aringFebruary 20, 2003 CCaringHEADLINES Collaborative governance Inside:

Collaborative Governance celebrates milestone 5-year Dinner ...... 1 anniversary Jeanette Ives Erickson ...... 2 z “Hope for Courage”

Fielding the Issues ...... 3 z Fire Safety and Required Training

New PCS Website ...... 4

Collaborative Governance .... 6 z Annual Dinner and New Members

Exemplar ...... 8 z Barbara Sprole, RN

Magnet Hospital Update ..... 10

Clinical Nurse Specialst ...... 12 z Patricia Connors, RN

Fire Safety Awareness ...... 13

Job Shadow Day ...... 14

Educational Offerings ...... 15

Birthday Surprise! ...... 16

In foreground: members of the PCS Diversity Steering Committee stand to be recognized. Superimposed, are (l-r): Jeanette Ives Erickson, RN, senior vice president for Patient Care; Trish Gibbons, RN, associate chief, The Center for Clinical & Professional Development; and Dottie Jones, RN, senior nurse scientist.

MGH Patient Care Services Working together to shape the future Jeanette Ives Erickson February 20, 2003 ‘Hope for Courage’ A holiday keepsake; a credo for our times his past holiday friendship, to try to season, I receiv- Saying, “My patient is reconnect with a coun- ed a gift that, in ready for discharge. Who try and a people from Taddition to being will I care for next?” whom we’ve been es- beautiful, really gave me These are acts of cou- tranged for many years. pause to reflect. Even rage. I recently attended now, weeks after pack- I think of the mem- an event here in the hos- ing it away, I’m still bers of our IMSuRT pital that shed light on thinking about it. The and DMAT teams (the The Islam Project, a gift was a crystal orna- International Medical- national initiative to ment engraved with the promote understanding Jeanette Ives Erickson, RN, MS Surgical Response team senior vice president for Patient words, “Hope for Cou- and the Disaster Medi- and education about Care and chief nurse rage.” cal Assistance Team) Islamic beliefs and cus- As I thought about toms. Many of you who stand ready to an- lence at all levels of clin- shy away from when it those powerful words joined me in learning swer unknown calls for ical practice. comes to ensuring the etched into that delicate- about the Muslim cul- help. They have self- PCS leadership along safety and well-being of ly cut glass, it reminded ture. We heard sobering lessly volunteered to with key individuals our patients. me of the challenges accounts of what it’s put themselves in harm’s throughout the organi- What do all these we’re facing right now been like for Muslims way, without even ask- zation are working to- examples have in com- as a society. No one living in our community ing what that harm may gether to formulate a mon? Courage. They all knows better than those in the days and months be. They have been call- solution to capacity- require that strength of of us who work in health since September 11th. ed, they have responded management issues. human spirit to which I care, the frailty and MGH nurses are well, and they will be To date, 19 nurses referred earlier. They all strength of the human working in Africa, bring- called again. have completed our reflect a fierce commit- spirit. No one sees it New Graduate Critical ment of which we can more vividly than we Care Nurse curriculum, be proud. And they all do. No one feels it more and 14 others are en- set a standard to which palpably than we do. Courage is the price that Life exacts rolled in the program healthcare providers ev- It’s that combination of for granting peace. right now. erywhere aspire. frailty and strength that The soul that knows it not, knows no To date, 36 nurses We are navigating gives birth to courage. release from Little things. have completed the through uncertain times. It’s knowing you’re MGH-Northeastern As we continue to break vulnerable, but stepping —Amelia Earhart University Periopera- new ground, set new up anyway. It’s know- tive Certification Pro- standards, and face the ing you could fail, but gram, and 8 others are challenges before us, I taking the chance any- ing education and treat- As I write this, a currently enrolled. pray for peace... and way. ment to the areas hard- team of MGH employ- Clinical narratives ‘Hope for Courage.’ I think of MGH and est hit by the HIV/ ees, in concert with a have become part of our Patient Care Services, AIDS epidemic. Update local non-profit organi- professional culture. and I ask myself: Is this We are in the pro- I’m pleased to announce zation, is in Cuba on a Every issue of Caring a place where courage cess of applying for that Walter Moulaison, humanitarian-aid visit Headlines contains an resides? You bet it is! magnet hospital certi- RN, has been appointed bringing much-needed exemplar written by a The simple act of fication, the highest co-director of the Anti- medical equipment, sup- PCS clinician, and clin- coming to work every recognition bestowed coagulation Therapy plies, and books to re- ical narratives are an day is courageous. Ad- by the American Nurse Program along with Ro- plenish badly depleted important component vocating for your pa- Credentialing Center. bert Hughes, MD, who schools and libraries. of our annual perform- tients, challenging the We have implement- had been sole director of This team of health pro- ance review process. status quo, going that ed a comprehensive, the program. Walter will fessionals, educators, We are constantly extra mile to ensure that multi-disciplinary clin- continue to serve as nurse business leaders and exploring new ways to every patient receives ical recognition program manager for the White 9 elected officials is on a improve patient care. the best possible care. that recognizes excel- General Medicine Unit. mission of peace and There’s no challenge we

