winter 2016 nursing beat

conehealth.com WINTER 2016 • Vol. 13 No. 1

T H E P U L S E O F N U R S I N G A T C O N E H E A L T HEditors

Nursing BeatMISSION STATEMENT

To communicate and celebrate

the dynamic power of

nursing innovations and

enduring values.

Rebecca Albertson, RN, BSNAnnie Penn Hospital

Sarah Clark, RN, MSN, CCRN, CHSESimulation Coordinator

Jennifer L. Fencl, DNP, RN, CNS, CNOR Clinical Nurse Specialist, Operative services

Belinda Hammond, RN, MSN, CEN, CCRNClinical Nurse Educator, Critical Care

Joan LoPresti, RN, MS, BSN, NEA-BCDirector, Nursing/Patient Services

Moses Cone Hospital

LouAnn ShortAdministrative Assistant, Setting the Pace Editor

Nancy Summerell, RN, MSN, CENAt Large

Editor-in-ChiefSarah Lackey, DNP, APRN, CCNS

Magnet Program DirectorNDNQI Site Coordinator

Rapid Response Team, Relief

MARKETING SUPPORTDeborah Humphrey, MA

Director of Communications

DESIGNERMary Jo Helms, CreativeMode

Special thanks to Lisa Boland, DNP, RN, NEA-BC, for assistance with this issue.

Terri Andrews, RN, MBA Executive Director, Quality Excellence

Theresa Brodrick, PhD, RN, CNS, CNA Executive Vice President & Chief Nursing Officer

Anne Brown, RN, MSN, PCCN Director, Nursing/Patient ServicesWesley Long Hospital

Dennis Campbell, RN, MS, BSN, NEA-BC VP, Nursing/Patient ServicesBehavioral Medicine Services

LaVern Delaney, RN, MSN, MHA/MBA, NE-BC VP, Nursing /Patient ServicesAlamance Regional Medical Center

Waqiah Ellis, RN, MSN, NE-BCDirector, Nursing/Patient ServicesMoses Cone Hospital

Debbie Grant, RN, MSN, CENP VP, Nursing Practice, Education and Community Outreach

Mona Easter, RN, BSN, MBA, NE-BC VP, Nursing/Patient ServicesAnnie Penn Hospital

Carol Harris, RN, MHA, CCRN, NE-BC Director, Nursing and Patient ServicesAlamance Regional Medical Center

Karin Henderson, RN, MSN, CENP Executive DirectorOrganizational Integration

Joan LoPresti, RN, MS, BSN, NEA-BC Director, Nursing/Patient Services Moses Cone Hospital

Sharon McCarter, RN, BSN, MHA, CNORExecutive Director of Operative Services

Wayne McFatter, RN, MSN, CNOR, RNFA Executive Director of Operative Services

Annette Osborne, RN, MSN, NEA-BC VP Nursing/Patient ServicesMoses Cone Hospital

Sue Pedaline, DNP, RNC, MS VP Nursing/Patient ServicesWomen’s Hospital

Cheryl Somers, RN, MSN, NEA-BC Executive Director, Emergency Services

Youland Williams, RN, MSN, NEA-BC VP Nursing/Patient ServicesWesley Long Hospital

Cone Health Nurse Executives

1200 North Elm Street, Greensboro, NC 27401conehealth.com/nursing

conehealth.com Fall 2014 • Vol. 11 No. 3

THE PULSE OF NURSING AT CONE HEALTH Editors

3rd Annual Nursing Research Symposium

Keynote address by Dr. Courtney Lyder

page 3 Nursing BeatMISSION STATEMENT




enduring values.

Lisa Boland, RN, MSN, NEA-BCManager, Nursing Outreach and Retention,

Setting the Pace Editor

Sarah Clark, RN, MSN, CCRNSimulation Coordinator

Jennifer L. Fencl, DNP, RN, CNS-BC, CNOR Clinical Nurse Specialist, Operative services


Thresa Haithcock Isley, DNP, RN, APRN-BCClinical Nurse Specialist

Nancy Summerell, RN, MSNClinical Nurse Educator, ED Academy

Editor-in-ChiefSarah Lackey, RN, MSN, CCNSMagnet Program Coordinator

NDNQI Site CoordinatorRapid Response Team, Relief






Dennis Campbell, RN, MS, BSN, NEA-BC Vice President, Nursing/Patient ServicesBehavioral Medicine Services

LaVern Delaney, RN, MSN, MHA/MBA VP, Nursing /Patient ServicesAlamance Regional Medical Center



Tracy Diffenderfer, RN, BSN, MSN, CNOR Executive DirectorOperative Services and Anesthesia

Mona Easter, RN, BSN, MBA Vice President, Nursing/Patient ServicesAnnie Penn Hospital


Joan LoPresti, RN, MS, BSN, NEA-BC Director, Nursing/Patient Services, Moses Cone Hospital

Annette Osborne, RN, MSN VP Nursing/Patient ServicesMoses Cone Hospital

Sue Pedaline, DNP, RNC, MS VP Nursing/Patient Services,Women’s Hospital


Youland Williams, RN, MSN, NEA-BC Executive Director, NursingOncology Services











enduring values.





































enduring values.





































enduring values.





























Reinventing Care MAGNETTRANSFORMATIONAL LEADERSHIP

2 27

Happy New Year! What an incredible

year we had in 2014!

First, Cone Health was re-

designated Magnet for the third

time as a health system. As you

all know, we were one of only

three health networks in North

Carolina to achieve this important

designation three times in a row. This is a true

testament to your excellence in nursing. Just a few months

after this honor, 26 of our nurses were named to the state’s

Great 100, making Cone Health the most recognized team in

North Carolina – for the fourth consecutive year!

These accomplishments truly reflect the outstanding

work you do every day for our patients and communities.

Congratulations on these well-deserved honors, and thank

you for your contributions!

As we move into 2015, I am energized by the fabulous

opportunity we have for another great year. Most

significantly, this includes our opportunity to make a

real difference for our patients as we work together in

Reinventing Care across Cone Health.

As nurses, each of you will be a driving force in redesigning

how and where we care for women, children, behavioral

health and surgical patients in Greensboro. Working together

with physicians and patients, we will develop a new model to

provide the very best, high-quality and cost-effective health

care long into the future.

As you know, we estimate this $100 million project will

include:

• Moving Women’s Hospital to a separate and distinct area

on The Moses H. Cone Memorial Hospital campus by early

2019.

• Redesigning behavioral health care to include: 1) opening a

new outpatient facility in 2016 and 2) replacing Cone

Health Behavioral Health Hospital, likely by late 2019.

• Renovating and expanding surgical areas at Wesley Long

Hospital, as one part of our continuing planning process

related to Operative Services.

As nurses and key care providers, you will be invited to

participate in everything from planning the care design and

the flow of the new facilities to sharing your specific ideas

about what will go where in our patient rooms and operating

suites. Your input is critical to this process.

These are very exciting times for all of us as Cone Health

caregivers. I look forward to learning more from you as we

work together to provide the most exceptional care possible

for our patients and our communities. As always, thank you

for all you do every day!

Respectfully,

Theresa Brodrick, PhD, RN, CNS, CNA

I recently heard a story – a written essay read aloud – on National

Public Radio. The essayist had heard one side of a phone

conversation while she rode home on a commuter train at

the end of the day. She described her impressions of the

speaker, the conversation, and the way the information was

delivered. The phrases sounded scripted, practiced and stale.

She wondered about the person on the other end of the

conversation, and how the call was being received.

I was heartened to hear that at the end of the essay, the author took

another perspective – that of the caller. She asked herself questions about the possible

situation, what mental state the caller was in, what the relationship between the two might

be, and what circumstances led up to the conversation. She asked some key questions that

would lead to more understanding of the overall situation, not just what she was directly

observing.

This issue of Nursing Beat is devoted to nursing research. Any kind of research activity is

searching for answers. The search for what is really true is complex. We have to open our

minds and consider all sides of an issue. When we start down that road – the one where we

genuinely ask questions – we have to be ready to let go of cherished ideas in favor of proof,

and beyond that, change our practice accordingly to benefit the people we serve. It is an

exciting path to take, and we must have the courage to be open to what we find.

Cone Health has some very fine structures in place to assist anyone in quality improvement,

evidence based practice, and nursing research projects. Opportunities to stretch our

thinking with nationally known speakers occur yearly at the annual research symposium. The

work of Cone Health’s Nursing Research Council to provide tools, mentoring and guidance

has helped nurses produce locally, regionally, nationally and internationally acclaimed

nursing science. Cone Health nurses contributed 26 articles to nursing journals in 2014.

Like the person listening in on the commuter phone call, we have to broaden our vision and

consider what might be happening outside the obvious. What does the other side of that

situation look like? Can we put ourselves in different shoes? Can we consider the possibilities

outside the flow of our daily routine? The gateway to innovation in our practice and in our

work environment resides in us. Read, think and research! v

Sarah Lackey, RN, MSN, CCNS, Editor-in-Chief

Magnet Program Coordinator, NDNQI Site Coordinator


[email protected]

CONE HEALTH CONE HEALTH

We serve our communities by preventing illness, restoring health and providing comfort, through exceptional people delivering exceptional care.

From the Editor

Send your presentations, promotions, graduations, accolades and honors to Lisa Boland at [email protected]

Check the nursing website at Cone Connects>Departments and Teams>Nursing>Celebrations or

https://sharepoint.conehealth.com/nursing/celebrations.aspx. v

When we start down that road – the one where we genuinely ask questions – we have to be ready to let go of cherished ideas in favor of proof, and beyond that, change our practice accordingly to benefit the people we serve.

INSIDE THIS ISSUEMessage from the CNONurses Need More SwaggerBedside Nurses and Nursing ResearchInnovation Spotlight GraduationsOne Size Fits AllSymposium Winners CircleQuality Improvement Evidence-Based PracticeEvidence-Based and Research Poster awards

Thriving with Interdisciplinary PartnershipsCertificationsContributing to NursingThe Outcomes of Magnet Re-DesignationFrom the Editor

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A Word from Theresa

2 31

Five years ago when the Institute of Medicine (IOM) published its landmark report, The Future of Nursing:

Leading Change, Advancing Health, it placed the future of health care squarely into the hands of nurses.

