caring august 15, 2002 - mghpcs.org

Inside:SummerWorks ...................... 11111

Jeanette Ives Erickson ......... 22222Restraints

Fielding the Issues ............... 33333New Defibrillators

International Nursing ............ 44444News from Africa

Exemplar ............................... 66666Barbara Rossi, RN

Employee Referral Program .. 77777

Clinical Nurse Specialist ...... 88888Joan Agretelis, RN

Professional Achievements .. 99999

ProTech Program ............... 1010101010

Educational Offerings ........ 1111111111

Illuminations ....................... 1212121212

Working together to shape the futureMGH Patient Care Services

CaringCaringAugust 15, 2002

H E A D L I N E S

SummerWorks

At left: SummerWorks

intern, George Thomas,

a graduate of the Timilty

Middle School in Roxbury,

shares insights about his

experience working in, and

learning about, Information

and Ambassador Services,

under the guidance of

WACC front-desk informa-

tion ambassador, Celeste

Peters. Says Thomas,

“Celeste and I had a great

time. She’s a terrific super-

visor. She taught me a lot

about the job, about the

hospital, and about life in

general. They say the mind

is a terrible thing to waste.

Celeste taught me that a

smile is a terrible thing

to waste, too.”

a program designedto raise awareness

among studentsentering high-school

about careers inhealth care SummerWorks intern, George Thomas,

with mentor, Celeste Peters

August 15, 2002August 15, 2002Jeanette Ives EricksonJeanette Ives EricksonRestraints

An interview with Joan Fitzmaurice, RN, director,Office of Quality & Safety; and Sally Millar, RN, director,

Office of Patient Advocacy

Jeanette: Sally, we’veseen an increase recent-ly in communicationabout restraints and ourpolicy on restraint use.Can you tell us what’sdriving this communi-cation?

Sally: We are alwaysconcerned about pro-tecting our patients andtheir rights. But therehas been renewed inter-est on the national levelaround restraint use,especially as it relates topatients with behavioralproblems. We’re usingthis as an opportunity tostrengthen and clarifyour commitment to pro-tecting all patients.

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

and chief nurse

Jeanette: Joan, when wetalk about restraints, arewe talking about a largepercentage of our patientpopulation.

Joan: Absolutely not.We know that cliniciansexhaust all alternativeinterventions to protectpatient safety beforeeven considering re-straints. Restraints areused only if less restric-tive measures wouldpose a greater risk to thepatient than using re-straints.

We’re talking about avery small percentage ofour total patient pop-ulation—less than tenpercent. And of that num-

ber, we’re talking pri-marily about minimalrestraints, such as siderails or geri tables withlocked trays.

Jeanette: What avenuesare we using to commu-nicate with staff aboutthis important topic?

Sally: We have run, andwill continue to run,articles in Caring Head-lines; we’ve sent out All-User e-mails; we’veworked with Pub-lic Affairs todevelop aposterdescrib-ing ourguidingprinciplesaround re-straint use (theposter is current-ly displayed onunits and in publicareas); we’ve met withthe GEC, the PatientCare Assessment Com-mittee, and members ofthe house staff to educateand inform them aboutchanges in our restraintpolicy.

Joan: And we’ve creat-ed a special card thatstaff can wear along withtheir ID badges as a quickreference to our guide-lines on restraint use.

Jeanette: What steps arewe taking to ensure thatstaff are aware of, andunderstand, our currentpolicy?

Joan: We have imple-mented a ‘review of prac-tice’ system whereby

restraint use isreviewed by

unit leader-ship on a

dailybasis.

Thatinforma-

tion comes tothe Office of Quality &Safety where we use it togenerate reports, whichwe then share with nurses,physicians and staff onthe units. This lets us seehow well we’re doing,and gives us an oppor-tunity to coach and men-tor staff around appro-priate use of restraints.

Sally: We’ve also madesome preliminary changesto the Provider OrderEntry (POE) system thatreflect the recent changesin our restraint policy.Staff can now access

excerpts of the restraintpolicy in POE at the timerestraints are ordered.Other changes to POEwill be made later in theyear.

I think it’s importantto note that although theemphasis is on physi-cians’ ordering restraints,nurse practitioners andphysician assistants alsohave the authority toorder restraints.

Joan: Another aid we’veimplemented is a newflow sheet. This is a doc-umentation tool to assiststaff in the initial assess-ment and ongoing eval-uation of patients in re-straints. The new flowsheet makes it easier forstaff to document re-straint use, and at thesame time ensures a co-hesive understanding ofthe policy.

Jeanette: Sally and Joan,thank-you, this has beenvery helpful. Who canstaff call if they have anyquestions?

Joan: Staff should callthe Office of Quality &Safety at 6-9282 if theyhave any questions.

Patients at risk for injury

ur mission is to provide the highestquality patient care in an environment

that is safe for all patients, families, visit-ors, and employees. MGH is committed tomaintaining the rights, dignity, and well-being of all patients. Below are our guidingprinciples regarding the use of restraints:

MGH is committed to the minimal use ofrestraint and seclusion

Alternative strategies to reduce risk ofinjury are tried prior to restraint use

Restraints are used only when the use ofless restrictive measures poses a greaterrisk than using restraints

All orders for restraints are time-limited

The patient and family are involved in thedecision to use restraints wheneverpossible

Patients are re-evaluated at regularintervals to assess the need for continuedrestraint.

