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N E W S f O R an D a B O U T

BWFH

NURSE
NursInG AwarDs hIGhLIGhts eXCePtIOnaL Care GIVers
The annual Nursing Awards once again showcased the expertise and commitment of Brigham and Womens Faulkner Hospitals nursing staff. The award recipients each year continue to amaze attendants at the ceremony with their accomplishments. Most importantly they highlight why we have such outstanding patient care outcomes.

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Congratulations to all of this years award recipients!

MRACHECK AWARD
The Mracheck Award honors individuals who demonstrate critical thinking and excellence in the nursing process in patient care, specically a nurses ability to assess patient needs and implement effective clinical skills and knowledge. From left, congratulations to Mary Deseignora, RN,
DFCI; Karen White, RN, BSN, Emergency Department; and Jodie Bavineau, RN, BSN, 6 North for receiving Mracheck Awards this year!

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MARY DEVANE AWARD

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The Mary Devane Award is given to a member of the nursing department in recognition of their commitment to delivering patient care with compassion, kindness, and humor. Congratulations to Ellen LaCivita, RN, DFCI for
receiving the Mary Devane Award this year!

ANGELA MCALARNEY AWARD

The Angela McAlarney Award is given to a member of the nursing department in recognition of excellence in patient teaching. Congratulations to Carolyn Hampshaw, RN, ICU for
receiving Angela McAlarney Awards this year!

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ELAINE HAZELTON MEMORIAL SCHOLARSHIP AWARD

The Elaine Hazelton Memorial Scholarship Award is given to a nurse who demonstrates a dedication to Brigham and Womens Faulkner Hospital within the practice and advance of nursing and is continuing their nursing education. Congratulations to Justine Lynch, RN, BSN, 6 North for
receiving this years Elaine Hazelton Memorial Scholarship Award! continued on P3 1

DEAR NURSING COLLEAGUES

Reward and recognition have been noted as one of the cornerstones of an engaged workforce. In preparation for our most recent employee survey, I reected on the culture here at Brigham and Womens Faulkner Hospital. I receive letters from patients and families on a weekly basis that seek to recognize the great nursing care they have received here. As a nurse, I know this is truly one of the best forms of recognition. In this issue of BWFH Nurse you will read of our most formal methods of acknowledging some of the exceptional nurses that we have the privilege of working with, including the annual Nursing Awards given to eight nurses for their unique contributions and expertise. This recognition is from leadership and colleagues from throughout the organization. This year we had an unprecedented event that created a unique opportunity for us to recognize each and every nurse.
Judy Hayes, RN, MSN, CNO

day and the weeks to follow. The recognition came from colleagues, our immediate community and for this event, the entire nation. I did receive a letter from the mother of one of the Marathon victims that we cared for and would like to close my words with a quote from her: I cannot believe how much caring the nurses were able to express for so many. Thank you for all you do to care for our patients, their families and each other.

You will also read a piece reecting on Marathon Monday. The message is that you are recognized as a nurse and your unique ability to care for others at the most vulnerable of times. Many were recognized for being able to provide care in areas they routinely may not have been viewed as an expert. Every nurse, no matter where they practice, had a role in the care that

Sincerely,

Judy Hayes RN, MSN, CNO Vice President of Nursing

Nursing Awards highlights exceptional care givers, continued from P1 MAL & LOIS LEWIS EXCELLENCE IN NURSING PRACTICE SCHOLARSHIP AWARD
The Mal and Lois Lewis Excellence in Nursing Practice Scholarship Award is given to a nurse working in cardiology that demonstrates compassion in a family centered context; a nurse that advocates for the patient using evidenced based research; and a nurse who is recognized by her/his peers for their unique contributions.
Congratulations to Emily Robinson, RN, MSN, 6 South for receiving this years and Lois Lewis Excellence in Nursing Practice Scholarship Award!

Published by Marketing and Public Affairs (617) 983-7588 djgoldberg@partners.org

We welcome your feedback and suggestions for future issues.