The report showed how the number of medical students and residents entering primary care is decreasing, and how the number of nurse practitioners and physician assistants is increasing.

It challenged us to increase the percentage of BSN nurses at the bedside to 80 percent by the year 2020,

and recommended we double the number of nurses with doctoral degrees by 2020.

We are rising to the challenge. Nursing schools are full; in fact, schools of nursing do not have enough faculty to expand BSN programs to admit qualified students. Enrollment in DNP programs is up to 15,000 per year, with 2,500 DNP graduates completing their programs every year.

IOM’s recognition of what nursing can do creates an opportunity for us to significantly impact what is important to all of us: the health of individuals, families and communities. While circumstances often lay opportunities in our path, support helps us make the most of them.

This issue of Nursing Beat is focused on the opportunities and support Cone Health provides to nurses, and how nurses have grown their careers because of the organization, its vision, and the actions taken to make that vision real.

For the climate of Cone Health nursing we now enjoy, we have Theresa Brodrick to thank. With the unique ability to command your attention, pull you up into your best self, send you out with full accountability for your own work products and help you laugh while you are doing it, our Chief Nursing Officer of the past five years drew from us our nursing culture. She saw what was best in us, helped us grow into it, and set us free to become what we are. This is the kind of leadership that Cone Health offers nurses.

As we bid Theresa a fond “Aloha,” let’s remember what she gave us because of her belief in us: confidence in our ability to meet the challenges tossed to us by the IOM—to transform health care, to lead change, and to advance health.

Cone Health nurses rock. v

Sarah Lackey, DNP, APRN, CCNS, Editor-in-ChiefMagnet Program Director, NDNQI Site CoordinatorRapid Response Team, Relief [email protected]


From the Editor

“Our CNO of the

last five years

drew from us our

nursing culture;

let’s remember

what she gave us

because of her

belief in us.”

2367891112131416

18192021222425283031


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include:



2019.

















Respectfully,















observing.





















[email protected]



From the Editor







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include:



2019.

















Respectfully,















observing.





















[email protected]



From the Editor







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MAGNETTRANSFORMATIONAL LEADERSHIP

Almost five years ago I came

to Cone Health nervous

and excited about what

we could create. It was

a cultural adjustment

for me having been in

the Northeast my entire

life. I had to learn “North

Carolinian” ways of speaking

and behaving. This team at Cone

Health was so welcoming, and I quickly

came to love North Carolina. Folks were kind, caring and

hugged each other just to say hello! It all felt so natural to me.

It was so easy to focus on developing opportunities for

nurses to grow and develop because we had system-

wide support to do so. One of my goals was to provide an

infrastructure of support and passion for you to aspire to any

role you wanted and to advance in nursing. Over the past

five years we have made enormous strides in this area, and

this has had a profound impact on the patients we care for

within our facilities and our communities.

I am now off to the West Coast to learn more. I have no

doubt Nursing at Cone Health will continue to thrive and

excel. I have a profound respect for all of you for your

dedication, your passion for what you do, what you stand

for and what you have accomplished at Cone Health. You

have reached national standards in patient care, quality and

safety. You have exceeded all expectations when it comes

to community service, education, personal growth and

development, national (and international) presentations and

publications, and the provision of exceptional patient care.

Please know you are impacting the profession of nursing

here at Cone Health, statewide and all across this country! I

could not be more proud of all of you! Best wishes for the

future.

With my deepest respect,


INSIDE THIS ISSUEMessage from the CNOOp·por·tu·ni·ty (noun)Growing Up with Cone HealthFrom High School to Grad School Unit Activities to System-wide CommitteesCone Health CaringSpecialty PracticeGrowing in PlaceAccountant to Researcher The Courage to LeadNursing Research Symposium

Staff to Executive Director Cone Health Support for Advancing RN EducationA Home-Grown Cone Health NurseBedside—Quality—InformaticsNursing as a Second CareerStep-by-Step Guide for NursesContributing to Nursing ScienceSetting the PACEFor Theresa Brodrick from All of UsFrom the Editor

From the staff

H

330

Here is a word that is full of potential. Every day we have opportunities: to be kind, to be thrifty, to laugh, to relax, to speak or not speak. We can face our opportunities with denial or resistance, or with openness, self-honesty and self-motivation.

Opportunity by itself is a blank canvas, “a set of circumstances that makes it possible to do something.” Opportunity is not active. It is passive. How does opportunity turn from a blank canvas into something meaningful? We seize it. We recognize and take advantage of the opportunities that cross our paths.

Nursing is rich with opportunity. The profession has more than 104 nursing area in which to specialize (Johnson & Johnson, 2015). Employment of registered nurses is projected to grow 19 percent from 2012 to 2022, faster than the average for all other occupations. This expansion is due to the shifting emphasis on preventive care, to the growing rates of chronic conditions and to the demand for more health care from an aging population (Bureau of Labor Statistics, 2015).

Four nursing leaders were interviewed by NursingJobs.com for their wisdom and advice in how to grow a nursing career (2015). Their interviews produced five top tips for advancing a nursing career:

1. Invest in your education. 2. Build and utilize your networks.3. Establish a mentoring relationship.4. Always pursue professionalism.5. Continue personal and professional development.

Consider how these five tips look through the lens of nursing at Cone Health:

Invest in your educationCone Health is uniquely qualified to take aspiring nurses from high school all the way through doctoral education, if that is the individual’s choice. The Nurse Tech Academy opens opportunities for nurse techs who previously thought they were limited to long-term care. It provides education and placement for acute care positions.

Existing RNs who are pursuing BSN degrees have the opportunity to belong to a campus-based cohort for one of three university programs in our area: NC A&T State University, University of North Carolina-Greensboro, and Winston-Salem State University. Classes are held on our campuses for convenience and familiarity with the setting.

Continued on page 4


Thank you for bringing out the best in us.

By Sarah Lackey, DNP, APRN, CCNS

Op·por·tu·ni·ty (noun)a set of circumstances that makes it possible to do something (Google)

From academy nurses

From nurse execs From nurse leaders

SETTING THE

PACE

Enter graduations and certifications in Lawson Nursing Profile: Cone Connects/Lawson Complete

American Sentinel UniversityLisa Boland, DNP, RN, NEA-BCSW Nursing Outreach and Retention

Karen Resh, DNP, RN, MHA/MBA, CENWL Emergency Department

Jacksonville UniversityAmy Tippett, RN, BSNARMC 1C Oncology

Mt. Olive UniversityTracie Ingle, RN, BSNARMC 1C Oncology

Pfeiffer UniversityKristie C. Johnson, RN, MHA, MSN, CPEN (correction to previous submission)MC Emergency Department

Rachel Fountain, RN, MBA/MHAMC 2 MidWest

South UniversityNatasha Salehani, RN, MSN-FNPMC eLink

Diane Morris, RN, BSNWL ICU/Stepdown

UNC-Chapel HillKobie Leiper, PhD, RN, MSNARMC 1C Oncology

UNC- GreensboroLauren Robinson, RN, BSNAPH Emergency Department

Meg Huffman, RN, BSNARMC Mebane Surgery Center

Kendra Hopkins, RN, BSNMC 2 MidWest

Jesse Wesselink, RN, BSNMC 5 West

Laurie Deaton, RN, MSN, CNORWL Bariatrics & Wellness Department

Ally Setzer, RN-BC, BSNWL 4th Floor Intermediate Care/Urology

Christian Smith, RN, BSNWL ICU/Stepdown

University of AlabamaSarah Lackey, DNP, APRN, CCNSSW Magnet Program Director

Western Carolina UniversityTiffany Fairing, RN, BSNMC 3 East

Western Governors UniversityLaurie Freeman, RN, BSNMC 3 East

Lindsay Varner, RN, BSNMC 2 MidWest

Chris Young, RN, BSN, CENSW CareLink

Tara Dark, RN-BC, MSNWL 4th Floor Intermediate Care/Urology

Marissa Long, RN, BSN, PCCNWL 4th Floor Intermediate Care/Urology

Kimberly Lutterloh, RN, BSNWL 4th Floor Intermediate Care/Urology

Bonnie Roth, RN, BSNWL 4th Floor Intermediate Care/Urology

Jean Wolf, RN, MSN, OCNWL Oncology

Jennifer Burns, RN, BSN, MSNWL 4th Floor Intermediate Care/Urology

Dana Dark, RN, BSNWL 4th Floor Intermediate Care/Urology

Education

4 29

Op·por·tu·ni·ty (noun), Continued


The REACH Scholarship program (see page 19) provides funding for RNs seeking degrees in nursing. Many Cone Health RNs have enjoyed advancing their education with considerable financial support.

Cone Health provides support through free certification review courses. Certification fees are paid for, with no need to reimburse the system if the exam is passed. Recertification fees are also paid for by the organization

Build and utilize your networksCone Health Shared Governance Councils rely on networking within each nursing department, each facility, and among hospitals and practices. Nurses are members of teams tackling clinical and practice issues, engagement, environmental concerns, program development and more.

The nursing clinical ladder (PNAP—Professional Nurse Advancement Program) creates networks within units and between hospitals; RN3s and RN4s meet to discuss and collaborate on inter-unit and organization based projects.

Professional nursing organizations of all types have members and leaders who are Cone Health nurses. Participation in professional organizations offers many opportunities: networking, discussions, education, and professional growth.

Conference attendance for our nurses builds strong networks that extend beyond the walls of our organization. Long-lasting friendships, working collaborations, and innovative initiatives have been born from the support for nurses who present at and attend nursing conferences. The nursing executive team at Cone Health maintains high standards for approachability through rounding, open-door policies and listening events. Accessibility to nurse leaders produces changes in practice and protocol as input from nurses is utilized.

Establish a mentoring relationshipThe Cone Health organizational culture is committed to the growth and development of employees through informal mentoring and formal coaching opportunities. The openness of communication, the practice of self-honesty and the true desire of many employees to better themselves and their skills makes the culture one where mentoring happens easily and naturally across many disciplines and levels.

Part of the onboarding process for new graduate nurses in the organization is a mentor-leader relationship in a cohort group, focused on bridging the gap between education and practice in the delicate and stressful first year of nursing practice. The Nursing Research Council, which establishes mentee-mentor relationships between researchers and evidence-based practice experts in the organization is an example of a formal mentoring structure.

