-tain strong alliances withgovernment, non-govern-ment, and academic agen-cies to bring aid to vic-tims of disease and dis-aster in the United Statesand internationally.

The work of the Cen-ter for Global Health &Disaster Response willfocus on five key areas:global health care (deliv-ery and education), dis-aster response, trainingand education, world-wide medical consul-tation, and research.

Burke most recentlyserved as attending phy-sician and associate clin-ical director of Emergen-cy Medicine at Brighamand Women’s Hospital.He also served as facultyin the division of Inter-national Health and Hu-manitarian Programs. Heis a member of the fac-ulty at Children’s Hos-pital and an instructor atHarvard Medical School.Burke has served in lead-ership positions at sev-eral hospitals and health-care organizations, in-cluding the InternationalTrauma Treatment Pro-gram in Olympia, Wash-ington, and the HarvardHumanitarian Initiativeat the Harvard School ofPublic Health. Burke hasworked with the ThirdBattalion/9th Infantry,

and as a tact-ical physicianwith the FBIsupportingvarious mis-sions includ-ing deploy-ments at RubyRidge, Idaho,and Waco,Texas. In themid-1990s,Burke es-tablished afoundation todevelop medi-cal systems inEastern Eur-ope and found-ed three com-

panies. He has publishedextensively and lecturedthroughout the worldregarding humanitarianissues.

Burke earned a med-ical degree from AlbanyMedical College, andbachelors’ degrees inMathematics and Neuro-science from the Univer-sity of Massachusetts inAmherst. He was born inGöttingen, Germany, andtoday resides in Newton.

Said MGH president,Peter Slavin, MD, “Aswe continue to advanceour global mission, Tomwill play a key role inorganizing and mobiliz-ing our internationalefforts to serve a varietyof populations. Pleasejoin me in welcomingDr. Burke to MGH andto his new role.”

New LeadershipBurke, new director,

MGH Center for Global Health& Disaster Response

Staff Perceptionsof the Professional

Practice EnvironmentYour opinion counts!

Staff Perceptions of the Professional PracticeEnvironment surveys will be distributed this

month

Clinicians will receive a hard copy andan on-line version and may choose which

they’d prefer to complete

Clinicians who complete the survey (by hardcopy or on-line) will be eligible to receive oneof 40 gift certificates worth $25 to The MGH

General Store & Flower Shop

For more information, contact Eric Campbellat 726-5213

Jewish HighHoly Days

Schedule of Services

Friday, September, 22, 2006, 11:00amErev Rosh Hashanah: the Eve of the NewYearHayom Harat Olam: Today the World Wasand Is Created

Sunday, October 1, 2006, 3:00pmErev Yom Kippur: the Eve of the Day ofAtonementMinchah: Afternoon Service, Kol NidreRecitation

Friday, October 6, 2006, 11:00amErev Sukkot: The Eve of the Festival ofBoothsThe Waving of the Lulav and the Etrog(palm branch and citron)

Friday, October 13, 2006, 11:00amErev Erev Simchat Torah: The Eve of theCelebration of the LawThe Parade of the Copies of the Torah

Thomas Burke, MDdirector, MGH Center for Global

Health & Disaster Response

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Back issues of Caring Headlines areavailable on-line at the Patient Care Services

website: http://pcs.mgh.harvard.edu/

CaringCaringH E A D L I N E S


M

continued on next page

Entry-level physicaltherapist gains insight from

expert colleaguesSheila Pallotta is an entry-level clinician

Clinical NarrativeClinical Narrative

Some portions of this text may have been altered to make the story more understandable to non-clinicians.

y name is SheilaPallotta, and Ihave worked atMGH as an inpa-

tient physicaltherapist for the pastyear. During the first ninemonths, I was the pri-mary therapist workingon the Cardiac SurgicalService treating patientswho had undergone valvereplacements and coron-ary by-pass surgery.

Toward the end of myfirst rotation as primarytherapist on the CardiacSurgical Step-Down Unit,I was asked to consult ona pre-operative patient.Mr. P was a 68-year-oldman from out of statewho had experiencedprogressive fatigue overthe past 18 months. Hestruggled with re-accu-mulating pleural effu-sions (fluid accumulatingaround the lungs) andhad bacterial endocardi-tis (inflammation of thelining of the heart), whichrequired valve-replace-ment surgery.

When I first met Mr.P, I was struck by hisimpaired posture andhow short of breath hewas lying in bed at rest.His respiratory systemwas compromised due tothe pleural effusions com-pressing his lungs andimpacting his ability tocatch his breath. With the

help of a walker to easethe exertion of ambulat-ing to the bathroom, Mr.P remained fairly func-tional. He did rely on theassistance of his nursesto maneuver his lines andtubes as he moved aboutthe unit.

