March 3, 2011 2011 Our Bicentennial Year; a Time to Look Back at Our Long and Storied Past

Headlines CaringMarch 3, 2011 2011 Our bicentennial year; a time to look back at our long and storied past

See Jeanette Ives Erickson’s column on page 2 and MGH Nursing Alumnae Association article on page 4

More than 8,000 operations were performed in the Ether Dome between 1821 and 1868. In the early days of nursing, the Ether Dome also served as a classroom for the MGH School of Nursing. (Photo provided by the MGH Nurses’ Alumnae Association)

The newsletter for Patient Care Services Massachusetts General Hospital Jeanette Ives Erickson

A brief history of Patient Care Services Commitment, service and leadership

n Friday, February 25, 2011, along with many of our colleagues, I had the privilege of attending the MGH and McLean Hospital charter re- newal ceremony at the Mass- achusetts State House in honor of the two-hundredth OOanniversary of the signing of legislation that founded our two hospitals. It was an inspiring occasion. I was Jeanette Ives Erickson, RN, senior vice president proud to be in attendance as we re-affi rmed our com- for Patient Care and chief nurse I was proud to mitment, “to tend to the health needs of Boston’s poorest, sickest and most vulnerable.” Cannon’s work was based on three fundamental be in attendance We’re almost three months into our bicentennial principles: providing patient-centered care; identifying and interpreting the psychosocial aspects of illness and as we re-affi rmed year, and I think we all feel that sense of history as we walk the halls of this great institution. We are the most placing the patient within the context of his family our commitment, recent stewards of one of the oldest and most revered and life; and teamwork, all disciplines working to- academic medical centers in the country. We have ev- gether to maximize good patient care. The concepts “to tend to the ery right to be proud of our contributions and the con- developed by Cabot and Cannon remain the guiding tributions of those who came before us — those who set principles of social work practice at MGH today (Look health needs of the bar high and who still challenge us to be the best for more on the history of Social Work in the March we can be. The histories of the professions that com- 17th issue of Caring Headlines). Boston’s poorest, prise Patient Care Services tell a powerful story of com- In 1905, Occupational Therapy (OT) was the fi rst mitment, service, and leadership. paramedical service offered within the broad scope of sickest and most The fi rst Social Services department in the country rehabilitation services at MGH. At that time, the fo- was founded right here at MGH in 1905 by Richard cus of OT was more recreational than remedial and not vulnerable.” Cabot, MD, and Ida Cannon. Cabot introduced the under any medical supervision. In the early days, a fi rst social workers into the outpatient setting, and clay-modeling class was offered, and later a cement Cannon joined the department after graduating from shop to help occupy handicapped men. the newly formed School of Social Work (now Sim- During World War I, OT was used to rehabilitate mons College). Cannon offi cially became director in soldiers, and that’s when the profession began to focus 1908 and held the position until she retired in 1945. on physical disabilities. During World War II, in the Together, Cabot and Cannon slowly integrated social period known as the Rehabilitation Movement, OT work into the inpatient setting. and PT were unifi ed into a single unit at MGH under continued on next page

Page 2 — Caring Headlines — March 3, 2011 Jeanette Ives Erickson (continued)

the direction of a physician. This was an active time In 1971, physical therapy became a key component of for OT as it was used to help soldiers returning from care in intensive and critical care units. war to be able to work again. In 1980, the MGH Institute of Health Professions ad- MGH opened the Baystate Rehabilitation Clinic in mitted its fi rst class to the Master of Science in Physical 1951, where the focus of OT was func- Therapy Program with the help of many ther- tional training, which later evolved apy leaders from MGH, including Nancy into ‘work therapy.’ Watts, BA Harris, Polly Cerasoli, and Colleen In 1960, occupational Kigin. We have every therapists began treating Physical Therapy expanded its presence to pediatric and developmen- the Chelsea and Charlestown health centers right to be proud of tally disabled patients, initi- in 1982 in collaboration with Roger Sweet, ating a move to two distinct MD, a staunch advocate for health care in our contributions areas of specializa- these then under-served communities. tion — physical disabilities The department welcomed it fi rst and the contributions and psychosocial dysfunction. board-certifi ed clinical specialists in 1985, In 1972, a team specializing and today boasts more than 40 board-cer- of those who came in hand and upper-extremities tifi ed specialist in all areas of PT was created comprised of occu- (Pediatrics, Geriatrics, Sports, before us — those pational and physical therapists, Orthopaedics, Cardiovascular & and in 2009, a clinic was opened Pulmonary, Neurology, and Women’s who set the bar in the Yawkey Building. Health). Since its inception in the In 1993, the Vestibular Rehabi- high and who still 1940s under the direction of Mary litation Program was created under challenge us to Nesbit, the Physical Therapy de- the direction of Kathleen Gill-Body, partment has shared a history of col- The original PT, in collaboration with Stephen be the best we can laboration with physicians and oth- MGH charter Parker, MD, and others. ers to bring essential services to pa- And over the past ten years, Physical be. The histories of tients and families. Most notably during the polio epi- Therapy has expanded its presence with practices at demics of the mid-twentieth century when Arthur MGH West, the Revere HealthCare Center, the Sports the professions that Watkins, MD, was chief of Physical Medicine, and Medicine Service (in 2006), and the BWH-MGH physical therapists played a pivotal role in caring for HealthCare Center at Foxborough (in 2009). comprise Patient patients with polio. continued on page 12 Care Services tell a powerful story of In this Issue

commitment, service, 2011: Our Bicentennial Year ...... 1 Clinical Narrative ...... 8 • Sarah Zumsande, RN and leadership. Jeanette Ives Erickson ...... 2 • A Brief History of Patient Care Services Dedicated Education Unit ...... 10 Looking Back at the MGH The Knight Center ...... 11 School of Nursing ...... 4 • Nurse Residency Program Quality & Safety ...... 6 Professional Achievements ...... 14 • The Importance of Filing Safety Reports Announcements ...... 15 Fielding the Issues ...... 7 • A Virtual Tour of the Lunder Building