Continued on page 5

Cone Health

work culture

has been

intentionally

created, step

by step, to help

employees

excel.

28 5


MAGNETEXEMPLARY PROFESSIONAL PRACTICE

Always pursue professionalismThe culture at Cone Health fosters initiatives that help us communicate effectively with patients and with each other, and programs to enhance our knowledge and skills. It is a culture in which to thrive.

Nursing at Cone Health follows the Professional Practice Model and Care Delivery System as theoretical underpinnings of practice. Each nursing area takes these models and identifies how nurses practice with their specific patient population.

Professional opportunities to write, present, research, explore and innovate exist throughout the network as nursing practice follows best practices for competency evaluation, peer and self-appraisal, research structures and leadership.

Cone Health nurses have represented 25-30 percent of the Great 100 nurses the last four years--testimony not only to the exceptional professional nursing climate, but also to the skill and diligence in sponsoring and recognizing each other for superb professional practice.

Continue personal and professional developmentThe opportunities to expand thinking, skills and abilities are diverse. Formal classes, computerized, self-paced learning, professional and personal relationships that spur critical and creative thinking are all readily available.

Annually nursing departments showcase their best initiatives in the popular ‘Magnet Showcase.’ Designed for networking, appreciation, value and fun, this event draws hundreds of participants who spend the day learning, sharing, growing and laughing.

Opportunities to practice presenting nursing research through poster and podium presentations are available at the annual Nursing Research Day. Participation in this event often provides a step for participants to present their work at regional or national events. Through leadership development programs offered at the unit, facility, or corporate level, nurses can pursue paths to leading change. Leadership in nursing is always encouraged. Work-life balance is an organizational value, encouraging staff to rejuvenate, refresh and bring the best of themselves into the intense work environment in which we practice. Seizing opportunityOpportunity to grow in personal and professional ways gets a ‘leg up’ with support. An organization that has vision, commitment to employees, is intent on refining its culture, and recognizes the value of individuals as well as teams becomes more than a support for opportunity—it becomes a catalyst.

Cone Health culture has been intentionally created, step by step, to maintain elements that will help employees excel. Cone Health is a great place to grow in nursing. All we need to do is follow our passion, recognize and take advantage of opportunity, and work hard. v

“Opportunity” is

from Thomas Edison:

“Opportunity is

missed by most

people because it is

dressed in overalls

and looks like work.”

Sources:The Campaign for Nursing’s Future; Johnson & Johnson, https://www.discovernursing.com/explore-specialties#no-filters; Accessed 10/19/2015Bureau of Labor Statistics, http://www.bls.gov/ooh/healthcare/registered-nurses.htm; Accessed 10/19/2015NursingJobs.com, http://www.nursingjobs.com/five-tips-for-advancing-your-nursing-career/; Accessed 10/19/2015

Adult-Gerontology Clinical Nurse SpecialistJessica Buckner, RN, MSN, AGCNS-BCAPH Clinical Support

Certified Emergency NurseZoe Baer, RN, BSN, CENARMC Emergency Department

Melissa Dean, RN, MSN, CENARMC Emergency Department

Certified Heart Failure NurseLeah Kelly, RN, BSN, CHFNMC 3 East

Certified Informatics NursePamela Vickers, RN-BC, BSN ARMC Information & Technology Services

Certified Nurse ExecutiveShannon Wineman, RN, BSN, MHA, NE-BCARMC Oncology

Cindy Smith, RN, MSN, NE-BCARMC 1C Oncology

Certified Professional Development SpecialistJulie O’Neal, RN-BC, MSN, CENSW Staff Education

Certified Wound AssociateRashida Haney, RN, BSN, CWCAMC 3 East

Certified Critical-Care Nursing – AdultJennie Davies, RN, BSN, CCRNMC 2 South

James Dunlop, RN, CCRNMC 2 MidWest

Emilee Smith, RN, BSN, CCRNMC 2 South

Flight Paramedic CertifiedMike Bennett, EMT-P, FP-CSW CareLink

Geriatric Resource NurseCindy Flores, RN, GRNMC 5 West

Medical-Surgical NursingMelissa Brannon, RN-BC, BSN WL 4th Floor Intermediate Care/Urology

Erika Hopkins, RN-BC, BSNARMC 2C General Surgery

Ashley Moore, RN-BC, BSN MC 3 East

Allison Setzer, RN-BC, BSN WL 4th Floor Intermediate Care/Urology

Jenny Thacker, RN, BSN, BCMC 5 West

Anitra Walker, RN-BC, BSN ARMC 2C General Surgery

Jesse Wesselink, RN, BSN, BCMC 5 West

Oncology Certified NurseSarah Padden, RN, BSN, OCNWL IP Oncology

Stroke Certified Registered NurseMonica Harper, RN, BSN, SCRNMC 3 MidWest

Lauren Kiser, RN, BSN, SCRNMC 3 MidWest

SETTING THE

PACEGrowing in Practice

Enter graduations and certifications in Lawson Nursing Profile: Cone Connects/Lawson Complete

6 27

CONTRIBUTING TO

NURSING SCIENCE

The adoption of an electronic health record (EHR) is mandated under current health care legislation reform. The EHR provides data that are patient centered and improves patient safety. Perioperative nurses work with one patient at a time in an intense, stressful, and highly technical environment. Frequently, there is a shortage of experienced personnel. Because the work environment and the nursing skill set required are different from those of other nurses, is it possible the attitudes and perceived barriers to using the EHR could be different as well?

The purpose of this quantitative descriptive study was to identify perioperative nurses’ attitudes toward the use of the EHR. Eighty (80) nurses working in Cone Health operative services completed an online survey to determine their attitudes toward the EHR in providing patient care. The 32-item questionnaire used in this study was modified from a survey used in 2004 by Moody et al. A four-point Likert scale was used to assess people variables, computer variables, and the organization variables. Participants also had the opportunity to write in comments and describe their biggest frustration with using an electronic system and to identify any potential barriers in using the system.

Overall, respondents felt the EHR was beneficial. Nurses felt that using the computer had improved documentation and would lead to improved patient care. Access to the computer and perceived support from the organization were also positive.

The biggest source of frustration expressed toward using an EHR was computer malfunction and slowness of the system. Nurses were in favor of the use of the EHR but were not completely satisfied with the system.

Conclusions: Nursing acceptance and the utilization of the EHR are necessary for the successful integration of an EHR and to support the goal of patient-centered care. Identification of attitudes and potential barriers of perioperative nurses in using the EHR will improve patient safety and communication, reduce costs, and empower those who implement an EHR. v

Perioperative Nurses’ Attitudes Toward the Electronic Health Record Laura S. Yontz, RN, MSN; Jennifer Z. Fencl, DNP, RN, CNS-BC, CNOR: Edward J. Schumacher, PhDElizabeth Moore, RN, had no

intention of becoming a nurse.

Nineteen years old and straight

out of high school, Elizabeth

wanted to earn some money.

She took a course to become

a certified nursing assistant

(CNA) and accepted a nursing

home job that she quickly

regretted.

Change in plansDesperate to find another

job, Elizabeth started searching for positions for which she

might qualify. She did not want to work for the hospital in her

hometown. She was familiar with Annie Penn Hospital, and

found an opening for an Emergency Department (ED) nurse

tech. “My plan was to work there while going through dental

hygiene school,” she stated. She applied for the job and was hired

immediately. That was when her plan derailed.

Her dental hygiene plan, that is. “I fell in love with emergency

nursing,” Elizabeth confessed. “It was because of my passion

for ED nursing, my co-workers, my director and my family’s

encouragement that I decided to go to nursing school.” The staff

at Annie Penn Hospital and Cone Health knew they had secured

a good employee, and made sure to support her as she made

decisions regarding her future. Elizabeth felt that encouragement,

and a Cone Health nursing star was born.

Encouraged in educationSandra Kueider, RN, BSN, MSHCA, NE-BC, is the Annie Penn

Hospital Emergency Department nursing director behind that

encouragement. Sandra is proud of her Emergency Department

staff, but few have grown up under her direction at Annie Penn

Hospital the way Elizabeth has. “Elizabeth began her career

at Annie Penn a nurse tech… worked for her ADN… and was in

the first new grad academy cohort at Cone Health. Elizabeth

is an incredible nurse and preceptor. She has grown up in the

department and I believe she will continue to climb the clinical

ladder.”

After working for three years

as an ED nurse, Elizabeth

decided to continue with

her education, with much

encouragement from her

director again, to pursue her

BSN. Elizabeth will complete

her degree in May 2016.

The recipient of a Cone Health REACH scholarship was

essential in helping her to fund

her BSN education. “I love the

values of Cone Health. I love the many opportunities that are

offered, including but not limited to the REACH scholarship.”

Elizabeth is a good example how Cone Health supports the

development of nurses into clinically strong team members,

members who provide evidence-based care to each patient.

Positive nursing culture“The nursing culture here is strong. It’s changing every day, in a

good and positive way. The culture is leading nurses to bigger

and better things in the future of health care.” Elizabeth has

witnessed many changes in nursing. “Evidence-based practice is

on the rise and has been for many years, but I’m seeing more and

more of it,” she stated. “Many more nurses are getting engaged in

research and evidence is guiding their decisions, leading to better

care and better outcomes for patients.”

Patients as inspirationElizabeth made it clear that her patients are the most inspiring

part of her nursing career. “There are days when I feel like I can’t

get it together, and all it takes is one patient to smile or show

gratitude for my care, or to be in good spirits despite their

conditions, to get me going. People say nurses make a difference

in patients’ lives, but sometimes I think it’s the patients who make

a difference in the nurse’s life.” v

Growing up with Cone Health: Annie Penn Hospital’s Elizabeth Moore

“People say nurses make a difference in patients’ lives, but sometimes I think it’s the patients who

make a difference in the nurse’s life.”


MAGNETSTRUCTURAL EMPOWERMENT

By Rebecca Albertson, RN, BSN

It is well established that malnutrition is linked to poor outcomes. A review of published literature failed to reveal any nursing protocols to implement nutritional supplements for patients who were assessed to be malnourished. Our question was, “Will a nursing protocol to enhance the patient’s diet with nutritional supplementation affect patient outcomes as measured by decreased length of hospital stay, decreased 30-day readmission rates, and decreased number of falls?”

