July - Saint Clare's Hospital

VOLUME 3 ISSUE 4
JULY - AUGUST 2012
2012 LONDON OLYMPICS: NURSES PARTICIPATE IN
OPENING CEREMONIES
PRACTICE COMPETENCE AND EXCELLENCE DIMENSION
DEBBIE’S NURSING NOTES
KUDOS
WELCOME TO
ROVING NURSE REPORTER
MUST READ
FAREWELL
DAISY NURSES
PRAYERS FOR AN IV
GET THE SCOOP ABOUT MENTAL HEALTH
NURSING NEWS
NDNQI
UNDERSTANDING BULLYING IN THE WORKPLACE; PART 2,
THE EFFECT ON THE NURSING TEAM
EDUCATION FOR PATIENTS AND FAMILIES RELATED TO
INFECTION PREVENTION
FAMILY HEALTH, THE NEUMAN MODEL
NEXIVA
NEWLY ISSUED WARNING ON ONDANSETRON (ZOFRAN ® )
DEAR ALLYSON
CULTURAL COMPETENCE DAY 2012 PHOTOS
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CCU staff and Sister Susan Evelyn at the Denville Cultural Competence
Day. For more photos of this event, see page 15.
2012 LONDON OLYMPICS: NURSES
PARTICIPATE IN OPENING CEREMONIES
WANTED ROVING REPORTERS!
Careful Nursing News is published every other month, and we are looking
for YOU to be a Roving Reporter. If you have a “nose for news,”
send your article or article ideas to Sue Weaver. The vision of this
newsletter is to share new evidenced-based practice information along
with nursing news at Saint Clare’s.
Many nurses read the May/June issue of Careful Nursing News and
were entered to win the book The Immortal Life of Henrietta Lacks by
Rebecca Skloot. Kathleen A. Dittrick, RN, BC, CDP, Director of
Resident Health, Franciscan Oaks, was the winner of this book -
Congratulations!
SO READ THE Careful Nursing News CAREFULLY. YOU may be
a winner!
Careful Nursing by Catherine McAuley is the Nursing Theoretical
Framework for Nursing at Saint Clare’s Health System.
The key concept is Practice Competence and Excellence:
Patient family, friends, and community supportive participation
in care. Read more about this element of Careful Nursing!
Six hundred costume-clad nurses, all of whom are members of Great
Britain’s National Health Service (NHS), performed during the Opening
Ceremony of the 2012 Olympic Games in London. The NHS is the
publicly funded healthcare system in the United Kingdom, founded in
1948 by the socialist government to help restore a country decimated by
years of war. The UK was the first large European nation to affirm health
care as a basic human right, not a privilege for the wealthy, as it had
been before the war. The systems are primarily funded through general
taxation rather than requiring insurance payments. For three generations,
the NHS has provided a comprehensive range of health services,
the vast majority of which are free to UK residents.
I found the tribute to the NHS particularly enjoyable because I had
the opportunity to work in the NHS for four years in the early 1980s.
The uniform the nurses wore during the tribute to the NHS was similar
to uniforms worn by my contemporaries in many large teaching
hospitals in London, Edinburgh, Glasgow and other British cities. I
often heard stories of these uniforms from my Mom who was a nurse
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VOLUME 3 ISSUE 4
“This concept encompasses the need to encourage and support patient’s
family members, friends and community services participation
in patients’ care, according to patients’ wishes and this is possible and
appropriate. In planning, implementing and evaluating patients’ care,
assessment is made of needs for social support and resources. Selected
family members, friends or community members are helped to dein
England during World War II. If you look closely at the picture,
you will see the nurses are wearing aprons and starched cuffs. English
hospitals were mainly staffed by nursing students from their schools of
nursing. Student nurses and single staff nurses lived in the “Nurses
Home.” Before coming down to breakfast, the nurse would don her
formal uniform with long sleeves and removable starched cuffs, and
starched cap. After breakfast, she put on her blue cape lined in red and
walked to the hospital. Upon arrival to the ward she was working on,
she would take off the starched cuffs, roll her sleeves up neatly, apply
her elastic cover to her rolled up sleeve, and put on her apron. The
hospital ward was divided into male or female each containing 30
beds; 15 on each side of the ward with curtains dividing each bed
space. When baths were given, bandages changed, toileting rounds
done and all the patients were sitting up in bed looking as neat as a pin,
the staff nurses and sisters would remove their apron, pull their sleeves
down and replace their starched cuffs before the Consultants or senior
physicians would come to do rounds with the Senior Sister. The patients
and the junior staff knew there was no talking while the
Consultants were on the ward. When the Consultants left the ward,
the nurses would once again roll up their sleeves, put their aprons on
and get back to work. The last change for the nurses came at 3 p.m.,
back to the formal uniform, when the afternoon tea cart arrived.
I worked in the city of Manchester at
Withenshaw Hospital in the Thoracic Intensive
Therapy Unit (ITU). My uniform
was the NHS uniform of the 80s. Staff
nurses wore a pale blue and white-checked
dress, similar to a shirt dress, buttoned
down the front with short sleeves and a
two-inch thick material belt with a wide
buckle. Tan stockings, black tie shoes with
a 1” stacked heel, a white starched cap,
and a fob watch were also part of the staff
nurse uniform. A fob watch pins to your uniform with the watch face
upside down so that when you look down you can easily read it. Nurses
did not wear wrist watches for infection control reasons, you can’t wash
the watch between patients. I still used a fob watch when I came to Saint
Clare’s in 2002.
When I became a “Sister,” which is comparable to our shift supervisor,
my uniform changed to a navy and white-checked dress with a
thick material belt with buckle. I also wore a cape when I went to
lunch and dinner. The uniform had changed at my hospital since the
1940s but the 30 bed wards and the rule of silence during the Con-
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sultant rounds with the Senior Sister remained the same. Of course,
the chatty American Sister didn’t know about the silence rule and “got
a talking to” after the Senior Thoracic Surgeon, finished rounds and
left the step-down ward. I returned to the U.S. in October 1985, after
four years with the wonderful nurses in the UK, who have a special
place in the heart’s of the British people. The nurses are kind, generous
and helpful. No wonder the British people call them ”angels of
mercy.”
Ann McLoughlin, BSN, RN, CMSRN
Admission Nurse
PRACTICE COMPETENCE AND
EXCELLENCE DIMENSION:
PATIENT FAMILY, FRIENDS, AND COMMUNITY
SUPPORTIVE PARTICIPATION IN CARE
Saint Clare’s Health System Nursing has adopted Careful Nursing as
its nursing theory for practice. Careful Nursing has FOUR Nursing
Dimensions and 18 accompanying Key Practice Concepts. In the
practice competence and excellence dimension, patient family, friends,
and community supportive participation in care is one of the eight
interrelated concepts of this dimension and the concept of this issue
of the newsletter.
