June 3, 2014

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The New England Journal of Medicine (NEJM) is known around the world as perhaps the most prestigious medical publication. The peer-reviewed medical journal publishes research, editorials, review articles and case reports and is a window into the world of medicine. So when the work of three Texas Children’s advanced practice nurses was selected to be published in the journal, they were thrilled about their findings being shared with medical professionals around the world.

Neonatal Nurse Practitioner Amy McCay, director of Advanced Practice Providers Elizabeth “Charley” Elliott, and Nurse Scientist Marlene Walden produced an instructional video on Peripherally Inserted Central Catheter PICC placement in neonates with information on what the complications can be. “Being recognized as a nurse published in a medical journal elevates the science of nursing,” Elliot said. “The selection involves a rigorous process that evaluates manuscripts for scientific accuracy and importance.”

The three learned so much from their investigation that they wanted to share their findings in a publication that would be seen around the globe. They submitted an instructional video on PICC placement in the neonatal patient population and a written overview of the process. The nurses hoped that sharing the knowledge they gained would help other nurses learn the best method for this procedure and how to avoid complications.

“The video is innovative and offers clinicians an opportunity to see into the procedure,” Elliott said. “It brings the process together for those who need visuals and brings the work to a whole new level.”

The journal receives more than 5,000 submissions a year and only about five percent are actually selected and published. All submissions are reviewed by panels of experts that review the current literature and determine if what is being submitted is relevant to current practice and represents evidence.

For the nurses, the process of submission started in 2011 when they began to determine the patients who would be involved in the video, the information that would be presented and how to best present this procedure.

Once submitted, a panel of experts reviews for content, relevance, and best evidence available before they will consent to publish in the journal. Most of the articles published are submitted by physicians and researchers, so the nurses were honored to be selected.

As Elliot puts it, “To have a nurse published in a medical journal is big and validating.”

May 20, 2014

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For Chief Nursing Officer Lori Armstrong the NICU is a special place. It’s where she began her career 29 years ago and where she learned the skills she now uses as a leader for the nursing team of nearly 2,500. Armstrong, who joined Texas Children’s a little more than two years ago, has already changed the face of nursing here through the reinvention of the nursing staff, advocating for more front-line managers, a reinvigorated system for retention and nurse development as well as more full time positions to focus on patient and family-centered care and improve outcomes. Her hard work and dedication was recently highlighted as she accepted the Dr. Jennifer L. Howse Award for Excellence in NICU Leadership at the annual NICU Leadership Forum in Florida.

“I am honored to have even been considered worthy of this nomination,” said Armstrong. “To be selected is overwhelming, humbling and the greatest honor of my career.

Click here to jump to the photo gallery of Lori’s journey in nursing and messages from her nursing staff

The Dr. Jennifer L. Howse Award for Excellence in NICU Leadership is dedicated to the president of the March of Dimes Foundation whose leadership and vision have helped promote research, programs and partnerships that benefit the health of babies in the NICU. Each year the award is given to a recipient who has demonstrated the vision and courage of a strong leader, has wielded significant influence within and beyond the NICU walls and leads with care and compassion for patients, families, colleagues and staff. Armstrong’s nomination letters came from three colleagues both here and outside of Texas Children’s who shared their personal letters about what Armstrong’s enthusiasm and leadership has meant.

52114armstrongawardinside640“Lori’s passion for neonatal care, leadership, and the profession of nursing make her the perfect applicant for this award,” said Shannon Holland, a former NICU leader. “Her enthusiasm for excellent family centered care and passion for continuous learning and growth are inspirational.”

The award recipient is judged on three characteristics which are highlighted by Dr. Howse including Leader Sight, Leader Care and Leader Courage. For Armstrong, each of those areas is an important part of the nursing leadership here at Texas Children’s. Armstrong explains Leader sight as the tremendous responsibility of leaders whose sight and vision for nursing galvanizes the staff, the leadership team and the physician partners which ultimately impacts the health of babies. Leader care is something she learned from a former patient family.

