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The MounT Sinai hoSpiTal

MagneT newSleTTer 2012 Winter 2012Spring 2012Summer 2012Fall 2012

2013Winter 2013

Welcome Pat Matos, DNP, RN Magnet Program Director

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What is Magnet? by Pat Matos, DNP, RN Welcome to the first edition of the Magnet Newsletter. This newsletter is designed to share information about the Magnet program with all nurses the Mount Sinai Medical Center. Mount Sinai was designated as a Magnet hospital for the first time in 2004 and re-‐designated in 2009 after meeting the rigorous standards outlined by the American Nurses Credentialing Center (ANCC). The process involves the submission of several volumes of documentation demonstrating evidence of standard compliance. This is reviewed by the Magnet Commission and if it demonstrates sufficient evidence of compliance, a survey is then scheduled. The re-‐designation survey in 2009 at Mount Sinai was conducted for three days, and while focused on nursing practice, staff of all disciplines in every area of the hospital participated. We were notified in March, 2009 that we had been re-‐designated. This is achieved by only a small number of hospitals in the United States.

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So, many ask, what is Magnet exactly? To explain, it is best to start with a brief history. In 1983, The American Academy of Nursing’s Task Force on Nursing Practice in Hospitals surveyed 163 hospitals in the U.S. to ascertain what factors created an atmosphere that attracted and retained nurses. Of the 163 hospitals, 41 demonstrated “magnet” characteristics that attracted and retained nurses. These characteristics came to be known as the “Forces of Magnetism.” The 14 forces included quality of care, autonomy, and professional development, to name a few.

In 2007, in response to changes in healthcare, the ANCC conducted a study in which a statistical analysis of surveyor scores was done and the result was a clustering of the sources of evidence into over 30 groups. The 14 Forces of Magnetism were grouped into five components (Transformational Leadership, Structural Empowerment; Exemplary Professional Practice; New

The Mount Sinai Hospital

Magnet Newsletter

Did You Know? • The Magnet Conference for 2012 will be in Los Angeles this year. The dates are October 10 -‐12. Register early! • The ANA National Nurses week is being celebrated at Mount Sinai April 30 – May 7. Traditionally, Nurses Week is celebrated around the May 12th birthday of Florence Nightingale, the founder of modern nursing.

If you want to make suggestions or comments to the newsletter send to [email protected]

This Month’s Issue: P. 2 “A Look at Leadership” P. 3 “Spotlight on KP5” P. 4 “Mind, Body & Spirit” & “Global Outreach” P. 5 “Red Carpet Treatment”

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Knowledge, Innovations & Improvements, and Empirical Outcomes) which form the basis for the Magnet Model. Currently, there are over 87 sources of evidence under these components. In the written documentation and the survey, each of these sources of evidence is evaluated.

The Magnet Recognition Program is a rigorous and ongoing process of achieving and improving nursing excellence. Magnet organizations must now demonstrate that quality outcomes exceed the norm over 50% of the time. It is no longer enough to have processes in place – we must show that these processes are effective. Being designated a Magnet hospital means we are meeting the highest standards we have in the nursing profession. It is reason to be proud and reason to continue to practice at this level in every area of practice.

WELCOME

Spring 2012 | Volume 1 | Issue 1

The Mount Sinai Magnet Newsletter, Spring 2012

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Carol Porter began her career as a nurse working in NJ while raising a family of three children. She was a bedside nurse in emergency and trauma care. After becoming a manager in a couple of different NY hospitals she joined Mt Sinai as Senior Director in 2004. Her specialties were bioterrorism preparedness, hazmat and critical care and trauma. She filled in as interim VP of Nursing when her predecessor, Tom Smith left.

Many of you know her from Nursing rounds, Pain rounds and the monthly meetings with the LBU and directors. Dr Porter has a strong belief that success should be recognized and appreciated, and that we should all take time out of our busy days to ask ourselves, “why was this day worthwhile?” She believes that the bedside nurse influences the patient’s experience, fellow nurses and the hospital as a whole. She believes that nurses are empowered to create change and act autonomously.