OOOOO

August 15, 2002August 15, 2002

New defibrillatorsThe Fielding the Issues section of Caring Headlines is an adjunctto Jeanette Ives Erickson’s regular column. This section gives thesenior vice president for Patient Care a forum in which to address

current issues, questions or concerns presented by staffat meetings and venues throughout the hospital.

Fielding the IssuesFielding the IssuesCall for Nominations

The Anthony Kirvilaitis Jr.Partnership in Caring award

In January, 2002, Jeanette Ives Erickson, RN,senior vice president for Patient Care,formally announced the creation of the

Anthony Kirvilaitis Jr. Partnership in CaringAward. The purpose of the award is to

recognize and celebrate staff in non-clinicalroles within PCS who exemplify the values and

qualities that made Tony so successful andappreciated in his work as training development

specialist in The Center for Clinical &Professional Development.

Those values include reliability,responsiveness, creativity, assurance,

collaboration, and flexibility.

The award will be given annually to amaximum of two individuals. Nominations are

now being accepted for recipients to beselected in October, 2002.

EligibilityEligibilityEligibilityEligibilityEligibilityOperations associates, unit service

associates, operating room assistants, unitassistants, patient service coordinators,

Emergency Department admitting assistants andpatient care information associates

are eligible for the award.

Nomination and selection prNomination and selection prNomination and selection prNomination and selection prNomination and selection processocessocessocessocessNominations are due by August 23, 2002.Any employee, manager, physician, patient orfamily may nominate a candidate.Those nominating may do so by completing abrief nomination form accompanied by a letterof support. Nomination forms will be availableon patient care units, in the Emergency De-partment, Operating Room, the Bigelow 10PCS Management Office and at the Gray In-formation Desk.Nominees will be asked to submit a letter ofsupport from their manager. If their managerwas the nominating party, then the nomineewill need to provide a second letter from aco-worker.A selection committee convened specificallyfor this purpose will review all letters andselect the award recipients.

AAAAAwarwarwarwarward and award and award and award and award and award-rd-rd-rd-rd-related activitieselated activitieselated activitieselated activitieselated activitiesEach recipient will receive an award of $1,500and will be acknowledged at a ceremony andreception among colleagues and family. Their

names will be added to a plaque honoringThe Anthony Kirvilaitis Jr. Partnership

in Caring Award recipients.

For more information, or assistance with thenomination process, please contact

Nancy DeCoste, training specialist, at 4-7841,or Carolyn Washington, operations coordinator,

at 4-7275.

Question: Is the hospitalconverting to a new de-fibrillator?

Jeanette: The hospitalhas already begun con-verting to the Phillips bi-phasic (two-way current)automated external de-fibrillator (AED) in thePerioperatve Service(including the Main OR,the SDSU, the CardiacOR, the PACU), the Car-diac Surgical and Arrhy-thmia services. Phase 2of the conversion, whichwill begin in the fall,will include the remain-ing intensive and specialcare units (where staffare already trained todefibrillate), The ED,Dialysis, Ellison 11, andthe Knight Cath Lab.

Phase 3 will includegeneral care units; andphase 4 will involve theoutpatient clinics andhealth centers.

AED is the sametechnology currentlyused in public areas, atairports, on airplanes, etc.

Question: Why are wemaking this change?

Jeanette: Bi-phasictechnology utilizes amore advanced energywave that self-adjustsaccording to the imped-ance factors of everypatient, thereby deliv-ering a more even dis-charge of energy regard-less of a patient’s size.Using an appropriateamount of energy to de-

fibrillate provides opti-mal protection to themyocardium. The suc-cess rate for convertinglethal arrhythmias intostable rhythms is signi-ficantly higher using bi-phasic technology.

Staff nurses will betrained to defibrillateusing an advisory alertfunction and externalpads. The advisory alertwarns if defibrillation isindicated based on car-diac rhythm, which issensed through the ex-ternal pads.

An educational planhas been developed byThe Center for Clinical& Professional Develop-ment to help preparestaff.

Call for Portfolios

PCS Clinical Recognition ProgramThe Patient Care Services Clinical Recognition Program is now acceptingportfolios for advanced clinicians and clinical scholars. Portfolios may besubmitted at any time; determinations will be made within three months of

submission. Refer to the http://pcs.mgh.harvard.edu/ website for more detailsand application materials, or speak with your manager or director.

Completed portfolios should be submitted to The Center forClinical & Professional Development on Founders 6.

For more information, call 6-3111.

Complementary andalternative medicine:

Program will look at acupuncture,meditation, and therapeutic touch.Case studies will help demonstrate

the impact of complementaryhealing modalities.