Page 2 Fielding the Issues February 20, 2003

Fire safety and annual MGH-Timilty Science Fair required training The MGH-Timilty Partnership Program is hosting its annual Science Connection Showcase. Question: Why is it nec- Jeanette: This question as new risks or concerns Students from the James P. Timilty Middle essary to participate in needs to be answered are identified by you, School who have been working closely with quarterly fire drills? We according to each em- your colleagues, or man- their MGH mentors will present their science all receive fire-safety ployees work assign- ager. projects to the MGH Community. training during orienta- ment. All employees The MGH-Timilty Partnership Program is part of tion. should review fire, elec- Question: How do I know the MGH Community Benefit Program. trical, and infection- what annual retraining I Jeanette: Familiarity should be taking? March 4, 2003; 9:00-11:00am with procedures ensures control training. But Main Corridor that we can perform additional training may Jeanette: Specific re- them properly when be required in chemical, quirements for safety needed. Fortunately, we radiation or mechanical and other types of re- rarely encounter a real hazards depending on an quired training are avail- The Employee Assistance fire emergency, so we employee’s specific work able from your manager Program don’t have many oppor- environment. It’s impor- and may also be found in tunities to test our know- tant to remember that your departmental Policy Work-Life Lunchtime Seminar Series presents ledge of those proced- safety training is intend- and Procedure Manual. ed to give employees the ures. If we regularly re- Question: If I identify a “Strategizing Your Financial Future” knowledge and awareness view our fire-safety train- workplace hazard, whom Presented by Dee Lee, CFP, MBA ing, there’s a much better they need to recognize should I contact? This seminar will help you manage all the chance that we will re- and manage workplace Jeanette: It’s always best components (investing, debt management, spond appropriately if/ hazards. to refer a safety concern taxes and estate planning) of your financial plan. when the need arises. Question: How often do to your manager, who in Tips will be provided for prioritizing your goals, General fire-safety pro- I need safety training? turn can refer it to one identifying investment income, grams may cover fire of the hospital commit- and minimizing debt. extinguishers and evac- Jeanette: Safety training tees or the department uation principles, but should be undertaken as Thursday, March 13, 2003 whose responsibility it is 12:00–1:00pm department-specific train- often as you feel you to address those issues. Wellman Conference Room ing includes the location need it; certainly often enough to keep the in- Occupational Health of extinguishers in your For more information, please contact the Employee Services, infection Con- area and evacuation and formation fresh in your Assistance Program (EAP) at 726-6976. trol, The Safety Office, other procedures specific mind. Once a year is a and The Hazardous Drug to your work place. good estimate, that’s why annual retraining require- Committee are just some Medical Grand Rounds Question: What types of ments have been estab- of the groups who play a safety training should lished within departments. role in maintaining the Restraint-Free Care employees receive? However, more frequent safety of our work place. training may be needed for Hospitalized Elders Presented By Neville E. Strumpf, RN, PhD, FAAN, Run for a Reason! Edith Clemmer Steinbright professor in Join the MGH Team Durant 2003 in support of the Gerontology and director of the Center for Thomas S. Durant, MD, Fellowship in Refugee Medicine Gerontologic Nursing Science University of Pennsylvania Throughout his life, Dr. Tom Durant exemplified the importance of humanitarian service to refugees and victims of war and disasters. The Lois K. Evans, RN, DNSc, FAAN, Thomas S. Durant Fellowship was established to honor Dr. Durant’s Viola MacInnes/Independence professor unique spirit of dedication and service. The Fellowship sponsors in Nursing and division chair, Family healthcare professionals who wish to serve refugee populations and and Community Health, University of victims of complex humanitarian disasters. Pennsylvania School of Nursing The 2003 Boston Marathon will be held on Monday, April 21, 2003. We Thursday, February 27, 2003 invite you to run with us or sponsor one of our runners. Our goal is to 8:00 – 9:00am raise $5,000.00 per runner. Please indicate your interest in joining Team O’Keeffe Auditorium Durant (as a runner or donor) by contacting Laurence Ronan, MD, at and Haber Conference Room [email protected] or calling Stacy Lewis at 617-724-3874. 1.2 contact hours Runners will be accepted on a first-come first-served basis. For more information, call 6-3111

Page 3 Resources February 20, 2003 resa Gallivan, RN, in- page features profiles cluded Eileen Flaherty, and photographs of Patient Care Services RN; Janet Quigley, RN; leadership and/or staff Wally Moulaison, RN; from those departments. unveils new website and Colleen Snydeman, Some departments with- —by Janet Madigan, RN, project manager RN. in PCS had existing web- The website is or- sites, and in those cases, fter a year of cess that began with a z provide a method of ganized under 11 main a link has been provided intensive plan- mandate from Jeanette internal communica- headings. Content for to the appropriate sites. ning, compiling, Ives Erickson, RN, se- tions for PCS staff each section was devel- The steering committee organizing and nior vice president for The steering commit- oped in collaboration wanted to ensure that Adesigning, the newly Patient Care, to develop with leadership and the website featured tee outlined the scope updated Patient Care the, “best Patient Care and timetable of the staff from each individ- actual staff of MGH, Services website was Services website in the project, approved the ual unit and/or depart- not stock photos; so the unveiled earlier this country.” A steering design elements and ment. Each unit page homepage and banners month. The new PCS committee was conven- navigational structure features profiles and were designed using website can be found at: ed in January of 2002, proposed by Alpha- photographs of the photographs of MGH www.mghpcs.org, and and began working with Strand, and developed a nursing leadership triad, employees. www.mghnursing.org, AlphaStrand Web, Inc. content outline for each and each department continued on next page or can be accessed from to develop a site that section of the site. A Members of the PCS Website the MGH homepage at: would achieve the fol- sub-committee of nurse Steering Committee: www.massgeneral.org, lowing goals: managers was asked to z Jess Beaham z Janet Madigan, RN by clicking on Depart- z assist in the recruit- develop a format for the z Megan Brown, HR (chair) ments and Programs, ment of PCS staff individual unit profiles and then Patient Care z showcase how care is z Marianne Ditomassi, RN z Sally Millar, RN and a template for the z Ellen Forman, LICSW z Steve Taranto, HR Services. delivered within PCS biographical sketches of z Theresa Gallivan, RN z Carmen Vega- This website is the z profile PCS depart- each leadership triad. z Trish Gibbons, RN Barachowitz, SLP culmination of a pro- ments and personnel This group, led by The-