“A parent once told me of his amazing definition of nurses,” said Armstrong. “He defined nurses as people who care and then care some more.”

Armstrong’s definition of courage is about finding your voice and the ability to use it when caring for patients who are too small to speak, too sick to speak and too scared to speak.

Her biggest message to not only the nursing leaders but her entire nursing staff is about their contribution to the organization and the lives of the children that are cared for here.

“I want them to know that there is an inseparable link between your sight, your care and your courage and the outcomes of the tiny infants in your care.”

Howse Excellence in NICU Leadership Award

May 13, 2014

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Dr. Maggie McClure is petite but with a large presence. McClure, one of the founders of Magnet and former Chief Nursing Officer at NYU Medical Center, was the guest of honor at one of the first events to kick off Nurses Week 2014. She spoke to a group of nursing leaders giving an inspirational speech about how Magnet was first established. Magnet is a program which recognizes health care organizations for quality patient care, nursing excellence and innovations in professional nursing practice. Texas Children’s is among the less than 10 percent of hospitals nationwide designated as Magnet facilities.

“When you have great nurses, you have great outcomes,” said McClure. “I don’t know an outcome that is not nursing-related.”

McClure spoke to the heart of nursing and brought laughter to the audience as she shared her experience as a nurse leader in the 70s when there was a shortage of nurses. For McClure, what is now the Magnet program, started out as research to decide what determined nurse retention. McClure’s story is one of collaboration. With the help of three other nurse leaders across the nation, findings were published as a learning experience for all nursing organizations.

Click here to jump to the photo gallery from Nurses Week 2014 below

Celebrations
The speech by McClure was just the beginning of a week of events and activities. Throughout the week, Chief Nursing Office Lori Armstrong made special stops to different units with treats to show her appreciation for all of the hard work by the incredible team of 2,500 nurses. Nurses were treated to a special chair massage, received a blessing of the hands and held a presentation of posters showing the work they’ve done over the last 365 days.

“It’s my goal that by the end of the week, you know how special you are,” Armstrong said, addressing a group of nurses.

Houston Chronicle Salute to Nurses honorees
Among the week’s celebrations included three award ceremonies. The Houston Chronicle Salute to Nurses awarded Janet Treadwell from Texas Children’s Health Plan, as one of the top 10 nurses of 2014. Another 10 nurses were honored in the top 100 including Adrian McKinney, Sandy Heartwell, Cynthia Kennedy, Adrienne Kocher, Patricia Bondurant, Raymund Benigay, Cristina Hernandez, Jennifer Pearson, Jennifer Lusk and Jeremy Thierry.

Texas Children’s Nursing Excellence Award recipients
The second annual Texas Children’s Nursing Excellence Awards Luncheon honored nurses who go above and beyond on a daily basis to make a difference in the lives of our patients. Armstrong opened the awards ceremony which included remarks by President and CEO Mark A. Wallace and Physician-in-Chief Dr. Mark W. Kline as well as closing remarks by Executive Vice President Susan MacDonald.

The honors went to:
Mary Pfeffer – rookie
Danielle Gregory – staff nurse
Brenda Balayut – preceptor
Lauren McCracken – certified nurse
Dr. Nancy Hurst – nurse researcher
Deitra Brown – nurse leader
Julie Kuzin – advanced practice nurse
Forensic Nursing Team – nursing team of the year
Dr. Tony Mott – friend of nursing

The week concluded with a Daisy Award presentation and a statue dedication in front of the Children’s Chapel in West Tower. The Daisy Award for Extraordinary Nurses is awarded each month to nurses based on nominations by patient families or peers. The latest recipient of the Daisy Award is Elise Chabot, 15 West Tower.