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A LASTING LEGACY
By Cara Marcus, Director of Library Services

Cara Marcus, Director of Library Services and Maureen Schnur, Nurse Director, CPE/ Preop Holding/PACU, recently welcomed a special friend to Brigham and Womens Faulkner Hospital. Phyllis Santucci, who worked with Maureen at Boston Childrens Hospital for many years and is currently a PACU nurse there, had two family members who graduated from the Faulkner Hospital School of Nursing. Her mother, Brenda (Jones) Guercio, graduated in 1945 and her aunt, Miriam (Lent) Jones in 1947. Phyllis and her sister Patricia Guercio donated all of their mothers nursing school memorabilia to the medical library archives, where it will be preserved and displayed. The generous donation included many photos, Brendas acceptance letter from the school, her alumni association constitution and bylaws, subscription book, human anatomy and physiology textbook, and invitation to the spring formal and accompanying dance card.

From left, Maureen Schnur, Phyllis Santucci and Cara Marcus.

The most unique donation were two of Brendas autographed bibs, which were buttoned to the front of her apron on her uniform and held in place by her skirt. Bibs were worn as part of the everyday uniform while in school, and were autographed at graduation. Brenda, affectionately nicknamed Queenie by her classmates, was born in 1924 in Everett. Her nursing career spanned from Beth Israel Hospital, where she worked in the nursery, to serving as a psychiatric nurse for Worcester State

Maureen Schnur and Phyllis Santucci display some of the donated items.

Hospital, VA Brockton Hospital and Brockton Hospital. Phyllis remembers her mom putting on her uniform and how she always smiled when she went to work. Nursing is not just a job, said Phyllis, It becomes a part of you. Though Brenda passed away in 1997, her nursing school experience will live on through Brigham and Womens Faulkner Hospitals archives.

Nurse receives honor from BWH

Paula Knotts, BSN, RN, Director of Inpatient Psychiatric Nursing, recently received the 2013 Administrative Award from the Brigham and Womens Department of Psychiatry. This award is in recognition of signicant contributions in the areas of: Quality Service Leadership and Innovation Teamwork Operational Efciency Overall Outstanding Contribution to the Fundamental Functioning of the Department This is the only non-physician award given out by the Brigham and Womens Department of Psychiatry. Congratulations, Paula!

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POOR PERFORMANCE: BEST PRACTICES FOR ADDRESSING AND RESOLVING PERFORMANCE GAPS
By Carol MacKenzie, BSN, RN, Med, BC and Helene Bowen-Brady, BSN, RN, Med, BC

Purpose: In the complex environment of acute care hospitals, addressing RN performance gaps is an integral component in the delivery of safe, high quality, patient and family centered care and in minimizing the risks of adverse events. If performance gaps are not addressed in a timely and comprehensive manner, the culture of safety is negatively impacted, standards of nursing practice erode, the professional development needs of the RN are neglected or seemingly dismissed, and organizational mission and goals are not consistently met. Prior to the development of this process, when RN performance concerns were identied, signicant variability in response existed among the leadership staff. Challenges were apparent in clearly and objectively identifying the specic performance gaps and also in developing a plan to comprehensively address and resolve the concerns. The aim of our performance improvement project was to work collaboratively with nursing stakeholders to frame a successful, comprehensive and individualized performance improvement process (PIP).

Outcome Measures/Results: There are two distinct successful outcomes from a performance improvement process: completion of the PIP or voluntary resignation. A successful performance improvement process is achieved when the RN completes the goals and objectives in the individualized plan and sustains improved performance. An alternative successful outcome is when the RN recognizes the benet of voluntary resignation. Our initial PIP was implemented in 2007. Prior to the development of this process, data was not sorted or maintained related to RN retention or termination based on competency or performance decits. The table below reects the data outcomes since the implementation of the PIP. Of note, the RNs that did not successfully complete the PIP voluntarily resigned from their positions and the resignations were not challenged by the MNA.