March 3, 2011 — Caring Headlines — Page 3 MGH Nurses’ Alumnae Association

Looking back at the MGH School of Nursing 100 years after The Quarterly Record was ﬁ rst published — by Linda Lass Orrell, RN, and Susan Fisher, RN, MGH Nurses’ Alumnae Association historians

his year, coinciding with the • In 1895, graduates of the Boston Training School MGH bicentennial celebration, met in response to a call by Sophia Palmer and Mary the newsletter for the MGH E.P. Davis to organize an alumnae association. They Nurses’ Alumnae Association, felt “that the Boston Training School, being one of The Quarterly Record (now simply the ﬁ rst to be established in the country, its gradu- called, The Record), celebrates its ates known and appreciated, not only for their ex- 100th anniversary. Members of cellent training, but for their executive ability and the Alumnae Association have professional acumen as well, thought this the psychi- Reviewing old TTworked with the department of Nursing over the past cal moment, as it proved to be, to form such a soci- year to help create a written and pictorial history of ety, and thus enable its members to take part in all photographs and MGH nursing, which will be released later initiative movements that made for progress this year. Reviewing old photographs and or improvement. Eighty-one graduates re- documents was documents was quite literally a ‘walk sponded to the call…” (From the His- down memory lane’ for Alumnae tory of the Alumnae Association quite literally a ‘walk Association historians, Linda Lass Boston and Massachusetts General Orrell, RN, and Susan Fisher, RN. Hospital Training School for down memory Some of the nuggets they un- Nurses) earthed include: • In 1896, after nearly a quarter lane’ for Alumnae • In 1872, a group of concerned century of independent existence, Boston citizens led by Sarah the school came under the manage- Association Cabot came together to discuss a ment of the hospital, and the school need for trained nurses. Until that ofﬁ cially became the Massachusetts Gen- historians, Linda time, nurses had little to no formal train- eral Hospital Training School for Nurses. Lass Orrell, RN, and ing. The group included Cabot, Cora Shaw, • In 1911, 11 years after the Alumnae Asso- Martin Brimmer, and Mary E. Parkman. Parkman ciation was formed, more than 600 graduates prac- Susan Fisher, RN. later met with Florence Nightingale to seek advice ticed throughout North America, Europe, Africa, on starting a training school in Boston. and the Philip pines. In order to maintain contact • In 1873, based on the Nightingale model, the with graduates and share information about MGH, Boston Training School for Nurses opened at MGH. The Quarterly Record was created and sent to gradu- The Bellevue Hospital School of Nursing in New ates four times a year. Over the years, the name and Photo shows the pin of York and the Connecticut Training School for frequency of the publication have changed (cur- the MGH Training School Nurses in New Haven had started similar programs rently called, The Record). It has been published and School of Nursing months before, but though it was the third school of without interruption for 100 years by volunteer edi- its kind to open, it was the last to close. tors and funds from the Alumnae Association.

Page 4 — Caring Headlines — March 3, 2011 MGH Nurses’ Alumnae Associa tion (continued)

• In 1940, as the academic level of education elevated the curriculum to • In 1981, after 108 years, the MGH School of Nurs ing more than a training program, the school became known as the Massa- graduated its last class. chusetts General Hospital School of Nursing. And the Alumnae Associa- • In 1982, nursing education at MGH resumed when tion incorporated to become the Massachu setts General Hospital Nurses’ the fi rst class of nursing students entered the MGH Alumnae Associa tion, Inc. (MGHNAA). Institute of Health Professions Grad uate Program in • In 1965–1970, the advent of Medicare highlighted the importance of Nursing. nursing education and staffi ng. In 1960, MGH had 958 beds and only 278 • In 2004, The MGHNAA commissioned a sundial nurses. Units were staffed primarily by student nurses, but Medi care sculpture to be created in honor of nursing and pre- didn’t cover students. By 1970, the hospital had grown to 1,085 beds and sented it to MGH nurses during Nurse Week. Soon 650 nurses. At the same time, the American Nurses Association pushed after, the sculpture was installed where it stands today for nursing education to take place in academic settings, putting hospital- on the lawn outside Treadwell Library. based nursing programs at risk. • In 2009, The MGHNAA Board funded two new en- • In 1973, retired nursing director, Ruth Sleeper, urged MGH general di- dowments, the fi rst to the MGH Institute School of rector, John Knowles, MD, to seek degree-granting status for the hospital. Nursing to be used for scholarships and the second to • In 1977, the Massa chu setts Board of Higher Edu ca tion conferred degree- the department of Nursing to be used for nursing re- granting authority to the MGH Educational Divi sions, making it the fi rst search and education. hospital to receive such authority. This paved the way for the creation of • In 2011, the centennial issue of The Record was pub- the multi-disciplinary MGH Institute of Health Professions. lished in March.

In 1923, at a 50th anniversary celebration, nurses re-enact the founding of the School of Nursing with costumes depicting original committee members: Sarah Cabot, Cora Shaw, Martin Brimmer, and Mary E. Parkman. The identity of the fourth woman is not known.

(Images provided by the MGH Nurses’ Alumnae Association)

March 3, 2011 — Caring Headlines — Page 5 Quality & Safety One small safety report; one giant step for patient-safety — by Chris Callahan, RN, patient safety staff specialist, Center for Quality & Safety