Mary Pfeffer, BSN, RN ~ Rookie

Mary Pfeffer is a 2012 Magna cum Laude graduate of the William F. Connell School of Nursing. She is a member of the Sigma Theta Tau International Honor Society of Nursing. Mary is a staff nurse on 14WT, our Pulmonary Adolescent unit. Although she is relatively new to the nursing profession, Mary has distinguished herself as a leader. She is well-known for constantly seeking out new information and ways to better equip herself to deliver the highest quality care possible to her patients and their families. For example, when new initiatives are discussed, Mary frequently volunteers to take an active part in the new process. Despite being a new nurse, Mary is committed to the nursing profession – and takes the responsibility of being a nurse very seriously. For example, she was recently the first responder to an auto-pedestrian accident. She immediately jumped out of her car, began CPR and instructed others who arrived on appropriate steps for support. She stayed with the injured man until EMS arrived to assume care. In the words of Mary’s manager, “Mary’s compassionate touch, positive demeanor, and family engagement in care make her a tremendous asset to the patients and families she cares for.”

Brenda Balayut, BSN, RN ~ Preceptor

Brenda attended nursing school in Pampanga, Philippines. She began working at Texas Children’s in 2009 on 14WT, our Pulmonary Adolescent unit. Brenda takes pride in being a life-long learner – she is BSN prepared and is currently working towards obtaining her CPN certification. Brenda has been described as a “natural nurturer to novice nurses.” Her background of having worked as a clinical instructor in the Philippines has contributed to her success as a preceptor. In the words of one of her orientees, “As a graduate nurse, I was thrilled yet nervous to begin my nursing career at Texas Children’s, and Brenda helped me confidently transition into my role as an RN. During my orientation time, Brenda encouraged me as I faced challenges and helped in still qualities in me that I will continue demonstrate throughout my nursing career.”

Lauren McCracken, BSN, RN, CCRN ~ Certified

Lauren began working as a staff nurse in our PICU in 2005. She is certified by the American Association of Critical Care Nurses. She has been a member of the American Association of Critical Care Nurses since 2005. Lauren became a part of the PICU Transport Team in 2010. As part of the team, she transports patients from 23 weeks gestation to adults from outlying hospitals to our Intensive Care Units. In the words of Dr. Graff, “Lauren embodies the best professional values of a staff nurse. The rigorous, highly pressured transport environment requires calm, deliberate critical thinking, immediate problem solving and a willingness to ‘go the extra mile.’ Lauren excels as a transport provider in all these aspects.”

Nancy Hurst PhD, RN, IBCLC ~ Nurse Researcher

Nancy began her career at Texas Children’s at 1984 as a lactation consultant. She currently serves as the director of Women’s Support Services – she has been in that role since 2010. Nancy is well known for having a longstanding program of research in lactation and breastfeeding the preterm neonate. She is currently the Principal Investigator on a study entitled, ‘Effects of freezing and thawing cycles and storage on the quality of human milk.” Dr. Steven Abrams noted that, “with Nancy’s effort Texas Children’s Hospital is recognized throughout the country and even in other countries as a leader in using human milk to help infants thrive and survive preterm birth or other critical illnesses.”

Forensic Nursing ~ Nursing Team

The forensic team is comprised of nurses that primarily work in the emergency center conducting medical forensic exams for sexual assault cases. At the heart of the forensic nursing team is an undeniable drive to provide quality healthcare to victims of child abuse. Each member of the team reports that their motivation to work in this highly specific and somewhat challenging role is to provide remarkable, compassionate, specialized care for patients and families enduring the unimaginable trauma of sexual abuse. In the words of social work colleague John Bickel, “Having worked with this team for several years, I am constantly amazed by their thoughtfulness, caring and authenticity with these children. We can’t ‘fix’ these children, but we can give them a new and happier ‘normal.’”

Dr. Tony Mott ~ Friend of Nursing

Dr. Tony Mott is a cardiologist and Medical Director of 15WT. Dr. Mott is well regarded for his collaborative leadership style and support of nursing. He takes an active part in the hiring of new nurses on 15WT – by sitting in on interviews or sending a personally emailing the candidate a welcome note of support and partnership. During daily unit rounds he takes the time to assess the nursing workload and advocates alongside nurse leaders to meet bedside nurse, patient and family needs. Dr. Mott always includes nurses in patient care discussions and consistently communicates to nurses how valuable their insight is. One of Dr. Mott’s supporters commented, “Dr. Mott has brought an era of hope and respect that has been pivotal in changing our culture and clinical knowledge on 15WT. He is not only academically brilliant; he is compassionate, understanding, and genuine. His admiration and respect for our profession leaves me speechless.”