Dr. Porter values education and is proud of our certification and tuition benefits. This reimbursement program is evidence of strong support for nurses’ educational pursuits. She recognizes the importance of our ongoing clinical competency in a high tech academic environment. She supports research and Evidence Based Practice (EBP) endeavors. Dr Joyce Fitzpatrick and Dr Emerson Ea are available part time to assist and provide

A Look at Leadership

A component of the Magnet Model is Transformational Leadership. Clinical nurses should have the support of leaders with vision. I had the pleasure of interviewing our leader, Dr Carol Porter, RN, CNO, Senior Vice President for Nursing and Associate Dean of Nursing Research & Education-‐ Mount Sinai

School of Medicine.

Even before I could tell her that she was the focus of my interview, she was helping me find someone in informatics who could assist with our

newsletter endeavor. This set in motion what I detected to be a theme with her; the desire to support new ideas and a passion for her work. Most of

all, I felt that she wanted me to succeed.

Submitted by Sylvie Jacobs, RN, BSN, CPAN

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resource for the staff nurses. She has an ongoing relationship with nurses from other countries. Even as we were speaking, a group of nurses from Hong Kong were spending the month at Mount Sinai. While nurses from other countries are learning

from us, they are also teaching us how they practice and how to approach our diverse clients in a more culturally sensitive way. Her magnet vision is not only hospital and community based, but global.

When asked what message she would want to deliver to the nursing staff, Dr. Porter replied that she would want us to know, “We are leaders in quality care 24 /7. One person can have an enormous impact and we all have the power to create meaningful, compassionate experiences for our patients. It’s the little things that make a difference”. She gave a personal example of how, as a trauma nurse, she had initiated the participation of family in critical/ code situations. This practice gave her families the opportunity to feel a part of the experience and in many cases, a chance to say goodbye. This was an innovative idea at the time (1980’s) and led to the inclusion of family centered care in her whole unit.

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She feels that our prime focus for improvement at this time should be cultivating patient satisfaction. The nursing department and institution as a whole need to better understand the patient’s

perceptions of their experience. We need to more successfully share strategies that work. We need to create an environment of more effectual teamwork. “We are only as strong as our weakest link”. A return to basics is a beginning strategy. Reviewing our fundamental nursing practices and paying attention to detail; like line and drain sites, diabetic foot inspection, mouth care and bathing technique may result in a decline in sepsis rates and an improvement in the patient’s perception of quality.

Dr Porter is proud of a staff she calls dynamic and excellent. The Magnet experience speaks to continual improvement and the journey to Excellence. My impression was that this is also her personal philosophy.

Acknowledgments to Maria Benzan, administrative assistant, without whom this interview could not have taken place.

“We are leaders in quality care 24 x7. One person can have an enormous impact and we all have the power to create meaningful, compassionate experiences for our patients. It’s the little things that make a difference”.


Spotlight on KP5 Women and Children's Services

“KP5 improves Patients' Satisfaction"

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on the wonderful nursing care and the cohesive, compassionate staff who will make their child bearing experience memorable.

Ann examined efficiency issues, encouraging family centered care, best practices and communication enhancement. Her valuing of staff input led to the creation of shower caddies so the women wouldn’t have to juggle bottles, soap and towels traipsing to the showers. They even get flip flops.

Hourly rounding helps meet patient needs faster and more consistently. They have also added anticipatory rounding, that is, they keep a cart handy with frequently requested items like sanitary napkins and ice packs. Some long term antepartum patients often decide to return to KP5 for their postpartum stay.

Communication has improved with adding Vocera and having all staff participate in AIDET training. The values of excellence in patient care are the expectation for all. The higher patient satisfaction scores reflect the dedication, improved morale, teamwork and compassionate care given by the KP5 staff.

KP5 Members interviewed were: Ann Clampet, CNM; Joanne Valladarez, RN; Alicia Lankford, RN, Mary Vitale, RN; Leah Mclaughlin,RN; Pat Sterner, RN, MSN, IBCLC Lactation Consultant; Rovena Desmarattes, RN

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I interviewed the manager and some nursing staff members to find out how they accomplished this achievement.