ever underestimate the impor- While medically managing the drop in pressure, she tance of fi ling a safety report. noted that the bag on the transducer was fl at, not hold- Staff nurse, Courtney Gray, In August, 2010, staff nurse, ing pressure, and the machine was giving false readings. RN (holding certifi cate), and Courtney Gray, RN, of the She changed the bag several times with the same re- clinical nurse specialist, Susan Stengrevics, RN (center back), Ellison 9 Cardiac ICU, submit- sult. Gray was able to obtain a properly working ma- are recognized for their part ted a safety report to the Ed- chine from the Cath Lab then fi led a safety report de- in rectifying a patient-safety ward P. Law rence Center for scribing her experience. issue by fi ling a safety report. They are pictured below Quality & Safety (CQS) re- The report was triaged by staff of the Center for Qua - with colleagues on Ellison 9 lated to a malfunctioning piece of equipment. While lity & Safety to the departments of Medicine, Nurs ing, and representatives from the NNpreparing to transport a patient to the Cardiac Cath and Materials Management. During the investigation MGH Center for Quality & Safety and the PCS Offi ce Lab for a pulmonary-artery-line placement, Gray no- on the unit, clinical nurse specialist, Susan Stengrevics, of Quality & Safety. ticed the patient’s blood pressure drop signifi cantly. RN, reported that two of the bags had been from the same lot. She recommended pulling the lot from inventory to ensure patient safety. Mater ials Manage- ment pulled the lot and sent it back to the manufac- turer with a full account of what had happened. Chris Callahan, RN, CQS patient safety staff specialist, reported the event to MedSun, the medical product-safety branch of the Food and Drug Admini- stration that helps healthcare facilities, clinicians, and manufacturers rectify issues with medical devices to protect patient safety. On January 31, 2011, MedSun notifi ed MGH that it was being recognized for Outstanding Contribu tion in Promoting Patient Safety because, based on feed- back triggered by Gray’s safety report, the vendor iden- tifi ed ways to improve the manufacturing process. Certifi cates of appreciation were presented to Gray and Stengrevics in recognition of the important role they played in correcting this safety issue. Never underestimate the importance of fi ling a safety report. Improvement depends on staff recognizing safety issues and bringing them to the attention of the Center for Quality & Safety so they can be investi- gated. For more information, call 6-9282.

Page 6 — Caring Headlines — March 3, 2011 Fielding the Issues A virtual tour of the Lunder Building

Question: I know the Lunder Building is nearing comple- All patient rooms will be private. Units in the Lunder Build- tion. When will units move into the new space? ing will be approximately twice the size of a typical 36-bed unit in the Ellison Building. Jeanette: The move will happen in phases. Materials Man- agement is scheduled to move in July, and that’s also when the Question: Will we have to go outside to get from the main new Emergency Department ramp will open. Pro cedure areas campus to the Lunder Building? will move in August and September, and inpatient beds and Radiation Oncology will move in September. Jeanette: There will be access to the Lunder Building from the fi rst three fl oors of the Ellison Building. The new Bander Question: Which units will be moving to the Lunder Build- Bridge (already in place over Fruit Street) will connect the ing? Yawkey Building to the main campus via the second fl oor of the Lunder Building. Once construction is completed, you’ll be able Jeanette: The Emergency Department, Perioperative to go from Cambridge Street, through the Yawkey Building, Services, Radiation Oncology, and fi ve inpatient units will across the Bander Bridge, and through the Lunder Building to move to the Lunder building; the Sterile Processing Depart- the main campus, without going outside. ment and Materials Management will shift operations to Lunder, as well. Question: Will the Lunder Building be ‘green’? Radiation Oncology will re-locate to lower levels two and three, which will house six linear accelerators (linacs). Some Jeanette: Yes. The Lunder Building will have many green Radiation Oncology services will remain in the Cox basement). characteristics, including its Healing Through Nature design. Patients coming to the new ED will arrive in a sheltered An 1,800-square foot atrium will provide a peaceful and heal- courtyard area. ing atmosphere throughout much of the building, and green The new Sterile Processing Department will feature state-of- roofs will bring the green space to nearly half the building’s to- the-art equipment and support the sterile-processing needs of tal footprint. More than 60% of the building’s power supply will the entire campus. come from renewable power sources, and the facility is on track Perioperative services will occupy the second, third, and to receive LEED® (Leadership in Energy and Environmental De- fourth fl oors. A new blood bank and pharmacy will support 28 sign, an internationally recognized green building certifi cation state-of-the-art operating rooms and 34 perioperative bays serv- system) gold certifi cation from the US Green Building Council. ing orthopedic, neuroscience, vascular, Churchill, and general- surgical patient populations. Question: Is it possible to tour the new building before it Floors six through ten of the Lunder Building will be dedi- opens? cated to adult inpatient units with a total of 150 beds: • The Blake 12 Neuro ICU will move to Lunder 6 Jeanette: Yes. We’re in the process of planning employee • White 12 will move to Lunder 7 tours for the Lunder Building during its dedication week in • Ellison 12 will move to Lunder 8 June. For more information about the Lunder Building, go to: • The ninth and tenth fl oors will be medical oncology units http://www2.massgeneral.org/lunderbuilding/; send e-mails to with the tenth fl oor equipped for bone-marrow transplant [email protected] to pose questions to the Lunder patients Project Team; and look for updates in MGH publications and • Phillips 21 will move to Lunder 9 All-User E-Mails. • Ellison 14 will move to Lunder 10

March 3, 2011 — Caring Headlines — Page 7 Clinical Narrative

New nurse experiences ‘growing point’ caring for complex medical patient

y name is Sarah Zumsande, and I am a staff nurse on the Bigelow 11 Medical Unit. I’d like to tell you about Mr. B, a 79-year-old male patient I cared for this past year. Mr. B had a medical history signiﬁ cant for dementia, benign prostatic MM Sarah Zumsande, RN, staff nurse, Mr. B’s daughter hyperplasia, recurrent urinary tract infection with Bigelow 11 Medical Unit chronic indwelling catheter, and he’d had a cerebro- and granddaughter vascular accident (or stroke) that left him with residual Mr. B was started on IV antibiotics. Due to his increas- feared for his safety. weakness on his left side. Mr. B was brought to MGH ing confusion and history of stroke, Mr. B required a lot by his family from a rehabilitation facility. He had re- of assistance with activities of daily living (including He had been an cently been discharged from another hospital, but the bathing, toileting, feeding, etc.) and several safety pre- inpatient many family became concerned when he developed a tem- cautions such as a bed alarm and a 1:1 observer. Mr. B perature and was increasingly confused and agitated at could no longer walk due to the effects of his stroke times before, and night. Mr. B’s daughter and grand-daughter feared for and needed frequent turning and re-positioning to pre- his safety. He had been an inpatient many times be- vent skin breakdown. His speech was garbled, and he they knew the risks fore, and they knew the risks associated with confu- was on a dysphagia diet and aspiration precautions due associated with sion. When Mr. B had had urinary tract infections in to swallowing issues. In essence, Mr. B was a ‘total care’ the past, he had become delirious (over and above the patient. Total care is a term used in nursing to refer to confusion. dementia he was experiencing) and more agitated, patients who require assistance with all activities of which caused him to try to get out of bed at night. daily living as they’re unable do anything indepen- I ﬁ rst cared for Mr. B during a day shift. His urine dently. culture had come back positive, and it was thought During his admission, I was one of Mr. B’s primary that the change in his mental status and onset of fever nurses. Mr. B’s grand-daughter would come in for at were likely due to another urinary tract infection. least a few hours every day. She helped the nurses continued on next page