Page 4 February 20, 2003

New Website z Nursing z Professional Resource z The Center for Clin- ‹ Yvonne L. Munn ‹ Cardiology/Cardiac Departments ical & Professional Research Program continued from page 4 Surgery ‹ Diversity Program Development z Clinical Recognition ‹ Central Resources ‹ Information Sys- ‹ Overview and Program ‹ Critical Care tems Organizational ‹ Program Overview The end result is a ‹ Emergency Depart- ‹ International Pa- Chart and Background website with more than ment tient Center (link to ‹ Award, Recognition ‹ Describing Practice 300 unique page loca- ‹ Medial International Pa- and Professional through Clinical tions, 5,100 links, 570 ‹ Neuroscience tient Center web- Certification Narratives external links, 210 pho- ‹ Oncology site) ‹ Blum Patient & ‹ Application Packet tographs; and 110 pro- ‹ Orthopaedics ‹ Management Sys- Family Learning for Clinicians and ‹ Perioperative tems Center (link to files of PCS staff mem- Clinical Scholars ‹ Psychiatry ‹ Medical Interpreters PFLC website) bers. Members of The ‹ Program Process ‹ Surgical (link to Medical ‹ Clinical Affiliations PCS Website Steering ‹ Levels of Practice ‹ Women & Child- Interpreters website) ‹ Clinical Recognition ‹ Frequently Asked Committee are con- ren’s ‹ Office for Patient Program Questions and fident they achieved z Health Professions Advocacy ‹ Collaborative Gov- Glossary of Terms their objective of creat- ‹ Chaplaincy (link to ‹ Office for Quality ernance Program ‹ Information and ing a website that is, Chaplaincy website) and Safety ‹ Continuing Educa- Discussion Sessions “Simply the Best!” ‹ Occupational Ther- ‹ Volunteer Depart- tion Offerings ment (link to Volun- Calendar z Blum Patient & Fam- The new PCS web- apy ily Learning Center site is structured as fol- ‹ Orthotics and teer Department ‹ Credentialing and website) Authorization (link to PFLC website) lows (with each major Prosthetics ‹ International Nurse z Caring Headlines (link Consultant Program to current and back ‹ Leadership Devel- issues) opment z Careers/Employment ‹ Links Opportunities (link to ‹ Orientation Pro- MGH Jobs) grams z What’s New (listing of ‹ Policies and Proced- What’s New topics) ures (link to Clinical P&P Manual in z Calendar of Events Trove) (link to CCPD Cal- endar of Continuing Education Offerings) For more information about the PCS website, call Janet Madigan, RN, project manager, at 6-3109, or check it out heading accessible from for yourself at: the homepage): www.mgh pcs.org. z About Patient Care Services ‹ Who We Are ‹ Our Vision ‹ Guiding Principles ‹ Strategic Goals ‹ Organizational Chart ‹ Leadership Team Biographies ‹ Physical Therapy ‹ Collaborative Gov- ‹ Reading Disabilities ernance ‹ Respiratory Care ‹ Professional Prac- Services tice Model ‹ Social Services (link ‹ Policies and Pro- to Social Service cedures (link to website) Clinical P&P Man- ‹ Speech-Language ual in Trove) Pathology

Page 5 Collaborative Governance February 20, 2003

increased my self-con- Collaborative governance kicks off fidence... and my desire to contribute to society,” year 6 with renewed commitment and, “Committee mem- bers have an increased and some new faces sense of involvement n Monday, Dorothy Jones, RN, and control over their February 3, Senior vice president to excellence. It’s good senior nurse scientist, practice.” 2003, mem- for Patient Care, Jean- to spend time with kin- shared the results of the Trish Gibbons, RN, Obers of the seven ette Ives Erickson, RN, dred spirits.” collaborative govern- director of The Center collaborative governance welcomed committee Ives Erickson asked ance evaluation survey, for Clinical & Profes- committees came toge- leaders and members to the members of each which compared data sional Development, ther for the 5th annual the grand ballroom of committee to stand and collected in 1997, 2000, took the opportunity to collaborative gover- the Holiday Inn, saying, be recognized for their 2001, and 2002. The recognize Kim Chelf for nance dinner to cele- “In the wake of the shut- efforts over the past survey is designed to her dedication and en- brate the accomplish- tle tragedy, it is good to year and their willing- measure empowerment thusiasm in providing ments of 2002 and wel- come together with this ness to remain focused among collaborative seamless administrative come new members to group. It’s good to re- as we respond to the governance committee support for the collab- the committees. affirm our commitment issues that impact our members over time. orative governance pro- patients and affect all Jones reported a stati- gram. Gibbons present- who work in health stically significant im- ed Chelf with a bouquet care. “We can’t work provement in empower- of roses in appreciation. any harder,” said Ives ment scores of commit- January marked the Erickson, “so we need tee members since the beginning of a new term to learn how to work inception of collabora- for committee members. smarter. Your commit- tive governance and in The following individ- ment and positive en- subsequent years as well. uals from all disciplines ergy is what keeps pa- Some of the feed- within Patient Care Ser- tients choosing MGH back received in the vices, will be serving on and what makes MGH survey included com- collaborative gover- the number one employ- ments like, “Collabo- nance committees this er in Massachusetts.” rative governance has year (see opposite page).

Above: Trish Gibbons, RN, associate chief nurse for The Center for Clinical & Professional Development, presents staff assistant, Kimberly Chelf, with bouquet of flowers; At right: members of The Staff Nurse Advisory Committee, stand to be recognized at this year’s annual collaborative governance celebration dinner.