November 22, 20028:00am–4:00pm

O’Keeffe Auditorium

For more information, call 6-3111

The Joint CommissionSatellite Network

presents:

“Patient Safety: AchievingMeasurable Results”

September 12, 20021:00–2:30pm

Haber Conference Room

For more information, call 6-3111


July 22, 2002A three-day HIV/AIDSNursing Conference,coordinated by SheilaDavis, RN, adult nursepractitioner, PartnersAIDS Research Center,and hosted by the Uni-versity of Natal NursingProgram, was held re-cently here in Durban,South Africa. Alongwith Sheila, presentersincluded our colleaguesDonna Gallagher, RN,Brianne Fitzgerald, RN,and IHP student, Jamie

Zagorski, RN, whomSheila had recently pre-cepted. Sheila has travel-ed back to the UnitedStates and other parts ofthe world in her efforts toeducate, advocate for,mentor, and provide edu-cation to nurses in thefield, not only in theUnited States, but here inSouth Africa, where theneed for education growsdaily. Seventy nursesfrom Kwa-Zulu Nataland other provinces came

together to gain know-ledge about the virus thatis filling South Africanclinics with patients suf-fering its devastatingeffects.

In Kwa-Zulu Natal,one of the hardest hitareas of the world, HIV/AIDS has been a grow-ing cause of concern fornurses. One conferenceattendee put the situationinto perspective whenshe said she could goback to her practice and,

even though she may nothave the means to curepeople, having the infor-mation she learned at theworkshop de-mystifiedthe disease and gave herhope.

For local nurses atthe bedside it is a greatmystery indeed to see somany young patientsdying in the prime oftheir lives. Sr. ChristaMary, a well respectednurse leader in the pro-vince, reports that re-cruiters are luring nursesaway from South Africafor jobs everywhere fromDubai to Australia. Butshe stresses it’s wrong tothink nurses are runningaway from their people.Nurses are paid an aver-age of 5,000 to 8,000rand per month, the equi-valent of $500 to $800US dollars, and expectedto support families. Theyare often the only em-ployed person in theirextended family, notastonishing in a countrywhere the unemploymentrate falls consistentlybetween 50 and 70%.

No single issue canbe attributed to the cause

for burnout and flightfrom the nursing profes-sion.

The three-day HIV/AIDS Nursing Confer-ence provided importantknowledge delivered tonurses by nurses in aformat that was open,caring and respectful.Participants shared theirrich and often misunder-stood cultural practicesand beliefs, and challeng-ed each other to opentheir hearts and minds tounderstand patients fromcultures and beliefs notfamiliar to them. Topicsdiscussed included theritual circumcision ofadolescent males whosometimes die of septicinfection. Instead of judg-ing these practices, dis-cussion focused on theneed for clinicians toteach traditional doctorsthe principles of steriletechnique and antibiotics.One South African nursespoke of a local team ofhealthcare workers whohelped educate a campwhere circumcision rit-uals take place and be-cause of the mutual in-

International NursingInternational Nursing

Chris Shaw, RN, and Sheila Davis, RN

MGH nurses bringimportant AIDS education

to South AfricaChris Shaw, RN, and Sheila Davis, RN, participants in the Nursing

Partners AIDS Project (NPAP), a joint undertaking with the PartnersAIDS Research Center, are currently working as part of a two-year

humanitarian assistance program in South Africa. NPAP sends cliniciansto areas hardest-hit by the AIDS epidemic to implement and coordinate

services to help alleviate the suffering caused by this devastatingdisease. Shaw and Davis have agreed to share their

experiences with readers of Caring Headlines.Below is a recent correspondence from Shaw..

continued on next page

Conference presenter and IHP student, Jamie Zagorski, RN, shares amoment with conference attendee, Mazwi (pronounced Mar-zway) a

community organizer and outreach worker.


volvement of traditionalculture and modern med-icine, the rate of infec-tion has decreased sig-nificantly.

There were discus-sions about race andculture which have thepotential to be chargedwith accusations ofblame, but within thesetting of this confer-ence, discussions wererespectful and thoughtful.Nurses in attendancereflected much of therich diversity of SouthAfrica. They recognizedthat the struggles of thepast contribute to manyof the current misunder-standings.

Brianne Fitzgerald,RN, a nurse who hascared for HIV patients in

a wide variety of venues,opened her presentationon psycho-social issueswith the quote, “Go insearch of your people,love them, meet themwhere they are, and lis-ten to them.” It was theperfect opening for ourinvited guest speaker,Arthur Jonkweni, a 22-year-old Zulu youth vol-unteer coordinator andoutreach worker for theTreatment Action Cam-paign here in Kwa-ZuluNatal. Arthur sharedpersonal stories of en-counters he’s had withyoung people in ruraland urban areas and chal-lenged nurses to reachout to people in commu-nities where HIV/AIDSpatients are ‘invisible.’ It

is a sad fact that manypeople who live in SouthAfrica never see theheartbreaking devasta-tion of HIV/AIDS. Butfor Arthur it is his dailymission to listen to thevoices of those who areunheard, and delivertheir message to the restof us.

For nurses, it’s im-possible not to encounterthose infected by HIV/AIDS as the rate of in-fection stands somewherebetween 70 to 80%.

New England AIDStraining director, DonnaGallagher, RN, closedthe conference with aninteractive presentationon “Care for the Carer,”a personal perspective ofher years of experienceas an HIV/AIDS special-ist in the United Statesand a global lecturer in

places hardest hit by thepandemic. Her talk em-phasized the need fornursing education toinclude comprehensiveworkshops on HIV/AIDSto de-mystify, de-stig-matize, and provide hopeat a time when hope is inshort supply.