Page 8 — Caring Headlines — March 3, 2011 Clinical Narrative (continued)

making it possible to take her grandfather home safely. bathe him, turn him, and feed him. It was obvious they She marveled at how we were able to work together to had a very close and special relationship. She knew help them, not just in the hospital but at home, as what foods he liked, what TV channels he liked to well. watch, and that he enjoyed being pushed in the wheel- Sometimes, as a nurse, I think it’s hard to think out- chair for part of the day. During Mr. B’s hospitalization, side of the immediate situation. It’s easy to get caught I got to know his family and grew to understand a lot up in the ‘tasky’ things and not take the time to fully Being able to about his home life. Mr. B’s wife was still living at understand the home situation. Sometimes we don’t home and also suffered from a (milder) form of demen- see the family members who are just as involved in approach Mr. B’s tia. A family member needed to be with her at all times care-giving as we are. I think this was a growing point to help her with activities of daily living. The grand- care with a multi- for me. I realized how stressful it can be to have a loved daughter had two children of her own, one of who had one in the hospital, especially when there are other disciplinary team learning disabilities, the other a feeding tube due to loved ones at home who need you just as much. malformations of her esophagus. Her husband worked Being able to approach Mr. B’s care with a multi- helped him and his full-time to support the family, so her sister was helping disciplinary team helped him and his family get care for the children while she and her mother were family get through through an incredibly diffi cult time. The role of nurse with Mr. B at the hospital. has so many facets — not just the technical and physi- an incredibly It all seemed mind-boggling to me. I couldn’t help cal care (the science of nursing) — but the emotional think how hard it must be for her. This situation hit support of the patient and family. diffi cult time. The me hard. It was one of the fi rst times I had really This situation helped me develop my communica- stopped to think about the patient and his family out- role of nurse has so tion skills by being an active listener and advocate for side the hospital, beyond the inpatient setting. Mr. B. After two years on this unit, I have learned not many facets — not The grand-daughter became teary as she told me to be afraid to ask for help. I’ve seen how important it about the high level of stress and the guilt she felt is to use my resources (my colleagues in other disci- just the technical about being overwhelmed by this incredible responsi- plines). The essence of nursing on Bigelow 11 is team- bility. I sat with her and told her how I admired her for and physical care work, and as a team, we are devoted to providing the being able to take this on. I told her about some of the best possible care to our patients and families. (the science of resources available at MGH, including the social worker on our unit. Comments by Jeanette Ives Erickson, RN, nursing) — but the The day came when Mr. B’s symptoms had resolved senior vice president for Patient Care and chief nurse emotional support and his mental status had improved to baseline. He What a wonderful story of a new nurse recognizing the was medically cleared for discharge; he would complete ‘lived experience’ of illness for Mr. B and his family and of the patient his course of antibiotics either at home or at a rehab fa- advocating for their relief. As Mr. B’s primary nurse, cility. When the family was presented with the option and family. Sarah was able to build a trusting relationship with of rehab, they politely declined saying they felt it was him and his grand-daughter. Be cause of that trust, Mr. safer to have him at home. B’s grand-daughter was able to share their story and re- I knew this family didn’t have the resources they veal the great stress they were under. needed (a low bed, a lift, etc.) to properly care for Mr. Sarah and her team came together. They listened. B. We called a family meeting including the social They were able to arrange for resources that would al- worker and case manager to try to come up with a low this family to take Mr. B home where he could re- plan. We found that Mr. B’s insurance would cover the cover in the company of his wife and loved ones. Not cost of these resources at home, including a visiting only did Sarah help Mr. B and his family, she added a nurse to check on them regularly. I saw the relief in the new layer to her own skill as a nurse and advocate. grand-daughter’s eyes. She thanked us profusely for Thank-you, Sarah.

March 3, 2011 — Caring Headlines — Page 9 Education/Support

Dedicated Education Units welcome students from UMass, Boston — by Gaurdia Banister, RN, executive director, The Institute for Patient Care

Dedicated Education Unit Staff nurses play a key role in the DEU, serving (DEU) is an innovative as instructors with support from faculty from UMass, model of clinical nursing Boston, MGH clinical nurse specialists, and nursing education designed to pro- director, Theresa Capodilupo, RN. vide practice-based learning Says Ellison 7 staff nurse, Vilma Pacheco, RN, and teaching. In the three “The students teach me a lot and make me strive to years since their inception, be a better nurse. I’ve become much more aware of the DEUs on White and my own practice as I try to be a good role model for Ellison 7 have been home to approximately 135 nurs- them. It really has been a great experience.” UMass Boston AAing students in a collaborative effort involving MGH, UMass, Boston, course coordinator for Adult students (l-r): Emma BWH, and UMass, Boston. Health, Katie Kafel, RN, observes, “This positive Chong, Kimberly Mysiuk, The objective of a DEU is to use a team approach working relationship challenges and invigorates Jessica Loria, and to transform a patient-care unit into an optimal teach- nurses’ practice skills. And course requirements are Siennaleigh Miller, present ing-learning environment. At MGH, the model in- inﬂ uenced by input from expert clinicians at on Communication and Delegation Practices cludes nurses, nurse leaders, faculty, students, and pa- MGH.” among Various Role tient care associates, allowing all members of the nurs- The collaboration between UMass, Boston, and Groups in Acute ing team to cultivate strong working relationships and MGH is designed to capitalize on the strengths of Care Settings. contribute to a culture of professional development. both organizations with a continuous exchange of knowledge and experience that allows nursing practice to inform nursing education and nursing education to inﬂ uence nursing practice. The gap between what’s taught in the classroom and what’s learned in clinical practice is reduced. Most organizations fortunate enough to have a DEU describe it as a win-win situation that en- hances nursing education and fosters a culture of learning. An evaluation of the MGH-UMass, Boston, DEU initiative is currently underway with funding from the Robert Wood Johnson Founda- tion, and plans to share our experience with the larger nursing community are in process. Recently, the DEUs welcomed 36 junior and senior UMass, Boston, students for their spring clinical rotations or one-on-one preceptorships in this exciting and innovative learning environment. For more information, call 4-4720. (Photo provided by staff)