A malnutrition screening tool has been part of the standard patient admission process for some time at Cone Health. For this 30-day pilot study, the following nursing protocol was initiated if the patient’s malnutrition screening tool score was >2.

Patients who have a P.O. diet order:• Offer Ensure Complete twice a day• If patient requires medication to control blood glucose levels, offer Glucerna twice a day• If patient has end-stage renal disease and is on hemodialysis, offer Nepro twice a day

Patients who have a “clear liquid” diet order:• Offer Resource Breeze twice a daySupplements may be thickened as needed.

A pre-pilot survey indicated that nurses felt patients would benefit from a nurse-driven protocol for nutrition intervention. The pilot was conducted using a paper form that proved to be a barrier to compliance and resulted in a low number of study participants. We were unable to link length of stay, readmission rates, or falls to our pilot interventions due to the low response rate. However, based on verbal feedback from nurses and current evidence related to the importance of nutritional support, we recommend implementing a nursing protocol for nutritional intervention based on the current malnutrition screening tool. We also recommend this protocol be built into the electronic medical record system to allow the nurse to more easily order the supplement. v

Nursing Protocol for Nutritional InterventionLisa Covington, RN, MSN, CMSRN and Cindy Morris, RN-BC

By Nancy Summerell, RN, MSN, CEN

Steve Marshall, RN, MSN, CBIS, CCRN (alumnus), director of inpatient oncology, Wesley Long Hospital, enjoys talking with people. Watching people get better, being able to help someone, and talking with patients and families, inspire him. “On leadership rounds a lot of times they just want someone to listen. For example, I talked with someone this morning who is being discharged tomorrow and we just talked about being home.”

Getting startedFor the first 15 years or so in his nursing career, Steve was content with his credentials. His initial interest in health care was piqued as a junior in high school after he had joined the volunteer fire department and served as a first responder. His focus on nursing grew from reading his step-mother’s nursing books. In 1993 when he graduated with a diploma from a hospital-based nursing program, his goals focused on critical care nursing and obtaining his critical care nursing certification: CCRN. It was a great start: Steve Marshall’s nursing career has spanned more than 20 years from critical care to inpatient rehab to oncology.

Steve did not have an education plan; the opportunities available to him in the network propelled his career ladder. The bachelor’s and master’s degrees in nursing that Steve earned reflect the changing demands of nursing over the years and how furthering his education opened doors in his career. The main reason he pursued a BSN was a desire to move up the clinical ladder and into the role of RN 4 in the Surgical Intensive Care Unit at Moses Cone Hospital. Steve finished his RN-BSN degree online from Chamberlain University in 2012. Soon after, changes in the clinical ladder to the Professional Nurse Advancement Program (PNAP) required a master’s in nursing for the RN 4 position.

Leadership trajectoryIn 2011 Steve took a leadership role as the Assistant Director of inpatient rehab. One month after he stepped into this role, the director left and Steve was named the nurse manager of the unit. Realizing that leadership was a fit, Steve enrolled in an MSN program offered by Grand Canyon University, completing the program in 2014.

Looking back on his educational journey, Steve mused: “I did enjoy my education – I enjoyed the national networking. It helped me understand a lot of what’s going on now in nursing that wasn’t taught in my nursing school 20 years ago. It was challenging.” His next challenge begins in January 2016 when he starts the Doctor of Nursing Program at Old Dominion.

Cone Health culturePersonal connections and transparency are values Steve knows exist in the culture at Cone Health. “The culture here is amazing. The ability for any staff member to approach any of our top leadership and actually be heard speaks volumes of what our culture is.” Steve exercised that culture when he openly disagreed with the changes in the PNAP program in 2012. It withstood the test, he appreciated the opportunity to voice his opinion, and he thrives today as one of Cone Health’s clinical leaders. v

726

CONTRIBUTING TO

NURSING SCIENCE

From High School to Grad School: Riding the Wave of Cone Health Nursing Culture

“The culture here is amazing. The ability for any staff member to

approach any of our top leadership and actually be heard speaks

volumes of what our culture is.”



Overcrowding in emergency departments (ED) is a major concern in health systems nationwide. The dynamics of overcrowding strain over-extended ED resources, decrease patient throughput, and are associated with patient safety issues. The purpose of this quality improvement (QI) project was to determine the effect of nurse education on the utilization of existing nurse-driven triage protocols and on patient throughput at the Wesley Long Hospital ED. ED throughput is a quality improvement initiative to decrease patient wait times, initiate medical orders more quickly, and coordinate movement of patients within the ED, to and from other departments (such as Radiology), and to inpatient admission or ED discharge.

A working group of ED nurses, leaders and physicians reviewed and revised current nurse-driven protocols and developed seven additional protocols. Education of staff included the use of HealthStream Learning Center (HLC) modules, huddle messages and educational slides related to the protocols flashing on the computer screen in the staff lounge. A “light bulb moment” occurred when staff realized they could implement more than one protocol at a time, making the use of these protocols easier and more meaningful.

Protocol use was determined from a report that had been built into Cone HealthLink. Following nurse education, the overall usage of triage protocols increased from 3 percent to almost 10 percent. Additional findings included a decrease in arrival-to-ED discharge time (from 202 minutes to 190 minutes), decrease in arrival-to-inpatient admission time (from 368 minutes to 319 minutes), and a decrease in arrival-to-ED discharge time for lower acuity patients (from 125 minutes to 114 minutes). During this time period the left-without-being-seen rate decreased from 1.5 percent to less than 1 percent. We feel the improved use of nurse-driven triage protocols had an indirect effect of increasing ED patient satisfaction scores from 86.4 percent to 88.9 percent. Another unexpected finding was improved communication between providers and nurses with ongoing dialogue regarding medical orders. v

Nurse-Driven Triage Protocols to Improve ThroughputDenise Rhew, RN, MSN, CEN; Jason Upham, RN, BSN, CEN; Martha Gustave-son, RN, MSN, CNE; Karen Resh, RN, MBA, MHA, CEN

Beginning in 2011, a highly engaged inter-professional team within the Moses Cone Hospital began the amazing and challenging journey to develop a cardiovascular (CV) hybrid operating room (OR). A hybrid OR is unique in that it must carefully and expertly combine high quality angiographic images obtained from a fixed angiographic system with the sterile surgical environment of an OR suite. The creation of this CV hybrid OR is evidence of our organization’s commitment to providing exceptional care , for it allows our community-based hospital to grow the endovascular program as well as expand the range of minimally-invasive cardiac procedures we offer.

The initial step in developing the hybrid concept included a careful review of the literature related to hybrid OR construction and operation. At the same time, we conducted both a community and facility needs assessment. Obtaining physician engagement was another important aspect of this concept-development phase.

Between 2011 and 2012, we developed an inter-professional working group of all stakeholders, ranging from frontline clinicians to the area vice president. The business plan included construction and equipment costs and led to obtaining a certificate of need and capital funds.

The operational phase (2012-2013) focused on developing and approving an open-minded staffing model and selecting clinical team members. A training plan was developed and implemented and included interdisciplinary team building and cross training. Participating in mock procedures helped us identify and correct potential problems.

The community CV hybrid OR opened in June 2013. We are now able to provide hybrid procedures such as endovascular repair of abdominal and thoracic aortic aneurysms, trans-catheter aortic valve replacement and fenestrated endovascular aneurysm repair. With the use of the hybrid OR technology and these minimally invasive approaches, patients have a less invasive surgery, a decreased length of stay, and a shortened recovery time. v

The Community Approach: From OR to Hybid ORKristin Garrett, MSN, RNFA, CNOR; Stacey Matsuoka, RCIS, BS; Stephanie DeHart, RN; Smokey Twine, RCIS, ST

8

“I came back [from national conferences]

appreciating Cone Health. Cone

Health is at the top…”

CONTRIBUTING TO

NURSING SCIENCE

Staff nurses may find themselves feeling overwhelmed when care of their patients is interrupted by the need to admit a new patient. Because it is time-consuming, the admission process is generally viewed in a negative manner. This led Annie Penn’s Medical/Surgical Telemetry department to ask, “Will a team approach to a patient’s admission positively affect the patient’s and the staff nurses’ satisfaction and engagement compared to the traditional admission method?”Prior to implementation of the three-month team approach, an anonymous survey revealed that 41 percent of nurses were dissatisfied with the current admission process. Additionally, 65 percent of respondents felt the current process required more than 30 minutes of their time.The team admission pilot was implemented on the 7 a.m. to 7 p.m. shift and consisted of the following steps:• Secretary announces the presence of a new admission• All available personnel respond to assist the primary nurse with the admission• Data related to time of patient arrival and time of completion of the admission are recorded on a paper log

OutcomesPress Ganey patient satisfaction scores increased from 89.3 prior to the pilot to 91.4 following implementation of the team approach. Patients may feel more welcomed to the department when several different members of the health care team greet them as they arrive.

Findings related to amount of time required for admission were interesting in that this time increased when an additional nurse assisted (See below). It may be that nurses working together did a more “complete” admission – beginning an IV, placing the sequential compression device (SCD), administering the first dose of pain medication, and providing a warm blanket – as opposed to simply completing the Admission History questions. v

Team Patient Admissions at Annie PennJessica Mays, RN, BSN; Mary Beth Hawkins, RN; Megan Bullins, RN-BC, BSN; Jessica Buckner, RN-BC, MSN

25



Donna Owens, RN4, BSN, PCCN3East Heart Failure/

Telemetry, Moses Cone Hospital

Unit Activities to System-wide Committees:

Celebrating Nursing PracticeBy Nancy Summerell, RN, MSN, CEN

Self-confidence in a new graduate nurse is integral to his/her ability to make sound decisions and perform nursing tasks. In addition, self-confidence in the clinical setting has a direct relationship to job satisfaction and retention of nurses. A literature review showed limited research examining whether there is a difference in the self-efficacy levels of nurses who actually participated in or simply viewed a simulation.

The purpose of this study was to examine the difference in self-confidence between new graduate nurses who either participated in or who viewed a high-fidelity simulation followed by a debriefing experience. The study involved new graduate nurses enrolled in the Cone Health Academy for Critical Care Nursing.