Page 6 February 20, 2003

2003 Collaborative Governance Staff Nurse Advisory Patient Education Committee Committee Members and Leaders Committee Chair: Jeanette Ives Diversity Steering Ethics in Clinical Nusing Practice Co-chairs: Erickson, RN Committee Practice Committee Committee Carol Mahony, OTR/ Members: Co-chairs: Co-chairs: Co-chairs: Lori Pugsley, RN Kevin Babcock, RN Beverly Cunningham Sharon Brackett, RN, Patricia Atkins, RN, Pamela Wrigley, RN Wendylee Baer, RN (outgoing) (outgoing) (outgoing) (outgoing) Immacula Benjamin, RN Firdosh Pathan, RPh Theresa Cantanno, RN Jennifer Kelliher, RN Coach: Lynne Bozzi, RN Lourdes Sanchez Marilyn Wise, LICSW Catherine Mackinaw, RN Taryn Pittman, RN Maureen Brecken, RN Coach: Coach: Coach: Members: Kathy Callahan, RN Deborah Washington, RN Ellen Robinson, RN Joanne Empoliti, RN Audrey Kurash Cohen, Ed Ciesielski, RN Members: Members: Members: SLP Denise Coldwell, RN Claribell Amaya, RN Nancy Balch, RPh Susan Atamian, RN Kathleen Creedon, RD Susan Diehl, RN Christine Donahue Michelle Bedor, RN Patricia Atkins, RN Debbie Essig, LICSW Kendra Dolloff, RN Annese, RN Sharon Brackett, RN Carolyn Bartlett, RN Alyson Goodman Fran Donovan, RN Leila Carbunari, RN Diann Burnham, RN Cheri Boulanger, RN Dean Haspela, RN, SN Beth Fortini, RN Charlie Ciano Kristin Calheno, RN Diane Brindle, RN Deborah Jameson, RN Agnes Froio, RN Beverley Cunningham Leila Carbunari, RN May Cadigan, RN Janet King Charlene Gallagher- Mary Cunningham Lin-Ti Chang, RN Anita Carew, RN Mary Elizabeth McAuley, Cherwek, RN Suzanne Curley, OT Alex FM Cist, MD Diane Carroll, RN RN Laura Ghiglione, RN David Krebs Toby Coltin, LICSW Patricia Fitzgerald, RN Jacqueline Michaud, RN Steven Grondell, RN Jacqueline Lynch Connie Dahlin, RN Eileen Flaherty, RN Donna Slicis, RN David Heitt, RN June McMorrow, RN Nancy D’Antonio, RN Dale Ford, RN Angela Sorge, RN Rebecca Horr, RN Kathleen Myers, RN Alexandra Detjens Stephanie Fuller, RN Quality Committee Rebecca Johnston, RN Judith Newell, RN Pamela DiMack, RN Susan Gavaghan, RN Jane Kleinjian, RN Ivonny Niles, RN Regina Doherty, OTR/L Julie Goldman, RN Co-chairs: Jacqueline Lally, RN Elisabeth Nolan Danielle Doucette, RT Grace Good, RN Ann Eastman, RN Daria LeSanto, RN Reverend Felix Ojimba Laurene Dynan, RN Kathleen Gottbrecht, RN Paige Nalipinski, SLP Anne LeTendre, RN Barbara Olson Kathy Evans, RN Pam Griffin, RN Coach: Jamie Liu, RN Georgia Peirce Jeanne Flannery, RN Mary Guanci, RN Lynda Tyer-Viola, RN Patricia Lynch, RN Donna Perry, RN Barbara Guire, RN June Guarente, RN Members: Mary MacLeod, RN Judith Pines Regina Holdstock, RPh Amy Guillemin, RPh Maureen Buckley Christine McCarthy, RN Marianne Williams, RN Jennifer Howard, RN Judy Gullage, RN Dawn Crescitelli, RN Joshua McGee Audrey Jasey, RN Sioban Haldeman, RN Lindsay Davidson, RN Patricia McGrail, RN Nursing Research Sharon Kelly-Sammon, RN Margie Johnson, RN Joan Fitzmaurice, RN Mary McKinley, RN Committee Cynthia LaSala, RN Patty McNamara, RN Patricia Flanagan, RN Hilda Morrison, RN Co-chairs: Martha Lynch, RD Ellen Pantzer, RN Nancy J. Kelly, OT Paula Nelson, RN Catherine Griffith, RN Deborah Lynch-Roden, RN Kathy Pollara, RN Mary Anne Killackey, RN Maura Neville, RN Kathy Grinke, RN Regis MacDonald, RN Edna Riley, RN Susan McKay, RN Gail Nilsson, RN Susan Jaster, RN (out- Phil McGaugh Jane Ritzenthaler, RN Linda Pelletier, RN Susan O’Brien, RN going) Brenda Miller, RN Martha Root, RN Joanne Peters, RN Charlene O’Connor, RN Coach: Christine Mitchell, RN Emilia Rudowski, RN Patricia Pires, RN Gayle Peterson, RN Joan Agretelis, RN Denise Montalto, PT Joyce Saturley, RN Elena Pittel, RN Amanda Ramos, RN Members: Sally Morton, RN Jayne Sexton, RN Judy Sacco Erin Riley, RN Mary Campbell, RN Rebecca Murphy, LICSW Rechelle Sprague, RN Sue Sheridan, RN Janet Roche, RN Elise Gettings, RN Jennifer Orcutt, RN Jean Stewart, RN Kimberly Smith Julie Robinson, RN Annmarie Hayes, NP Gayle Peterson, RN Amanda Todd, RN Laura Sumner, RN Brenda Girasella Donna Hills, RN Susan Ricci, RN Aileen Tubridy, RN Kathleen Tiberii, RN Schwartz, RN Robin Holloway, RN Lois Richards, RN Barbara Walsh, RN Julia Whelan Nyla Shellito, RN Susan Jaster, RN Jo-Anne Riley, RN Patricia Wright, RN Heidi Simpson, RN Mary Lou Kelleher, RN Joseph Roche, RN Patricia Simoes, RN Diane Ladd, RN Naline Stewart, RN Amie Sokolowski, RN Committee Leaders co-chairs: Mary Larkin, RN Maureen Thomassen, RN Trish Gibbons, RN, associate chief, CCPD Amy Sozanski, RN Mary Lou Lyons, RN Althea Wagman-Bolster, Erin Timoney, RN Dorothy Jones, RN, senior nurse scientist, CCPD Talli McCormick, RN SLP Staff Assistant: Kimberly Chelf Susan Tower, RN Donna Plunkett, RN Susan Warchal, RN Linda Younie, RN Heather Vallent, RN Brenda Woodbury, NP Karen Zoeller, RN

Page 7 Exemplar February 20, 2003 Nurse’s practice informed by being ‘on the other side of the curtain’ My name is who knew him very was in the parking lot at Barbara Sprole well. That’s when I met the beach because he and I have been Roy and his amazing couldn’t catch his breath. M a staff nurse family. I remembered how hot in the Medical Intensive Initially, I was ner- it had been that day and Care Unit (MICU) for vous about taking care I felt badly that he’d three years. I have seen of a CF patient. I didn’t had to go through that. I many patients and fam- know very much about met his wife, mom, dad Barbara Sprole, RN, staff nurse, ilies through the worst the disease, especially and sister. They were Medical Intensive Care Unit of times. Because of the in the adult population. all so supportive and high level of acuity in I had taken care of other gracious. I liked them they wanted, even dur- curtain. It was horrible, the MICU I am accus- adult CF patients, but right away. ing procedures. I quick- but I learned something tomed to working with only after they’d been I left for the day, not ly got to know the whole so valuable through that patients near death, but transplanted with new expecting to see Roy family. We chatted about experience. The one I have not been desen- lungs. When I walked when I got back. I as- our families, restaurants, thing I wanted most sitized by the losses into his room and met sumed he’d be trans- shopping, music, and when my mom was ill I’ve seen people endure. Roy, it was clear that he ferred to a unit in my anything else that was was information. I want- Rather, I have been in- was incredibly know- absence. The next day, I on our minds. I looked ed to be treated like I spired in so many ways ledgeable about his dis- was shocked and upset forward to seeing them was an important part by my patients and ease. He was friendly to find that he was still every day. I enjoyed of the healing process. I their families. I have and talkative, despite in the MICU, and even their company. And I vowed that I would do seen kindness and gen- the fact that he was more shocked to learn shared some of my per- my best to treat the erosity in situations often short of breath. that he’d been intubat- sonal experiences with families of my patients where anger and frustra- He kept staring at the ed. I knew that intuba- them as well. with the respect and tion would have been oxygen saturation levels tion for a CF patient My mother has been kindness that I wanted understandable. There on his monitor. He even was bad because they sick for two years with so desperately when is one family in partic- took off his nasal can- are rarely able to be cancer. Last year after my mother was sick. ular that touched me nula a few times to see extubated. It was a hor- one of her many surger- My nursing practice both personally and what his saturation was rible feeling to be talk- ies, she suffered compli- changed for the better professionally. on regular air. Roy had ing to a patient one day cations and ended up in as a result of that exper- On an evening shift spent his whole life and then see him so an ICU in a hospital in ience back in August, I was being in control of his seriously ill the next. Pennsylvania. It was As the days, weeks, assigned to a patient disease, and being in the His family was absolute- the worst experience I and months progressed, who had just arrived ICU was not going to ly devastated. Roy’s ever had. My mother Roy had his share of from a community hos- change that. parents, who were from was in an ICU bed just ups and downs. He was pital. He was a 35-year- I wondered why out of state, had taken like one of my patients, extubated and re-intub- old man with cystic Roy was in the ICU, up residence at the Hol- and I was absolutely ated several times. He fibrosis, who had sus- because he looked too iday Inn near the hospi- helpless. I wanted to was on and off BiPap (a tained a spontaneous healthy to be there. The tal. His parents and his have control, I wanted ventilation support sys- pneumothorax while at majority of MICU pa- wife were at his bedside to take care of her, but I tem). Eventually, as the beach with his wife tients are intubated and day and night. I had couldn’t. I was no long- options were exhausted, and 3-year-old son. He sedated, so I enjoyed never seen such dedica- er a nurse; I was a daugh- he received a tracheost- was taken to a hospital having a patient I could tion before. I did my ter, and I needed to let omy after much consid- where they placed a have a conversation best to accommodate the nurses and doctors eration by his team and chest tube, and shortly with. He told me about them during their long do their jobs. For the his family. His secretions thereafter was trans- the events leading up to stays in the MICU. I first time, I experienced were extremely difficult ferred to MGH to be his hospital admission, allowed them to stay in what it felt like to be on to manage. He required followed by his CF team including how scared he the room for as long as the other side of the continued on next page