Their journey together began when Ann Clampet became Nurse Manager a little less than two years ago. The KP5 staff had been operating without a permanent Clinical Nurse Manager for many months. Their morale was low and they were not working together as a team. Ms. Clampet noted that the patient satisfaction scores had dropped.

Ann’s strategy was multifold. She began to hold regular staff meetings in which she encouraged identification of issues pertinent to patient satisfaction and came up with initiatives to address them. These included problems related to the environment, efficiency in the flow of operations and communication among staff.

Weekly staff meetings give her staff the message that they are included, their ideas and contributions are valued and allow for education and dissemination of information. It was at these meetings that staff first learned about the HCAHPS, Press Ganey scores and reimbursement issues pertinent to patient satisfaction.

The environmental issues of the unit are many. The building is old. There are communal showers for a population who may be struggling with body image issues postpartum. Many patients tour the floors in preparation for the birth experience. When they see KP5 they frequently express concern about the accommodations. Fortunately, Pat Sterner, the lactation consultant, reminds them not to focus on the environment, but



In the spirit of magnet nursing, I want to share with you a personal belief which will reinforce your own practice or introduce a way to help you enhance your nursing practice. Taking time out of each day to reflect on gratefulness can improve your physical and emotional health, strengthen your relationships and our community as a whole and can improve coping in crisis situations.

The things we can take for granted; our organs of perception, our ability to feed, clothe and shelter ourselves and our loved ones, even our awakening this morning are things to be thankful for. To get yourself started, begin a journal, document five things you can feel grateful for each day. Soon it will begin to be habitual and with this shift you should start to feel happier, energized and more connected.

Simple? Yes. Easy? No. To be diligent about observing your thoughts and honest about how they are affecting your experience takes courage and a reversal of habits. But it’s the beginning of being aware and being willing to grow.

You may find yourself wanting to express your gratitude to those around you. William Arthur Ward said: “Feeling gratitude and not expressing it is like wrapping a present and not giving it”. Conversely, you may find yourself wanting to express your anger, impatience or annoyance with those around you. During these times I would urge you to pause, flip it to what the moment might be teaching you and find a better way to say what it is you really want to convey.

An attitude of gratitude can elevate, inspire, energize and transform. Thank you for listening.

Mind, Body and Spirit Sylvie Jacobs

I was invited to attend a meeting with Pat Matos DNP, RN, Magnet Program Director and Director of Nursing in Psychiatry and four Nurse Managers from Hong Kong hospitals: Ms Leung, Ms Ha, Ms Chong and Mr Lau. They were visiting Mt Sinai to learn about our nursing practices. This meeting was to share our experience and educate them as to the process of attaining Magnet accreditation.

Dr Matos began by referring us to the ANCC Magnet website and shared her copy of the application manual. She reviewed Magnet standards and components; Transformational Leadership, Exemplary Professional Practice, Structural Empowerment, New Knowledge, Innovations and Improvements, and Empirical Outcomes.

Examples of empirical outcome measurement tools are: Nurse Satisfaction surveys, Patient Satisfaction Surveys and Nurse Sensitive Indicators such as pressure ulcer prevalence. Press Ganey surveys for Patient Satisfaction scores, online training, AIDET and customer satisfaction training were brought up as ways to measure and improve patient satisfaction. Pat shared her own implementation of a customer satisfaction program used by other companies with consistently high customer satisfaction success, such as Disney and Marriot. She knows they make a difference because after the training the patient sat scores improved.

We discussed the Magnet principle of Shared Governance in which staff and management work together to achieve goals. An example of this is how we arrived at our decision to accept and implement Relationship Based Care as our Professional Nursing Practice Model. The meetings between Dr Joyce Fitzpatrick, Magnet Champions and staff nurses led to the adoption of Relationship Based Care.