AIDS Education in South AfricaAIDS Education in South AfricaAIDS Education in South AfricaAIDS Education in South AfricaAIDS Education in South Africacontinued from previous page

Sheila has returnedhome, but will continueto fund-raise and preparefor the next series ofworkshops scheduled forFebruary, 2003. It is aprivilege to be living andworking here with nurseson the front lines andhave the support andexpertise of fellow nurses,educators and clinicianslike Sheila, Donna, andBrianne, and the indirectsupport of nurses atMGH who share theirknowledge, experience,and hope with me incorrespondences andprayer. Your strength andsupport are allowing meto help nurses who needit most.

Sister Christa Maryhas told me she wishesshe could keep Sheila,Donna, Brianne, andJamie here to continueeducating nurses in Kwa-Zulu Natal. From theland of the Zulu whoselove, good will, and hu-mor is balm for the soul,I share this with you andask for your continuedsupport and prayers.Chris

At a support group/training session, Sheila Davis, RN, conductsworkshop on antiretrovirals for people living with HIV/AIDS.

Mazwi (right), helps bring nurses into ruralareas to teach about HIV/AIDS virus.

(Photos from Africa provided by Chris Shaw and Sheila Davis)


Barbara Rossi, RN,staff nurse, Emergency Department

y name isBarbaraRossi, and I

have been anurse for 33 years, anMGH Emergency Depart-ment (ED) staff nurse forthe last two years. As amember of the ED resus-citation team, I recentlycared for a young womanwho presented to the EDin pulseless electricalactivity arrest (PEA).Being involved in thisteam effort reminded meof why I became a nurseand why I love this pro-fession.

The mutual decision-making, trust, and team-work during this criticaland extremely difficultsituation was outstand-ing, and I feel made adifference in the outcomefor this patient. I alsofeel that everyone in-volved made valuablecontributions to the criti-cal thinking and processof care for this patient.All thoughts and ideaswere considered; every-one participated in acohesive decision-mak-ing process.

Mrs. R was a 42-year-old, married, mother ofthree, who was at homewith her family on theevening of her admis-sion. She had recentlyfractured her left ankle.Over the previous fewdays, she had complain-ed of increased discom-fort with less activity.Her husband reportedthat her primary carephysician was concernedabout the possibility of aDVT (blood clot in herleg) but an MRI hadbeen negative. Mrs. Rhad been taking aspirinonce a day. Her medicalhistory was significantfor varicose veins andoral contraceptives.

According to herfamily, Mrs. R had beensitting on the couch whenshe stood up and com-plained of pleuritic chestdiscomfort, and thencollapsed. Her husbandsaid she appeared to beseizing with rhythmicmovements of her extrem-ities. He immediatelycalled 911. When theparamedics arrived she

had agonal (strained)respirations and a heartrate in the 140s. She wasimmediately intubated.Following intubation,her heart rate droppedand CPR was started.Mrs. R was then trans-ported to MGH.

When Mrs. R arrivedin the ED, we all felt thesituation was tense be-cause we were awarethat a young and fragilelife hung in the balance.Mrs. R had a rapid heartrate of 140-150, and shewas not perfusing (get-ting blood to her extrem-ities). Chest compres-sions were continued.She received IV fluids aswell as atropine; epine-phrine; D50; NaHCO3;and dopamine and levo-phed via continuousinfusion. Her oxygensaturation was 70-80%and her initial blood gaslevels were criticallylow.

In spite of our efforts,Mrs. R’s condition didnot improve. The teamsuspected pulmonaryemboli (PE). For thatreason, it was decidedthat Mrs. R should re-ceive a dose of TPA (aclot-breaking agent); abolus was given follow-ed by continuous infu-sion. Once Mrs. R re-ceived the TPA, her col-or improved and herperfusion was maintain-ed. We sensed hope inone another and a feel-

ing that maybe Mrs. Rwould survive.

Mrs. R soon develop-ed hematuria (blood inher urine) and a nosebleed, but her oxygensaturation and blood gaslevels improved drama-tically. She had somepurposeful movement onthe right side. Again, Isensed that the entireteam was feeling hope-ful.

Mrs. R’s husband andfamily came in to seeher. We explained thegravity of her situation.They cried, and I cried. Itried to support Mrs. R’sfamily and encouragethem to talk to her, holdher hand, and let herknow they were there.Years of emergency nurs-ing experience told methe situation and progno-sis were bleak. However,because of my experi-ence, I also knew thatcaring for the family isan important part of em-ergency nursing, espe-cially during criticalsituations.

Once Mrs. R wasstabilized in the ED, shewas transferred to the

CCU. Her prognosis didnot look hopeful givenher recent resuscitation,which included intermit-tent CPR for almost anhour, hypoxia (low oxy-gen level), and criticalblood gas values.

When I returned towork the following Mon-day, I was greeted by oneof the team doctors whosaid, “You must go to theCCU. You won’t believeit.”

I gathered myselftogether and off to theCCU I went. Staff theretold me that, remarkably,Mrs. R was able to fol-low commands, althoughshe was a little slow torespond. I cried when Ileft. I felt humbled byher recovery, and an es-sential part of it.

I later visited Mrs. Ron one of the medicalunits. Again, I was over-whelmed by her aston-ishing recovery. Althoughshe had no recollectionof the events, she told methat her husband hadfinally shared what hap-pened with her. “It wastime,” she said.