Page 8 February 20, 2003 vigorous chest PT three It was wonderful, of the generosity and glazed, and he was back I have taken so much times a day, monitoring later, to see him finally warmth this family on maximum ventilator away from my experi- by physical therapists, able to get out of bed, showed me during their support. I sat down ence with Roy and his nurses, and respiratory walk around, and eat. It time at MGH. with Roy’s dad and we wonderful family. The therapists. So much looked like he was going In November, Roy talked. We both knew importance of family teamwork and collabo- to make it to transplant rallied again. With some this was it. The next involvement in the cri- ration went in to giving after all, and it was no finely tuned changes in morning I called and tical care environment is Roy the best care pos- surprise to me that his ventilator settings and spoke to Roy’s primary paramount to healing and sible. The CF team was family members were sedation, he was back nurse, but he had al- relieves some of the help- always available to help willing to risk their per- on track. He was more ready passed. lessness that is inevitable manage his care in col- sonal well being to be alert and able to work That night was the when loved ones are cri- laboration with the med- living donors for him. with physical therapy. I annual holiday party tically ill. The human ical team. We worked as I received a call from ran into his family in for the nurses, doctors connections I have made hard as we could to get Roy’s primary nurse the cafeteria one day and staff of the MICU in situations of hardship Roy better. one day in late October. and they invited me up and RACU. I talked to and pain have been in- Our goal was to get Roy was not doing well. to his room for a birth- Roy’s nurses for a long valuable. Although I deal Roy well enough to His blood gases were day party for his son time. We toasted him with the inevitable loss receive a lung trans- getting worse every day who was turning four. and his family. It was a of human life in the plant. He finally made and no amount of chest Roy looked weak and bittersweet event. We MICU, I continue to be it out of the MICU, and PT or antibiotics could emaciated but was de- were really going to encouraged and resolved was transferred to the stop the downward termined to get into the miss them. that I have the ability to RACU on Bigelow 9. I spiral. I went up to see chair for the party. His Roy’s memorial ser- make a difference. remember giving report him, and things looked son was so excited about vice was held at the Comments by to his new primary grim. For the first time a train set he had re- country club where he Jeanette Ives nurse and specifically since he arrived at MGH ceived. He handed it to had celebrated his 35th Erickson, RN, MS, talking about his unique his heart, once consist- Roy, and I remember birthday just last year. senior vice president family dynamics. I told ently tachycardic, was how heartbroken I felt So many people came for Patient Care and her how involved his down in the 60s. We that he could barely lift to celebrate his life that chief nurse family was, and how thought this was the it. We all continued to there was standing room This is a wonderful nar- great they were. It had end. His family was hope that Roy was on only. His sister spoke rative about teamwork in truly been a pleasure exhausted. I recall his his way to getting a eloquently about Roy the delivery of patient taking care of Roy and mom saying she felt like transplant. and his many talents, care. And not just team- his family. I was sad to she was in a dream, no- Nutrition continued strengths and his deter- work among caregivers, see them go, but I knew thing seemed real. to be a problem for mination to live his life but partnering with the Roy would be in good I tried to keep the Roy. He was down to without the constraints patient and family to hands. The nurses in the conversation light. I less than 100 pounds of a chronic illness. I maximize the support RACU were great. I was mentioned that I was and was in constant learned about the per- and involvement of the always welcomed for going to be running in need of tube feeding. son he had been before entire team. visits and they kept me the Cystic Fibrosis Foun- The decision was made he became so ill. His Barbara’s experience updated on his pro- dation’s Annual Hallo- to place a gastric tube. dad thanked me for tak- with her own mother gress. ween Run that night. None of us knew that ing care of all of them informed her practice as In the RACU, Roy And that night, as I ran this would be the be- while Roy was sick. He she cared for this family continued to have more through the streets of ginning of the end for went on and on about at this critical time in complications. He re- Boston in my fairy cos- Roy. how I made a difference, Roy’s illness. She knew turned to the MICU tume, I was greeted by I received a call from and how much they first-hand the impor- twice for various rea- Roy’s mother and sister. Roy’s primary nurse appreciated my kind- tance of keeping them sons. He suffered other It made my night! I was letting me know he was ness. I told him I had informed, and she main- pneumothoraces, had a so touched that they not doing well. We fear- only reciprocated the tained that level of com- very difficult time with waited out in the cold to ed he wouldn’t rally kindness they had shown munication even after anxiety management, cheer for me. I couldn’t again. When I visited me. Roy’s family is Roy was transferred to and adequate nutrition believe they were going Roy, it looked to me as such an inspiration. If the RACU, creating a was a constant issue. I through such a horrible though he’d already left love, commitment, and seamless support system visited him and his fam- time and still had the this world. He hadn’t compassion were med- for Roy and his family. ily frequently in the kindness to think of regained consciousness icine, Roy’s family Thank-you, Barbara. RACU. someone else. And since receiving the gas- surely could have saved that’s just one example tric tube. His eyes were his life.