Three cohorts of approximately 20 nurses each participated in the Academy over a nine-month period. Each cohort was divided into thirds and each sub-group participated in one simulation scenario and viewed two other scenarios via live video feed. All nurses participated in instructor-led debriefing. Data were collected after each scenario using a validated eight-item self-confidence scale.

The study found no difference in self-confidence between nurses viewing or participating in simulation (p-value: 0.612).

The design of the simulation activity did not affect new graduate nurses’ perception of their self-confidence. The nurses felt more confident whether they participated in the simulation or viewed others simulating at the bedside. We feel these findings support the idea that simulation debriefing may actually be the most important aspect of simulation activities. Educators can use these findings to provide effective and cost-effective high-fidelity simulation to large groups of nurses. v

Viewing or Doing: Effective High-Fidelity Simulation for Large GroupsSarah Clark, RN, MSN, CCRNBelinda Hammond, RN, MSN, CEN, CCRN

Admission Time with NT

Assistance

30.25 minutes

Admission Time with RN

Assistance

32.357 minutes

Admission Time with RN and NT Assistance

30.016 minutes

Admission Time with

No Additional Assistance

30.85 minutes

Why did you become a nurse? I chose nursing for financial stability and ended up loving nursing as a career.

Why did you come to Cone Health to work? My sister worked here so I decided to interview here.

Why do you stay?I can be all I want to be as a nurse. I like the values and how Cone Health works in the community. And Cone Health has a lot of integrity as an employer.

What inspires you about nursing?Patients are at vulnerable states when they come in. To be able to provide expert nursing, to be able to sit and listen to their stories, and connect with the patients as people not just as a person with a diagnosis inspires me. I enjoy the relationships with patients and their significant others. I also benefit from providing nursing care for them. It’s not every day, every shift but if there’s been a connection then it’s not uncommon for me to thank a patient at the end of a shift and tell them they blessed my day.

I still have passion but I don’t wear rose colored glasses. Bedside nursing can be very stressful and very rewarding – that’s just the nature of bedside nursing. When I come in each day I expect to have between two and four discharges and two to four admissions – that’s a lot of activity. I expect it, and I try to teach new nurses that is the flow to anticipate.

What excites you about nursing at Cone Health?There are so many opportunities for nurses at Cone Health – from unit activities to system-wide committees. As an RN, you can pursue higher levels of education to move up the clinical ladder; you can also be an RN and choose not to move up the clinical ladder, yet still be involved as much as you want to be.

Last year I went to two national conferences: Magnet® and the National Teaching Institute (NTI) of the American Association of Critical Care Nursing. When I went to the national conferences, I came back appreciating Cone Health. Cone Health is at the top and I see nursing in that realm. For example, I sat in a pacemaker class at NTI and they talked about four hospitals in the nation where leadless pacemakers are placed and Moses Cone Hospital is one of the four. I’m a nurse who takes care of those patients and that’s pretty awesome.”

How have you grown at Cone Health?Currently, I am interim assistant director. I feel respected in my role, and I feel I’m informed of the bigger picture. However, I plan to return to my RN 4 role, which is a great role – it keeps expertise at the bedside. I staff, I nurse at bedside, and I have indirect time to work on projects, orientation and competencies. With the department director’s support, I was able to create an orientation model specific for our department. Our goal is for newly hired experienced nurses to get as much intentional education and support during orientation as academy nurses receive. We’re excited about our orientation, and our retention scores support that it’s a good model.” v

24 9

Integrating nursing theory and practiceNursing unit culture and assimilation of nurses into a new practice setting, particularly for new graduates, have a profound effect on nurses’ satisfaction and professional engagement, and on the overall practice environment and quality of care.

Our evidence-based project goals were to create a departmental environment of nurturing practices leading to improved role satisfaction for nurses, improved quality of patient care and enhancement of the department’s nursing practice environment. To engage staff and leadership in transforming our unit’s culture, we chose to apply Watson’s Caring Theory and Caritas Processes to new nurses and to existing staff who served as their preceptors and mentors.

Jean Watson’s Caritas ProcessesWatson focused her theory on special caring activities engaged in by nurses as they interact with others. Ten Caritas Processes serve as a framework for the core of nursing. (see sidebar). Watson values the nurse as well as the client in the caring relationship. The first three Caritas Processes begin with the preparation of the nurse. The next two present the importance of the development of relationships and accepting feelings in yourself. The last five Caritas Processes address aspects of caring within a context of mutuality, creative reflection, and use not only of scientific knowledge but also intuitive, aesthetic, and ethical knowledge. The Caritas Processes are attributes of caring that characterize the human/transpersonal caring relationship. Watson stresses the lived experiences not only of the client but also of the nurse.

Jean Watson’s Caring Theory: 10 Caritas Processes™

1. Embrace altruistic values and practice

loving kindness with self and others.

2. Instill faith and hope and honor others.

3. Be sensitive to self and others by

nurturing individual beliefs and practices.

4. Develop helping – trusting/caring

relationships.

5. Promote and accept positive and

negative feelings as you authentically listen

to another’s story.

6. Use creative scientific problem-solving

methods for caring decision making.

7. Share teaching and learning that address

the individual needs and comprehension

styles.

8. Create a healing environment for the

physical and spiritual self which respects

human dignity.

9. Assist with basic physical, emotional, and

spiritual human needs.

10. Open to mystery and allow miracles to

enter.


By Paul Summerell, RN4, MHA, CCRN, SCRN

Cone Health Caring: Using Jean Watson’s Caritas Processes

to Transform a Nursing Practice Environment

Continued on page 10

Cone Health values education as a means of growing your nursing practice. The financial support structure helps make it affordable for employees entering a nursing program or returning to school for an advanced degree. Many schools require coursework to be completed in a health care setting. This may include direct patient care, education projects, participation in research or evidence-based practice projects, or attending meetings. Cone Health refers to all of these educational activities as “Course Work.”

The first step for going back to school is an important one: it is the result of a federal law. This law requires all nursing programs that require a clinical component be approved by a governing body. For North Carolina, the administrator of the process is the North Carolina Board of Governors (NC BOG). Before you do anything else, go to the NC BOG website to ensure your school has approval. The website is updated every 6 weeks. Go to:http://www.northcarolina.edu/?q=content/approved-degree-programs-licensed-institutions

Also, check with your school and program to confirm that the school/program has an affiliate agreement with Cone Health.

Once you have ensured that your school/program is approved by the NC BOG, and has an affiliate agreement with Cone Health, refer to the Employee Section of the Cone Health Clinical Placement website for step-by-step instructions on proceeding. The path is Cone Connects > Tools and Applications > Resources > Clinical Placement. Here is a summary of the steps you need to take:

• Ensure your school will verify and maintain the student screening requirements.• Find a preceptor (Cone Health does not assign preceptors).

• Ensure your Academic Point of Contact completes and submits the Course Work Request Form. This must be submitted by the school and not the student, because the school is verifying the student has completed the on-boarding requirements and will maintain the supporting documentation .• Complete the student requirements stated on the Course Work Request Form, and listed on the website.

Detailed instructions, all of the requirements, and the forms and documents are available online. Follow the pathway as noted above or go directly to the Clinical Placement website at https://www.conehealth.com/healthcare-professionals/clinical-placement/

For further information, contact Connie Lewter, RN–BC, MSN, CNE, at [email protected]. v

By Connie Lewter, RN-BC, MSN, CNE

Step-by-Step Guide for Nurses Going to School – How Cone Health Can Help


10 23

attitudes and are often more career focused because of their previous life and work experiences.

Rick was 56 years old when he began nursing. ”Because of my age and life experiences, I was able to bring a perspective and presence to my nursing that patients and their families seemed to appreciate. I think that the organizational and project management skills that I developed also have been helpful”.

Their contributions are many and varied. While on the inpatient oncology/palliative care unit at Wesley Long Hospital, Rick was an active member of shared governance. Along with several colleagues, he was involved in a research project that investigated nurses’ understanding of end-of-life nutrition (EOL) and hydration. He has provided EOL education to new graduate nurses in the Medical/Surgical Academy at Cone Health, as well as teaching the same subject to nursing students at the Breckenridge School of Nursing. He was involved with the development of the Professional Nurse Advancement Program. His most recent honor was to serve as a panel member on the inaugural North Carolina State Agriculture and Technical University School of Nursing Dean’s Distinguished Lecture. On the panel he discussed his bed-side experience with aromatherapy and pet therapy.

Connie contributes to her practice environment, and has grown professionally since starting her nursing career. She is an active member of the hospital-wide committees for Ventilator Acquired Pneumonia, Meaningful Use, and Mortality Chart Review. She was appointed as one of her unit’s RN3 nurses, sat for and passed her exam for professional certification, and is currently enrolled in her first semester at University of North Carolina, Greensboro, for a Masters of Science degree in nursing with a concentration in education.

Second career nurses bring a richness of experience, perspective and value to the colors of the nursing tapestry. Drawn by the desire to serve, their own interests and talent, or the many other reasons that bring them into the profession, their contributions add depth and perspective to the vision of what we can do for our patients. v

“My managers, nursing

and nurse tech colleagues

provided the best possible

support and encouragement

that this new grad nurse could

ever have expected.”


Applying the Caritas Processes to our unitEmphasis on cultural fit (empathy, compassion, communication, teamwork, respect) over clinical experience was our first change to be introduced. Our unit on-boarding process is designed to acknowledge the immediate value of each new nurse, and to begin building positive new staff relationships. We send a welcoming message to new staff members, including personal contact prior to arrival on the unit, reinforcing their immediate value to our unit, and providing information on scheduling, unit expectations, and contacts.

We celebrate new nurses’ arrival, introducing each new nurse to unit staff, physicians and other clinicians and recognizing prior achievements (nursing school, experience in nursing, other careers and talents). We value the precepting process through matching new nurses to a single primary preceptor and one identified “back-up preceptor”. We celebrate precepting as professional growth and a professional responsibility for practicing nurses. New nurses are encouraged to serve as preceptors at 10-12 months post-orientation to reinforce and recognize their own skills and contributions.

During and after orientation we introduce and support ongoing professional growth goals and activities. We invite new nurses to attend and participate in the Department Shared Governance Council meeting during orientation, we involve new nurses actively in unit and hospital activities, and we promote national specialty certifications, membership in national professional organizations, and educational advancement.