Page 10 — Caring Headlines — March 3, 2011 The Knight Center

Nurse Residency Ensuring a smooth transition from student to staff nurse — by Gino Chisari, director, The Norman Knight Nursing Center for Clinical & Professional Development

n keeping with our 200-year tradition of leader- • Demonstrate understanding of healthcare organizations ship and innovation, the department of Nursing and systems and their effect on the patient-nurse rela- is launching the new Nurse Residency program. tionship Under the executive leadership of Gaurdia • Communicate effectively Banister, RN, Debbie Burke, RN, Dawn Tenney, • Function as a member of a team RN, and Theresa Gallivan, RN, and in collab- • Recognize safety and quality as the hallmarks of oration with leadership of ICU and oncology effective patient care services, the Nurse Residency is the latest pro- • Engage in quality-improvement IIgram to come out of The Norman Knight Nursing • Incorporate evidence into nursing practice Center for Clinical & Professional Development. In The Nurse Residency Program is a faculty-guided, 26- preparation for the opening of the Lunder Building, the week transition from student/graduate nurse to practicing Nurse Resi dency will support the expansion of oncology staff nurse. New registered nurses, under the mentorship and critical-care nursing by preparing new nurses to of program faculty, participate in a three-phase program, practice in these clinical settings. each phase designed with the unique needs of the new The Residency is built on the philosophy that new nurse in mind. nurses are among our most valuable resources. The pro- Through close interface with faculty and other peers, gram promotes nursing practice built on knowledge, nurse residents will begin to acquire the knowledge, skills, skill, compassion, and inquiry to ensure the best nursing abilities, attitude and competencies required to deliver care for patients and families. The goal is to provide a safe, effective, patient care. The program is built around supportive, caring, engaging, and intellectually stimulat- the principles of Benner’s Novice to Expert philosophy, ing transition from student/graduate nurse to practicing focusing on a progressive mastery of competencies. staff nurse. Toward that end, the Nurse of the Future Faculty is comprised of ICU and oncology clinical Nursing Core Competencies© of the Massachu setts nurse specialists who: Depart ment of Higher Education Nursing Initia tive have • create an environment that provides nurse residents been incorporated: with opportunities to learn essential elements of pa- • Develop nursing knowledge necessary for the safe, ef- tient care fective care of complex patients in a high-tech, fast- • offer supervised clinical experiences where nurse resi- paced, dynamic environment dents can practice newly acquired skills • Understand the uniqueness of the patient- and family- • coach and mentor new nurses centered care model • help develop of a sense of salience • Embody professional behavior built on ethical princi- • use self-reﬂ ection to evaluate performance and seek/ ples create additional learning opportunities • Acquire leadership skills as tools for managing the pa- The oncology component of the Nurse Residency pro- tient care experience, self, and others gram begins March 7, 2011; the ICU component begins • Successfully master technology and informatics April 4th. For more information, call 3-6530.

March 3, 2011 — Caring Headlines — Page 11 Jeanette Ives Erickson (continued from page 3)

First established as the Oxygen Therapy Depart- the outpatient Neurology Department under the direc- ment by HK Beecher, MD, in 1946, the Respiratory tion of Edwin Cole, MD. In the beginning, the Lang- Care Department has seen striking changes in the past uage Clinic evaluated a small population of patients 60+ years. In the early days, oxygen tents, an iron lung, with language problems. But during World War II, the and very basic mechanical ventilators were used to sup- clinic became the primary center on the Eastern sea- port patients in respiratory distress. In 1959, 72 patients board for treating patients with aphasia and training were mechanically ventilated outside the operating clinicians in the fi eld. room (compared to nearly 5,000 patients today). The Language Clinic continued to grow as clini- Since 1988, a team of MGH physicians and respira- cians gained a broader understanding of the fundamen- tory therapists have managed the care of infants, pedi- tal causes of speech-language disorders and more so- atric, and adult patients receiving ECMO (Extra-Cor- phisticated treatment procedures became available. poreal Membrane Oxygenation). In recent years, a re- During the 1970s the Language Clinic became the spiratory care team was formed to manage patients Speech-Language Pathology Department under the di- with tracheostomies on general care units, and respira- rection of Julie Atwood. Today, it is known as the De- Standing by the original tory therapists were instrumental in developing proce- partment of Speech, Language & Swallowing Dis orders MGH iron lung during dures to improve the delivery of aerosol medications to to better refl ect the services it provides here on the recent Respiratory Care patients with artifi cial airways. With increasing de- main campus and in many of the MGH health centers. Week celebration are mand for respiratory care services, respiratory therapists The Volunteer Department dates back to the earli- respiratory therapists (l-r): have become a critical part of the patient-care team est years of MGH with the Men’s and Ladies’ Visiting Pam Brown-Early, RRT; Vincent Riggi, RRT; within and outside of intensive care units. Committees (form ed in 1821 and 1869, respectively). Christa Fournell, RRT; The department of Speech, Language & Swallow- In 1953 it became a dispatch service serving all depart- Le Tanya Taylor, RRT; and ing Disorders traces its roots to the MGH Language ments at the hospital. With the surge of volunteerism Deborah Chase, RRT Clinic, established informally in the 1930s as part of during World War II, MGH appointed its fi rst chief of volunteers, Eleanor Greenwood, in 1941. The department continued to enjoy a close relationship with the Ladies’ Visiting Committee, a relationship that still thrives to this day. The MGH Medical Interpreters Department began as a volunteer program in 1976 and has fl ourished into a multi-language medical interpreter service offering in- person and telephone interpretation for all lan- guages and video interpretation for Spanish-speaking patients and families. continued on next page

Page 12 — Caring Headlines — March 3, 2011 Jeanette Ives Erickson (continued)