Danielle Gregory, BSN, RN, CNRN ~ Staff Nurse

Danielle is a 2011 graduate of the UT Health Science Center at Houston School of Nursing, where she was on the Dean’s List and also the recipient of the Ann Poage Award for Outstanding Academic Achievement and Leadership. She is a certified neuroscience nurse and member of the Society of Pediatric Nurses. She is a staff nurse on 10WT – where she has taken on several projects and roles. For example, she is a member of the epilepsy monitoring unit (EMU) core team, a member of the unit quality practice committee (UQPC) and also serves as a preceptor for new nurses. Danielle has been described as someone that, “embodies perfection as a nurse and colleague. She is a loving, caring individual who is committed to her patients and peers. Her passion is evident in each of the tasks she performs and each of the lives she touches.”

Deitra Brown, MHA, RN, CCRN ~ Nurse Leader

Deitra has served as the nurse manager of the CVICU since 2010. She is certified critical care nurse and a member of the American Association of Critical Care Nurses (AACN). Last fall she was elected as the AACN Houston Gulf Coast Chapter Secretary – elect. Deitra serves as the director of Camp Pump it Up, and collaborates with staff from various departments to coordinate a safe and fun weekend camp for cardiac patients and their siblings. Deitra makes every effort to “lead by example” in how she interacts with other departments, patients and families, staff and physicians. In the words of Dr. Tume, “She has shown that in times of stress in the unit one is able to encourage constructive attitude and enable others to overcome system’s challenges. She is well liked and respected by our nursing and physician team.”

Julie Kuzin ~ Advanced Practice

Julie is a pediatric nurse practitioner (PNP) with the Cardiology service. Julie’s colleagues describe her as being “relentless about professional advancement, scholarly endeavors and involvement in professional organizations.” She is well-known for her integrity, ethical behavior, extraordinary teaching skills and her ability to maintain focus on ‘priority number one’ – providing outstanding patient and family centered care. Julie is an active member of the Houston chapter of the National Association of Pediatric Nurse Practitioners – and serves as their legislative chair. Julie’s newest venture includes a recent appointment as recurrent faculty at Texas Tech School of Nursing where she is developing the curriculum for the new acute care PNP program.

Janet Treadwell, RN, director of care coordination at Texas Children’s Health Plan.
Nominated by fellow nurses Gail Bean, RN; Marie Jackson, RN; and Colleen Carpenter, RN, BSN

Believe it or not, Janet Treadwell’s introduction to nursing came while she was clowning around.

“My father was a member of one of the Shiners Clown Patrol Units and they regularly entertained in their clown suits while children and their parents were waiting,” Treadwell said. “When I was in fifth grade, my mother made me a clown costume so I could go with my father and entertain.

“I could see the kids smile and see them become engaged, not so scared as they were, and I decided then I wanted to be a nurse. Later, in high school, I traded my clown suit for a Candy Striper uniform and after I graduated, attended DePaul Hospital in St. Louis, Missouri, earning my associate degree in nursing in 1975. My family has always been compassionate toward others, and I was fortunate to have this role model of doing unto others,” she said, and although her responsibilities as director of care coordination focus on the basics and building relationships, she continues to see the value of doing unto others.

A believer in lifelong learning, Treadwell, originally a diploma grad, has returned to the classroom numerous times. After earning a BSN, she went on to complete a master’s degree in community health nursing from Southern Illinois University. Then, changing from an acute care focus to a career using her nursing skills in the area of managed care, she pursued a PhD in business. These degrees were all accomplished while working full time, raising a family and being active in community activities.