MCaring for patients in times

of crisis, a privilegefor ED nurse

ExemplarExemplar

continued on next page

Educational Offerings and EventCalendar Now Available On-Line

The Center for Clinical &ProfessionalDevelopment now lists educational offerings

on-line at

http://pcs.mgh.harvard.edu

To access the calendar, click on the linkto CCPD Educational Offerings.

For more information or to register for any program,call the Center at 6-3111.


Even though the EDcan be a very stressfulenvironment in which towork, caring for Mrs. Rin such a critical situa-tion, and seeing the posi-tive outcome, makesbeing a nurse and a mem-ber of this dynamic teamworthwhile. Mrs. R’srecovery has renewed for

me the meaning and pri-vilege of being a nurse. Iam fortunate to be partof a team of profession-als who care for patientsand their families intimes of crisis.Comments byJeanette IvesErickson, RN, MS,senior vice presidentfor Patient Care andchief nurse

This narrative gives us awonderful glimpse into

ExemplarExemplarExemplarExemplarExemplarcontinued from page 6

Retention & RecruitmentRetention & Recruitment

the high-tech, fast-paced,life-and-death decision-making that epitomizesED nursing practice.Barbara’s account ofteamwork in this criticalsituation is more thanpeople just working sideby side; it’s a team ofclinicians so united inpurpose, they feel eachother’s hope, determina-tion, and commitment.That is a special kind ofteamwork.

The combined wis-dom, skill and experienceof this team enabledthem to assess, diagnoseand treat this gravely illwoman about whom theyinitally knew very little.Barbara understood thefear and anxiety of Mrs.R’s family, waiting help-lessly for news. Despitethe critical nature ofMrs. R’s condition, Bar-bara included the familyas soon as it was safe todo so.

Despite the fact thatMrs. R was unconsciousduring the time she spentin the ED, a connectionwas made; a connectionbetween Barbara andMrs. R, and betweenBarbara and Mrs. R’sfamily. Barbara’s visitsto Mrs. R in the CCUand medical unit speakto the strength of thatconnection.

Thank-you, Barbara,this is a wonderful story.

Employee Referral Program: bringingquality clinicians to MGH

t was the NewGraduate Critical

Care Nurse Pro-gram that really

attracted me to MGH,”says Kate Garrigan, RN,who has two weeks leftof her orientation in thePediatric Intensive CareUnit. Garrigan is one ofalmost a hundred clini-cians who has come toMGH since July, 2001,through the MGH Em-ployee Referral Program.

Garrigan was referredby staff nurse, NancyGiese, RN, of the Bige-low 13 Burn Unit. Garri-gan’s mom met Giese ata Christmas party, thetwo got to talking, andGiese suggested she haveKate call her.

Says Garrigan, “Wetalked for about an hour.I knew I wanted to work

I“ in Pediatrics, but being anew nurse, I didn’t thinkcritical care would be anoption for me. So when Iheard about the NewGraduate Critical CareNurse Pro-gram, it real-ly sparkedmy interest.”

The pro-gram involvesa six-monthorientationperiod, dur-ing whichthe newnurseworks closelywith a preceptor. SaysGarrigan, “It is such agreat learning experience.I’ve been exposed to somany different situationsthat you just don’t get innursing school. It’s aunique opportunity to

learn in a very complexsetting with the supportof an experienced nurseand mentor.”

Garrigan graduatedfrom Simmons College

with anursingdegree inDecember,2001, andstartedworkingat MGH

New graduate nurse, Kate Garrigan, RN (left), andpreceptor, Lisa Henderson, RN, in the PICU

in February, 2002. SaysGarrigan, “I’m in theprocess of getting mymaster’s degree, andboth Brenda Miller(nurse manager) andKathryn Beauchamp(clinical nurse specialist)have been very suppor-tive. I have to say. . . Ifeel like I have the sup-port of the whole staff. Ilove the pace, the envi-ronment, and the people.

Bigelow 13 is a 22-bed adult patient care unit with12 beds designated for plastic surgery, 10 beds forburn patients (5 of those dedicated to critically illburn patients).

The PICU is an 8-bed, critical care unit for childrenfrom newborn to age 19.

It’s a great unit.”Giese, who is herself

a preceptor for the NewGraduate Critical CareNurse Program on herunit, has been a nurse for13 years.

Talk about a win-winsituation. Giese receiveda $1,000 referral bonus,which she generouslysplit with Garrigan. SaysGiese, “I know how hardit is when you’re justgetting started and goingto school. I thought itwas only fair that she gothalf.”

Nancy Giese, RNstaff nurse, Bigelow 13


ecently, Kar-leen Habin,RN, researchnurse managerfor the Gillette

Center for Women’s Can-cers, and I attended thefirst Cooperative GroupCancer Nursing ResearchSummit, which broughttogether nationally rec-ognized nurse research-ers and nurse leadersrepresenting the NationalCancer Institute (NCI),the National Institute ofNursing Research (NINR),the Komen Foundation,the American CancerSociety (ACS), and theOncology Nursing So-ciety (ONS), as well asrepresentatives fromseveral cooperative re-search groups.

A number of keynurse leaders attendedthe summit includingDrs. Claudette Varric-chio and Ann O’Mara ofthe NINR.