Our outcomes Our department has seen growth in measures of staff’s professional engagement, with our percentage of nurses earning national specialty certifications increasing from 6 percent in 2009 to 72 percent in 2015. Department nurses advancing in the Cone Health Professional Nurse Advancement Program has grown from 3 percent in 2009 to 25 percent in 2015.

Our National Database for Nursing Quality Indicators (NDNQI) Practice Environment Scores have improved from the 10th percentile nationally in 2009 to the 95th percentile in 2013. Our Cone Health Employee Partnership Scores grew from the 38th percentile in 2009 to the 85th percentile in 2013.

Our department has also seen improvement in key clinical performance measures from 2010 through 2013, with our Catheter Acquired Urinary Tract Infection (CAUTI) rate decreasing 74 percent, our Central Line Acquired Blood Stream Infection (CLABSI) rate decreasing 100 percent, and our Ventilator Assisted Pneumonia (VAP) rate decreasing 64 percent.

Our journeyThese outcomes validate previous literature and demonstrate the value and impact of intentional caring behaviors in creating a positive nursing practice environment. Application of Watson’s Caring Theory and Caritas Processes to nursing unit staffs can yield significant improvements in the nursing practice environment at minimal implementation cost. v


Cone Health Caring: Using Jean Watson’s Caritas Processes to Transform a Nursing Practice Environment, Continued

Our unit on-boarding

process is designed

to acknowledge the

immediate value of

each new nurse, and

to begin building

positive new staff

relationships.


Rick Diehl consults with patients by phone, in person, and during patient teaching.

What would drive someone from a successful, 24 year career in water quality monitoring to go to school for a nursing degree? In the case of Rick Diehl, RN3, BSN, CHPN, the oncology nurse navigator at the Cone Health Cancer Center at Wesley Long Hospital, it was being downsized when his company was sold. “I was guided by church friends who were nurses and who knew of my passion for caring for people through my work as a Stephen Minister and hospice volunteer to consider nursing for a second career. I received great counsel from a friend who had been a lawyer for 25+ years when he changed careers to become a nurse.”

How about a full-time mother and wife with a Bachelor of Science degree in biology from James Madison University? A class at her church was the catalyst: “Living Your Strengths,” based on the book Strengths Finder by Tom Rath.

Connie Dupont, RN, BSN, RN3, SCRN, a member of the Moses Cone Hospital 3MW Trauma/Neuro ICU team found nursing this way. It helped her rekindle her childhood desire. “As my youngest entered high school, I realized that my aptitude and strengths could still be pursued. It was that week that I called University of North Carolina Greensboro to find out the process of pursuing a BS degree in nursing.”

Diehl and Dupont represent a growing number of adults who are drawn to nursing because of meaningful work, financial stability, employment opportunities and upward mobility, according to a 2009 study by Carol Brewer, PhD, RN, FAAN, and Christine Kovner, PhD, RN, FAAN, funded by The Robert Wood Johnson Foundation.

Employment of registered nurses is projected to grow 19 percent from 2012 to 2022, faster than the average for all occupations according to the Bureau of Labor Statistics. Research funded by Robert Woods Johnson Foundation indicates second-career nurses are helping to delay a projected nursing shortage while contributing to the profession and to their patients.

Unique challenges of being a noviceIt isn’t easy to give up one career and transition to one completely different in the middle years of maturity. Nursing has its own set of skills, language and culture. Becoming a student, and then a novice in the profession, takes determination and support.

Rick realized that he had to be patient with himself as he developed his nursing skills. “It was challenging to be at the lower end of the learning curve after having been at the top in my first career. But my managers, nursing and nurse tech colleagues provided the best possible support and encouragement that this new grad nurse could ever have expected.”

Connie got help and support from the Cone Health Critical Care Academy, a program designed specifically for new graduate nurses. She also credits her unit with supplying her with exactly what she needed. “The support and collaboration on my unit (one of the main reasons I love this unit!) made the transition much easier. Everyone was very open to teaching and answering the many questions of a new grad nurse. Initially I was often mistaken, because of my “advanced age”, as a more experienced nurse. At times that was awkward. Working full time for the first time in 25 years was an adjustment all by itself”.

Second career nurses add value to the professionWhat does a second career nurse bring to the mix? Experts agree these nurses offer strong coping skills, positive


On Second Thought...Nursing as a Second Career


22 11


Specialty Practice:

Celebrating Nursing Practice

Why did you become a nurse? My mother was a missionary and I wanted to help people. I was eight years old when I knew.

What inspires you about nursing? I love people, all different kinds of people. Patients are happy to see me as an expert at starting IVs. I feel such a sense of accomplishment when the patient is relieved that I got their IV started.

What drew you to our health system?My husband’s job brought us to this area. We had small children and I wanted to work nights. It took six months, but I found the perfect job at Cone Health. That was 23 years ago.

What is your take on nursing culture at Cone Health?Nurses here have buy in, consideration for decisions about what happens. That makes our jobs better and is better for our patients. Nursing is collaborative, there is teamwork. We have shared governance, a Clinical Ladder (PNAP) and my director is very supportive. As a team, we leave at the end of the day with a clear head.

How has Cone Health Nursing helped you grow?Personally, the wellness program has helped me a lot. I’m running now, and I feel so much better. This summer my daughter and I did strength training. I eat healthier, and can get into the gym 24 hours a day. Sometimes I go walk on the treadmill during the day. Peaceful!

Professionally, people encouraged me to see my own potential, to understand I could be an informal leader. They helped me to develop, then gain confidence in my abilities. Opportunities are always here. A story to share: A few years ago, I got a call on my day off. There was a callout. I was asked to come in to support the team. I wasn’t happy about it, but I came in because I felt a responsibility to the team and our patients. I was asked to start an IV on two patients: The first patient was a lady, and I started the IV with ease. The patient said: “Thank you, God must have sent you!” The second patient was a man in his 80’s and he was a missionary. He told me several stories about his missionary work in Africa. He was so interesting! He was so thankful that I was able to start his IV, he asked if he could bless my hands. He had the softest hands. That day I was reminded that a change could be positive. I was glad I was called into work. v

Nurses here have

buy in, consideration

for decisions about

what happens. That

makes our jobs

better and is better

for our patients.



Linda Terry Alford, RN VA-BC, BSNAssistant director, VAST/IV Nursing

Connie Dupont (left) teaches Ellie Messer RN, BSN, in the trauma/neuro ICU at the Moses H. Cone Memorial Hospital.patient teaching.

Bedside—Quality—Informatics:


How did you come into nursing? My goal has always been to help others. There were so many different types of nursing careers and nurses were in high demand – job opportunities were plentiful. I have been fortunate to work and gain experience in many different clinical areas, all of which I have enjoyed. My background as a nurse includes: medical-surgical, operative services, oncology research, quality excellence, and my current role in the Health Information Department.

What inspires you about nursing? I am inspired by the powerful impact nurses have when they touch lives everyday. I am also inspired by the expanding opportunities for nurses as health care evolves and the diverse opportunities offered within Cone Health as our system continues to grow.

What drew you to our health system?I grew up in this community; Cone Health had (and still has) an excellent reputation. I knew from the very beginning, I wanted to work here, in my community hospital.

What is your take on nursing culture at Cone Health?I stay because of the ability to do interesting and meaningful work. I stay because of the people, the incredible relationships and friendships that I have made. I stay because of my work family. I came to Cone Health as a new graduate and here I am 28 years later – still learning something new every day. Cone also offers amazing opportunities to grow and develop. No matter what you are interested in as a nurse, Cone Health will help you learn new skills to be successful.

How has Cone Health Nursing helped you grow?The nursing culture at Cone Health is a very supportive environment. Cone Health nursing provides opportunity for growth in roles, pursuit of higher education, and development of career paths. A story to share: As a nurse, you can find positions to support your work-life balance and time with your family during the different phases. I have also seen nursing roles expand from the traditional roles to include areas such as working with computers/informatics data analytics, and the reimbursement/finance side of health care. Scheduling flexibility options are also better for nurses than they were many years ago, making it easier for nurses to stay in the workforce. v

“No matter what

you are interested

in as a nurse, Cone

Health will help you

learn new skills to

be successful.”

By Jennifer L. Fencl, DNP, RN, CNS, CNOR


Vangela Swofford, RN, BSN, ASQ-CSSBB, CPHQ

Clinical documentation improvement specialist

12 21

M“My mom always told me I was going to be a nurse,” reflected Tara as we were talking

about how she had decided to become a nurse. Although her original intention in high

school was to become an accountant, a summer job and her sister changed her mind.

“My sister talked me into four years of nursing school.” After graduation from University

of North Carolina Greensboro (UNCG) in 1994, Tara became a staff nurse on 4th Floor

Intermediate Care & Urology at Wesley Long Hospital. Since beginning her nursing

career there, she has never doubted her decision. “As a nurse you can have such a

meaningful connection with patients and families, you can truly help somebody when

they need it the most.”

Tara has been a staff nurse, a team leader and in the RN 4 role for the last 13 years. She

enjoys the diversity of the RN 4 role--taking care of patients, teaching and mentoring,

helping to lead change. Acknowledging that Mary Ann Amos, her unit director, had

always wanted her to go back to school, Tara shared that she was really upset when she

learned she had to go back to school for her master’s degree to keep her RN 4 role. “I’m

really glad I got the push.” She had support from her family, her unit and unit leadership,

a REACH scholarship and tuition reimbursement. “The REACH scholarship is a wonderful

investment they made in us. I went to school virtually free.”

Tara has seen the culture change over the years and she’s excited about getting everyone

in the system on the same page, “The culture is changing for the better – focusing on

quality and safety. And they want the front line staff to make the changes.” Currently

she is very involved with a LEAN project on her unit, the first inpatient value stream.

In fact she is doing her master’s project on LEAN outcomes. Her advice to anyone

contemplating going back to school: “Just jump in and do it. I waded in the waters for a

while and that didn’t work so I finally just paid my first tuition and had to start.” v

“The culture is

changing for the

better – focusing on

quality and safety.

And they want the

front line staff to

make the changes.”


Growing in Place: Tara Dark, RN-BC, BSN, RN 4, Wesley Long Hospital

By Nancy Summerell RN, MSN, CEN

Above: Tara Dark discusses LEAN project board with team members.