In the midst of obtaining the degrees, Treadwell has achieved certification in Healthcare Quality (CPHQ), as an Accredited Case Manager (ACM), Certified Care Manager (CCM), Certified Managed Healthcare Nurse (CMCN) and Lean Six Sigma Greenbelt (LSSGB).

She is now completing her doctorate in nursing practice. Her research area – intercollaborative nursing – connects the dots between relationships, education, outreach and support for chronic disease and the Affordable Care Act.

But her academic accomplishments are only one facet of this multifaceted, multitasking nursing professional.

As one nominator described her:
“Janet Treadwell has a passion for nursing, believing it is a profession where a person should never become bored. Janet’s strengths are in the areas of development – of both people and programs.”

In another nomination:
“Janet is innovative, collaborative and in the forefront of adopting new approaches to the health plan. She is a leader in care management and ahead of most areas of the country in implementing programs to positively impact the lives of those patients served by our health plan.”

Another colleague said:
“Janet is exceptional in her work. Janet influences all people she touches to excel beyond their potential and she is one of the most caring and compassionate people I know.”

In her experience, the greatest challenge in nursing today is the high level of change.

“Because change comes so rapidly and so often, collaboration and being flexible (nurses historically have been the most flexible) is essential,” she said. “I’ll also say the people going into nursing are great multitaskers and are at their best, connecting patients with facilities with entities in the community. Of course, juggling those things is always a challenge, so in addition to our clinical knowledge, there’s that psycho-social knowledge we also must apply.”

Treadwell remembered a time, earlier in her career, when she was working on a geriatric medical unit in a small hospital.

“I always had the sense that people were not merely ‘diagnoses,’ but people with families and a past and such rich stories to tell. It was during that time I mastered the skill of considering people within the whole context of who they are,” she said, “and there was more time to listen. Through it all, those patients could tell you were treating them with caring, compassion and respect, as well as doing what you needed to do in giving them treatment.”

Nurses Week Gallery

May 6, 2014

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Nearly 2,500 make up the nursing team at Texas Children’s. Representing the largest segment of our workforce, nurses play a significant role in almost every aspect of the patient and family-centered care we provide across the system. Each year, National Nurses Week is dedicated to these men and women who work tirelessly every day to ensure every patient and their family receives Texas Children’s quality care. This year, the theme of national Nurses Week is “Nurses Leading the Way.”

“This year’s theme is a perfect one for nursing at Texas Children’s,” said Chief Nursing Officer and Senior Vice President Lori Armstrong. “It is reflective of the role that nurses play across the organization in every clinical setting. Every nurse is a leader in the eyes of our patients and their families.”

As a tribute to the founder of modern nursing, Florence Nightingale, Nurses Week is celebrated from May 6 through May 12, Florence’s birthday. For the Texas Children’s nursing team, it’s a week of celebrations and a chance to all to say thank you to the nursing staff for their vast contributions across the organization.

Say thank you to the hard working men and women on our nursing team – send them a card today.

April 15, 2014

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Fifty two nurses sat in a Pavilion conference room attentive and ready to hear from their leader. As Chief Nursing Office Lori Armstrong greeted each table of new RNs, you could feel the excitement and anticipation in the room for “lunches with Lori” which this month was a graduate nurse welcome lunch for this special group.

“You are the largest new graduate nurse class Texas Children’s has ever had,” said Armstrong.

The comment was met with applause by the RNs who graduated nursing schools in December. They were among hundreds who applied for the latest batch of nursing positions that have been added since Armstrong and her nursing leadership team launched the reinvention of nursing in November. Since then, 212 new RNs have been hired filling vacancies as well as new full time employee positions that were added to combat the staffing needs throughout the organization. These grads are among the best and brightest according to Armstrong. Each was required to not only graduate from nursing school, but have a 3.5 grade point average or higher, complete the application with two letters of recommendation as well as write mission and vision statements. The rigorous new requirements and hiring process are meant to determine not only if the nurses are the right fit for the organization, but if we’re the right fit for them.