The goal of the sum-mit was to exchangeinformation and formcollaborations to faci-litate multi-site nursingresearch. Five objectiveswere identified:

To understand thenursing researchstructure and cultureof other organizationsTo investigate fundingopportunities forcollaborative groupnursing researchTo develop strategiesto integrate nursingresearch into coopera-

Joan Agretelis, RNclinical nurse specialist

Clinical Nurse SpecialistsClinical Nurse SpecialistsNew strides in nursing research:

a report on the Cooperative GroupCancer Nursing Research Summit

R tive group researchagendasTo establish a collab-orative, national net-work through whichnursing studies can beconductedTo increase nationalawareness of nursingresearch opportunitieswithin cooperativegroup settings.To appreciate the

magnitude and relevanceof this unique gatheringof nurse leaders, it isimportant to understandthe historical barriersthat have influencednursing research in thepast. Unlike medicalresearch, most nursingresearch has been con-ducted at single institu-tions, utilizing small,minimally diverse pa-tient populations, there-by limiting the general-izability of nursing know-ledge to the broader pop-ulation. Large, multi-cen-ter nursing research hastaken place only rarely.

By gaining access to alarger source of scientificexpertise, and a larger,more diverse patientpopulation, nurses at alllevels can facilitate sci-entifically credible nurs-ing research. This sum-mit was a first step inwhat could be a monu-mental change in hownursing research is con-ducted in this country.

The current state ofcooperative group nurs-ing research spans a

wide range. Of the ninegroups represented at thesummit, nursing researchstudies have been con-ducted in all but threegroups. However, only ahandful of nursing stud-ies have been completedover the past 50 yearscompared to thousandsof medical studies. Ad-ditional studies are cur-rently accruing patientsor have been approvedbut are pending funding.And other studies arestill in the developmentphase. In the groups thathave not yet developednursing studies, facilita-tion of nursing researchwas clearly identified asa goal for the future.

In addition to nurse-initiated studies, nursesat all levels have madesignificant contributionsto the design and execu-tion of medical and be-havioral-science-focusedstudies, functioning asconsultants, study co-ordinators, clinical re-search associates, andco-investigators. Nursesare beginning to identifynursing-specific out-comes from these non-nurse-initiated studies.Dissemination of thesefindings through publi-cation of results in peer-reviewed journals will beimportant.

Several areas of sci-entific focus where iden-tified by participants atthe summit. ClaudetteVarricchio, RN, reportedthat funding is available

for cancer nurse research-ers targeting clinical-trialdevelopment in severalareas, including:

Health promotion indiverse populationsNeuro-function andsensory conditionsImmune responses andoncologyEnd of lifeDisease preventionSymptom managementMinority health issues.One presentation pro-

vided evidence support-ing the lack of improve-ment in overall survivalfor cancer patients be-tween the ages of 25-39,primarily due to poorclinical trial participa-tion among this group.The presenter challengedsummit nurse leaders totarget this young adultand older adolescentpopulation when design-ing research agendas.

Several challengeswere identified that needto be considered whendeveloping strategies toadvance a nursing re-search agenda withincooperative group set-tings. The following listsummarizes areas for

future focus by summitparticipants:

Funding is needed forclinical-trial execu-tion, travel for nurseresearchers and clini-cal experts to attendcooperative groupmeetings, and futuresummitsNeed to educate aca-demically focusednurses regardingstrategies for navigat-ing within cooperativegroup systems and onimportant, yet subtle,requirements withingrant applications thatwill lead to fundingNeed to educate/mentor clinical nurseexperts regardingresearch methodologyLinkage of nurseresearchers withclinical nurse expertsEducation withincooperative groupsregarding the contri-butions of nurse re-searchers-clinicalnurse dyadsConsider concernsregarding who ownsthe data and paperauthorshipcontinued on next page


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

Services at Massachusetts General Hospital.

PublisherJeanette Ives Erickson RN, MS,

senior vice president for Patient Careand chief nurse

Managing Editor/WriterSusan Sabia

Editorial Advisory BoardChaplaincy

Mary Martha Thiel

Development & Public Affairs LiaisonGeorgia Peirce

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

Materials ManagementEdward Raeke

Nutrition & Food ServicesPatrick BaldassaroMartha Lynch, MS, RD, CNSD

Office of Patient AdvocacySally Millar, RN, MBA

Orthotics & ProstheticsEileen Mullen

Patient Care Services, DiversityDeborah Washington, RN, MSN

Physical TherapyOccupational Therapy

Michael G. Sullivan, PT, MBA

Police & SecurityJoe Crowley

Reading Language DisordersCarolyn Horn, MEd

Respiratory CareEd Burns, RRT

Social ServicesEllen Forman, LICSW

Speech-Language PathologyCarmen Vega-Barachowitz, MS, SLP

Volunteer, Medical Interpreter, Ambassadorand LVC Retail Services

Pat Rowell

DistributionPlease contact Ursula Hoehl at 726-9057 for

all issues related to distribution

Submission of ArticlesWritten contributions should be

submitted directly to Susan Sabiaas far in advance as possible.

Caring Headlines cannot guarantee theinclusion of any article.