I decided my skillswould be best focused onMr. P’s impaired posture.The first day, when he saton the edge of the bed, Irealized his spine wasflexed so forward that hewas unable to look me inthe eye. Mrs. P explainedthat as Mr. P had becomemore ill, he spent most ofthe day sitting in a reclin-er and frequently fellasleep with his chin onhis chest for hours at atime. Due to severe neckpain, he had gone fromsleeping with one pillowbehind his head to threepillows in the past threemonths. In the hospital,Mr. P slept with the headof his bed elevated andtwo pillows behind hisneck. An MRI earlier inthe week had to be term-inated because Mr. P wasunable to lie flat on theexam table.

Knowing that Mr. Pwas awaiting cardiacsurgery, I was concernedthat he was unable to lieflat, because he’d need tobe intubated for surgery.Looking at Mr. P’s neck,

it was hard to imaginethey’d be able to fit atube down his airwaywith the amount of flex-ion he needed in order tobe comfortable. I alsothought that if Mr. P wasforced to lie down afterbeing anesthetized, hecould wake up in evenmore excruciating painthan he was already ex-periencing.

I spoke with my in-patient clinical specialistand together we decidedMr. P should be treatedfor his cervical spineissues the same as pa-tients we see in the out-patient setting. I wenthome that night and re-viewed the literature oncervical spine exams.The next day, I collectedall the data I needed todetermine the cause ofMr. P’s neck pain. Al-though it was a chroniccondition that had startedmore than three monthsago, he was in the acutephase of pain. He hadimpaired posture, limitedrange of motion, muscletightness, and muscletenderness with minimalpalpation. I also foundthat Mr. P was in a phaseof ‘muscle guarding’ thatmade any more than fivedegrees movement to hisneck intolerable.

Not knowing the bestway to treat Mr. P, I con-

sulted with a clinicalspecialist in the outpa-tient Physical Therapysetting, who specializesin treating spinal condi-tions. Together we review-ed the data I had collect-ed about Mr. P’s cervicalimpairments, and wewent to see him to deter-mine the best treatmentplan. We surmised thatMr. P’s pain was beingcaused by muscle guard-ing. If we could relax hismuscles he might feelsome relief, and it wouldallow us to improve hispostural alignment.

The clinical specialistexpertly performed man-ual therapy, and after 20minutes, Mr. P was com-fortable enough to liewith the head of his bedflat and with only onepillow. This change inposition was a huge im-provement, and if he wasable to tolerate it, he’d beable to comfortably makeit through surgery with-out increased neck pain.The clinical specialistworked with me to devel-

op my manual therapyskills, and with my newhands-on joint-mobiliza-tion and stretching tech-niques, I was able to treatMr. P effectively. Mr. Pdidn’t experience anynegative changes in hisposture or neck position-ing during the night, andwith daily manual ther-apy, he continued to seeimprovement in his align-ment, ability to sleep,and level of comfort.

I was able to educateMrs. P in some of thesoft-tissue techniques tohelp alleviate Mr. P’spain during evenings andweekends. In the end,Mr. P underwent success-ful valve-replacementsurgery without aggra-vating his cervical spine.

Mr. P’s case was aneye-opening experiencefor me during my lastmonth on the CardiacSurgery Service. I hadgotten into a routine ofseeing the same patientproblems over and over,and Mr. P helped me

Sheila Pallotta, PTphysical therapist


Clinical Narrativecontinued from previous page

challenge myself to learnmore. Also, I realizedhow important it is totreat the patient as awhole person, not just amedical diagnosis. Al-though Mr. P had manyother impairments, alle-viating his neck painallowed me to improvehis quality of life.

This case made merealize the advantages Ihave as a physical thera-pist working at MGH.Physical therapists aretrained to treat the wholebody, and as a new thera-pist I saw how importantit was to be thorough inmy initial examinationregardless of the reasonfor the consult.

It made me appreciatewhat it means to work ata world-class teachinghospital with so manyresources available to meand my patients. I wasable to consult a physicaltherapy spine specialistto assist me in treating apatient when I was un-sure of the best treatmentmyself. The environmentat MGH is one of themost challenging I haveever encountered, andone of the most reward-ing. I’m overwhelmed atthe new skills and know-ledge I acquire here.