Page 9 Magnet Hospital Update February 20, 2003 cal practice is a rich and Articulating our z identify and resolve living manifestation of impediments to our professional prac- clinical practice and tice model. professional practice model answer the question, To help clinicians —submitted by the Magnet Steering Committee “What systems need better articulate the fin- further refinement, er points of their prac- s we move for- our professional prac- Through our profes- and what resources tice, we are providing a ward in our pre- tice model in (the Sep- sional practice model, are needed for the review of our profes- parations for the tember 19, 1996) issue we: advancement of sional practice model Magnet site visit of Caring Headlines. z delineate the know- expertise in clinical along with some sample Ain the spring, it’s im- She explained that the ledge embedded in our practice?” questions you might portant that we be able model encompasses all practice and answer z define strategies that expect when the Mag- to articulate the many the important work the question, “How encourage and cele- net appraisers visit facets of our practice. being done within Pa- do we acknowledge brate professional your unit (see opposite One topic the Magnet tient Care Services, but and capture clinical development and page). Please use this appraisers will want to maintains the identity expertise?” answer the question, review as a springboard hear about is our pro- and integrity of each of z describe our process “How do we acknow- for discussions with fessional practice model the individual profes- of skill acquisition ledge, celebrate, and your colleagues and the and how we translate sional disciplines. A and answer the ques- reward clinical exper- Magnet champions on the components of that professional practice tion, “How do we tise?” your unit. The more we model into our practice. model is not a stagnant create an environment talk about our practice, As you may recall, thing; it is designed to for continuous learn- More than six years the better able we are to Jeanette Ives Erickson, evolve over time as cli- ing and capture op- after the first iteration capture the intricacies RN, senior vice presi- nicians continue to learn portunities to teach of our professional and complexities of the dent for Patient Care and develop as profes- and share our know- practice model, we can important work we do. Services, first described sionals. ledge?” truly say that our clini-

Lauren Holm, RN, staff specialist (standing), facilitates group discussion with staff nurses at recent Magnet Champion Retreat.

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Values a comprehensive descri- Professional Practice Model Our values are derived ption of what we be- from our vision state- lieve, and it helps us ment, a statement that articulate our practice Values Philosophy Standards was shaped by nurses to others. of Practice who practice at MGH. z Share our philosophy As clinicians, we ensure with your nursing and that our practice is car- non-nursing colleagues. ing, innovative, scienti- Professional Standards Development fic, empowering, and Collaborative Patient Care of Practice Decision-Making Delivery Model based on a foundation Standards of Practice of leadership and entre- exist to ensure that the preneurial teamwork. highest quality of care Philosophy is maintained regardless Privileges, Research Descriptive Our philosophy state- of the number of pro- Credentialing, Theory Models ment is a formal expres- fessionals providing Peer Review sion of the values, prin- care, or the experience ciples, and beliefs that of those professionals. support the individual- z Can you identify ized work of each dis- some of our standards Collaborative Professional Research cipline within Patient of practice? One Governance Development Nursing practice is bas- Care Services. A draft of example would be our By participating on the Professional Develop- ed on scientific research. our philosophy state- Nursing Practice seven committees that ment is essential to our A ‘spirit of inquiry’ ment was originally Guideline for Risk for currently comprise our ability to provide qua- advances our knowledge shared in Caring Head- Impaired Skin Integ- staff-led collaborative lity care. and enhances the quality lines at which time all rity governance structure, z How do staff on your of the care we deliver. staff had an opportu- z Do you know where nurses at MGH have a unit use the resources z What research studies nity to comment on, and to find our standards strong voice in deci- available from The have influenced your help craft, the paragraph of practice? sions that affect their Center for Clinical & practice? that would become a z Are there any stand- practice. Professional Develop- z Are any nurses on lasting statement of our ards specific to the z Can you name the ment? your unit currently philosophy of care. Our patients you care for seven committees? z How do nurses on participating in a philosophy statement is on your unit? z Who are the repre- your unit share in- research study? sentatives on formation with col- z Did you know that Our philosophy statement your unit who leagues when they there are 21 doctoral- serve on com- return from profes- ly prepared nurses at We believe that the essence of nursing mittees? sional conferences? MGH? They are an practice is caring. Caring that is zHow do you invaluable resource in Privileging, ... a science and an art share your an environment that Credentialing, and ...deliverable, teachable, researchable concerns and values research-based Peer Review …accomplished with wisdom, knowledge, stay informed practice. Our requirements around compassion, and competence. through commit- privileging, credential- We believe the clinical practice of nursing is built tee representa- Descriptive Theory ing, and peer review on a scientific base tives. Models ensure that our patients ...evaluation of nursing practice is a At MGH, we’re always Patient Care and their families re- professional responsibility looking for new ways to Delivery Model ceive quality care from ... critical thinking and scientific inquiry are essential inform our practice. We The foundation of competent providers. to the improvement of practice. subscribe to a variety of the care we pro- z Why is it important We believe we have the responsibility to theories in support of vide is an interdis- to have a system of ...educate ourselves and others our nursing care. ciplinary, patient- privileging, creden- ...expand our knowledge and expertise z Can you identify any and family-cen- tialing, and peer ...share our growing body of knowledge, and theories of practice tered model. review? ...provide such opportunities to the greater that inspire the way zWhat does this z How does this sys- healthcare community. you deliver care on look like on your tem support nurses your unit? unit? and protect patients?