Articles/ideas may be submittedby telephone: 617.724.1746

by fax: 617.726.8594or by e-mail: [email protected]

Please recycle

Next Publication Date:September 5, 2002

Develop a common languagewhen articulating our visionMerge nursing science intocooperative group agendasIdentify and establish con-nections with nurse research-ers not present at the summit.Next steps identified by the

group include:

CNSCNSCNSCNSCNScontinued from previous page Disseminate summit outcomes

via journals, publications,press releases and presenta-tionsEducate all cooperative groupnursing committees.Obtain fundingContinue networking to enlistparticipation of more nurseresearchersI hope this overview helps

shed some light on the future

role of nurses in cooperativeoncology research groups. Iwas recently appointed to theCancer and Leukemia Group B(CALGB) Oncology NursingCommittee as the nurse research-er for symptom management, sothis was a great opportunityfor me to get a glimpse intonursing research on the nation-al level before going to NurseScientist Training at NIH.

Bilodeau certified critical careclinical nurse specialist

On June 21, 2002, Bigelow 13 clinicalnurse specialist and nurse practitioner of theMGH Burn Service, MaryLiz Bilodeau, RN,

became certified as a critical care clinical nursespecialist by the American Association

of Critical Care Nurses.

Madigan receives MONE’sSherwood Service Award

Janet Madigan, RN, project managerfor Nursing Information Systems, receivedthe Elaine K. Sherwood Service Award atthe Massachusetts Organization of Nurse

Executives (MONE) annual meeting,May 23, 2002. The award recognizes

outstanding commitment and contributionsto the work of MONE, including longevityof service, project management, leadership,

dependability, and support of peersdeveloping within the

organization.

Whitaker presents posterat ANNA conference

Blake 6 staff nurse, Debra Whitaker,RN, was lead author of the poster, “A

Collaborative Protocol for the Transplant ofMultiple Myeloma,” at the American

Nephrology Nursing Association’s annualconference in May, 2002. The posterdescribed the team approach used in

successful, simultaneous, combined renaland bone-marrow transplants. Contributing

authors include: MaryLiz Bilodeau, RN,Loretta Godfrey, RN, Lisa Sohl, RN,

and Nina Tolkoff-Rubin, MD.

Lawson receivesmed-surg certification

Donna Lawson, RN, staff nurse, Bigelow 11,is the first nurse on her unit to receive

medical-surgical certification.

Morton presents at Burnand Wound Care Symposium

Sally Morton, RN, Bigelow 13 staff nurse andmember of the MGH DMAT Team, presented,“Burn Team Response to a National Disaster,”at the John A. Boswick, MD, Burn and WoundCare Symposium, on February 18–20, 2002,

in Maui, Hawaii.

Noska presents at TransplantManagement Forum

Susan Noska, RN, Blake 6 transplantcoordinator, presented, “Transplantation,”

at the 10th annual United Network for OrganSharing’s Transplant Management Forum,on May 20, 2002. The presentation was abroad-based overview of organ and tissue

transplantation, including a historyof organ transplatation and a discussion

of anticipated future enhancements.

Professional AchievementsProfessional Achievements

The Employee Assistance Programpresents

“Stress Management in Today’s World”

Presented by Stacey Drubner, JD, LICSW

Seminar will educate staff on the causes of stressand help participants adapt coping styles to more

effectively respond to stressful situations.

September 12, 200212:00–1:00pm

Wellman Conference RoomFor more information, call 726-6976.


he ProTech Pro-gram, a collab-

orative ventureinvolving MGH,

East Boston High School,and the Private IndustryCouncil, provides oppor-tunities for juniors andseniors at East BostonHigh School to gainknowledge about jobsand careers in a hospitalsetting. Through parti-cipation in the program,students become familiarwith the roles of nurses,therapists, pharmacists,dieticians, technicians,

secretaries, and environ-mental service workers.

The ProTech Programis coordinated throughthe MGH CommunityBenefits Office. WithinPatient Care Services,the program is coordi-nated by The Center forClinical & ProfessionalDevelopment. ProTechoffers students a chanceto:

gain awareness oftheir talents and careerinterests

T

Student OutreachStudent OutreachProTech Program spotlightshealthcare careers for high

school students—by Carol Camooso Markus, RN

and Mary McAdams, RN

develop work habitsto promote futuresuccesslearn skills that can bebrought back to theclassroomhave a paid workexperience while stillin school.

This year, we haveone ProTech intern oneach of the followingunits: Bigelow 7, Bige-low 11, Ellison 3, White7, White 9, Ellison 7,

and in the department ofOccupational Therapy.

In Nursing, there aretwo levels of ProTechinterns. Level 1 internsare trained in specificskills such as filing med-ical records, creatinginventories, maintainingthe nurse-station workarea, and doing specificprojects under the direc-tion of the operationscoordinator and nursemanager. Level 2 train-ing includes assisting

nurses in the transfer ofpatients, making beds,filling water pitchers,and assisting patientswith menus.

ProTech studentswork 15 hours a weekduring the school yearand 40 hours a weekduring the summer. Formore information aboutthe ProTech Program,please contact CarolCamooso Markus RN,professional developmentcoordinator, at 4-7306.