PERFORMANCE IMPROVEMENT PROCESS (PIP) DATA 2007 2012 Year # of PIPs Inpatient Areas 2 3 3 5 5 18 3 # of PIPs Outpatient Areas (PACU, OR, ED, Infusion Center) 0 0 2 0 4 6 4 Successfully Completed PIP 0 1 5 4 8 18 6 Voluntary Resignation Sustained Improvement

2007 2008 2009 2010 2011 Totals 2012

2 2 0 1 1 6 1

0 1 5 4 7 17 Pending

Practice Implications: The following outcomes resulted from our project. Since the 2007 implementation through 2012, thirty one RNs have participated in a PIP. As of 2011, 17 of the 18 RNs that completed the PIP have sustained their individualized performance improvements and remain in the employ of the hospital. Six RNs chose to voluntarily resign. The data for 2012 reects that 6 of 7 RNs successfully completed PIPs and sustained results are pending. The PIP is applicable across several different practice areas. The components of the plan provide a framework to address performance concerns across the experience continuum, from entry into practice, to the very seasoned RN and can also be utilized in a wide variety of health care settings. Our dened PIP process and tools will be made available to ONL members. The members can adapt the process and tools for use in a wide range of health care settings.

The heightened awareness of the importance of addressing performance gaps in a timely and comprehensive manner has helped to drive a proactive response. The leadership staff now approaches unsafe practice proactively, by identifying and addressing the practice as early as possible. As a result, several practice concerns have been successfully resolved by immediate interventions. The immediate interventions may include attending a remedial education class or completing a competency, thereby reducing the need for progressive disciplinary actions and formal performance improvement plans. When experienced RNs are retained through the use of a well dened and successfully implemented PIP, clear advantages result. Advancing competent practice for the RN aligns with high quality, safe, patient centered care, the Nurse of the Future Core Competencies, the hospitals mission, and supports the trust the public holds for our profession. It is also more cost effective to implement a successful PIP than it is to recruit, hire and orient a new RN.
Harding, A. & Connolly, M. (2012). Remediation: A necessary function for employers to correct incompetence regarding clinical professional registered nurse practice. JONAs Healthcare Law, Ethics, and Regulation, 14(2), 48-52. Howatson-Jones, I. (2003). Difculties in clinical supervision and lifelong learning. Nursing Standard. 17(37), 37-41.

SELECTED REFERENCES: American Nurses Association. Professional Role Competence (Position Statement). Silver Springs, MD: ANA; 2008. Asselin, M. & Cullen, H.A. (2011). Improving practice through reection. Nursing 2011, 41(4), 44-46. Chappell, K. & Koithan, M. (2012). Validating Clinical Competence. The Journal of Continuing Education in Nursing, 43(7), 293-294.

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CLINICAL LEADERSHIP COLLABORATIVE FOR DIVERSITY IN NURSING 100+ MILESTONE

By Helene Bowen-Brady, BSN, RN, Med, BC

The Clinical Leadership Collaborative for Diversity in Nursing (CLCDN) scholarship has recently reached and surpassed 100 recipients. This program was developed to help address the disparity between the patient population and the nurses. According the Sullivan Commissions 2004 report, African Americans, Latino Americans and Native Americans comprise 25% of the U.S. population but only 9% of the nations nurses. The need for increased diversity of the healthcare workforce has been identied as a critical factor in addressing health disparities. The Institute of Medicines 2004 report, In the Nations Compelling Interest: Ensuring Diversity in the Health Care Workforce has called attention to this issue. The report noted that, Increasing racial and ethnic diversity among health professionals is important because evidence indicates that diversity is associated with improved access to care for racial and ethnic minority patients, greater patient choice and satisfaction, and better educational experiences for health professions students, among many other benets. Furthermore the recent IOM report on the Future of Nursing supports increasing the diversity of students to create a workforce prepared to meet the demands of a growing diverse patient population. To achieve in part the concept of diversity, Partners HealthCare and the University of Massachusetts, Boston, College of Nursing and Health Sciences, joined forces to support the clinical leadership development of socio-economically disadvantaged undergraduate nursing students to make a smooth transition into clinical practice upon graduation. The College of Nursing and Health Sciences, (CNHS)/Partners HealthCare Clinical Leadership Collaborative for Diversity in Nursing, (CLCDN), is a workforce development project designed to achieve, in part, the vision of diversity as described above by facilitating the successful progression of socio-economically disadvantaged students through the generic undergraduate nursing program at the University of Massachusetts, Boston, College of Nursing and Health Sciences. Participants are invited to participate from among students recently accepted into the undergraduate nursing major who demonstrate academic excellence, the promise of success and leadership potential.