I. Therapeutic Milieu
II. Practice Competence and Excellence
1. Great tenderness in all things
2. ‘Perfect’ skill fostering safety and comfort
3. Watching and assessment
4. Clinical reasoning and decision-making
5. Patient engagement in self-care
6. Nursing diagnoses, outcomes, interventions
7.Patient family, friends, and community supportive
participation in care
8. Health education
III. Management of Practice and Influence in Health System
IV. Professional Authority
(continued on next page)

VOLUME 3 ISSUE 4
DEBBIE’S NURSING NOTES
As our new Chief Nursing Officer, Debbie Regen
values and recognizes the importance of our patients’
and nurses’ family and friends, the theme
of this issue of the newsletter. Since Debbie is
spending time with her family, she sends her regards
and this special poem by Maya Angelou:
Human Family
I note the obvious differences
in the human family.
Some of us are serious,
some thrive on comedy.
Some declare their lives are lived
as true profundity,
and others claim they really live
the real reality.
and laugh and moan in Guinea,
and thrive on Spanish shores.
We seek success in Finland,
are born and die in Maine.
In minor ways we differ,
in major we're the same.
I note the obvious differences
between each sort and type,
but we are more alike, my friends,
than we are unalike.
We are more alike, my friends,
than we are unalike.
We are more alike, my friends,
than we are unalike.
The variety of our skin tones
can confuse, bemuse, delight,
brown and pink and beige and purple,
tan and blue and white.
I've sailed upon the seven seas
and stopped in every land,
I've seen the wonders of the world
not yet one common man.
I know ten thousand women
called Jane and Mary Jane,
but I've not seen any two
who really were the same.
Mirror twins are different
although their features jibe,
and lovers think quite different thoughts
while lying side by side.
(continued from previous page)
velop care-giving, assistive and supportive roles as necessary.”
From the beginning of my nursing career in the surgical ICU,
I valued the role of the patient’s family and friends. I learned that
having the family at the bedside was a benefit because at least I
knew the patient would not fall out of bed when they were there.
I also encouraged the family to bring in pictures of the patient
and music for the patient.
Meehan, T. C. (2011). Interim notes on the Theory of Careful Nursing.
Sue Weaver, MSN, RN, CRNI, NEA-BC
Shift Administrator
KUDOS
Congratulations to Andrea Sousa, MSN, RN, WHNP-BC, Urban
2, Staff nurse, who graduated in January from Rutgers, the State University,
Newark, with an MSN in Women's Health and passed the certification
board exam in June.
We love and lose in China,
we weep on England's moors,
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VOLUME 3 ISSUE 4
WELCOME TO...
Gifty Adjin-Tettey, RN, RRC Shift Supervisor
Sarah Albanese, RN, RRC Staff nurse
Joan Aversa, RN, CCIS Staff nurse
Paige Ballard, RN, ED Staff nurse
Robin Blatzheim, BSN, RN, SCTU nurse
Lenore Bodnar, RN, Maternal-Child Staff nurse
Allison Brown Jones, RN, ACIS Staff nurse
Angela Castellano, RN, ACDU Staff nurse
Maura Donohue, RN, PES Staff nurse
Heredia Filomena, RN, CCIS Staff nurse
Julie Flores, RN, RRC Staff nurse
Patricia Grzybowski, RN, PICU Staff nurse
Fatme Keten, RN, PCU Staff nurse
Hugo Nenuz, RN, OR Staff nurse
Gladys Seeham, RN, ED Staff nurse
Jenna Vogel, RN, ACIS Staff nurse
Pamela Wohlgemuth, RN, PACU Staff nurse
ROVING NURSE REPORTER
The Roving Nurse Reporter asked, “Do you have any specific
examples of how patient’s family members, and friends helped or
participated in patients’ care?”
Katie Pierson, MSN, RN-BC, ONC,
Nurse Navigator, Orthopedics, states, “I
consistently see family and friend involvement
when it comes to our total joint replacement
patients. As with maternity, we
call our family and friends ‘coaches.’ They
receive the ‘coach’ button at the pre-op
class, come to the hospital and learn how to correctly move the patient
with physical therapy, and then ensure that they provide care for them
once they return home after their hospital stay.”
Cristina Kowalski, RN, Case Management Specialist, states, “In the
role as a case manager, I have a lot of contact
with patients and their family members during
their hospital stay. The majority of families are
willing and able to assist their loved ones and
seem very engaged in their plan of care. My
role is to help the patient reach their personal
goals, maintain their autonomy, and make sure they are involved in
every stage of their care based on the individual’s needs and preferences.
I feel this type of approach helps the patient and their family
members to have more control over their own treatments.
This can also foster the families to be more empathetic and understanding
of the patient’s needs and desires, as well as identifying barriers
to a safe discharge, such as the patient cannot manage their
medications any longer. But most significantly, sometimes patients
seem to lose the desire to participate in their care and this is where I
see many families pull together to assist their loved one, all while still
including the patient in their care.”
Daniela Carrera, RN, Urban 2 Shift Supervisor
and Dorothy Skordinsky, BSN,
RN, Urban 2 staff nurse explain that when
they had a young patient from Canada,
they contacted her mother in Canada and
encouraged her to come to help her daughter.
While they waited for the mother’s arrival,
the staff had the boyfriend and his
family to provide support for this young patient. When the mother arrived
she spent 24 hours a day with her daughter and was able to get
her daughter to eat by recommending specific foods and encouraged
her to walk.
Catherine Jacinto, BSN, RN, 4B staff nurse says,
“It is important to include the family in postoperative
education to enhance compliance after
discharge.”
From the CCU perspective: Hildi Schneider,
RN, CCRN, CCU Staff nurse, states,
“It is important for the family to provide
emotional and spiritual support for the patient
and to assist in patient care as appropriate.”
While Marjorie Yagumyum, BSN,
RN, CCRN, CCU Staff nurse explains, “We
do have some situations where a family member can help and is willing
to feed the patient and even do some passive range of motion.”
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VOLUME 3 ISSUE 4
MUST READ
They Called Them Angels:
American Military Nurses of World War II
by Kathi Jackson (Jackson, K. (2000). Thy Called Them
Angels: American Military Nurses of World War II. Westport,
CT: Greenwood Publishing Group.)
Step back in time and read about the experience
of the American military nurse of
World War II. These nurses volunteered to
serve their country and were sent all over the
world to care for American soldiers. During
World War II, hospitals were brought to
the patients, so the nurses took care of the
soldiers on the front lines. These military
nurses quickly learned to care for patients
with horrific war injuries, burns, amputations,
along with many medical problems such as respiratory diseases,
malaria, typhus, and infectious hepatitis. It was interesting to read
about things uncommon to nurses in the 21st century such as jungle
rot and trench foot along with the Wangentsien apparatus. The nurses
even had to deal with pressure sores, caused when the wounded soldiers
laid for several days on canvas cots, under rough wet blankets,
waiting to be evacuated.
These military nurses adapted and adjusted to military life, varied
climates, and the uniform. The best part of the uniform for these
adaptable nurses was the helmet, because it could be used for everything,
such as a hat, bucket, washtub, bathtub, basket, and chair.