“Our culture is one where we would do anything for our patients,” Armstrong told the excited crowd. “Your first job is a time you will never forget and I’m so happy you chose to be here for that.”

The group shared their own excitement in their new positions.

“I’ve been at a lot of companies at different levels and I’ve yet to see this level of satisfaction at every level from janitors to staff, nurses and doctors,” said Aaron Clay, RN.

“I started at a Texas Children’s Pediatrics office, moved to hospital as I entered nursing school and now I’m a nurse so that’s growth,” said Jeanette Costilla, RN.

For the nursing department, the new hires are just a small step toward the bigger picture of reinventing the role of nurses across the organization with hopes of attracting nurses from top nursing schools across the U.S. Growing the educated nursing population is not just a priority at Texas Children’s, but across the nation. Evidence shows nurses that have at least a Bachelor of Science in Nursing significantly impact morbidity rates and infection rates.

March 11, 2014

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Texas Children’s Advance Practice Providers hosted their first International Conference recently. It was a huge success with more than 130 attendees from across the world. The conference started with two days of pre-conference seminars focusing on pharmacology, skills labs and palliative care. The main conference included attendees and speakers from across the nation to equip advance practice providers with acute and subspecialty care knowledge, as well as to connect with experts for collaboration.

The mission of the Texas Children’s Hospital Advanced Practice Provider Conference (TCHAPP) was to empower advanced practice registered nurses (APRNs) and physician assistants (PAs) through state of the art education, training, innovation, collaboration and professional development. The conference curriculum was diverse and allowed attendees to tailor their learning experience to their own unique practice needs.

February 25, 2014

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Finding herself awake in the middle of the night, Jenni Stearman, a NICU nurse at Texas Children’s Newborn Center, began scrolling through posts on Facebook before stopping at one that struck a chord in her heart.

It was a touching update from a NICU parent expressing appreciation for everything the NICU nurses do, and it inspired Stearman to return the compliment by conveying her appreciation and empathy for NICU parents.

“I guess I was just a little bit emotional and I read the post and it was just really inspiring. It was too late to call anyone and talk about my feelings, so I typed,” said Stearman.

Although she was home, off-duty, and had a lot going on in her personal life with an upcoming move, wedding and honeymoon, Stearman took some time to reflect on the rewarding experience of getting to know so many loving families in the NICU at Texas Children’s. In her late-night Facebook post, Stearman recounted the journey and struggle of a NICU parent.

“You are in a situation that you didn’t plan on being in and everything that you did plan is now unobtainable. You feel completely out of control of the situation around you. You are dependent on others to do what you so dearly long to be able to do for your own child. Everything that you would normally do to comfort and care for your baby has been taken away from you. I’m here to tell you, I understand your pain and I appreciate you,” she wrote.

She continued by sympathizing with them and expressing gratitude for all that they do to make her job and life even better.

“You trust me with your most valued possession. You learn to trust my instincts and I yours. We become a team with one common goal in mind and that is to get your child home with you as quickly as possible and as healthy as possible. Thank you for that trust. You become my “friends” while we spend 36hrs/week together. After months of this, we have shared more conversation than I have with some of closest friends. We have shared times of pain and times of joy. We have cried together and we have shared laughter. In some cases we share bonds that will extend far beyond the NICU. Thank you for being my friend.”

And finally, she thanked them for staying in touch and giving her hope during tough times.

“The NICU can be a depressing place (as you know). Your updates help us keep faith that all we do is for a very good reason,” she wrote.

Stearman tagged some of the NICU parents she knew in the post, and by morning, many people had forwarded it on and reached out to tell her how much it meant. The post gained so much momentum that the Huffington Post decided to publish it as an op-ed health piece on their national site, highlighting how much our NICU nurses care about the patients and families at Texas Children’s. The post has generated thousands of social media “likes” and shares.

“I wrote it for the NICU moms so I was happy to hear they were sharing it,” said Stearman. I’m really, really happy that people loved it and felt inspired by it.”