Components of the program include scholarship support, leadership development, NCLEX preparation, pairing with diverse mentors for coaching and problem solving and educational opportunities. In 2007, the rst cohort was launched and was comprised of juniors and seniors. Since then, four additional cohorts, made up exclusively of rst semester juniors, have been added to total 75 undergraduate nursing students participated in the program. Beginning in spring 2011, the CLCDN had expanded to incorporate an Advanced Practice Component to its program. Graduate students from within the Partners HealthCare System, benet from many of the same benets that are afforded to the undergraduate nursing students. To date, 27 Partners HealthCare nurses have received scholarships in the amount of up to $5,000 for each semester. Partners HealthCare has awarded the CLCDN program $2,924,475.00 since the inception of the program and it is geared to support 84 undergraduates, 34 graduates and create a new administrative fellowship program. Of the undergraduate students supported through the program, 59 have graduated. Currently, 14 are employed at Brigham & Womens Hospital, 1 is employed at Faulkner Hospital, 25 are employed at Massachusetts General Hospital, 1 is employed at North End Rehabilitation and Nursing Center, 1 is employed at Newton-Wellesley Hospital and 2 are employed at Spaulding Rehabilitation Hospital. Of the advance practice nurses supported through the program, 9 are employed at Brigham & Womens Hospital, 12 are employed by Massachusetts General Hospital, 1 is employed by Newton-Wellesley Hospital, and 5 are employed by Spaulding Rehabilitation Hospital. In 2011, the CLCDN administrative team launched an evaluation with the rst four undergraduate cohorts to evaluate the components of the CLCDN program including its focus on mentoring, leadership development, educational and nancial support and networking opportunities. Another longitudinal research study is in development to explore the constructs of transition to practice, leadership development and mentorship,

COHORT INFORMATION
Cohort I Cohort II Cohort III Cohort IV Cohort V Cohort VI Asian

ETHNICITY BREAKDOWN
Black/AA Hispanic

Undergraduate Component 18 0 19 0 18 0 9 16 11 11 9* 12 14 5 Advanced Practice Nursing Component *Cohort begins in Fall 2013 EMPLOYMENT PIPELINE Undergraduate Component
Brigham & Womens Hospital Faulkner Hospital McLean Hospital Mass General Hospital Newton Wellesley Hospital North End Rehab & Nursing Center Spaulding Rehabilitation Hospital

Undergraduate Component 46 Advanced Practice Nursing Component 20 2 15

Shaughnessy-Kaplan Rehabilitation Hospital

Partners Health Care at Home

Employed Outside of PHS

Unemployed

14 9

1 0

0 0

29 12

1 1

1 0

2 5

0 0

0 0

7 0

3 0

Advanced Practice Nursing Component** **6 Additional recipients will be added in Fall 2013
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NURSING SCHOOL CLASS OF 1969 HOLDS 44TH REUNION

Its possible that not many Brigham and Womens Faulkner Hospital employees know about Faulkner Hospitals School of Nursing, which closed in 1978. Earlier this year, 14 members of the class of 1969 celebrated their 44th reunion, as they have done every year since graduation, continuing to gather and support each other even as they have begun to retire. nursing, restricts what many of them can do now. When we get together we still remember patient names from school, said DiVecchio. We talk about a particular patient who was constantly admitted for headache pain. We all took care of her, and she loved having a student nurse to hold her hand. There was another, our rst patient death, a man who had cancer. There wasnt the same pain treatment as today, and sometimes holding his hand was as benecial as his pain medicine.