“Magnet Champions” were mentioned as Mt Sinai’s most valuable Magnet resource by Dr Matos. We are the group of nurses who have been invited to pool our professional standards, dedication and love for nursing to help elevate the professional practice in Mt Sinai. She described our monthly Magnet meetings and the Champion’s role to return to their areas of practice to share the information with fellow staff, manager and director. We shared the experience of attending a Magnet Conference; the mass numbers of nurses from around the globe who attend and positive energy and power one feels there. The next one is in Los Angeles in October and the group was encouraged to attend.

Pat shared that her largest obstacle in implementing the Magnet process in Mt Sinai was communication. The sheer size and number of employees makes it difficult to reach everyone.

Finally the discussion came to cost. We learned that the application and survey fees alone were a large expenditure. Mr. Lau asked how he could justify spending large sums of money to his superiors. The answer was that the value of improving patient care and attracting and retaining quality nurses is priceless.

Global Outreach, Community Service Submitted by Sylvie Jacobs, RN, BSN, CPAN


Red Carpet Worthy

by Chris Seidler, RN

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was held in November 2011 at the New York Academy of Medicine and was attended by more than 450 people. Many of the lectures and panel discussions were conducted by Mount Sinai’s own nurse practitioners.

After such success, I asked Janet what she planned to do next. To my surprise, her reply was not “going to Disney World.”

So what is next in your busy schedule and what projects do you have in the works? J: I am working with a Dutch Nurse Practitioner students program. The students are sponsored for job shadowing with nurse practitioners here at Mount Sinai. The NPs will share their experiences with us and we will share our knowledge and experiences with the students. This will create a true international educational experience. We plan to write a publication about the experiences working together.

I am also busy working with a fellow NP to put together an Evidence-‐Based Practice skills course. We anticipate the course to be started this April. Initially, the course will be for Advanced Practice Nurses but our plan will be to open the course at a future point to all Nurses. You definitely should sign up!

With all of her great ideas and forward thinking in the education of nurses, I really wanted to know what if anything she would like to see changed about nursing education

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From the New York Times to AM New York, this time of year we are reading all about MVPs, Grammy and Oscar winners. In the spirit of the award season, it seems that we should take a moment and roll out the Red Carpet for one of our own right here in Mount Sinai’s Department of Nursing.

So… the envelope please…the New York Times Tribute to Nurses Award goes to… Janet Johnson, ACNP, ANP-‐BC, nurse practitioner in Cardiology at Mount Sinai Heart.

On December 12, 2011, Janet received the New York Times Tribute to Nurses Award for Education. For those unfamiliar with this award, it was established by the New York Times as an opportunity to recognize contributions to the field of nursing in several categories: Leadership, Education, Research, Innovation, and Service to Community. The award recipients are highlighted in a special section of the New York Times Magazine.

I know Janet well professionally, but wanted to sit down and personally discuss her accomplishment. This was a chance to learn more about Janet and understand what got her to where she is today. In the New York Times Magazine Janet says, “If you love nursing, you must share the gift of knowledge with other nurses.” Since she received this award for education, knowledge is where we start.

Why do you believe that nursing education and knowledge are important? J: [Education) is part of advanced practice and I feel that we have to take responsibility for our own expertise.

How did you get started in the education of nurse practitioners? J: It was really through one of my previous managers. She came up with the initial idea of having a nurse practitioner symposium. The nurse practitioners really liked the idea and this manager was able to take a step back and really let it become a nurse practitioner designed symposium. We take the responsibility for the conference planning, organization and content.

Janet says that the nurse practitioners collaborate very closely to ensure the success of each event. The most recent symposium

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here at Mount Sinai.

Do you have a recommendation for something about the education of nurses that you would like to see changed? J: I think that there should be more on –the-‐ unit direct nursing education. Nurses should join in physician rounding and there should also be conduction of monthly in-‐services on each unit that focus on the particular specialty of care in the unit.

After all of the time spent understanding her contributions to nursing education, it was time to get down to the fun parts, the festivities and her experience receiving this award.

Did you see the New York Times Tribute to Nurses Award as recognition of your best accomplishment? J: Yes, this along with the Excellence in Nursing Practice Award I received here at Mount Sinai during Nurses Week. The Nursing Excellence Award was special because it was my fellow colleagues in Nursing and Medicine who nominated me for the award.