I wish I had come tothis realization on myown, however, I creditmy inpatient clinicalspecialist, who diligentlypushed me to be detail-

Improving the Healthof Women

Perspective on women’s healthin the 21st century

presented by Vivian Pinn, MDdirector, Office of Research on Women’s

Health, National Institutes of Health

Wednesday, October 4, 200612:00–1:00pm

O’Keeffe Auditorium

A light lunch will be provided

For more information, call staff specialist,Mel Heike, RN, at 4-8044

oriented and allowed meto work on my own. Ittook caring for a non-routine patient for me torealize I still had a lot tolearn as a new therapist.Looking back on my firstweeks here, I’m almostcertain I would havetreated Mr. P differentlyhad I not had the benefitof the expertise of mycolleagues. It’s easy togloss over details, but tobe an excellent therapist,I’ve learned to listen tomy patients, constantlystrive to provide the bestpossible care, and not beafraid to ask for assist-ance.

Comments by JeanetteIves Erickson, RN, MS,senior vice presidentfor Patient Care andchief nurse

It’s so important for entry-level clinicians to sharetheir stories. There ismuch to be learned fromreflecting on care at ev-

Collaborativegovernance

membership driveOpen enrollment

September 1–October 15, 2006

Collaborative governance is theformal, multi-disciplinary, decision-making

structure of Patient Care Services.Its mission is to stimulate, facilitate, andgenerate knowledge to improve patientcare and enhance the environment in

which clinicians practice

Open HouseAttend a committee meeting any timeduring the month of September to see

collaborative governance in action(please notify a co-chair beforehand)

Ice Cream SocialCome get the ‘scoop’ on collaborative

governance!

Tuesday, September 26, 200611:00am–3:00pm

Under the Bulfinch Tent

Domestic ViolenceEducation andSupport Group

The Employee Assistance Program isoffering a confidential, ten-week educationand support group for women employees

who have been affected by domesticviolence, in past or current relationships.Weekly discussions will help members

understand the impact of domestic violenceon their lives and the lives of their children

while promoting strength and healing.The group is free, confidential, and opento all women employees of the Partners

HealthCare System

First meeting:Thursday, October 5, 2006

4:30–6:00pm

For more information and location, contactDonna at 617-726-6976 or 866-724-4EAP

ery level of competence.When Sheila first met

Mr. P, his posture imme-diately concerned her asa primary focus of treat-ment. She recognized theimplications for intuba-tion, ambulation, and Mr.P’s overall recovery. Sherecognized the need toconsult with an experi-enced colleague. Sheilasought out theoreticalknowledge on cervicalspinal exams and workedwith a clinical specialistto gain hands-on experi-ence. This is a wonderfulexample of clinical in-quiry, hands-on learning,and the important roleexperienced cliniciansplay in developing newclinicians.

Sheila is an entry-level clinician; she didwhat every novice shoulddo in the face of a clini-cally challenging situa-tion—she sought theguidance and consulta-tion of an expert col-league and based herinterventions on evi-dence-based practice.


y name is LyndaTyer-Viola, and Iam one of theperinatal clinical

nurse special-ists for the Vincent Ob-stetrical Service. I havebeen a member of the OBteam at MGH for the pastseven years. My career innursing has taken me allover the world, and itbrought me back to myhome, Boston, and thepractice I love, Obstet-rics.

As a clinical special-ist, my focus is on thecare of patients and theknowledge of nurses.Knowing how pregnancyaffects the body is veryimportant for obstetricalcare, because you’re car-ing for more than onepatient—the mother andthe unborn child. TheVincent Obstetrical Ser-vice was re-opened in1996 with a mission toprovide comprehensiveperinatal care. Althoughpregnancy is a normaloccurrence, it affectsboth the physical andemotional state of themother and family. Oftenour patient populationincludes women whohave complex medicalproblems in addition tobeing pregnant: cancer,cardiac disease, trans-plants, cystic fibrosis,HIV, and a host of otherchronic or terminal con-ditions.

Creating a birth ex-perience for women withcomplex medical needscan be challenging; thisis where the multi-fac-eted expertise of MGHclinical nurse specialistsshines. My role is to usemy knowledge, my com-munication and researchskills, and my bedsideexpertise to assist nursesthroughout the MGHcommunity to create asafe and healthy birthexperience. Let me tellyou about two of ourfamilies.

Ms. R was a comput-er specialist living in aBoston suburb. Ms. Gwas a wife and motherfrom Nigeria. Both wo-men believed they werehealthy and were excitedto be pregnant. Yet, bothfound they weren’t ashealthy as they believed.One knew she would oneday be a mother; the oth-er knew she should nevergive birth again. Bothwanted a birth experi-ence they would remem-ber for the rest of theirlives.

Ms. R and her hus-band had a life plan. Itincluded education, greatcareers, new home, andthen a family. Ms. R feltwell most days yet knewthat something was odd.Her elbow and shoulderwere sore especially aftera long day of computerwork. She didn’t think ithad anything to do with

her pregnancy. She hadbeen evaluated for astrain and was using ace-taminophen and heat toease the pain. One day,she went to pick up a boxand her humerus (upperarm bone) snapped. Inthe Emergency Room shewas told she had multiplefractures of her arm. Shewas devastated. Her jobdepended on her beingable to type, and with thebaby coming, she wantedto use her time off afterthe baby was born.