These World War II nurses functioned in roles as nurse anesthetist,
nurse practitioner and even primary care provider. Today, we have
these varied nursing roles and this is the legacy of the World War II
nurses.
Several essays written by nurses are also included in this book. In
one essay, nurse Frances Slanger writes a letter to Stars and Stripes
about the GIs and how impressed she has been caring for these brave
American soldiers. The GI’s responded to her letter and are so grateful
for the caring and compassion of the American nurses.
Finally, this book reminds us of why we are nurses; to help those in
need and to do our best at a job worth doing.
Sue Weaver, MSN, RN, CRNI, NEA-BC
Shift Administrator
FAREWELL
We are saddened to report that Terry O’Dell,
RN, Respiratory Rehabilitation Center (RRC)
in Dover, passed away suddenly on Thursday,
July 5, 2012. Terry began working at Saint
Clare’s in June 1997 and spent most of her
years working in The Dwelling Place and RRC.
She started as a Certified Nurse Assistant while
attending William Paterson University for her BSN. Terry was kind,
caring and generous to a fault. She was dedicated to her patients and
colleagues so much so that RRC was her top priority. According to
Terry’s son, Sean, because his mother loved being an RRC nurse at
Saint Clare’s, she never considered it work. Terry will be missed greatly.
She will be forever in our hearts.
Love your friends in RRC
DAISY NURSES
Congratulations to the new DAISY nurses.
April 2012 - Deborah Ginard, RN
April 2012 - Jacqueline Lezcano,
RN, Emergency Department
Pictured (l-r): Suellyn Ellerbe, MN,
RN, NEA-BC; Jan Bednar, BSN,
MS, RN, CEN, Executive Director
of Nursing; Jacqueline Lezcano,
RN; and Cheryl Beers, DHA, RN,
NE-BC, CALA, Director, Nursing
Operations.
Pictured (l-r): Suellyn Ellerbe,
MN, RN, NEA-BC; Jan Bednar,
BSN, MS, RN, CEN, Executive
Director of Nursing, Tess
Medina, BSN, MAS, RN, Administrative
Director; Director
Debbie Ginard, RN; and Mary
Ann Piro, BSN, RN, CARN,
Operations Manager, Adult Crisis
Intervention Services.
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VOLUME 3 ISSUE 4
Jacqueline Lezcano is a DAISY nurse. A patient wrote: “This past
Sunday, I had the unfortunate experience of dealing with dyspnea.
Given the circumstances, I had my brother bring me to the Denville
ED. Considering this was the first type of such an episode for me I was
very nervous. My ED nurse that day was Jacqueline Lezcano. Upon
my arrival into my room, she greeted me in a way in which I immediately
felt comfortable under her care. This “moment of truth” set
the tone for what would be the transformation of an uncomfortable
circumstance – me arriving nervous – to a controlled situation in
which I fully trusted the forces of care that were being seamlessly implemented
around me. Throughout my stay, Jacqueline was extremely
attentive, clinically knowledgeable, and absolutely role modeled our
system values in her delivery of care. Given that the disposition of my
role rarely awards me the opportunity to witness the great clinical work
going on here, it was a rare – albeit unfortunate – opportunity for me
to dive into the clinical side of the business. As I departed from our
Denville ED, I felt so proud that I work for a system which selects
and develops nurses like Jacqueline. She is truly a role model for the
type of behavior our values hope to inherently create in all our organizations.”
May 2012
Pictured (l-r): Suellyn Ellerbe,
MN, RN, NEA-BC, with the
May 2012 Daisy Nurses, Debbie
Miller, RN, Jeanette Pascale, RN,
CEN, CPEN, and Maureen
O'Connell, BA, RN.
May 2012 Debbie Miller, RN, 4 WEST
Debbie Miller is a DAISY nurse. A patient’s family wrote: “I want
you to be aware of the most wonderful and compassionate care my
mother received from one of your nurses on 4 West during the final
four days of her life. My mom volunteered at Saint Clare’s for 33 years
helping patients, their families, and visitors as if they were her own
family members. It was so fitting therefore, that she was blessed to
have Debbie on duty for those final days. Debbie comforted not only
my mom, but comforted my 92-year-old dad and myself, by going
beyond her daily duties. She kept close watch on my mom attending
to her bed sheets, washing and cleaning her many times during the
day, combing her hair, and keeping her comfortable and warm. She
called for a complimentary lunch cart for my dad and me so we didn't
have to leave my mom’s side. When it was imminent my mom was
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passing, Debbie hugged us and stayed with us helping through the
initial grieving process, and waited with us until the funeral director
came to mom’s room. Debbie should be exalted for her professionalism
and for being a true model of our core values. My dad also wishes
to thank her, and everyone at Saint Clare’s for the care his wife received
from the hometown hospital that they depended on since 1945.
As we both look back with sadness, we count our blessings that someone
like Debbie was here for us when we needed them the most!”
May 2012 Maureen O’Connell, BA, RN, Maternal Child Department
Maureen O’Connell is a DAISY nurse. A few months ago, the Maternity
Unit was especially busy and the nurses needed extra help, so
they called “Mo,” and of course she said she would help. Upon her
arrival, she learned that one particular patient was to be discharged.
Mo went to the nursing office and asked the nursing supervisor what
she had to do to prevent this baby from being potentially discharged
to an unsafe environment. When Mo speaks, people listen. A hospital
hold was placed on the baby, and DYFS (Division of Youth and
Family Services) was again involved. Eventually DYFS determined it
would be safe for the baby to be discharged to this mother. However,
because of Mo’s due diligence during the discharge process, reevaluations
were done and home visits were arranged to provide reassessment
of the situation. The baby went with the mother and DYFS was
to provide home support to the mother and baby. Later it was learned,
the mother never followed up with her own care and DYFS took custody
of the baby. Mo’s intuition about the safety of the baby was first
and foremost in her mind.
Other examples of Mo’s DAISY attributes include: A new father
was also celebrating his birthday as well as the birth of his new baby,
so Mo arranged for a birthday cake for this family. She also went out
of her way after work to pick up formula for a family that had a specific
request.
May 2012 Jeanette Pascale, RN, CEN, CPEN, Emergency Department
There are so many examples of how Jeanette is a DAISY nurse. One
Sunday night there was a young patient on the Pediatric unit who
needed an IV and was considered a “hard stick.” Nurses tried to insert
the IV but were unsuccessful. Jeanette was asked if she could assist.
The child’s parents were more than a little anxious, but they relaxed
with Jeanette’s arrival and her expertise in starting the IV. Plus, Jeanette
did even more. The parents could communicate in English but it was
tough. Since Jeanette is bilingual, they could talk with her in Spanish
and her calming reassurance made a world of a difference for them.