Originally called the MGH Brace Shop, the patients by instinct or relying on what they overheard Orthotics and Prosthetics Department was established doctors saying. In 1873, more than 50 years later, the around 1908 with a staff of four. At fi rst serving only Boston Training School for Nurses opened at MGH, MGH patients, in 1937, under the direction of Karl only the third school of nursing in the country associ- Bushenfelt, the department expanded to provide ser- ated with a general hospital. Linda Richards, widely vices outside the MGH community. During the polio recognized as the country’s fi rst trained nurse, became epidemic, staff worked long days to keep up with the superintendent of the school in 1874 and is credited need for braces and orthotics. In 1980, under the direc- with transforming the institution into a premier train- tion of William Murphy, orthotic standards were devel- ing ground and model for other nursing schools in the oped, such as lumbar spine bracing. And in 1972, un- US and abroad. Under her leadership, nursing as a pro- der the direction of John Snowden, thermo-plastics fessional discipline began to emerge. were introduced to the fi eld. Since then, countless Sophia French Palmer, an early graduate of the Bos- techniques and applications have been developed as ton Training School at MGH, co-founded the Ameri- the department has become a major resource in the can Journal of Nursing and served as its fi rst editor. Del- fi eld of sports medicine. egates from the MGH Nurses’ Alumnae Associa tion Dr. Richard Cabot, who helped bring social work to helped organize the Nurses’ Associated Alumnae of the MGH, was also a supporter of clinical pastoral care. In United States, which later became the American 1933, he appointed Reverend Russell Dicks to the po- Nurses Association. sition of hospital chaplain. In 1934, Cabot and Dicks During the Spanish-American War, MGH nurses implemented the fi rst Clinical Pastoral Education cared for sailors and soldiers aboard the hospital ship, (CPE) program in a general hospital. The program cel- Bay State, the fi rst hospital ship in the world to be out- ebrated its 75th anniversary last year and has taught fi tted by an aid association and authorized by a sover- more than a thousand theological students, clergy, eign power under the articles of the Geneva Confer- seminarians, and healthcare providers. ence. Nursing (going back to its earliest iteration) is the MGH nurses were among the fi rst in the world to Speech pathologist enter the fi eld of anesthesia. Annabella McCrae pub- introduces solids to a oldest discipline within Patient Care Services. MGH lished, Procedures in Nursing, which standardized nurs- 12-month-old baby with nurses were among the fi rst in the country to receive airway, gastrointestinal, and formal training. When MGH began admitting patients ing procedures for the fi rst time. Sara Parsons’ Nursing swallowing issues. in 1821, nurses weren’t formally trained; they cared for Problems and Obligations had a signifi cant and lasting impact on nursing and nursing education and served as a nursing standard for many years. The concept of intensive care units emerged in response to the polio epidemic of the mid-twentieth century. With intensive care units came the need for critical care, and MGH nurses were at the forefront of this new nursing specialty. Ruth Sleeper, RN, former superintendent of the MGH School of Nursing and director of Nursing for MGH, served as president of the National League of Nursing Education and later the National League for Nursing, which encouraged colleges to establish schools of nursing and award bachelor’s degrees. Ada Plumer, RN, is believed to have been the fi rst person to practice in the role of IV nurse and in 1973, co-founded the National Intravenous Therapy Associa- tion, now the Infusion Nurses Society. As chief of Nursing, Mary Macdonald, RN, was responsible for broadening the scope of nursing by introducing the unit teacher role, which was replicated in hospitals across the country. The role of unit teacher (Photo provided by staff) continued on page 16