As it turned out, thebreak was the least of herworries. She learned shehad an invasive tumorand was referred to MGHfor evaluation. I wasasked by a nurses on theOncology Service to seeher regarding pain-man-agement. She had beentold that morning she hadmultiple myeloma.

Ms. R. was sitting upin bed. One arm was in asling; the other was drap-ed across her pregnantabdomen. There weregreeting cards, stuffedanimals, and a bookabout pregnancy on herbedside table. This wasnot a woman suffering;this was a woman withhope. I introduced my-self, and we talked abouther experience and pre-sent condition. I askedher to tell me her plans.She told me about herarm, the tests, and theneed for radiation.

I interrupted. “I’msorry,” I said. “I meantplans for your baby.”

Her eyes lit up. Shepatted her stomach andsaid, “No one asks meabout the baby.”

We talked about herstay at MGH, her painmedication, and her plansfor delivery. Having ga-thered what was impor-tant to Ms. R and herperceptions about hercare, the nurses and Idiscussed how we couldmeet her medical andpregnancy needs. Theoncology team fearedthat medicating her overa long period of timecould hurt the baby. Wediscussed physiologicalchanges during pregnan-cy and fetal circulation.It was important for Ms.R to be comfortable andmobile to increase per-fusion (transfer of fluids)to the baby and preventhemostasis. We plannedto have the OB nursingteam evaluate the fetalheart status daily, doprenatal teaching, and beavailable as a resource.

We also discussed theneed to acknowledge the

pregnancy. Ms. R felt noone asked about the babybecause of the cancer,and this was making heranxious. Acknowledginga mother’s perception isvery important duringpregnancy. Knowing thepatient, seeing her world,allows the nurse to pro-vide care that is uniqueand meaningful. Ms. Rneeded to be comfortablein order to heal and forher pregnancy to conti-nue to develop. Nursesneeded to know that Ms.R’s care was being tai-lored to the unique needsof her situation. I con-nected our OB resourcenurses with Ms. R’s careteam. Together, OB andoncology nurses develop-ed a care plan for a safeand comfortable delivery.My role as perinatal spe-cialist was to help blendthose two worlds so thenurses would be know-ledgeable and confidentin their care.

Mr. and Mrs. G werean animated couple fromNigeria. During her firstpregnancy, Mrs. G hadbeen short of breath and

Clinical Nurse SpecialistsClinical Nurse Specialists

Lynda Tyer-Viola, RNclinical nurse specialist

M

continued on next page

CNS role allows OBnurse to contribute on many

levels—by Lynda Tyer-Viola, RN, clinical nurse specialist


debilitated for manymonths. She had beendiagnosed with postpar-tum cardiomyopathy.Since coming to the Unit-ed States, she’d been treat-ed by a team of cardiolo-gists and had been ad-vised against becomingpregnant again due to therisk of cardiac problemsand potentially, death.

But Ms. G wantedmore children and hadbecome pregnant twoyears after the birth ofher twins. She wouldneed invasive cardiacmonitoring and the careof an ICU team. Our goalwas to enable her familyto experience the birthwith her while ensuring

invasive monitoring ofthe mother’s heart, on theother, the sound of a fast-beating fetal heart. Theroom was abuzz. Staffwere enjoying the cama-raderie and sense of com-mon purpose. I preparedthe OB staff for thechanges that would occurin Ms. G’s hemodynamicstatus during labor andpotential deviations andeffects on the fetus. Thenurses enjoyed caring forMs. G as a joint special-ized team and were im-pressed with the exper-tise each had in theirrespective specialties.Despite being one of themost high-risk patients atMGH, Ms. G had a prob-

lem-free birth with herhusband at her side.

The multi-facetedrole of clinical specialistallows me to influencecare from the perspectiveof clinical expert, educat-or, and researcher. Nurseswho don’t practice inObstetrics fear they mayharm the baby if theygive the mother treat-ments such as chemo-therapy or pain medica-tion. Integrating the ethicthat ‘caring for the mo-ther is caring for the baby’can be distressing. Often,there’s no way to knowthe best practice. Evi-dence-based practice inObstetrics requires inte-grating existing know-ledge within the clinicalcontext and state of preg-nancy. Applying relevantknowledge and evaluat-

ing outcomes informs ourcare for the next patient.Involving staff in theplan of care allows usall to share experientialknowledge in a way thatcontinuously informspractice. As a CNS, Icultivate these discus-sions and use best prac-tices to improve systemsand design care. Ourhospital-wide and ICUcollaborations are be-coming more frequent,and they always presentextraordinary learningopportunities.