We talked a lot at the reunion about what it was like then, said The 1969 graduating class of Faulkner Hospitals Training Anna Divecchio, who has helped School for Nurses. to keep the group united. We were new high school graduates, speak highly of the wonderful education, Perhaps because of the closeness they maybe some a little older, living together as well as training, they received at the experienced in school, Class of 1969 24 hours a day, no summers off, for Faulkner school. alumnae continue to gather every year, three years. The training wasnt like it is and since their 40th reunion they have today. We were thrown into a lot of adult DiVecchio said that many of her group begun to gather more frequently. Fourteen situations, patients who were dying or found nursing a good choice, given that of them gathered at the June reunion, seriously ill, situations that few of us had in the late 1960s there were not a lot of including one classmate from New experienced before. We worked the oors career choices for women. All of us are Jersey who came for the rst time. Many on weekends, and in the last two years we still very caring people. Faulkner gave us husbands come too. Theyve only lost one staffed oors for the hospital. Many girls a lot of condence to be able to go out classmate, who died of ALS. We took didnt live close, and stayed over every into the world, and gave us wonderful care of her, said DiVecchio, and then we weekend. training. took care of her husband. We purchased a memorial bench for her. One classmate It was difcult, and we had to support Most graduates, said DiVecchio, remained has multiple myeloma, and we are helping each other. Nurses today are trained in nursing, and about six of them joined her. We made her a quilt with best wishes very differently, working toward a college Faulkner upon graduating. Their work has panels. degree, with short clinical rotations. When ranged from dean of nursing education, we were there we actually took care of director of nursing, long term care, The group may try to rent a cottage on the patients. Wed live at Childrens Hospital clinician in Rheumatoid Arthritis research, Coast of Maine for a week for their 45th, for 3 months, or commute to Norwood visiting nurse, OR, ER, and ICU nurse. as it seems three days isnt long enough. Hospital for obstetrics, or Boston State Another has continued her nursing work One friend said yesterday our getHospital (now Boston Medical Center) for for the past 15 years at the Boston Shelter togethers arent really reunions anymore, psychiatric training, for similar amounts for the Homeless. Only one of them is still but family gatherings. of time. We started out with about 40 working today, while a few are doing per students, and 30 of us graduated. All diem assignments. Back pain, typical for
The 1969 graduating class gathers for their annual reunion. The group has been meeting annually since their graduation. Front row left to right: Martha Degon Ridlon, Carolyn Buckley OReilly, Linda Gaulin Carroll, Janice MCCord, Barnard, Anna Loring DiVecchio. Back row: Meredith Harris, Susan Potter Woods Alpeter, Linda Rugg Hannoosh, Karen Erickson Carafoli, Pat Shields Reinker, Kathy Duffy Fargo.

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BWFH NURSES CONNECT WITH MASSACHUSETTS EMERGENCY NURSES ASSOCIATION

By Bee Potter, RN

The Emergency Nurses Association (ENA) has nearly 40,000 plus members and continues to grow, with members representing over 35 countries around the world. The mission of the Emergency Nurses Association is to advocate for patient safety and excellence in emergency nursing practice. Here at Brigham and Womens Faulkner Hospitals Emergency Department, many of our nurses are active members. Bee Potter, RN, CEN, is the 2013 Mayower Chapter President and Kathy Shubitowski, RN, MSN, CEN, is the Chapter Secretary/ Treasurer. Kathy also sits on the State Council Board of Directors.