Thank you to Janet Johnson for your mentoring of nurses, for taking the time to contribute to this article, and for always striving to make our profession better.

I wish we could put a red carpet out in front of Mount Sinai for you every day.


Editor: Sylvie Jacobs, BSN, RN, CPAN

Staff Contributors: Patricia Leo Holloman, BSN, RN, CNOR Audrey Ludmer, RN Jacklyn Price, RN Felice Rosen, BSN, RN, CMSRN Chris Seidler, BSN, RN-‐BC Alicia Simpson, MS, APRN-‐NPP

Advisor: Pat Matos, DNP, RN

Creative Consultant: Thomas DeNardo, Graphic Designer

Welcome Pat Matos, DNP, RN Magnet Program Director


Magnet Newsletter

This Month’s Issue: P. 2 “MOUNT SINAI CLINICAL EXCELLENCE AWARDS” P. 3 “RELATIONSHIP BASED CARE”

Spring 2012 | Volume 1 | Issue 2

Nurses are celebrated during Nurse’s Week which coincides with the birthday of Florence Nightingale. This year Mount Sinai has a full week of scheduled events to honor, recognize and enrich our nurses. Please find a way to attend some of these events. Please take time to honor your colleagues. And, most importantly, please recognize your own valuable and unique contributions.

Mount Sinai Awards for Excellence in Nursing Practice Each year during Nurse’s week, Mount Sinai recognizes outstanding nurses throughout the institution. This year I am honored to be one of them.

How does it feel to be the recipient of a prestigious nursing award? I have got to admit that it feels wonderful to have your efforts applauded. The ego loves the attention and it gets the validation it seeks. But after the initial excitement, I wonder why? Why me? There are so very many other wonderful Mount Sinai nurses, why would I be singled out? There’s the longevity piece, the fact that I’ve stuck around for 32 years proves my loyalty to the institution. There’s the Benner theory of how, after years of training and practice, one becomes not just competent, but expert at nursing. There’s the fact that I love to read and so have continued learning throughout all these years. I’ve kept abreast of current trends and the forward progression of our profession. I’ve volunteered beyond my basic employment requirements to enrich our community. But so has many, many other Mount Sinai nurses. So why? Why me?

The only answer that makes sense to me is that there is something about my personal belief system that makes me stand out. I believe that there are many paths to fulfillment and so respect the many ways people seek their answers. I believe that since there is more than enough to go around and so I need to share. I believe that we have to think about what we do and say, so as to not harm, but to help. I believe that we are all interconnected, you are me and I am you. Many people say they share some of my beliefs, but still operate from places of fear. This hinders their ability to truly reach out and give fully. I believe that when we acknowledge our true intention; we can deliver.

I am accepting the Mount Sinai Award for Clinical Excellence with the deepest of gratitude for my leaders who guide me, my colleagues who teach me so much and my patients who give me wisdom and purpose. I am accepting this award on behalf of all nurses who are making a better world for us all.



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Self-‐knowledge and awareness supports all other interactions. Understanding our own intention and focus, allows us to be fully present for others. In practical terms, this is done by an inner investigation of our mind. It’s useful to take a centering pause, perhaps a deep breath, before patient contact. Some have recommended using hand washing time to examine our inner state. How are you feeling at that moment? Your emotional state will affect your interaction with your patient and their family as well as your colleagues. If you are finding that you are more times than not in a negative mental state, then perhaps you need to seek help. Friends, family, employee assistance programs, psych, social services or clergy can all help in turbulent times. And as care givers, we need to care for ourselves first by developing healthy habits to manage stress. There are so many ways to search for spiritual peace: yoga, meditation, prayer, creative hobbies, sports, music and arts, tai chi to name just a few. A healthy balance of mind-‐ body-‐ spirit will allow for intentional caring, that is, caring with thought and purpose. As nurses, we should role model not only healthy balances of rest, nutrition and exercise, but also spiritual care as well.