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VOLUME 3 ISSUE 4
On another weekend evening, an L&D nurse asked, “What was the
name of that ED nurse? She was great!” L&D had a patient ready to
deliver at any moment. At just the same time, another new L&D patient
presented to Registration in the ED area. Usually an ED tech
would bring such a patient up to L&D from Registration. But Jeanette
had done an “eyeball assessment” and decided to put this very soonto-be
mom in a wheelchair and bring her to L&D herself. Upon entering
L&D, Jeanette saw how busy it was. So, she asked someone
where the IV tray was. She helped the patient change into a gown, assisted
the patient to a bed, obtained blood samples, started the IV and
reported off to an L&D nurse. Jeanette’s patient delivered about 15
minutes later, just 40 minutes after arriving to the hospital.
Jeanette is willing to help just about everybody, any department,
and any campus.
May 2012 Vincenta Balbin, RN, Respiratory Rehab Unit
Pictured (l-r): Cheryl Beers, DHA, RN, NE-BC, CALA, Director, Nursing
Operations; Timothy Doyle, Administrator RRC; Vincenta (Vicki)
Balbin, RN; Marianne DeAlessi, BSN, MPA, RN, CSN-NJ, Director of
Nursing RRC; and Suellyn Ellerbe, MN, RN, NEA-BC.
Vincenta or “Vicki” is a night-shift nurse, and two hours prior to
Vicki’s arrival to work on RRC, a resident began her “terminal wean”
process. Over a three-hour period, Vicki continually assessed the
resident’s response to the weaning process. Using her critical thinking
skills and compassion, Vicki initiated ongoing communication with
the physician. Medication orders were changed promptly to make her
more comfortable. Vicki was empathetic and compassionate to both
the resident and her family. She was a support for the family, she
prayed with them as they watched their loved one journey through
the end-of-life process.
Two days after the resident died, the family members called to express
their gratitude to Vicki for providing a calming and spiritual atmosphere
during this journey.
The DAISY Award
The DAISY Award is a nationwide program that rewards and celebrates
the extraordinary clinical skill and compassionate care given by
nurses every day. DAISY Nurses are the kind of nurses about whom
other RNs say, “I would want this nurse to take care of my mother.”
Saint Clare’s Health System is proud to participate in the DAISY
award program and presents 12 DAISY awards each year.
The nomination process is simple; just provide a specific story about
why a nurse or colleague should receive this award. Nominations can
be made on the intranet – Nursing Departments – DAISY Award.
PRAYERS FOR AN IV
Recently I was called to start an IV on a patient who was dying. As I
entered the room, I saw a frail, cachectic elderly woman with no visible
veins who was moaning in pain. This patient's daughter was pacing
in the room, and most anxious because she wanted her mother to
receive medication for her pain. I prepared to start the IV, selected a
24-gauge catheter and prayed, “Hail Mary full of grace, put this vein
in its place.” Only by prayer and divine intervention, did this IV
catheter slip into the vein and we were able to administer pain medication.
And let's not forget the namesake of our hospital when starting an
IV. When we think we feel but don't even see the vein, pray the following
silently, “Dear and holy, good Saint Clare, I pray to you a vein
be there.” Harmony McConnell, BSN, RN, CEN, ED staff nurse
also has an IV prayer, “Lord help this man and guide my hand.”
Now I hope you will join us in saying a prayer whenever starting IVs.
Martha Bittner, RN
Shift Administrator
GET THE SCOOP ABOUT MENTAL HEALTH
The World Health Organization gives the following as a definition of
mental health: “A state of emotional and psychological well-being in
which an individual is able to use his or her cognitive and emotional
capabilities, function in society, and meet the ordinary demands of
everyday life” (WHO, 2010).
Mental illness impacts the lives of at least one in four adults and
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VOLUME 3 ISSUE 4
one in 10 children or 60 million Americans. To
support someone you love who suffers from
mental illness can present a multitude of challenges.
These clients did not seek out this disease,
they or their loved ones can’t “cure it” and
those who are part of their world need to accept
that there is no “blame” to be placed for
having a mental illness. There are however, Susanne J. Graham
many things that we can do to help people with mental illness to seek
treatment, help those around them to understand and become educated
on the various forms of mental illness and treatments available,
and how to envelop the client with care and support in their environment
and community.
Having a mental illness is extremely stressful for the client, the family,
and their community. Often, the designated client cannot understand
or verbalize everything that is happening to them when they are
symptomatic. The more that those in his/her world ask “why are you
doing, saying this” the more difficult and frustrating it becomes for the
client. They don’t have the answers, they did not choose for this to
happen, they don’t mean to upset, anger, embarrass or disappoint
those who love and care about them. If you would like to be entered
to win a copy of the book featured in this issue, They Called Them
Angels: American Military Nurses of World War II, please email Sue
Weaver at sweaver@saintclares.org.
So when you ask, “what can I do to help,” the first answer is to ED-
UCATE yourself about the illness. Knowing what to expect, the symptoms
and treatments, will allow you to offer support without
personalizing some of the negative behaviors and consequences you
may be encountering. When you create an environment of understanding
and a community of acceptance for our clients, they will have
a greater chance to flourish and thus minimize the stigma that many
feel is associated with having a mental illness.
To partner with the team of professionals who stand ready to help
your loved one is a matter of trust. It will require a “leap of faith”
sometimes that you place the emergent or immediate care of your family
member in the hands of someone you might not know. However,
if you continue to reach out and ask questions, Saint Clare’s Hotline
973-625-0280, we can hopefully earn that trust by connecting you
with the provider that will best help you along your journey.
In Morris County, indeed within Saint Clare’s, we are extremely fortunate
to have an outpatient system with programs that are focused on
promoting the health and recovery of our Behavioral Health clients.
We have Intensive Family Support Services (IFSS) 973-625-
7095. This team of professionals will work with family members or
significant others who have a loved one with mental illness. They provide
emotional support, educational opportunities, group discussions,
professional speakers, and a host of other opportunities that will help
a family or community to better support their family member in treatment.
The Wellness and Recovery Center, 973-625-0096, is a non-hospital
setting in which a client in crisis can be seen by a team of professionals
and develop a plan of care to mitigate the crisis while being
able to remain in their own home or with family support for up to 30
days, and then transition the client to a next level of care, if needed.
The Self Help Clearinghouse, 973-989-1122, provides a listing
of all the Self-Help Support groups in the area for just about any topic,
and includes how to begin a group of your own.
The Supported Education Program, 973-625-7124, the staff in
this program will help the client seek educational opportunities within
their community to promote their personal growth and future opportunities
and assist them in achieving their goals, promoting a sense of
accomplishment and self worth.
The Supported Employment Program, 973-625-7070, works
with local community businesses and matches clients with employment
opportunities available. This enables many of our clients to live
independently, and have independence.
The Supported Living Program, 973-298-8640, seeks out affordable
housing opportunities in local communities that will allow our
clients to live independently, with the least amount of support necessary,
to enable them to enjoy personal freedom, while letting them
know that they are a phone call away from assistance, if needed.
The most important message the Behavioral Health Team can convey
to you is, YOU ARE NOT ALONE! When in doubt…Reach
Out! We are here to help!