ProTech interns (l-r): Lillian Gonzalez (White 7);Victoria Fernandes (Bigelow 11); Filomena Barros (White 9);

and Nancy Ventura (Ellison 7)

Mary McAdams, RN, clinical educator, trainsinterns in proper bed-making techniques.

Training specialist, Nancy DeCoste, talks withinterns about the importance of labelling,

organizational skills, and courtesy to all patients.

In memory of September 11thThe MGH Chaplaincy will offer a specialservice on the one-year anniversary of

September 11th. The service will includeparticipants of many religious traditions and

will be tele-conferenced to theHaber Conference Room.

Wednesday, September 11, 200211:30am–12:00pm

O’Keeffe Auditorium.

2002

2002

August 15, 2002Educational OfferingsEducational Offerings

August 15, 2002

For detailed information about educational offerings, visit our web calendar at http://pcs.mgh.harvard.edu. To register, call (617)726-3111.For information about Risk Management Foundation programs, check the Internet at http://www.hrm.harvard.edu.

DescriptionWhen/Where Contact Hours

Intermediate ArrhythmiasWellman Conference Room

3.9August 268:00–11:30am

Pacing : Advanced ConceptsWellman Conference Room

5.1August 2612:15–4:30pm

Neuroscience Nursing Review 2002 (Day 1)BWH

TBAAugust 27 (and September 19)8:00am–4:15pm

New Graduate Nurse Development Seminar IITraining Department, Charles River Plaza

5.4 (contact hoursfor mentors only)

August 288:00am–2:30pm

Chemotherapy Consortium Core ProgramWolff Auditorium, NEMC

TBASeptember 38:00am–4:30pm

CVVH Core ProgramVBK601

6.3September 48:00am–4:00pm

CPR—American Heart Association BLS Re-Certificationfor Healthcare ProvidersVBK 401

- - -September 57:30–11:30am,12:00–4:00pm

Nursing Grand RoundsO’Keeffe Auditorium

1.2September 51:30–2:30pm

Heart Failure: Management Strategies in the New MillenniumO’Keeffe Auditorium


OA Preceptor DevelopmentTraining Department, Charles River Plaza

- - -September 68:00am–4:30pm

CPR—Age-Specific Mannequin Demonstration of BLS SkillsVBK 401 (No BLS card given)

- - -September 108:00am–12:00pm (Adult)10:00am–2:00pm (Pediatric)

Mentor/New Graduate RN Development Seminar ITraining Department, Charles River Plaza

September 118:00am–2:30pm

6.0(mentors only)

OA/PCA/USA ConnectionsBigelow 4 Amphitheater

- - -September 111:30–2:30pm

Introduction to Culturally Competent Care: Understanding OurPatients, Ourselves and Each OtherTraining Department, Charles River Plaza

7.2September 128:00am–4:30pm

---September 121:00–2:30pm

The Joint Commission Satellite Network presents:“Patient Safety: Achieving Measurable Results.” Haber Conference Room

---September 138:00am–4:30pm

Staying on Top of Your Game: Advanced Cancer NursingO’Keeffe Auditorium

Pacing: Basic ConceptsHaber Conference Room

---September 171:00–3:00pm

CPR—American Heart Association BLS Re-Certificationfor Healthcare ProvidersVBK 401

- - -September 187:30–11:30am,12:00–4:00pm

Social Services Grand Rounds“An Overview and Application for DBT.” O’Keeffe Auditorium. Formore information, call 724-9115.

CEUsfor social workers only

September 1910:00–11:30am

Neuroscience Nursing Review 2002 (Day 2)Wellman Conference Room



CaringGRB015

MGH55 Fruit Street

Boston, MA 02114-2696

CaringH E A D L I N E S

First ClassUS Postage PaidPermit #57416

Boston MA

“Wrap it up,We’ll take it to go!”

special painting goes homewith special patient

(Pho

to p

rovi

ded

by B

eth

Hom

icki

)

(L-r):Jerry and Jane Lapriore, the painting,“Morning Light,” and Teresa McCue (the artist).

ane Laprioregot more than

great care at MGH.She got Morning

Light, a painting bylocal artist, Teresa

McCue. The painting waspart of the Illuminationsart exhibit that was ondisplay in the MGH Can-cer Center. Illuminationsis a rotating art exhibit,made possible with fund-ing from the Friends ofthe MGH Cancer Center,that uses art to create ahealing and comfortingenvironment for patientsand families.

JWhen Jane was

diagnosed with cancer,she began an aggressiveregimen of radiationand chemotherapy.Jane’s husband, Jerry,recalls, “It was a ter-rible time for us; a verydifficult time for mywife. When we came toMGH for treatment andwe sat in the waitingarea on Cox two, wewere drawn to thispainting called, Even-ing Light. It broughtboth of us such peace.We found ourselvesgravitating to it when-

ever we came here.”Says Jerry, “As my

wife neared the end ofher treatment, I thoughtshe deserved a majorpresent! So I got in touchwith the artist, Teresa

McCue, and arranged tobuy it and have it de-livered the day Jane fin-ished her treatment.”

The Lapriores havesince renamed the paint-ing, Morning Light, and

have it in their home,where it occupies a placeof distinction. Says Jerry,“It has a very specialplace in our hearts, andstill brings us a sense ofpeace and comfort.”

IlluminationsIlluminations

caring august 15, 2002 - mghpcs.org

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