I recently earned adoctorate degree in Nurs-ing Research. My pro-gram of study focuses onthe care of HIV-positive,pregnant women andperinatal depression.Though this is a discretepopulation, women with

Clinical Nurse Specialistcontinued from previous page

chronic diseases whogive birth represent abroad spectrum of theobstetrical population.

Current research tellsus HIV-positive, preg-nant women suffer emo-tional distress, fatigue,and the stigma of givingbirth when there’s achance they could trans-mit HIV to their babies.Nurses play a vital rolein the care of people withchronic disease. Conduc-ting research from theperspective of a clinicalcare provider allows meto translate literature intopractice and continuous-ly mine for meaningfulresearch questions at thebedside. The CNS roleallows me to make a dif-ference in the lives ofpregnant women andthose who care for them.

her intensive care needswere met. My role was todevelop a plan that couldbe activated whenevershe went into labor. Thisrequired educating andcoordinating a multi-disciplinary team thatcould be activated anytime of the day or night.In collaboration with theSurgical Intensive CareUnit (SICU) team, wecreated a plan for Ms. Gto be induced in theSICU. The family wasgiven a tour of the unitbefore her scheduledvisit. Ms. G and her hus-band were very anxiousand felt that all the ‘fuss’wasn’t necessary. Ms. Gmet some of the nursesand on the day of herdelivery, the OB andSICU teams were wellprepared. The set-up ofthe room was amazing;on one side there was

he American

Association of

Retired Persons

(AARP), the

leading non-profit

organization for peo-

ple over the age of 50

in the United States,

has named MGH one

of the best employers

in the country for

workers over 50. Only

two organizations in

Massachusetts were

included on the list;

the Massachusetts

Institute of Technol-

ogy (MIT) was the

other.

AARP started this

program six years ago to

acknowledge companies

and organizations that

provide programs and

policies that address

issues affecting older

employees. With an ag-

ing workforce, programs

for older employees have

increasing value in to-

day’s marketplace.

MGH was selected

because of the programs

and services we offer

that serve mature work-

ers as well as younger

employees. Training and

career-development pro-

grams, health benefits

for current employees

and retirees, a wide range

of options for retirement

plans, financial-planning

services, flexible work

hours, and special ac-

commodations to the

work environment to

meet the needs of all

employees are just some

of the reasons MGH was

selected by the AARP.

Says Jeff Davis, se-

nior vice president for

Human Resources, “The

MGH workforce over

the age of fifty has grown

through retention of

current employees

and hiring of new

employees over the

age of 50. We value

our mature staff for

their broad range of

life experiences,

knowledge, exper-

tise, and the value

they bring to the

MGH community.

Receiving this honor

from the AARP dem-

onstrates our com-

mitment to being an

employer that meets

the work-life needs

of all employees.”

MGH recognized by AARP as oneof best employers for workers over 50

T


n an effort toimprove the ef-fectiveness ofcommunication

among caregivers,one of the 2006 Na-

tional Patient SafetyGoals instructs hospitalsto, “Implement a stand-ardized approach to hand-off communications.”

There are many typesof hand-offs in a hospitalsetting, including: changeof shifts, coverage forbreaks, patient transfersto other areas such as thePost Anesthesia CareUnit, Radiology, the ICU,among others.

Hand-offs can occurat any time during the

course of care; they canbe temporary or perma-nent; they can be of var-rying durations. Imple-menting a standardizedapproach to hand-offsmeans establishing aconsistent process forgiving and receiving in-formation that limitsinterruptions and pro-vides an opportunity fordiscussion between theclinicians involved. Theintention of this PatientSafety Goal is to ensureaccurate information isexchanged about a pa-tient’s care, treatment,condition, recent or anti-cipated changes, and oth-er relevant information.

MGH has developeda policy called, “Trans-ferring Responsibility ofCare.” Every hand-offshould follow a specificformat called SEAM.

S: Summary of thepatient’s status, includ-ing identification, re-sponsible physician,diagnosis, and status oflife-sustaining ordersEA: Every Active clin-ical issue, includingrecent changes andanticipated eventsM: Management ofactive clinical issuesand planned next stepsHand-off communica-

tions should be verbal(preferably face to face)and direct whenever pos-sible. At the time of hand-off, clinicians should

Quality & SafetyQuality & Safetydescribe how to accessthe written informationavailable to all providers.Hand-off communica-tions should be interac-tive, uninterrupted, con-fidential, and allow forverification and ques-tions.