CCassandra Galloway, RN, BSN, MBA/MHA, is an inspired nurse. She believes nursing is more than a profession. Cassandra says, “If you love nursing, it shows in your practice. People see it.” The love for nursing shines in Cassandra.

Cassandra entered nursing as a Nurse Tech in 1990 and became a nurse two years later. She worked at Wesley Long Hospital on the same unit for 15 years as a Nurse Tech first, then later as a nurse. She has a special place in her heart for Nurse Techs, and all unlicensed assistive personnel. As a professional development specialist in the Staff Education Department, Cassandra coordinates the Nurse Tech +3 program and Nurse Extern program. She makes a personal connection with every nurse tech in the system and extends her support to them as a mentor.

Cone Health opportunities Cone Health has offered a variety of opportunities for Cassandra’s professional growth. She has worked as a staff nurse, charge nurse, team leader, assistant director, informatics specialist and educator. When asked what excites Cassandra about her role in Staff Education, Cassandra beams and says, “I love the new students, whether they are nurse techs, nurse externs, new graduates or experienced nurses. It is so great when they can ‘connect the dots’ and see the benefits of education. They can see how what they learn will help them in their practice.” Cassandra’s enthusiasm is contagious. She lights a fire of interest for new employees in orientation and shows her pride in being a Cone Health nurse.

Cassandra sees the culture at Cone Health as one of innovation and inclusion. She won the Nursing Excellence Award twice. She successfully co-nominated her co-worker, Jerome Wheeler, Jr., for the Cone Health Diversity and Inclusion Award. After being recognized as a North Carolina Great 100, she has gone on to nominate others for this honor.

Cassandra sees nursing going in a positive direction and states, “higher education is driving these changes.” In 2007, Cassandra earned dual degrees -- a master’s degree in business administration and a master’s degree in health administration. This program was offered at Cone Health in partnership with Pfeiffer College. She received tuition reimbursement to assist her in earning her degrees. Cassandra is currently enrolled at East Carolina University earning her Master’s of Science degree in nursing education and is a recipient of the REACH (RN Educational Advancement at Cone Health) scholarship fund and tuition reimbursement. Her Department Director Jean Reinert, RN-BC, MSN, is very supportive of her education as well. Cassandra states, “People invest in your growth here.” v

A Home-Grown Cone Health Nurse Success Story

By Sarah Clark, RN, MSN, CCRN, CHSE

Cassandra Galloway ushers nurse externs ‘onboard’ at the beginning of Cone Health’s

Nurse Extern Program.

“People invest in your

growth here.”

Accountant to Nurse Researcher:


Why did you become a nurse? I had a bachelor’s degree in accounting and had worked other jobs for 16 years. I wanted to work for Cone Health, but in accounting. To get my foot in the door I took a Nurse Tech course and got hired as a nurse tech. I knew then this was the profession for me. I graduated from nursing school when I was 47. I had lots of support from people around me.

What inspires you about nursing? The caliber of people I work with, their knowledge, their compassion. And nursing instructors--how do they do their jobs? It takes skill to juggle all that.

What drew you to our health system?My wife is an RN here; our daughter was born here. The care for my family was always good. I can’t imagine working anywhere else. I want to retire here. The benefits are good; the people are why I stay here.

What is your take on nursing culture at Cone Health?Cone Health has gone out of its way to support nurses. The values have really shaped our nursing culture. Caring for Each Other is the most important one to me. Nurses are the greatest asset to Cone.

How has Cone Health Nursing helped you grow?Cone Health is never at a standstill, we don’t get complacent. We’re encouraged to move, try new areas, get certifications.

Cone Health has helped me realize how important it is to care for people, and what it will mean to me one day when I need care. Nursing brings life’s realities in front of you.

A story to share: When I was a new nurse, straight out of school, I was working with two experienced nurses on either side of me, Nancy and Stacey. One of my patients started to crash, both of those nurses came to help me without being asked. They told me they were going to manage the patient and then debrief me after the patient was stabilized. That impressed me so much and has stayed with me all these years. I think that is what shaped me as a nurse and how I practiced in the years to come. Take care of the patient, take care of each other and always be a professional. v

“Cone Health has

gone out of its way

to support nurses.

The values have

really shaped our

nursing culture.

Caring for Each

Other is the most

important one to

me. Nurses are the

greatest asset to

Cone.”



Hugh Pruitt, RN, BSN, BASClinical research

coordinator

20 13



14 19

DDonna Wear, RN, remembers being a 15-year-old Candy Striper at Baptist Hospital in a blue and white pinstripe pinafore and deciding to become a nurse. Donna Wear’s first, only, and best nursing job has been on the Mother Baby Unit at Women’s Hospital. After 33 years, she still lights up when she talks about her profession. Donna says her co-workers “keep me coming to work. I know they have my side and my back.” And without realizing it, Donna has always been “Crocus Minded.”

One of Donna’s crowning achievements in nursing has been to work with Dr. Pam Reitnauerand, Dr. Kaye Gable and the teaching service to lead the Skin-to-Skin (S2S) pilot. In this care model the neonate is placed in contact with the mother’s skin immediately following birth. Drying and routine care happen while baby is on mom’s (or dad’s) chest. Donna beams as she describes the positive results in glucose stabilization and decreased rates of jaundice, and how this practice nearly eliminates the need for baby warmers. Donna is passionate about how this practice improves outcomes for the mother and baby. So what does this have to do with a crocus?

Encouragement from leadersIn 2011, Donna was putting her heart and soul into the S2S program. It was her first major project as a new RN4. Although Donna believed strongly S2S would improve care, she was meeting resistance from nurses and patients’ families. She was becoming discouraged. Donna says she will always remember the day Sue Pedaline, DNP, RN-C, MS, vice president of nursing at Women’s Hospital, saw her on the department and asked how Skin to Skin was going. Donna shared some of her concerns, and Sue offered support and comfort. Sue said, “You are a crocus, Donna” and immediately after this conversation, she emailed Donna a poem, “Crocus-Minded” by Jo Sorley (see facing page).

Donna showed me the printed copy of this email that she has hanging in her office. This inspiring poem’s first line, “It takes courage to be crocus-minded” describes Donna perfectly. Donna has led the way on the Mother Baby unit. She worked with an inter-professional team to gather evidence that S2S is best practice. She has worked with the Safe Sleep model of excellence. She has also worked on the Postpartum Hemorrhage Protocol. Donna says, “These protocols are hardwired, so everybody’s on the same page. That makes for better patient outcomes.”

Embracing changeDonna was inspired to become an RN4 because of the Enrollment Team. Along with her cherished email, Donna keeps a quote from the Enrollment Team hanging prominently in her office. The quote reminds her that change is hard and often uncertain. Donna says uncertainty is out of her comfort zone, but working with the Enrollment Team has taught her to embrace change, which comes with the unknown.

The Courage to Lead from the Bedside By Sarah Clark, RN, MSN, CCRN, CHSE

Donna Wear with her grandson after his very first bath.

“I couldn’t be

more pleased

with my career

at Cone Health.

It’s a great place

to work.”



How has Cone Health Nursing helped you grow? Sharon: When I reflect on our key nursing leadership, their inspiration to others is phenomenal. The endless opportunity nurses have here at Cone Health for advancement is very exciting to me and for the future. And the opportunities are at all levels, whether you are a staff nurse wanting to be a part of the Professional Nurse Advancement Program, or you are ready to advance in leadership, the opportunities are here. It is also exciting to see nurses holding senior executive leadership positions in our organizations.

Wayne: Our nursing leaders believe in us! Leaders are open and transparent; they seek input from those they lead. The interprofessional relationships have also impacted our culture--nursing is part of the discussion with other disciplines, truly working with each other to deliver safe and quality patient care. Cone Health supports nursing’s growth. I really enjoy the job I do so much that I have to make myself leave at the end of the day. Nursing at Cone Health is very fulfilling.

A story to share: Sharon: It was one of the first times I was on call, one Christmas Eve and I was called in for an emergency. It was an emergency open heart surgery on a 45 year old. I remember this experience, as I could personally relate to this person, as if it was someone I knew, and I was there as their OR nurse to provide care. Although the patient did not make it through the surgery, this was a powerful experience for me as a young nurse, as I realized I could provide great care, even when difficult and unfortunate events happen.

Wayne: I can remember when I was s surgical technologist working 2nd shift and a trauma came into the OR. It was a 16 year old who was involved in a motor vehicle accident on Highway 29. I remember vividly working with Dr. Burney for this chest case and after working as hard as we could, it wasn’t enough and she passed away. That is when I realized that I wanted to do more then pass instruments, that I wanted to go back to school to become a nurse. v

Cone Health Support for Advancing RN Education

By Lisa Boland, DNP, RN, NEA-BC

Importance of Advancing RN EducationIt was 2010 when the Institute of Medicine (IOM) published its report, The Future of Nursing: Leading Change, Advancing Health. It presents evidence of the important role nurses play in the delivery of high-quality care to patients and keeping patient safe (IOM, 2010). The report references the health care

transformation that will unfold in the United States and the equally profound changes in the education of nurses that will be required to deliver safe and quality patient care across the continuum of care. The IOM established bold recommendations to increase the proportion of nurses with a baccalaureate degree to 80 percent by the year 2020, and double the number of nurses with a doctoral degree by 2020 (IOM, 2010). The evidence was clear: the higher the education of the nurse, the better outcomes of the patient.

Vision for Cone Health RNsIn 2011, Cone Health decided that because of our commitment to provide exceptional patient care, the right thing to do would be to adopt the goal of achieving the proportion of baccalaureate nurses to 80 percent by the year 2020. In order to achieve such a goal, barriers would have to be removed that would allow our nurses to advance their education. One barrier was financial. The REACH (RN Educational Advancement for Cone Health) Scholarship Loan program was established to provide financial support for our RNs returning to school for a nursing degree. The scholarship provides $6,000 for nurses in our organization to obtain their BSN, MSN, DNP, or PhD in nursing.

Who Qualifies for REACH?Any Cone Health RN who is employed as a full-time or part-time (more than .45 FTE) RN at Cone Health and who has been accepted into an accredited nursing program for BSN, MSN, DNP or PhD is considered qualified. RN’s must be in good standing to be awarded a scholarship.