March 3, 2011 — Caring Headlines — Page 13 Professional Achievements

Robbins elected Capasso and Collins Steiner presents Stefancyk appointed Christopher Robbins, RN, endoscopy recognized Linda Steiner, PT, physical therapist, Amanda Stefancyk, RN, nursing staff nurse, was elected president Virginia Capasso, RN, and presented, “The Benefi ts of Exercise in director, was appointed a member of the of the New England Society of Jacqui Collins, RN, were awarded the Managing Your Arthritis,” to the Malden Health Care Reform Tax Force for 2011, Gastroenterology Nurses and Associates Partners in Excellence Team Award, Council on Aging, in Malden, for the American Organization of Nurse in January, 2011. from the Partners Network for Quality, January 20, 2011. Executives, in January, 2011. Treatment, and Service, at an award ceremony in Waltham, January 20, 2011. King elected PT team honored Nurses present Janet King, RN, endoscopy staff James Zachazewski, PT, clinical director, Marjorie Voltero, RN; Kimberly Foley, nurse, became president-elect of the Cynthia Peterson, administrative director, RN; and Jane Harker, RN, presented, New England Society Chase honored and the entire staff of the BWH/MGH “Sedation vs. Anesthesia in the Care of of Gastroenterology Nurses and Barbara Chase, RN, MGH Chelsea Health Care Center at Foxborough, ERCP and EUS Patients in Endoscopy,” at Associates in January, 2011. HealthCare Center, received the were recognized with the 2010 Good the Winter Meeting of the New England Portraits in Primary Care Award, from Neighbor Award for Community Service, Society of Gastroenterology Nurses and the John D. Stoeckle Center for Primary by the Tri-Town Chamber of Commerce Associates, in Burlington, Care Innovation, in January, 2011. in Foxborough in January, 2011. January, 22, 2011. Ananian appointed Lillian Ananian, RN, clinical nurse specialist, was appointed a member of the Research Committee of the Society Inter-disciplinary team Capasso presents Inter-disciplinary team of Critical Care Medicine, publishes Virginia Capasso, RN, clinical nurse publishes in January, 2011. specialist, presented, “Advances in Mary E. Larkin, RN; Paul McGuigan, RN; Karen Miguel, RN, Joshua Hirsch, MD, Wound Care,” in a teleconference with and Robert Sheridan, RT(R), published Denise Richards, RN; Karen Blumenthal; Saudi Aramco Medical Services, Kerry Milaszewski, RN; Laurie Higgins, the article, “Team Training: a Safer Future January 18, 2011. for Neurointerventional Practice,” in RD; Jill Schanuel; and Christen Long, Peterson certifi ed the on-line Journal of Neurointerventional published the article, “Collaborative June Peterson, RN, clinical educator, Surgery in January, 2011. Staffi ng Model: Reducing the Challenges became certifi ed as an adult clinical of Study Coordination,” in Applied Clinical nurse specialist by the ANCC and as Chang presents Trials, in January 2011. a critical care nurse specialist by the Lin-Ti Chang, RN, staff specialist, AACN, in January, 2011. Mulligan presents presented, the MGH International Trauma and Disaster Institute’s, Janet Mulligan, RN, nursing director, “Advanced Disaster Medical Response” Inter-disciplinary team presented, “Can IV Teams Survive in this course at the Hong Kong Association publishes Arnstein elected Changing Healthcare Environment,” at for Confl ict & Catastrophe Medicine in the IV Nurses Day Celebration, New Hong Kong, January 6-7, 2011. Laurel Radwin, RN; Lillian Ananian, RN; Paul Arnstein, RN, clinical nurse England Chapter of the Infusion Nursing Howard Cabral; Adele Keeley, RN; and specialist, Pain Relief, was elected co-chair Society, in Dorchester, January 25, 2011. Paul Currier, MD, authored the article, of the Pain Education Special Interest “Effects of Patient/Family-Centered Group of the American Pain Society, Practice Change on the Quality and January 17, 2011. Chase presents Cost of Intensive Care,” in the Journal of Klein appointed Barbara Chase, RN, nurse practitioner, Advanced Nursing, in January, 2011. MGH Chelsea HealthCare Center, Aimee Klein, PT, physical therapist, presented, “Facilitating Behavior Change,” Dorman appointed was appointed a member of the at Simmons Graduate Nursing Alumni Credential Services Committee of the Association, in January, 2011, Robert Dorman, PT, physical American Physical Therapy Association, Brunelle a writer therapist, was appointed, chair of the a sub-committee of the American Board Cheryl Brunelle, PT, physical therapist, Research and Education Committee of PT Residency and Fellow Education, in was an item writer for Cardiovascular of the American Physical Therapy Alexandria, Virginia, in January, 2011. and Pulmonary Examination for the Association of Massachusetts, Levin-Russman appointed Specialization Academy of Content January 1, 2011. Elyse Levin-Russman, LICSW, Experts of the American Board of clinical social worker, was appointed Physical Therapy Specialties, Burchill and Curley present a member of the Board of Directors in Alexandria, Virginia, and chairperson of the Quality of Life in January, 2011. Guarente elected Occupational therapists, Committee for The Association of Gae Burchill, OTR/L, and Suzanne Pediatric Oncology Social Workers June Guarente, RN, endoscopy staff Curley, OTR/L, presented, “Anatomy of in January, 2011. nurse, was elected a member of the Flexor and Extensor Tendons,” at Tufts Board of Directors of the New England University, January 24, 2011. Beardslee Society of Gastroenterology Nurses and and Wojcik present Associates in January, 2011. Olson presents Brian Beardslee, RN, and Sarah Wojcik, RN, presented their poster, Olson narrates DVD Gayle Olson, wellness coordinator, “Development of a Nurse Education at the BWH/MGH Health Care Center Gayle Olson, wellness coordinator, at Module to Navigate Clinical Trial Hultman appointed at Foxborough, presented, “Injury Care Protocols,” at the 11th National the BWH/MGH HealthCare Center at Your Fingertips: Lower-Extremity Todd Hultman, RN, nurse practitioner, at Foxborough, provided the expert Conference on Cancer Nursing Research Techniques,” and “More Than Just of the Oncology Nursing Society, in Los has been appointed a member of the voice-over for the four-DVD set, Gold: the Olympic Sports Medicine Board of Directors of the Hospice and “Comprehensive Aquatic Exercise: Angeles, February 10-12, 2011. Experience,” at the Second Year Athletic They authored a poster abstract on the Palliative Nurses Association for 2011. a Better Workout, Better Therapy,” Training Curriculum at Florida Southern produced by SwimEx same topic for the on-line Oncology College, in Lakeland, Florida, Nursing Forum in January, 2011. in January, 2011. January 21, 2011.