Our “Safe TransportPolicy,” says that, “Allpatients transferred froma care unit will be assess-ed to determine theirstatus related to transfer.All pertinent clinicalinformation will be docu-mented by the clinicianproviding care to the nextclinician responsible fortheir care.”

Nurse manager, Kath-leen Myers, RN, andAndrew Karson, MD,represent Nursing andMedicine on an inter-disciplinary group work-ing to ensure compliancewith the new hand-offpolicy. A script has been

Ensuring safe ‘hand-offs’at every juncture

—by Katie Farraher, senior project specialist, Office of Quality & Safety

Ideveloped to help clini-cians adhere to the infor-mation they need to ex-change when transfer-ring responsibility for apatient’s care.

Patient hand-offsrepresent one of the mostprevalent opportunitiesfor break-downs in com-munication among care-givers. And communi-cation break-downs canlead to an interruption inthe continuity of care.All caregivers are respon-sible for providing accu-rate, thorough informa-tion about their patients’care.

Use the SEAM ap-proach to ensure yourpatients’ safety whentransferring responsi-bility of care.

For more informa-tion about SEAM orpolicies regarding transferof care, call Katie Far-raher at 6-4709.Third Annual Kidney

Care DayThursday, October 5, 2006

8:00amO’Keeffe Auditorium

Medical Grand Rounds“Epithelial Sodium Channel Function andDysfunction: Revisiting Diuretic Therapy”

presented by Bernard Rossier, MDUniversity of Lausanne, Switzerland

9:00am–2:00pmMain Corridor

Information tables with representativesfrom the Center for Renal Education, Renal

Associates, Hemodialysis, PeritonealDialysis, Social Services, Food & Nutrition

Services, and the Transplant Service

Come learn about the resources availablefor patients with kidney disease and meet

some of the professionals in thosespecialty areas

For more information, contactLaurie Biel, RN, at 617-720-1317

Hand HygieneGloves do not provide a perfectbarrier

Gloves can have microscopicholes or tears that are invisible tothe naked eyeGerms can pass through those holes

How well do gloves prevent handcontamination?

The good news is, gloves are70–80% effectiveThe bad news is, gloves are only 70–80% effective

Gloves do not protect you from germs already present onyour skin

Gloves provide a protective covering for your skin, but theyalso create a warm, moist environment where bacteria on yourskin can multiply, especially when gloves are worn forextended periods of time

Use Cal Stat before and after glove use

Stop the Transmissionof Pathogens

Infection Control UnitClinics 131726-2036

September 21, 2006

September 21, 2006

Next Publication Date:

October 5, 2006

Published by:

Caring Headlines is published twice eachmonth by the department of Patient Care

Services at Massachusetts General Hospital.

Publisher

Jeanette Ives Erickson RN, MS,senior vice president for Patient Care

and chief nurse

Managing Editor

Susan Sabia

Editorial Advisory Board

ChaplaincyMichael McElhinny, MDiv

Editorial SupportMarianne Ditomassi, RN, MSN, MBAMary Ellin Smith, RN, MS

Materials ManagementEdward Raeke

Nutrition & Food ServicesMartha Lynch, MS, RD, CNSDSusan Doyle, MS, RD, LDN

Office of Patient AdvocacySally Millar, RN, MBA

Orthotics & ProstheticsMark Tlumacki

Patient Care Services, DiversityDeborah Washington, RN, MSN

Physical TherapyOccupational Therapy

Michael G. Sullivan, PT, MBA

Police, Security & Outside ServicesJoe Crowley

Public AffairsSuzanne Kim

Reading Language DisordersCarolyn Horn, MEd

Respiratory CareEd Burns, RRT

Social ServicesEllen Forman, LICSW

Speech, Language & Swallowing DisordersCarmen Vega-Barachowitz, MS, SLP

Volunteer, Medical Interpreter, Ambassadorand LVC Retail Services

Pat Rowell

Distribution

Please contact Ursula Hoehl at 726-9057 forquestions related to distribution

Submission of Articles

Written contributions should besubmitted directly to Susan Sabia

as far in advance as possible.Caring Headlines cannot guarantee the

inclusion of any article.

Articles/ideas should be submittedby e-mail: [email protected]

For more information, call: 617-724-1746.

Please recycle

hen cooking, mostof us have followed

a recipe at one timeor another. I find the

most tedious and time-consum-ing part of cooking is measuringall the ingredients. A cup of this...a tablespoon of that... a handfulof something else.

I’ll bet you’d be surprised tosee 462 pounds of flaked tuna onyour list of ingredients for tunasalad. Well, at MGH, that’s aneveryday occurrence for Food &Nutrition employees who workin the Ingredients Room.