References:
World Health Organization. (2010). Mental health: strengthening our
response. WHO Media Centre: Fact Sheet N 220 September 2010.
http://www.who.int/mediacentre/factsheets/fs220/en/
Susanne J. Graham, MA, RN-BC
Psychiatric Emergency Service
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VOLUME 3 ISSUE 4
NURSING
NEWS
CAGE (Cut - Annoyed - Guilt - Eye Opener)
Upon admission, when completing the patient history, the
nurses questions the patient about alcohol use. When the
patient indicates that they drink alcohol daily or weekly consider
asking the following CAGE questions:
1. Have you felt you ought to Cut down on your drinking?
2. Have people Annoyed you by criticizing your drinking?
3. Have you ever felt Guilty about your drinking?
4. Have you ever had a drink first thing in the morning
(Eye opener) to steady your nerves or get rid of a hangover?
If the patient answers more than two of these questions positively,
they are considered alcohol dependent.
Reference:
McKinley, M. (2005). Alcohol withdrawal syndrome: overlooked
and mismanaged? Critical Care Nurse, 25(3), 40.
HINDU
Asian Indians are the second largest Asian group in the United
States.
Eighty five percent of Asian Indians are Hindu.
The Hindu believe in:
• one God,
• Karma, from this life or a past life, influences one’s health,
• reincarnation of the soul until all of the Karma’s are resolved,
• the endless cycle of the universe.
The Hindu has a tight-knit, extended family who usually all live together.
The grandparents aid in raising the children.
A family member will usually stay with the patient while he or she
is in the hospital to aid with the care of the patient. The entire family
is involved in the decision making process.
The Hindu are strict vegetarians. They do not believe in killing animals
or fish, as they feel that all life is sacred.
The Hindu may utilize Ayurevdic medicine which incorporates the
body, mind, and soul.
They are predisposed to metabolic syndrome due a genetic resistance
to insulin.
Hindu patients are very modest and prefer that they be cared for
by someone of the same gender, if possible.
They believe in a natural death that is calm and pain free surrounded
by their family. They do not believe in artificially prolonging life.
Lisa Grath, BSN, RN, NE-BC
Shift Administrator
HPV
Genital human papillomavirus (also called HPV) is the most common
sexually transmitted infection (STI). Most people who become
infected with HPV do not develop symptoms or health problems
and their body’s immune system clears HPV naturally within two
years. But some people who get HPV will go on to develop cancer
or other health problems.
• HPV can cause genital warts in males and females.
• HPV can cause cervical cancer and other, less-common cancers,
including cancers of the vulva, vagina, penis, anus, and
head and neck (tongue, tonsils and throat).
Since 2006, HPV vaccines have been available as three shots to
protect against HPV infection and HPV-related diseases. Two vaccines
(Cervarix and Gardasil) have been shown to protect against
most cervical cancers in women. One vaccine (Gardasil) also protects
against genital warts and has been shown to protect against
cancers of the anus, vagina and vulva. Both vaccines are available
for females. In 2009, Gardasil was approved for males.
HPV vaccines offer the greatest health benefits to individuals
who receive all three doses before having any type of sexual activity.
That’s why HPV vaccination is recommended for preteen girls
and boys at age 11 or 12 years. Nurses should provide information
and encourage parents and students to receive the HPV vaccine.
References:
Centers for Disease Control and Prevention,
http://www.cdc.gov/hpv/vaccine.html
Johnson-Mallard, V., Thomas, T., Kostas-Polston, Barta, M.,
Lengacher, C., & Rivers, D. (2012). The nurse’s role in preventing
cervical cancer: A cultural framework. American Nurse Today, 7(7),
37-40.
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VOLUME 3 ISSUE 4
NDNQI
This October, Saint
Clare’s Health System
will again participate in
the National Database
of Nursing Quality Indicators
RN Survey. The survey is offered to direct care RNs in member
hospitals. According to the NDNQI, in 2011 over 325,000 RNs
from 893 hospitals responded to the survey. The purpose of the survey
is to obtain a picture of the RN work climate on every participating
unit in Saint Clare’s. This year, the Maternal Child units will
participate for the first time and Saint Clare’s will utilize the long form.
Confidentiality is protected and reported information is summarized
for the entire hospital as a whole and individual units. Details will
emerge as the October start date gets closer.
Marianne DeAlessi, BSN, MPA, RN, CSN-NJ
Director of Nursing, RRC
UNDERSTANDING BULLYING IN THE
WORKPLACE: PART 2, THE EFFECT ON
THE NURSING TEAM
In Part 1, what is bullying? a definition of bullying/workplace violence
and five types of bullying were discussed. To review, bullying is
consistent, repeated, offensive behavior that undermines employees
and creates a stressful work environment for the victim and the other
employees (Beers, 2012). Bullying can be both covert, subtle rude behaviors
and innuendos, or overt, openly abusive, physical or psychological
(Lesley, 2006). The five categories of bullying include: 1) threat
to professional status, 2) threat to personal standing, 3) isolation, 4)
overwork, and 5) destabilization (Rayner & Hoel, 1997). The challenge
to the reader at the end of Part 1 was to observe the personal
work environment to identify any bullying behaviors that may fit into
one of the five categories. Nurses often tolerate bullying as part of the
job and unless nurse leaders provide training, nursing staff may not
identify the behaviors toward them as bullying. Identification of bullying
is necessary to prevent deterioration of the nursing team, which
promotes a safe patient care environment.
The effects of bullying on the nursing team result in decreased
motivation, decreased morale, decreased productivity, increased error
rates, increased turnover, and increased stress (Martin, Gray & Adam,
2008; Yildirum, 2009). Verbal abuse is the most common but least addressed
behavior on the nursing unit. The verbal abuse behaviors of
- 10 -
the bully include aggressive communication behavior, sarcasm, insults,
and refusal to support the nursing team. On nursing units, the staff
sometimes creates work-a-rounds to reduce interaction with a bully.
An example of subordinate to manager vertical workplace violence
is when a unit secretary is rude or sarcastic toward the charge
nurse. The nurse may ask the unit secretary to place a call to a physician
and the unit secretary responds with undertones, nasty facial expressions,
or does not make the call. The charge nurse is intimidated
and may create a work-a-round such as asking a nursing assistant to
perform the task, or doing the task herself so that she does not have
to interact with the bully. All of the nursing team members, including
the manager, are probably aware of the situation and bullying behaviors,
but no action is taken to address the behavior. The result is a
devalued feeling among the rest of the nursing team. One concern is
that if an emergency occurs on the nursing unit, and the unit secretary
is scheduled to leave the unit for a break, the deflated charge nurse
may not confront the bully and ask her to take her break at a later
time. The message the nurse leader is sending to the staff is that the
bullying behavior is acceptable, which further demoralizes the staff
and creates a stressful environment.