Relationship Based Care

The essence of relationship based care is the delivery of more meaningful health care by the strengthened relationships between self, colleagues and patients


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Maintaining collegial relationships requires a team effort, but it has to start with the individual. Noticing our own patterns of interacting and how they are received gives us insight as to how we are perceived by others. Irritability and impatience are tempered when we take our breaks, stay hydrated and maintain a healthy diet throughout the day. Rushing usually adds stress, and while we need to hustle at times, there are other times when it just leads to feeling overwhelmed. Mistakes are more prone to occur when shortcuts are taken to save time. What would happen if we stopped telling ourselves that we don’t have enough time, express appreciation to patients or colleagues for their patience and to just slow down when needed.

Our relationships with our patients and families make the delivery of our care more or less effective. The feeling of authentic, empathetic communication builds bridges of trust at a vulnerable and often frightening time. An honest appraisal of our interpersonal skills and body language may surprise us. We may begin our interactions with positive intention, but when confronted with

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anger or arrogance change how we respond. Seeking the meaning behind the patient’s communication may open up a more honest and helpful exchange. The nurse’s knowledge, information and skill play a role, but in the end it’s the experience that creates the healing moment.

Relationship Based Care is one of the tenets of our model, which is Relationship Centered Care. As we embrace this Professional Practice Model, it is an especially suitable time to examine our practices. When we role model positive, therapeutic communication our colleagues learn from us as well as benefit from the kind intention created. And how priceless is it when a patient can really open up to you and use your wisdom and experience to help with fears and anxieties. As my Director of Nursing, Geralyn Mcdonough put it so aptly: “It’s just the right thing to do.”


MOUNT SINAI MAGNET NURSES AND FLORENCE NIGHTINGALE Mount Sinai Magnet Nurses stated values: Caring, Compassion, Respect, Integrity, Teamwork

Miss Nightingale is recognized as the first nursing theorist. Her “Notes On Nursing” and other books and her voluminous correspondence have had a deep influence on nursing, medicine, and public health from her own time to the present and into the global age.

Nightingale’s philosophy of nursing was to put the patient in the best condition for nature to act upon him”. The environment was the center of her theory. She believed that environment, both internal and external, could be changed and this would allow nature to heal the patient. She detailed the concepts of diet, cleanliness, light, warmth, ventilation and noise, which we currently term environmental.

Her leadership was transformational-‐ defined as self knowledge, authenticity, flexibility, shared leadership, charisma, expertise, vision and the ability to inspire others. She was a woman before her time—a driving and relentless advocate for her patients.

Her caring and compassion were evidenced by her rounds. She is remembered as the Lady with the Lamp. She brought caring and respect by her personal attention to the wounded and dying in the barracks of Scutari and Balaclava. She spoke with the men, touched them, and respected their persons. She wrote letters to the families of many of those who died and gave comfort, compassion and respect to them. Her caring for them carried far beyond the Crimean War and was evident in her work with the British War Commission in securing benefits and respect for the soldiers.

Her work in establishing schools of nursing; St. Thomas Hospital and Kings College Hospital in London, had the effect of demonstrating that good nursing could and should be achieved only with good education. She maintained strong ties with the students and nurses until she was well into her eighties. Respect, Teamwork, Integrity.

Miss Nightingale was a statistician and advocate for data and record keeping which made her a natural researcher. A keen and practiced observer, her data was sought by the government and utilized in the work of several commissions. She is deemed by many to be the originator of the medical record. Her work demonstrates caring and concern; an expression of her true will to use knowledge for healing.

Her messages to women, not only to nurses, and her deeply held belief in the inclusion and involvement of women in public life was a forerunner of modern day feminism. She worked with many women to advance this ideal including Elizabeth Blackwell, first American woman physician who lived for a time in England and France because she could not obtain a residency in America.

FN was a reformer. She became the focus and agent for promoting hospital administration reform while she was in the Crimea. Her interest in social reform continued with her work with the Sanitary Commission in Britain as well as her work on behalf of the Indian poor. Care, Compassion, Respect.