Page 11 Clinical Nurse Specialists February 20, 2003 Clinical nurse specialist as collaborator —by Patricia M. Connors, RNC, MS, WHNP he role of clini- cal nurse spec- (VAC) therapy has been tion. It’s worth noting ialist has been called for in a few in- that this patient had Tdescribed as one stances, and since this been under psychiatric of educator, consultant, is not a treatment com- care, but substance abuse researcher, and collabora- monly used on obstet- had never been an issue, tor. On any given day, a rical units, Ann has ex- and her psychiatrist had CNS may perform in plained the physiology always found her to be any or all of these roles. of the healing process compliant. It is a diverse and often with this technique and In talking with the challenging position supported staff as they staff and trying to offer Patricia Connors, RN, helping staff carry out cared for patients. It some guidance, I decid- clinical nurse specialist the most appropriate has been a great learning ed to consult with a plan of care for their experience for all in- psychiatric CNS to help Lynda Tyer-Viola, her third trimester she patients. As a perinatal volved and an example formulate a plan for RN, Marylou Lyons, was admitted with ven- clinical nurse specialist, of how we sometimes how best to care for RN, and I are perinatal tricular tachycardia, I have found it neces- need to pool our know- this patient. Tina Gulli- clinical nurse specialists which was monitored in sary to seek the advice ledge to facilitate the ver, RN, responded and for the Obstetrical Ser- the 200+ range. She of my colleagues who best outcome. within an hour we had vice, and we are often described lightheaded- specialize in areas less Last summer, pain- an impromptu meeting, called upon when preg- ness with these episodes familiar to me. In so management was an which resulted in staff nant women are hospi- that had become pro- doing, I have been able issue for an antepartal verbalizing their frus- talized on other units. gressively worse. The to demonstrate to staff patient despite the in- trations and Tina pro- We have been asked to patient was visited every the importance of col- volvement of the Pain viding a greater under- visit patients on Oncol- day by a member of the laborating with other Management Team. standing of the patient’s ogy, Neurology and in obstetrical medical and disciplines. This patient was having behavior. She stressed the medical and surgical nursing team, and as her Occasionally, patients difficulty understanding the importance of con- intensive care units. In delivery date drew clos- are re-admitted to the the plan of care and tinuity and consistency this way, we share our er, her plan of care and OB Unit with wound didn’t think people ful- in the message being expertise with other delivery was discussed infections following a ly appreciated the level given to this patient members of the health- by her nurses, obstetri- Cesarean section. Most of discomfort she was concerning the manage- care team. We may be cian, cardiologist, anes- of the time, patients experiencing. She react- ment of her medica- called on to assess a thesiologist, and neona- respond well to antibi- ed angrily to caregivers tions. It was decided fetal heart, teach a pa- tologist. We provided otics and prescribed when attempts were that the patient was to tient about what to ex- patient education to wound care. However, made to discuss her be included in the plan, pect when she goes into prepare her for a Caes- when a wound shows pain-management. It’s and if she deviated from labor and prepare her aren section, which was resistance to healing not often that staff on what had been mutually for delivery. Educating to be the mode of deliv- properly and the integ- the obstetrical unit en- agreed upon, she would staff about the anato- ery. The patient had rity of the surrounding counter this kind of be reminded of the ag- mical, physiological and labored and deliverd her tissue becomes vulner- challenging behavior. reement. Staff became emotional changes of first child vaginally, but able to further break- Staff was frustrated and more confident in their pregnancy is important due to her cardiac status down, it has been neces- the patient only became approach to this patient, as these changes can during this pregnancy, sary to seek the exper- more resistant. Several and, I believe, more se- greatly affect the recov- she was scheduled to tise of other CNSs. times she wouldn’t al- cure in their nursing ery process when a co- have an operative deliv- Wound care specialists, low a nurse to enter her care since they had a morbid situation exists. ery. I met several times Joan Gallagher, RN, and room because she was better understanding of The Coronary Care with the patient as did Ann Martin, RN, have tired of ‘retelling her the dynamics behind the Unit was home for sev- my colleagues, and we shared their knowledge story’ and trying to patient’s behavior and a eral weeks for a woman discussed not only the with me and my staff. convince people she concrete plan of care. who was pregnant with different procedures she Vacuum-assisted closure needed more medica- her second child. During continued on next page

Page 12 Published by: Caring Headlines is published twice each month by the department of Patient Care Services at Massachusetts General Hospital. February 20, 2003 wareness Publisher A Jeanette Ives Erickson RN, MS, senior vice president for Patient Care Raising awareness about and chief nurse Managing Editor/Writer fire safety and burn prevention Susan Sabia Editorial Advisory Board urses from the Bigelow “It’s only a couple of days Some tips included: staying Chaplaincy 13 Burn Unit took turns before Valentine’s Day,” said in the same room whenever Mary Martha Thiel staffing an educational Gina Cenzano, RN. “We want candles are lit; placing candles Development & Public Affairs Liaison N booth in the Main to make sure everyone is well out of reach of children and Georgia Peirce Lobby on Wednesday, Febru- informed of the dangers before pets; and keeping all matches Editorial Support ary 12, 2003, in an effort to they cuddle up in front of a and lighters in high, locked Marianne Ditomassi, RN, MSN, MBA raise awareness about fire safe- roaring fire or sit down to a cabinets where children won’t Mary Ellin Smith, RN, MS ty and burn prevention. candlelight dinner.” be tempted to play with them. Materials Management Edward Raeke Nutrition & Food Services Patrick Baldassaro Martha Lynch, MS, RD, CNSD Office of Patient Advocacy Sally Millar, RN, MBA Orthotics & Prosthetics Eileen Mullen Patient Care Services, Diversity Deborah Washington, RN, MSN Physical Therapy Occupational Therapy Michael G. Sullivan, PT, MBA Police & Security Joe Crowley Reading Language Disorders Carolyn Horn, MEd Respiratory Care Ed Burns, RRT Bigelow 13 nurses, Gina Cenzano, RN, (left) and Brook Morgan, RN, staff Burn Safety table in the Main Social Services Lobby during Burn Prevention Awareness Week. Ellen Forman, LICSW Speech-Language Pathology Carmen Vega-Barachowitz, MS, SLP Volunteer, Medical Interpreter, Ambassador CNS Her successful, uneventful The MGH Nursing and LVC Retail Services Alumnae Association Pat Rowell continued from previous page delivery of a healthy baby boy was the culmination of all of presents Distribution our efforts. Nursing Update 2003 Please contact Ursula Hoehl at 726-9057 for would need prior to surgery It has been my experience all issues related to distribution (prep, foley catheter, intraven- in my seven years at MGH The Operating Room of The Future ous placement with a potential that clinicians here possess a Framingham Heart Study Submission of Articles arterial line), but also the sup- wealth of talent and expertise MGH and Disaster Written contributions should be port she would receive during that they are unselfishly will- Childhood Cancer submitted directly to Susan Sabia as far in advance as possible. her time on the labor and de- ing to share. Providing the best Gerontology/Psychiatry Caring Headlines cannot guarantee the livery unit. The patient was possible patient care is our March 28, 2003 inclusion of any article. appropriately concerned about primary goal and that is so 8:00am–4:30pm Articles/ideas should be submitted her well-being and that of her obvious when I call upon my O’Keeffe Auditorium in writing by fax: 617-726-8594 unborn baby and needed re- colleagues or they seek my or e-mail: [email protected] assurance that the whole team assistance. The CNS fosters 7.2 contact hours. For more information, call: 617-724-1746. was aware of her status and collaboration and in so doing Cost: $40 what needed to be accomplish- serves as a role model for the For more information, Next Publication Date: ed for the optimal outcome. next generation of nurses. call 617-726-3144 March 6, 2003