Page 14 — Caring Headlines — March 3, 2011 Announcements Published by Caring Headlines is published twice each month by the department of Patient Care Services at Massachusetts Lunchtime Fitness Considering Doctoral Red Sox Foundation and General Hospital Sessions Education? MGH Home Base Program Publisher Participate in this year’s Jeanette Ives Erickson, RN Lunchtime fi tness sessions “Pathways to Professional senior vice president annual Run to Home Base, a for Patient Care offered by personal trainer, Development in Nursing through 9-kilometer run to support our Mike Bento, from The Clubs at Doctoral Education: a Panel veterans ending at storied Fenway Managing Editor Charles River Park. Presentation and Discussion” Park. Registration is now open. Susan Sabia Next session: presented by the MGH Doctoral For more information, or Editorial Advisory Board Nursing R esearch Forum with to register, go to: www. March 16, 2011 runtohomebase.org. Chaplaincy Haber Conference Room panelists: Gino Chisari, RN; Michael McElhinny, MDiv 12:00–12:30pm Patti Dykes, RN; Peggy Settle, RN; Run to Home Base will be held and Colleen Snydeman, RN Disability Program Manager For more information, call 6-2900 Sunday, May 22, 2011. Zary Amirhosseini Thursday, March 10, 2011 Editorial Support 1:30–2:30pm Marianne Ditomassi, RN O’Keeffe Auditorium Mary Ellin Smith, RN One-stop intranet For information, call 4-0340. Blum Center events Materials Management Edward Raeke site for strategic Healthy Living Series “Eating with Color” Nutrition & Food Services priorities Martha Lynch, RD Wednesday March 9, 2011 Susan Doyle, RD Want to know more about New MGH phone 12:00–1:00pm Offi ce of Patient Advocacy the Partners-MGH patient care numbers Book Talk Robin Lipkis-Orlando, RN re-design, patient affordability, Due to the increasing need for “Healthy Eating During and budget review initiatives? Offi ce of Quality & Safety telephone lines, MGH has begun Pregnancy” Keith Perleberg, RN Wondering about the time line? presented by Stacey Nelson, RD using a new area code and Orthotics & Prosthetics To read the latest articles about three-digit exchange number in Thursday, March 17, 2011 Mark Tlumacki this work, or if you have a cost- addition to the existing 724; 726; 12:00–1:00pm PCS Diversity reduction idea or better way to and 643 exchanges. In January, All sessions held Deborah Washington, RN deliver patient care, visit the new MGH Telecommunications began in the Blum Center. MGH/MGPO intranet site: incorporating the new area code Physical Therapy and exchange number: For information, call 4-3823. Occupational Therapy http://priorities.massgeneral.org. Michael Sullivan, PT 857-238-XXXX. Police, Security & Outside Services Staff will still be able to dial the Joe Crowley fi ve-digit extension (8-XXXX) Ash Wednesday Public Affairs Living with Cancer: when calling internally. Suzanne Kim March 9, 2011 Navigating the Journey For information call 6-4357. Respiratory Care Ed Burns, RRT A free conference for patients Services will be held in the MGH and families on maintaining quality Chapel on Ellison 1 Social Services of life from diagnosis to long-term • Roman Catholic Mass: Ellen Forman, LICSW 11:00am and 4:00pm survivorship. National Patient Speech, Language & Swallowing Featuring information on: • Interfaith Service: 12:15pm Disorders and Reading Disabilities Safety Awareness Carmen Vega-Barachowitz, SLP Advances in cancer research • Ashes will be distributed in the • Week Chapel between 9:00am and • Managing side-effects Training and Support Staff Maintaining wellness and 5:00pm Stephanie Cooper • The Center for Quality & Tom Drake balance in your life Safety is proud to present: • Ashes will be distributed on • A panel of cancer survivors patient-care units between The Institute for Patient Care The HOPES Wellness Fair “Listening to the Voices 8:00am and 4:00pm Gaurdia Banister, RN • All Chapel services are of Patients and Families” • Volunteer Services, Medical April 9, 2011 featuring Dave deBronkart broadcast on Channel 16 on Interpreters, Ambassadors, 9:00am–3:00pm the in-house television system and LVC Retail Services Yawkey 2 March 9, 2011 Paul Bartush 1:00pm Ashes will also be distributed at To register, call 617-724-1822, O’Keeffe Auditorium the following locations: Distribution or stop by the Cancer Resource • Charlestown Navy Yard Ursula Hoehl, 617-726-9057 Room (Yawkey 8C). Dave deBronkart believes Charlestown Health Center patients should be fully involved in • Submissions Chelsea Health Center All stories should be submitted Sponsored by the MGH Cancer their care. He shares his story as a • Center and the Network for • Revere Health Center to: [email protected] cancer patient and active member Massachusetts Eye & Ear For more information, call: Patients & Families. • 617-724-1746 of his care team. Infi rmary For information, call 6-9282. Next Publication For more information, March 17, 2011 call 617-726-2220.

March 3, 2011 — Caring Headlines — Page 15 Jeanette Ives Erickson (continued from page 13)

evolved into clinical teacher and became part of the new erations coordinator, which in 2008 became the dual- model for The Center for Clinical & Professional pronged operations manager role. Under the new Development when it opened in 1996. model, an administrative operations manager and an With the ever broadening scope of nursing and its inev- environment-of-care operations manager have respon- itable move toward evidence-based practice, nursing re- sibility for a cluster of units ensuring patient- and staff- We inherited search took on added importance in the later decades of satisfaction and heightened attention to quality and the twentieth century. Yvonne L. Munn, RN, associate safety and patient fl ow. a great legacy general director of Nursing from 1984–1993, was a staunch To further advance the inter-disciplinary team ap- advocate for nursing research. In 1993, the Annual proach, in 2007, we established The Institute for of commitment, Yvonne L. Munn Lecture and (in 1997) the Yvonne L. Patient Care, a fi rst-of-its-kind, multi-disciplinary insti- Munn Nursing Research Awards were created in her tute designed to bring together all disciplines to gener- service, and honor. Today, The Yvonne L. Munn Center for Nursing ate new ideas to advance our mission of patient care, Research supports a growing inventory of research-related education, research, and service to the community. leadership, and programs, including a post-doctoral nursing fellowship pro- The Institute supports The Norman Knight Nursing gram; a peer-support and networking group for its doctor- Center for Clinical & Professional Development; The we add to that ally-prepared staff; a grant program for staff interested in Yvonne L. Munn Center for Nursing Research; The conducting research; and a nurse-scientist advancement Maxwell & Eleanor Blum Patient and Family Learning legacy every day. It model. Center; and The Center for Innovations in Care Deli- Recently, Ed Coakley, RN, received a signifi cant grant very. This infrastructure is designed to foster teamwork; is awe-inspiring to from the Health Resources and Services Admini stration to provide a forum for sharing best practices; and bring an look back on the fund the innovative RN Residency Program: Transitioning informed, inter-disciplinary approach to patient- and to Geriatrics and Palliative Care. The program was de- family-centered care. The formation of the Institute is formidable history signed to improve the care of older patients while extend- the culmination of a vision that included the developing the careers of veteran nurses at the bedside. ment of a robust professional practice model; the for- that brought us In the fall of 1996, MGH president, James Mongan, mation of the collaborative governance structure; im- MD, appointed me to lead Nursing and the other non- plementation of the multi-disciplinary Clinical Rec- all together... We physician clinical disciplines in order to promote greater ognition Program; and the establishment of a multi- inter-disciplinary collaboration. That’s how all these im- media learning center for patients and families. do, indeed, have pressive disciplines came to be under the banner of Patient We inherited a great legacy of commitment, ser- Care Services. vice, and leadership, and we add to that legacy every reason to be Early in my tenure as senior vice president for Patient day. It is awe-inspiring to look back on the formidable Care, we implemented a new Patient Care Delivery Model history that brought us all together. With 200 years of proud. introducing three new support roles: the unit service asso- selfl ess service behind us, we enter the third century of ciate, responsible for the overall cleanliness of the unit; the MGH with the same passion and dedication that drove operations associate, an expansion of the unit secretary our founders to, “tend to the health needs of the poor- role responsible for transcription, chart-management, cus- est, sickest and most vulnerable.” tomer service, and other clinical support tasks; and the op- We do, indeed, have reason to be proud.

First Class US Postage Paid Headlines Permit #57416 aringMarch 3, 2011 Boston, MA C Returns only to: Bigelow 10 Nursing Ofﬁ ce, MGH, 55 Fruit Street Boston, MA 02114-2696

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