ENA offers many opportunities for continuing education. Recently some RNs have become certied in the Trauma Nursing Core Course and Emergency Nursing Pediatric Course offered in collaboration with the Boston Emergency Consortium. Karen White, RN, BSN, Clinical Leader in the Emergency Department, has been posting study questions to motivate staff in taking the Certied Emergency Nurse exam. The next step is a study group. This past spring, nine of our emergency department nurses attended the two day New England Regional Symposium in Plymouth, MA. This was attended by over

200 emergency nurses from around New England. This programs goal is to enhance the professional growth of emergency nurses by offering current topics, which reect the needs of a changing health care environment. It was also a great time with activities including a dinner at Plimouth Plantation, a walking Ghost Tour and networking time with other professionals. If youre interested in learning more about the Emergency Nurses Association and how to get involved, contact Bee Potter through the emergency department or at baoneill@partners.org

MARATHON MONDAY
By Bee Potter, RN

Monday, April 15, 2013 affected each and every one of us as nurses. Whether you worked that day or were off, if your area received victims from the bombing or not, if you or someone you knew was at the marathon or safe in your home that day affects us. It reminds us that what we do is important. It reminds us that every day we may not be trauma nurses in our jobs, but we are prepared to help when needed. This was never truer than on that day. There was so much added support from people coming to the Emergency Department to help. There were areas of the hospital that moved patients quickly to have an open and ready department to manage the trauma patients as they came in. It was not just an emergency department that managed that tragedy, it was our entire hospital. Patients were admitted to the operating area and the inpatient oors where care was continued with compassion and skill. I was at work on that Monday when the rst radio call came in of a bombing at the Boston Marathon. The emergency department started preparing immediately. The care we all gave that day in the face of tragedy has never made

me prouder to be a nurse. The care, compassion, and courage far surpassed any fear. I have a renewed respect for my profession and what we do. I was blessed to get a ticket to attend the church service honoring the responders, victims and the city of Boston. Some of you may also have been lucky enough to attend or watched the service on the news. This as an experience is hard to describe. First, the feeling there was that of honor. Honor to be among those who survived and responded with all their hearts to such a disaster. Yes, there were lives lost and injuries to recover from, but the message was that as a community we can comfort and conquer. We are all members of the Brigham & Womans Faulkner Hospital community. As members of this community we were there for those affected by this tragedy so close to home. Bee Potter, RN CEN Mayower Chapter President of the Massachusetts Emergency Nurses Association

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MCCARTHY PROMOTED TO OPERATING ROOM DIRECTOR

Patricia (Pat) McCarthy, RN, recently assumed the role of Operating Room Director at Brigham and Womens Faulkner Hospital. When asked what her new role entails, McCarthy shares that the Operating Room Director works in collaboration with the Associate Chief Nurse to organize, implement, and plan the nursing practice of the unit. In particular, she explains, the director is responsible for the level of nursing practice, the safety of the patients, and the staff and development of quality improvement projects. She will also be responsible for ensuring that the OR meets the mission of the hospital, and all of the regulatory requirements for Joint Commission on Accreditation of Healthcare Organizations, and other accrediting agencies along with state and local requirements. McCarthy will also work closely with surgeons to ensure that patient care runs smoothly. McCarthy has over 20 years of experience in OR practice beginning as a circulating nurse, scrub nurse, surgical rst assistant/nurse practitioner, and most recently, as BWFHs Operating Room Assistant Director. As Assistant Director of the OR, McCarthy implemented multiple quality and safety initiatives to improve patient outcomes, introduced the reprocessing program for single use items throughout the organization, authored articles on re safety and telesurgery, and presented on orthopedic topics and the re safety program. Within her new role as Operating Room Director, McCarthy hopes to increase patient centered, surgeon, and staff satisfaction. Pat McCarthy, RN We have already started working on staff satisfaction, she explains. There is increased inclusion of the staff in all decisions, and both the nurses and surgical techs are actively studying for certications in their elds. McCarthy is an active member of the Association of Operating Room Nurses, and holds certication in operating room practice from Certied Nurse Operating Room (CNOR).

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