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Please recycle Student Outreach February 20, 2003 Students get up-close look OTR/L, to speak with Says Peterson, “Every- the students about what one was so helpful. I it’s like to work as an think the students were at careers in health care occupational therapist, given a realistic look at ayle Peterson, regular topics at our chance to bring students what level of education what it’s like to work in RN, staff nurse meetings. Jeanette [Ives to our unit.” is required, and the im- health care. And I think on Phillips Erickson] has always Peterson planned a pact that occupational they liked what they saw.” House 21, has promoted the idea of whole morning of edu- therapy can have on Students, Monet Gbeen a member student outreach and cational activities for patients after injury or Evans, Kelen Silva, and of The Staff Nurse Ad- educating our youth the students and enlist- illness. Shannon Sousa, came visory Committee since about careers in health ed the aid of her col- Students had a chance from East Boston High its inception in 1997. care. So when I saw the leagues, Michael Flynn, to observe nurses work- School as part of the Says Peterson, “Reten- e-mail about Job Shadow RN, and Janice Camer- ing with patients. They MGH-Boston Public tion and recruitment are Day, I jumped at the on-Calef, RN. visited the Ether Dome, School Partnerships Pro- Peterson invited the MGH Chapel, and gram coordinated by the occupational thera- the Back-Up Day Care MGH Community Ben- pist, Daniel Kerls, Unit. efit Program.

(Clockwise from top left): Flynn and Cameron-Calef with students in Ether Dome; Kerls (third from left) talks to group about occupational therapy; Cameron-Calef and Peterson with students in Ether Dome Museum; Peterson and student, Monet Evans, with patient, Paul Mousseau, on Phillips House 21.

Page 14 8:00–4:30pm February 21(Day1) 1:30–2:30pm February 20 1:30–2:30pm February 19 When/Where 8:00am–4:30pm March 13 1:30–2:30pm March 12 8:00am–2:30pm March 12 8:00–4:00pm March 7(Day1) 1:30–2:30pm March 6 1:30–2:30pm March 6 12:00–3:30pm 7:30–11:00am, March 6 8:00am–4:30pm March 4 8:00–4:30pm February 28 1:00–2:30pm February 27 7:00am–12:00pm February 27 7:30–11:30am; and12:30–4:30pm February 27 10:00am–2:00pm (Pediatric) 8:00am–12:00pm (Adult) February 27 7:30am–4:00pm and 11 February 26,27,March3,4,10, 8:00am–2:30pm February 26 8:00–4:30pm February 26 10:00–11:30am February 20 E E For detailedinformationabouteducational offerings,visitourwebcalendarathttp://pcs.mgh.harvard.edu. To register, call( ducational ducational For informationaboutRiskManagement Foundationprograms, checktheInternet at O’Keeffe Auditorium End-of-Life NursingEducationProgram more information,call724-9115. “Children fromFamilieswith Alcoholism andSubstance Abuse.” For Social ServicesGrandRounds O’Keeffe Auditorium Nursing GrandRounds Description Bigelow 4 Amphitheater USA EducationalSeries Training Department,CharlesRiver Plaza Patients, OurselvesandEach Other Introduction toCulturallyCompetent Care:UnderstandingOur Bigelow 4 Amphitheater OA/PCA/USA Connections Training Department,CharlesRiverPlaza New GraduateNurseDevelopmentSeminarI O’Keeffe Auditorium CCRN ReviewDay Haber ConferenceRoom Commission Accreditation Shared Vision–New Pathways: A New Approach toJoint O’Keeffe Auditorium Nursing GrandRounds VBK 401 CPR—American Heart Association BLSRe-Certification WolffNEMC Auditorium, Chemotherapy ConsortiumCoreProgram O’Keeffe Auditorium Cancer NursingUpdate2003 VBK 601 Conflict ManagementforOAsandPCAs VBK 601 CVVH CoreProgram Wellman ConferenceRoom Pediatric TraumaUpdate VBK 401(NoBLScardgiven) CPR—Age-Specific MannequinDemonstrationofBLSSkills BWH Core Program ICU ConsortiumCriticalCareintheNewMillennium: Training Department,CharlesRiverPlaza New GraduateNurseDevelopmentSeminarII Training Department,CharlesRiverPlaza Workforce Dynamics:Skillsfor Success O O fferings fferings Page 15 http://www.hrm.harvard.edu. Contact Hours for completingallsixdays for socialworkersonly 5.4 (formentorsonly) (for mentorsonly) February 20,2003 February 20,2003 617)726-3111. CEUs TBA TBA TBA TBA TBA 45.1 ------1.2 20037.2 6.0 1.2 6.3 Surprise! February 20, 2003 tion, but for their on- Perleberg turns 50; going commitment to nursing and to the pa- staff nominate him for tients of Phillips House 21. He thanked Jeanette Nurse of the Year Ives Erickson, RN, se- nior vice president for n a packed vis- ilies... Keith says that Patient Care, and Ther- itor’s lounge on ‘Nursing is not just a esa Gallivan, RN, asso- Phillips House profession, it is a call- ciate chief nurse, for I21, on Thursday, ing.’ To have our work their support and guid- February 13, 2003, framed that way is in- ance, and for the confi- staff surprised nurse spiring, and so is our dence they placed in manager, Keith Perle- nurse manager.” him in asking him to be berg, RN, with a surprise A genuinely surpris- nurse manager of Phil- 50th birthday party and ed Perleberg thanked his lips 21. news that they had nom- staff, not just for the Happy birthday, Moment of impact! inated him for Nursing party and the nomina- Keith! Spectrum’s Nurse of the Year award. Staff nurse, Nicole, Filosa, RN, read the letter of nomination, which captured many of the qualities and rea- sons they chose this means to observe Perle- berg’s ‘coming of age.’ Said Filosa, reading from the letter, “Keith creates an environment that focuses on what is best for the patient. His frequent presence and knowledge of the pa- tient help us achieve the goals we set. His creat- ive thinking and ability to seek out resources allow us to give the best Perleberg (center) with staff possible care to our of Phillips House 21 patients and their fam-

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