Verbal abuse by power and status occurs between a physician and
a nurse or a patient and a nurse. The literature documents several studies
where nurses fall prey to the verbal abuse of physicians. Physicians
may scold, demean, or behave in an intimidating manner to nurses in
public areas and in front of patients. Physician intimidation may result
in delays in patient care because nurses may become afraid to call
with abnormal blood values or change in status. A novice nurse may
be intimidated to the point that she is unable to critically think in an
emergent situation in the presence of a physician who is intimidating
(Berry, Gillespie, Gates, & Schafer, 2011). Patients may be verbally
and at times, physically abusive to nursing team members citing the
Patient Bill of Rights as a license to be abusive.
The patient is a passive victim of bullying behaviors for several
reasons. Morale is low on the unit which results is decreased team
work that causes delays to patient call bell requests and may result in
care delays if a nurse or nursing assistant is tied up with a patient and
can’t attend to other patients or round hourly. A positive correlation
between nursing staff illness and bullying results in increased sick calls
and turnover rates, which in turn may result in short staffing and increased
agency nurse usage (Berry, Gillespie, Gates, & Schafer, 2011).
Bullying behaviors of seasoned nursing staff impedes the ability of the
novice nurse to focus on critical thinking skills, and cope in complex
situations. The delay in gaining competency skills results in decreased
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VOLUME 3 ISSUE 4
productivity and increased error rates. Workplace violence increases
turnover rates of the novice nurse within the first two years as a result of
increased stress and physical illness. A new nurse may adapt to the behavior
and intimidate the behavior of the bully creating a bullying cycle as
a means of survival in the culture of the organization (Thomas, 2010).
Nurse leaders and educators are responsible to create a safe environment
for employees and patients. In 2009, The Joint Commission
mandated a leadership standard that accredited health care organizations
implement a code of conduct for employees that creates a culture
of safety (Thomas, 2009). The culture of safety standard requires
the leadership team to execute a code of conduct that defines acceptable
and unacceptable behaviors and a plan of action to address unacceptable
behaviors. An educational program and discipline policy,
which protects employees from intimidation, sarcasm, and other bullying
behaviors, must be documented. Nurses must be empowered to
report bullying behaviors of peers, physicians, managers, and patients
so that the leadership team has the information necessary to address
the unwanted behaviors (Berry, Gillespie, Gates, & Schafer, 2011,
Thomas, 2010). Nurse productivity, error rates, morale and retention
will improve in a culture of zero tolerance and safety.
If you are a victim of workplace violence or bullying, report the incident
to your manager immediately. At the end of Part 1, the author
challenged the reader to observe the environment for bullying behaviors.
The challenge for Part 2 is to report those unacceptable behaviors
so that nursing leadership can intervene. Any employee who wants to
make a confidential report can call the ethics hotline for assistance.
The entire health care team must work together to promote a Culture
of Safety for our employees, patients, physicians, and families.
Rayner, C. & Hoel, H. (1997). A summary review of literature relating
to workplace bullying. Journal of Community and Applied Social
Psychology, 7, 181-191.
Thomas, C. (2010). Teaching nursing students and newly registered
nurses strategies to deal with violent behaviors in the professional
nurse practice environment. The Journal of Continuing Education in
Nursing, 41(7), 299-308.
Yildirim, D. (2009). Bullying among nurses and its effects. International
Nursing Review, 56, 504-511.
Cheryl Beers, DHA, RN, NE-BC, CALA
Director, Nursing Operations
EDUCATION FOR PATIENTS AND FAMILIES
RELATED TO INFECTION PREVENTION
References:
Beers, C. (2012). Understanding bullying in the workplace: Part 1,
what is bullying? Careful Nursing Newsletter, 3(3), 7.
Berry, P., Gillespie, G., Gates, D., & Schafer, J. (2011). Novice nurse
productivity following workplace bullying. Journal of Nursing Scholarship,
44(1), 80-87.
Gray, A., Gray, C., & Adam, C. (2008). Nurse’s responses to workplace
verbal abuse: A scenario study of the impact of situational and
individual factor. Research and Practice in Human Resources Management,
15(2), 1-17.
Lesley, F. (2006). Why, when we are deemed to be Carers, are we so
mean to our colleagues? Canadian Operating Room Nursing Journal,
24(4), 13-16.
- 11 -
What can we do to help our patients and their families have a better
understanding of what we will do and what they can do to help prevent
healthcare-acquired infections? It all starts with education. Studies
show that patients who are on isolation feel like they do not get the
same care from the nursing staff that the other patients receive. It is
important to explain to them and their families why isolation is in
place and how organisms are spread.
Patient education sheets are available in English and Spanish in your
isolation books on your units for:
• MRSA
• C-Diff
• ESBL
• Tuberculosis
• VRE
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VOLUME 3 ISSUE 4
The Infection Control Nurses are always available to help answer
questions your patients and their families may have.
Remember to also give your patients the education sheets attached
to the start kits for Central Lines and Indwelling Catheters when these
devices are inserted. These sheets explain to them what the device is,
how we will prevent infections and what they can do to prevent infections.
….and of course remember to document all the education you
provide!!
Hand hygiene continues to be the backbone of good infection prevention.
All visitors need to be encouraged to perform hand hygiene when
they come in to visit and when they leave to go home. If their family
member is on isolation they need to be instructed if they need to wear
PPE and that they should be washing their hands when they leave the
room to go out to the nurses’ station, into the nourishment center, etc.
Encourage having your patients and visitors ask questions. Again,
we are always here to help answer any questions they or you may have.
Laura Anderson, MSN, RN, CIC
Infection Control, Nurse Epidemiology
Sarah Granda, RN, APN
Infection Control, Nurse Epidemiology
FAMILY HEALTH, THE NEUMAN MODEL
For those who have studied the Betty Neuman Systems Model, (and
I’ll bet there are plenty of us), the influence of the family in health
promotion coincides with nurse practice beliefs. The Neuman Systems
Model expands to include the family members as an extension
of the patient to become an inclusive primary focus (Neuman, 1995).
The concept of family health has two distinct aspects: it may include
the health or absence of disease of family members, or it may include
the condition of the family itself. Therefore, the concept of
“family health” can refer to an individual within that group, or of the
family as a whole. This can also pertain to physical or emotional wellness
or illness (Neuman, 1995). Neuman’s idea of family health includes
a concept of holistic family health, body/mind/spirit and
incorporates wellness and illness in interaction with the environment
(Neuman, 1995). Five processes are included within this theory:
1. Interactive processes: inclusive of family relationships, communication,
nurturance, intimacy, and social structure.
2. Developmental processes: inclusive of family transitions and the
dynamic interaction between family development and individual
developmental experience in both health and illness.
- 12 -
3. Coping processes which includes decision making, problem solving,
and adaptation to stressors that are part of health promotion
and health maintenance.
4. Integrity processes which includes such concepts as shared meaning
of experiences, family identity and commitment, family history,
values, boundary maintenance and family rituals that relate
to health experiences.
5. Health processes that embrace family health beliefs, family health
status, family health responses and lifestyle practices, and familycentered
health care provision during illness and wellness (Neuman,
1995).