The Ingredients Room is acritical part of food productionin the department of Food &Nutrition Services. Employees

in the Ingredients Room are re-sponsible for slicing, dicing,weighing, and measuring all theingredients for all 150 recipesprepared there daily. They por-tion out ingredients and distri-bute them so that each cook hasexactly what he/she needs tocomplete a given recipe.

Each year, almost 94,000pounds of flaked tuna are pre-pared; 30,000 pounds of ham-burger; and 53,000 pounds ofturkey. Up to 40 fruit-and-cheese platters are prepareddaily, which accounts, in part,for the 20,500 cantaloupes slic-ed annually and the 7,800 hon-eydew melons. Some countriesdon’t consume that much!

Food & NutritionFood & NutritionHow many employees does

it take to manage the volumeof food prepared in the Ingre-dients Room at MGH eachday? Forty people? Fifty? Ty-pically, eight employees staffthe Ingredients Room everyday (nine on a good day) andtwo on weekends. This is askilled and talented group ofemployees that functions at ahigh level of order and effi-ciency.

So, the next time you go tothe fish counter at your localgrocery store, imagine askingfor 14,000 pounds of scrod,12,000 pounds of salmon, or15,000 pounds of tuna. (That’sa lot of omega-3 fatty acids.)

For more information aboutthe Ingredients Room, or anyof the other services providedby the department of Food &Nutrition Services, contactSusan Doyle at 6-2579.

A cup of this...a tablespoon of that...

—by Susan Doyle, senior manager, Patient Food ServicesW

In the Ingredients Room are (l-r): Judith Higginbotham, Gary Montout,Sing Tosi, Ellie Flore, Jamie Valentin, and Neslie Exilus. Not pictured:

Kenrick Harvey, Stephen Russell, Jean Gelin, Mike St. Jusin, David Hall


n Wednesday,August 23, 2006,eight registered

nurses were rec-ognized for complet-

ing the intensive MGH-IHP New Graduate Nursein Critical Care Program.The integration of thesenew professionals intopractice brings the totalnumber of graduatesfrom this program to 99.Certificates of comple-tion were presented to:Kristen Bradley RN;Lindsay Waller, RN;Meaghan Kanser RN;Aileen Schiller, RN; Hal-ary Patch, RN; JessicaFellman, RN; KathrynLizotte, RN; and BiojaPires, RN.

Speaking at the cere-mony, nurse manager ofthe Coronary Care Unit,Colleen Snydeman, RN,congratulated partici-pants on meeting therigorous and demandingchallenges of the pro-gram. After thankingpreceptors and unit-bas-ed nursing leaders fortheir expertise and sup-port, Snydeman acknow-ledged senior vice presi-dent for Patient Care,Jeanette Ives Erickson,RN, medical directors ofthe ICUs, and clinicianswho taught in the pro-gram for their generoussupport.

Speaking on behalf ofher fellow graduates,Halary Patch, RN, readher narrative describingthe nursing care she pro-vided to a woman who

had suffered cerebralanoxia and eventuallybecame an organ donorwhile a patient in theEllison 9 Cardiac CareUnit. Patch describedhow she came to ‘know’her comatose patientthrough a developingrelationship with herhusband. This knowledgeenabled her to effectivelyadvocate for, coach, anddevelop an individualiz-ed plan of care for boththe patient and her hus-band.

Patch’s dedication tothe comfort and well-being of the family wasexemplary. She thrivedunder the expert guid-ance of preceptors, KatieSwigar, RN; Lisa Davies,RN; and Kathy Carr, RN.

Swigar spoke abouther five years of experi-ence coaching new nursesand shared some pearlsof wisdom, like the im-portance of collaboratingwith senior staff to faci-litate meaningful patientassignments during ori-

Education/SupportEducation/Supportentation. Carr, who hasmentored new nursessince the program beganin 2001, described theimportance of balancingguidance with enoughspace to allow the newnurse to develop an inde-pendent clinical practice,experience success, anddevelop confidence. Carremphasized that a pre-ceptor’s knowledge ofthe new nurse’s strengthsand her own comfortwith relinquishing con-trol are key for optimalbalance.

Coordinators of theNew Graduate Nurse inCritical Care Program,Miriam Greenspan, RN,

and Laura Mylott, RN,spoke about the uniquepartnership that precep-tors and new graduatesform during the six-month program, and howcritical that relationshipis to the successful trans-ition of the new nurseinto practice.

For more informationabout the New GraduateNurse in Critical CareProgram, contact thenurse manager or clinicalnurse specialist in any ofthe ICUs, or call LauraMylott at 4-7468. Forapplication information,call Sarah Welch or Da-vid Pattison in HumanResources at 6-5593.