What does REACH involve?REACH is a reimbursement program that provides up to $6,000 and is disbursed over time based on documentation requirements. Nurses are reimbursed in the paycheck following the date submitted so there is not a waiting period. In return for the scholarship support, recipients agree to a two-year work commitment to Cone Health after they graduate. Reach recipients may also apply for Cone Health tuition reimbursement. v

Why did you become a nurse? Sharon: I was in 11th grade on a Friday night. I was a cheerleader, and as I was on the field cheering on the football team, I looked up and saw my father grab his chest---right then and there, my father, in front of my eyes, was experiencing a heart attack in the stands. After that event, there was no doubt in my mind that I wanted to be a nurse, so I could help him and others.

Wayne: I took the aptitude test for the military, and scored very high in the medical area. I enlisted in the Navy and went to school to become a surgical technologist. I became frustrated with the limitations of not being a registered nurse; I wanted to do more. That’s when I decided to go back to school to become a nurse.

What inspires you about nursing? Sharon: I am inspired with how challenging and rewarding nursing is—all at the same time.

Wayne: I echo Sharon. I am inspired by how nursing is ever changing and challenges you—I am also inspired by how nursing has grown and evolved over the years. And as a registered nurse, especially in leadership, you can combine different skill sets to define your practice, such as your clinical skills and knowledge, along with business and human resource skill sets--being able to pull all these aspects together is very rewarding and always keeps nursing fresh and exciting.

What drew you to our health system?Sharon: Cone Health offered a unique opportunity to join the OR team, even if you didn’t have experience. I applied and was 1 of 15 nurses hired into the OR program. The OR is like a “member’s only club” and I have truly enjoyed every day I have worked here.

Wayne: When I got out of the Navy, Cone Health had the reputation as a very desirable place to work--I knew I would be supported in my personal and professional growth and development. Cone has contributed about 90 percent of my education funding; it sends a powerful message, that Cone Health values its employees so much, the organization is willing to finically contribute to their growth and development.

What is your take on nursing culture at Cone Health?Sharon: Cone Health is committed and dedicated to support, grow and develop staff at all levels. At each level of my career, Cone Health has helped me achieve my personal and professional goals. I am a great example of someone who started as a staff nurse on the open heart team, and transitioned through the ranks to executive director.

Wayne: Cone Health has given me the opportunity to grow as an OR nurse. Cone Health has helped me achieve my personal and professional goals. I started my career here as a surgical technologist and have been given the opportunity to learn, grow and develop, whereas now, I am an executive director for Operative Services.

“Leaders are open and transparent;

they seek input from those they lead.

Our nursing leaders believe in us.”


Sharon McCarter, RN, BSN, MHA, CNORExecutive Director of Operative Services,

Cone Health

Wayne McFatter, RN, MSN, CNOR, RNFAExecutive Director of Operative Services,

Cone Health

Staff to Executive Director:

Celebrating Nursing Practice By Jennifer L. Fencl, DNP, RN, CNS, CNOR

18 15



AutonomyDonna is excited about working at Cone Health. She feels the Professional Nurse Advancement Program has supported her growth. Donna is certified in care for low risk newborns. She is proud of the culture that encourages professional growth and supports others to become certified in their specialty. She states, “It’s so great that Cone Health pays for initial and re-certification. Why wouldn’t a nurse take advantage of this?”

One of the changes that energizes Donna is the push toward Evidence-Based Practice, especially in the past five years. She says if nurses see things that need to be changed, they are empowered at Cone Health to take action. Nurses have the autonomy to think and apply what they know to make a difference. Donna says, “Bedside nurses have support and resources to do their own research here. You can’t do that in most jobs. That’s powerful.”

Donna concluded by saying, “I couldn’t be more pleased with my career at Cone Health. It’s a great place to work. Not many nurses stay on the same unit for 33 years. I love what I do.” This love of nursing shows in everything Donna does. Donna has the courage to be crocus minded, and the support from her department and Cone Health to make things happen. v

Crocus-Minded by Jo Sorley

It takes courage to be crocus-minded.God, I’d rather wait until June,

Likewise roses,When the hazards of winter are safely behind,

and I’m expected, and everything’s ready for roses.But crocuses?

Highly irregular.

Knifing through hard-frozen ground and snow,and sticking their necks out,

because they believe in springand have something personaland emphatic to say about it.

God, I am by nature rose-minded.Even when I have studied the situation here

and know there are wrongs that need righting,affirmations that need stating,

and know also that my speaking out may offend . . .for it rocks the boat . . .

Well, I’d rather wait until June.Maybe later things will work themselves out,

and we won’t have to make an issue of it.God, forgive, Wrongs don’t work themselves out.

Injustices and inequities and hurts don’t just dissolve.Somebody has to stick her neck out,

Somebody who cares enough to think throughand work through hard ground,

because she believes and has something personaland emphatic to say about it.

Me God? Crocus-minded?Could it be that there are things that need to be said,

and you want me to say them? I pray for courage.

Source: http://eastwestadventconversation.blogspot.com/2011/03/crocus-minded-by-jo-sorley.htmlAccessed Oct 13, 2015Continued on page 19

16 17

CNursing Research Symposium

Cone Health nursing and Greensboro Area Health Education Center jointly provided the 4th Annual Nursing Research and Evidence-Based Practice Symposium which attracted statewide media coverage on the noon news Nov. 13. Reporters from Fox News 8 shared the importance of nursing research and how nursing research improves care in the community. The event attracted more than 325 participants from more than 29 counties were represented, with nurses from all backgrounds in attendance.

Social media was also a theme for the day as Symposium organizers created fun through selfie opportunities with historical nursing figures, or by posting quotes using hashtag boards and video clips using #RNResearch.

SpeakersThe Symposium boasted several national and international speakers: • Barbara Drew, PhD, RN, FAAN, FAHA, an expert in alarm fatigue and professor of critical care nursing and clinical professor of medicine in cardiology at the University of California, San Francisco, spoke about best practices in monitoring, identifying arrhythmias and offsetting false alarms. She also highlighted how to successfully integrate research into clinical practice in a meaningful way.• Debra J. Barksdale, PhD, RN, FNP-BC, ANP-BC, CNE, FAANP, FAAN, professor and director of the DNP program at the University of North Carolina at Chapel Hill, spoke on the role of advanced practice nursing related to evidence-based practice and research. Dr. Barksdale is the only nurse appointed to the Patient-Centered Outcomes Research Institute (PCORI), an independent, non-governmental organization that links clinicians, researchers and patients for making choice in health care alternatives easier for patients and families. Her message to nurses emphasized the importance of true patient-centered care.• Prashant Mittal M.S., M.Sc., clinical assistant professor and director of the Data Analytics Lab at the University of New Hampshire, focused on how to develop, and drive quality and safety initiatives by harnessing the power of big data from within the electronic health record. He outlined innovative approaches to using data to make more informed decisions and how to best leverage data in the future in order to improve outcomes for individuals in our communities. • William “Bill” Duffy, RN, MJ, CNOR, FAAN, is a past president of the Association of PeriOperative Registered Nurses (AORN) and is currently the regional chief nursing officer of Lakeshore Region Presence Healthcare in Chicago. He shared how nursing has shaped public policy and challenged nurses to think differently about how we bring innovation into practice. He inspired us all to not only celebrate nursing’s rich history, and influence on public policy and health care, but to also embrace the challenges we have ahead of us in health care and encourage nurses to lead the way.

MAGNETNEW KNOWLEDGE, INNOVATIONS

AND IMPROVEMENTS


Bedside nursing research highlightedThis year the symposium had four concurrent sessions that highlighted the power of the bedside nurse in driving nursing practice for the future. In an effort to emphasize bedside nursing research, several of the concurrent session consisted of panel presentations. These addressed important health care topics including community, caring theory and patient-centered care, hospital-based safety and quality initiatives and population health discussions.

PostersThe symposium included 40 posters in two categories, Research and Evidence-Based Practice. For the first time, the symposium offered a new category for posters that allowed students to present research still in process. The winners of the poster presentations are presented in the table.

Sponsors and VendorsIredell Hospital in Statesville, NC, and Randolph Hospital in Asheboro, NC, were hospital sponsors that helped make the event a success. A record eight vendors presented products for review through displays set up throughout the day.

Nurses are the largest workforce in health care. Nursing research has a direct impact on the health of our patients and our communities. The 4th Annual Nursing Research and Evidence-Based Symposium provided a fitting venue for sharing the exceptional care nurses deliver in our communities. v

Nursing Research Symposium 2015Poster Winners—Research and EBP

Poster Winners—Research

Viewing or Doing: Effective High Fidelity Simulation for

Large Groups

Cultivating Compassion Through Awareness

Making a Difference with Using a Diversional

Activity Cart

Poster Winners—EBP

Patient Falls Prevention

What our Patients Need: Increased Patient and Family

Involvement in Total Joint Replacement Preoperative

Education

Putting the Pieces Together

Poster Winners—People’s Choice

Blood Transfusions and Vital Signs: What Does the

Evidence Say?

Person/Facility

Sarah Clark, MSN, RN, CCRN, CHSE

Belinda Hammond, MSN, RN, CEN, CCRNCone Health

Kathy Farley, DNP, RNCentral Carolina Community

College

Denise Rhew, MSN, RN, CENSandra Kueider, MHA, RN, NE-BC; Susan Owens, BSN, RN, CEN; Julie Eastwood, MSN,

RN-BCCone Health

Joyce Whitaker, BSN, RN; Joanie Thomasson-Waters, MSN, RN, CMSRN; Frances Pleasant, BSN, RN; Karen

Young, BSN, CMSRNCone Health

Eva Hyde, MSN, RN, ONCAdrienne Jacobs, BSN, RN;

Donna Niemela, RN; Katie Silk, BSN, RN

Cynthia Shores, PhD, RNNCAT

Joanna Cortez- Gann, RN; Kristen Foley; BSN, RN, OCN; Kimberly Gilmore,

BSN, RN; Melanie Kennedy, MSN, AGPCNP- BC, OCN;

Daria Kring, PhD, RN, NE- BC; Tammy McGee, RN, OCNNovant Health: Forsyth

Medical Center

Place

First Place—Research

Second Place—Research

Third Place—Research

First Place—EBP

Second Place—EBP

Third Place—EBP

People’s Choice

By Jennifer L. Fencl, DNP, RN, CNS, CNOR

winter 2016 nursing beat

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