Neuman’s primary health care goal is to “facilitate optimum level
wellness for the client by retaining, attaining, and maintaining client
system stability” (Neuman, 1995, 139). As those of us who are familiar
with Neuman’s theory, stressors from the internal or external environment
can penetrate the flexible and normal lines of defense,
causing a systemic reaction of varying degrees or deviation from wellness
(Neuman, 1995). Our primary goal as nurses includes decreasing
the stressors within the patient’s environment and maximizing cohesive
and positive health influences within the patient’s life. We can
utilize our assessment skills to identify positive and negative resources
within the family unit, and introduce healthy coping measures for all.
Sometimes this might include the use of resources outside of nursing;
however, our commitment to the family reduces individual illness
within a solitary member, and strengthens the family as a whole.
Reference:
Neuman, B. (1995). The Neuman systems model (3rd ed.). Norwalk,
CT: Appleton & Lange.
Sandy Clark, BSN, MHA, RN, NE-BC
Boonton Shift Administrator
NEXIVA
After much discussion, research, unit-based trials and with support of
the Nurse Practice Council, Saint Clare's began using the BD Nexiva
closed catheter IV system. The primary reason for conversion to this
closed IV catheter is there is no exposure to blood during insertion. One
research study found there was a statistically significant difference in
nurses exposure to blood between insertion with the BD Nexiva closed
IV catheter and Braun Introcan Safety Catheter (Bausone-Gazda,
Lefaiver, Walters, 2010). With the Nexiva catheter, the Statlock IV start
kit was eliminated and the 3M Tegaderm IV securement dressing intro-
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VOLUME 3 ISSUE 4
duced. Stabilization and securement
of IV catheters are
critical in reducing IV
restarts and preventing IV
complications such as infiltration
and phlebitis. So take
your time getting used to
this new IV Nexiva catheter, it will benefit you and your patients.
Reference
Bausone-Gazda, D., Lefaiver, C., & Walters, S. 2010. A randomized controlled
trial to compare the complications of 2 peripheral intravenous
catheter-stabilization systems. Journal of Infusion Nursing, 33(6).
Sue Weaver, MSN, RN, CRNI, NEA-BC
Co-Chair, Patient Care Value Analysis Committee
Kathy Basile, MS, MSN, RN, ONC
Project Lead, Nexiva IV Catheter
At the June Careful Nursing News Editorial Board meeting, it
was suggested that we have a Letter to the Editor column. So if
you have comments about articles in newsletter, please send to the
Editor at nurse@saintclares.org and your letters will be published
in the next issue.
Careful Nursing Newsletter Editorial Board pictured after annual
meeting from left to right: William L. Holzemer, RN, PhD, FAAN,
Dean and Professor, Rutgers, The State University of New Jersey;
Megan Weller, BSN, RN, Staff Writer; Sue Weaver, MSN, RN, NEA-
BC, CRNI, Editor; Beth Smith, BSN, RN, Staff Writer; Suellyn
Ellerbe, MN, RN, NEA-BC, former Executive Editor; Robert Hess,
PhD, RN, FAAN, Executive Vice President, Global Programming
Gannett Education, Gannett Healthcare Group; Janice Lynch, MSN,
RN, Regional Nurse Executive, Nurse.com; Lori Price, Columnist,
New Jersey Herald.
NEWLY ISSUED WARNING ON
ONDANSETRON (ZOFRAN ® )
The Food and Drug Administration (FDA) issued a warning on the
anti-nausea medication ondansetron (Zofran®, GlaxoSmithKline) on
June 29, 2012. A recently completed clinical study suggested that a 32
mg single intravenous dose of ondansetron may affect the electrical
activity of the heart, causing QT interval prolongation and predispose
patients to develop abnormal heart rhythm that can potentially be
fatal, such as Torsades de Pointes. 1
Ondansetron is a selective serotonin receptor antagonist that is available
in both oral and parenteral dosage forms. Ondansetron is FDAapproved
for the treatment of chemotherapy-induced nausea and
vomiting (CINV) and also for the treatment and prophylaxis of postoperative
nausea and vomiting (PONV). The higher dose of 32 mg intravenous
injection was used for pre-chemotherapy prophylaxis. The
FDA had previous noted cardiac side effects that are associated with
ondansetron. 2-3 GlaxoSmithKline, the manufacturer of Zofran, was
required by the FDA to conduct a thorough QT study to assess the
cardiovascular side effects of the drug. Preliminary review of the study
suggests that QT prolongation caused by ondansetron occurs in a
dose-dependent fashion, with the largest mean QT difference of 20
msec occurring with the highest single intravenous dose of 32 mg
when compared to placebo. 1
With the newly issued warning, the FDA also provided additional
recommendations to the healthcare professionals on the use of ondansetron,
some of the recommendations are listed below: 1
• The use of a single 32 mg intravenous dose of ondansetron
should be avoided.
• For CINV patients, the lower dose of 0.15 mg/kg every 4 hours
for three doses can be used; however, No single intravenous dose
of ondansetron should exceed 16 mg.
• Patients who may be at particular risk for QT prolongation with
ondansetron are those with congenital long QT syndrome, con-
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VOLUME 3 ISSUE 4
gestive heart failure, bradyarrhythmias, or patients taking concomitant
medications that prolong the QT interval.
• Electrolyte abnormalities, such as hypokalemia or hypomagnesemia
should be corrected prior to the infusion of ondansetron.
This warning does not affect the recommended oral ondansetron
dosing regimen which includes a maximum of 24 mg per day, or the
lower intravenous dose for PONV.
In response to the FDA’s recommendation, the Pharmacy and Therapeutic
Committee at SCHS has voted to implement an automatic
truncation policy where all pre-chemotherapy intravenous ondansetron
orders will be automatically capped at 16 mg. If you have
any questions on the dosing or side effect of ondansetron, please contact
the pharmacy department.
Janet Shen, Pharm.D.
Clinical Pharmacist
References
1. FDA Drug Safety communication: new information regarding QT
prolongation with ondansetron (Zofran). Available at:
http://www.fda.gov/Drugs/DrugSafety/ucm271913.htm, accessed
2 August, 2012.
2. Charbit et al. Droperidol and ondansetron-induced QT interval
prolongation. Anesthesiology 2008; 109(2): 206-212.
3. Charbit et al. Prolongation of QTc interval after postoperative nausea
and vomiting treatment by droperidol or ondansetron. Anesthesiology
2005; 102(6): 1094-1100.
DEAR ALLYSON
As nursing students and others graduate and we
begin recruiting for our 5th Nurse Residency program,
the advice by Karen Roush, MS, RN, FNP-
C, clinical managing editor for the American
Journal of Nursing, is relevant to us all in staying
well-rounded as nurses.
Stay alert. Be vital. Sharpen your mind and your skills. Read journals
for nurses and on health care in general. But don’t limit your knowledge
to health-related information. Read political discourse, economic
theory, and great literature. At the time of this writing, a book of
poems, Slope of the Child Everlasting by Laurie Kutchins, sits on my
desk at home. Each evening it pulls me into a deep reflection that informs
my practice in a way clinical study alone can’t possibly do.