ONew Graduate Nurse in Critical

Care Program graduation—by Laura Mylott, RN, New Graduate Nurse in Critical Care Program

New graduates (l-r; back row): Bioja Pires, Jessica Fellman,Meaghan Kanser, Aileen Schiller, and Lindsay Waller

(front row): Kathryn Lizotte, Halary Patch, and Kristen Bradley

Educational OfferingsEducational Offerings September 21, 2006September 21, 2006

2006

2006

When Description Contact HoursMGH School of Nursing Alumni Homecoming ProgramO’Keeffe Auditorium

TBASeptember 298:00am–4:30pm

BLS Certification for Healthcare ProvidersVBK601

- - -October 38:00am–2:00pm

CPR—American Heart Association BLS Re-CertificationVBK401

- - -October 47:30–11:00am/12:00–3:30pm

Special Procedures and Diagnostic Tests: What you Need to KnowO’Keeffe Auditorium

TBAOctober 68:00am–4:00pm

End-of-Life Nursing Education ProgramBurr 6 Conference Room

TBAOctober 10 and 138:00–4:30pm

Congenital Heart DiseaseYawkey 2220

4.5October 107:30am–2:00pm

New Graduate Nurse Development Seminar ITraining Department, Charles River Plaza

6.0(for mentors only)

October 118:00am–2:30pm

Intermediate ArrhythmiasHaber Conference Room

3.9October 118:00–11:30am

Pacing ConceptsHaber Conference Room

4.5October 1112:15–4:30pm

OA/PCA/USA ConnectionsBigelow 4 Amphitheater

- - -October 111:30–2:30pm

16.8for completing both days

Oncology Nursing Society Chemotherapy-Biotherapy CourseYawkey 2220

October 12 and 198:00am–4:00pm

Pediatric Advanced Life Support (PALS) Certification ProgramTraining Department, Charles River Plaza

- - -October 12 and 13Day 1: 7:30am–4:00pmDay 2: 8:00am–1:00pm

- - -Advanced Cardiac Life Support (ACLS)—Provider CourseDay 1: O’Keeffe Auditorium. Day 2: Thier Conference Room


Nursing Grand Rounds“Zambia Nursing Project.” Haber Conference Room

1.2October 1811:00am–12:00pm

Nursing Grand RoundsO’Keeffe Auditorium

1.2October 121:30–2:30pm

Chaplaincy Grand Rounds“Guided Imagery.” Sweet Conference Room

- - -October 1711:00am–12:30pm

Intra-Aortic Balloon Pump WorkshopDay 1: SRC-3110; Day 2: VBK607

14.4for completing both days


New Graduate Nurse Development Seminar IITraining Department, Charles River Plaza

5.4 (for mentors only)October 258:00am–2:00pm

CPR—American Heart Association BLS Re-CertificationVBK401

- - -October 267:30–11:00am/12:00–3:30pm

Psychological Type & Personal Style: Maximizing YourEffectivenessTraining Department, Charles River Plaza

8.1October 268:00am–4:30pm

Nursing Grand Rounds“Pulmonary Hypertension.” O’Keeffe Auditorium

1.2October 261:30–2:30pm

BLS Certification–HeartsaverVBK601

- - -October 318:00am–12:00pm


ecently, theWhite 12 andEllison 12Neuroscienceunits welcomed

students froma number of nursing pro-grams in the region tolearn more about thespecialty of neurosciencenursing. The studentsfunctioned as patient careassociates, supporting thecare of acute and complexneuroscience patients.The experience was apositive and rewardingone for patients, staff,and students. In a note tonurse manager, Ann Ken-nedy, RN, student, Karo-line Grogan from St.Anselm’s College wrote,“Thank-you for the in-credible opportunity yougave me this summer. Ilearned so much everyminute I was there. Thenurses and patient careassociates were so help-ful and valuable in mylearning experience. Ialready miss everyone Imet.”

To thank the studentsfor their interest and con-tributions, they wereinvited to participate in aday-long conference onneuroscience diagnosesand professional prac-tice. Ann Kennedy, RN;Marion Phipps, RN; Jean

Neuroscience unitsinvesting in the future

—by Ann Kennedy, RN, nurse manager

Education/SupportEducation/Support

Fahey, RN; Patri-cia Galvin; andJackie Somerville,RN, provided stu-dents with an ar-ray of perspectiveson caring for pa-tients in the neuro-science setting.

R

Jean Fahey, RN, clinical nurse specialist (center), givesstudents an up-close look at the care of neuroscience patients.

Above, students review information in a classroom setting

CaringSend returns only to Bigelow 10

Nursing Office, MGH55 Fruit Street

Boston, MA 02114-2696

First ClassUS Postage Paid

Permit #57416Boston MA

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