We are clasping hands with her across the years and still embrace the values which she embodied and promulgated so long ago. Patricia Leo Holloman, RN Class of 1953 May 2012

“ I think one’s feelings waste themselves in words; they ought all to be distilled into action which bring results”

-‐ Florence Nightingale

Sir Harry Verney, Florence Nightingale (seated with scarf) & the Nightingale nurse probationers at Claydon in 1886, with Mary Crossland, home sister for the probationers standing behind

“Scutari Hospital” sash worn by the Nightingale nurses and the actual Turkish Lantern Nightingale used

when making evening rounds at the Barrack Hospital at Scutari


A call for Nominations for the second annual National Magnet Nurse of the Year awards program

The American Nurses Credentialing Center (ANCC) has a National Magnet Nurse of the Year awards program. The awards recognize the outstanding contributions of clinical nurses in each of the five Magnet Model components:

• Transformational Leadership • Structural Empowerment • Exemplary Professional Practice • New Knowledge, Innovations and Improvements • Empirical Outcomes

The National Magnet Nurse of the Year awards will be presented during the ANCC National Magnet Conference in Los Angeles, CA (October 10-‐12, 2012). In addition to an all-‐expense-‐paid trip to the conference, award winners will be presented during the plenary session of the opening ceremonies and will be featured in the “Profiles of Excellence” section on the ANCC Web site. In addition, award announcements will be published through local and national press releases.

The ANCC’s Web site has full details on award criteria, eligibility and the onling submission process for CNOs and MPDs. Completed nominations must be received by 4pm on May 25, 2012 4pm.

One day in 2007, while rounding on her geriatric psychiatry unit, Clinical Nurse Manager Lorna

Green encountered an agitated 89 year old crying for her Mommy and her doll. What do nurses do when confronted with emotional anguish? We stay present and listen. We feel and acknowledge the pain. We formulate a plan and act. Ms Green turned to Lola Bloomfield, Mental Health Associate and asked her to somehow come up with a doll. Ms Bloomfield created a pillowcase doll with arms and legs and “dressed” her with a red sash around her waist. The patient immediately embraced this pillowcase doll, her face lit up and she calmed down.

Curious and determined, Ms Green investigated doll therapy. She found a small amount of information on the internet and noticed most of the doll therapy research was done overseas. She sent one of her nurses, Kathy Clancy to Toys R Us and their first doll purchase was made.


Magnet Newsletter

The Doll ProjectSubmitted by Sylvie Jacobs, RN, BSN

Now Klingenstein Clinical Center 7 South seems to have dolls all over. They’re on shelves, they’re riding in a cart and they’re being carried in arms. They are culturally and gender diverse, with different facial expressions and dress. They are offered to patients who choose their doll, saying

sometimes that they remind them of relatives. Patients who are uncooperative with feeding seem to relax and eat better if they are also

“feeding” their babies. One gentleman was so agitated that he required four caregivers just to get through AM care. He chose a doll and became calm and cooperative. He was able to be discharged back to his long term care

facility. On follow up, he is still carrying and caring for his doll there.

This caught the eye of Dr Davis and Dr Porter who visited the unit and encouraged research to measure outcomes. 7 South began a log of patient observations. They

also measured the use of prn Haldol between patients who had dolls and those that did not. These results showed that patients with pre-existing symptoms of agitation who accepted the doll, used less Haldol prns than patients who did not accept the doll. (story continues on page 3)

Patients benefit by the care and connection they feel when holding a doll...members of the health care team can feel a

greater sense of satisfaction and purpose.

This Month’s Issue:The Doll Project

Spotlight on GP9C

Philippines Welcomes Back Leilani and Imelda

Helping Hand to Haiti

Nursing Research & Evidence Based Projects

Nurses Week 2012 Highlights

New York’s Friendliest

My Overseas Experience in Nursing

Summer 2012 / Volume 1 / Issue 3

These are the first two lines of an appeal for help for Haiti from Linda Benoit, a nurse at Mount Sinai.

Linda was among the first to go to Haiti on a medical mission after the horrific earthquake in 2010. She has since made several trips there to continue her work. She returned to Haiti for a three year project and is currently arranging for their 4th annual Medical Mission to Grandgoave and the Jeremi School of Nursing. She has touched the lives of many people with her strong will and caring nature.