- 14 -
Keep moving. Learn, change, uncover, discover. There’s no other profession
that allows you to do this like nursing. Whether it’s within
your facility or as a travel nurse exploring the country, or perhaps
going from clinical care to a policy-making position, movement will
awaken the anticipation and excitement that you felt in the beginning
of your career.
Look beyond your borders. Whether they’re a shift, a hospital, a specialty,
a state, a country. Reach outside of what you know. See yourself
as part of something bigger than nursing.
Act out. Be willing to anger people. Remember, you are valuable and
necessary. Get your facts straight, then speak up loud and often. Make
some noise and get some attention. And then be ready to back up
your words with actions.
Become nursing’s biggest fan. Promote it. Boast about it. It will go
a long way in making nursing what it should be—well paid, well understood,
and respected. It will draw talented people to the profession.
Nursing suffers from gender bias, this is important to recognize
whichever gender you happen to be. It affects who goes into nursing,
how your role is allowed to evolve, and how much you get paid. The
answer isn’t in making the profession good enough for men; it’s in
making the profession good enough.
Lastly, don’t let nursing define your whole being. Be a baker, a runner,
a book club member, a father, a wife. Whatever it is, be it totally,
ferociously, and separate from nursing. As a writer of poetry, I am
often referred to as a nurse-poet and I always protest. I am not a nursepoet
or a nurse-anything. I am a nurse and a poet . . . among other
things. Nursing takes incredible mental and physical energy. Shelter
that part of you that is away from nursing and it will energize your
presence as a nurse.
If you have a question for Allyson Bakewell, Saint Clare’s Nurse Recruiter,
please email her at AllysonBakewell@saintclares.org and your question
might be featured next month in her Dear Allyson column.
“is not only to carry out the proper measures
yourself but to see that everyone else does so too.”
— Florence Nightingale
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VOLUME 3 ISSUE 4
CULTURAL COMPETENCE DAY 2012
For Denville Cultural Competence Day on May 10, 2012, Ann
McLoughlin, BSN, RN, CMSRN, Admission Nurse represents Ireland
and served her world-famous Irish soda bread with Irish butter.
Dana Palmer, BSN, RN, CCU Staff nurse represents Deutschland
(aka Germany) serving apple cake and German chocolate cake at
Denville Cultural Competence Day.
Enjoying a bit of Poland at the Annual Saint Clare's Cultural
Competence Day, pictured (l-r) are: Stacey Rodimer, BSN, RN,
Quality Management Specialist; Ruth Alea, BSN, RN, CCRN, CCU
staff nurse; Maryanne Onuegbu, Lauren Krause, BSN, MBA, RN,
Quality Management Specialist; Sarah Granda, RN, APN-C,
Infection Control, Nurse Epidemiology; and Auston Halverson,
Sustainability Supervisor, Housekeeping Department.
For Denville Cultural Competence Day, Jaricsa Lopera, 4B Unit Service
Coordinator, Nancy Corrales, BSN, RN-BC, 4B Shift Supervisor,
Natalia Gutierrez, NA, and Angela Garces, RN, 3 Hope Clinical Educator,
represent Colombia in colorful outfits serving delicious empanadas,
chicken and rice, rice pudding, and coffee hard candy while playing videos
of the exotic Colombia displaying all their beauty, color, music, culture,
and amazing vacation spots. They also added flavor to the Nurse's Week
celebration by bringing two Colombian salsa professional dancers who
made everyone want to get off their chairs and do some dancing.
The dancers of "The Pagdiwata Dance" an ethnic Filipino dance are congratulated
by nursing leadership, pictured (l-r) are: Maridel Tenned, BSN,
RN, OCN, ATU staff nurse; Arlene Fidellaga, Choreographer; Dannette
Marin, BSN, RN, RNFA, CNOR, OR staff nurse; Jan Bednar, BSN,
MS, RN, CEN, Executive Director of Nursing; Jean Gloria, RN,
Maternal-Child staff nurse; Debbie Regen, BSN, MS, RN, Chief Nursing
Officer; Desiree Besana, RN, ED staff nurse; Martina Mendoza, RN,
OR staff nurse; and Josie Nemeth, RN, ED staff nurse.
- 15 -
For Denville Cultural Competence Day, Brian Chan, BSN, RN,
OR staff nurse, represents China with a colorful poster depicting the
country's rich culture, and serving popular snacks and desserts.
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VOLUME 3 ISSUE 4
One of the highlights of the Denville Cultural Competence Day was
"The Pagdiwata Dance" an ethnic Filipino dance performed by Ruth
Alea, BSN, RN, CCRN, CCU staff nurse; Desiree Besana, RN, ED
staff Nurse; Arlene Fidellaga, Choreographer; Jean Gloria, RN,
Maternal-Child staff nurse; Martina Mendoza, RN, OR staff nurse;
and Dannette Marin, BSN, RN, RNFA, CNOR, OR staff nurse.
Reunion – Rose Crist, RN, Same Day Surgery; Robert Hess,
PhD, RN, FAAN, Executive Vice President, Global Programming
Gannett Education, Gannett Healthcare Group; and
Lorraine Lewandowski, RN, Same Day Surgery; reminisce
about when they worked together in Saint Clare’s Denville
ICU. Bob was the Director of the ICU, Lorraine worked the
day shift, and Rose was in charge on the night shift.
Careful Nursing Newsletter
For Denville Cultural Competence Day, Veronica Garces, BSN, RN,
Urban 2 staff nurse, and Andrea Alcocer, BSN, RN, Maternal-Child
staff nurse, represent their country of Ecuador by highlighting the
country's many festivities and sites along with serving a dish of ceviche.
Editor:
Staff Writers:
Production
Director:
Editorial Board:
Sue Weaver, MSN, RN, NEA-BC, CRNI
Scott Freitag, BSN, RN, JD
Megan A. Weller, BSN, RN
Beth Smith, BSN, RN
Cathy Dunn, Marketing Communications
Cheryl Beers, DHA, RN, NE-BC, CALA,
Director of Nursing, Operations
Jeannie P. Cimiotti, DnSc, RN, Executive Director,
NJ Collaborating Center for Nursing
Robert Hess, PhD, RN, FAAN,
Executive Vice President, Global Programming
Gannett Education, Gannett Healthcare Group
CCU staff were delighted and proud to share their unique cultures at the
Denville Cultural Competence Day. Pictured (l-r) are: Natalia Gutierrez,
NA; Tracy Oster, BSN, RN, CCU Clinical Educator; Pat Kruse,
RN, CCU Shift Supervisor; Vivek Agnihotri, MSN, RN, CCRN, APN,
CCU staff nurse; Ruth Alea, BSN, RN, CCRN, CCU staff nurse; Dana
Palmer, BSN, RN, CCU staff nurse; and Sister Susan Evelyn.
- 16 -
William L. Holzemer, RN, PhD, FAAN,
Dean and Professor, Rutgers, The State University
of New Jersey
Janice Lynch, MSN, RN, Regional Nurse Executive,
Nurse.com
Lori Price, Columnist, New Jersey Herald