Ms Benoit was born in Haiti and immigrated to the United States as a child along with her family.

She earned her BSN Degree at Dominican College and has worked as a Nurse for nearly 30 years. Currently she is working on getting her Master’s degree and has worked as a Clinical Nurse on Madison 6, Child Adolescent Psychiatry for over 10 years. She has occupied several leadership positions including being a Nursing Director for several hospitals and nursing homes in New York City. She was a Lieutenant in the United States Army Medical Corps Reserve for over 15 years.

In her free time, Ms Benoit spends time with her family which includes 7 grandchildren. She is the consummate people person, feeling that “God put her on this earth to help people”. Her

volunteer work in the community includes responding to 911 calls and dispatching ambulances in the Rockland Ambulance Corps. She is involved in her church providing medical care and other services for the less fortunate.

Ms Benoit was characterized as a selfless and noble individual from a young age who was always passionate about helping others. It was only fitting that she would go on to pursue a nursing career.

Contact information for anyone interested in more information is [email protected]

Two Mount Sinai Nurses: Imelda Tuason, RN, BS of the Cath Lab and Leilani Pineda, RN, BSN of the PACU, returned to their native Bangued, Abra in the Philippines to participate in a Medical Mission.

Lani was going to her neighborhood Rockland Filipino store to buy some fish sauce. She ran into her childhood friend who is a surgeon in the New York metropolitan area. He invited her to join the group who was traveling to the Philippines. There they would work with local doctors, hospital personnel and students to help poor people who could not otherwise afford care.

The venture is sponsored every two years by the governor of Abra, the province where Bangued is located. He provides transportation from Manila and food for the group throughout their stay.

Imelda triaged the patients in the clinic where it was determined if they could

be treated medically or if they needed surgery. Those that required surgery would return the following day for their surgery appointments. These were relatively minor surgeries: thyroidectomies,

cholecystectomies, hernia repairs, mastectomy and one pediatric patient who needed a hernia repair. Lani worked in a four bed Recovery Room that had bare bones equipment including a portable sphygmomanometer, suction, pulse oximeter and an oxygen tank. Most of the equipment was cleaned and reused. This same equipment here would be considered disposable. Lani needed blowby for the 7 month old who had had a hernia repair. One of the

volunteers showed her how to improvise cutting paper and using a nasal cannula to fashion a blowby O2 set up. There was no pediatric BP cuff, so they just monitored the baby’s pulse oximeter and heart rate. Patient’s families brought their own blankets from home since the air conditioner kept the room cool. The ability

to speak Ilocano, the local dialect was very helpful since many poor people speak limited English. The patients and their families were appreciative for their care and gave gifts of food to the volunteers.

At the end the governor threw a party for the volunteers in the capital and gave them

each a certificate. Lani says it was a heartwarming and gratifying experience to be able to help people in need, like a return to the essence of nursing for nursing’s sake. Imelda, who was a returning volunteer, feels everyone should be able to experience the deep satisfaction and rewards of helping others. We would like to add our thank you to Imelda and Lani for representing Mount Sinai and extending our excellent nursing care around the globe.

“We are quite fortunate to live in a land of plenty where most of us are privileged to have more than life’s basic needs of food, clothing and shelter. Most of us take those privileges for granted and sometimes forget the less fortunate.” Helping Hand to Haiti

Submitted by Jeannie Jung, RN-BC, MS

Philippines Welcomes Leilani and ImeldaSubmitted by Sylvie Jacobs, BSN, RN

The Mount Sinai Magnet Newsletter Summer 2012

Mount Sinai was visited by two international Magnet commissioners in March.

Ms. Veronica Casey from Australia and Mr. Franz Wagner from Germany were welcomed and we were able to share our initiatives and achievements. Mount Sinai Queens joined in and presented their journey to excellence as they are applying for their first Magnet designation when we apply for our redesignation in 2014.

An impressive poster presentation followed our discussion. Outlined were our programs of Safe Patient Handling, “Call, Don’t Fall” Falls Prevention, Skin

Care and Pressure Ulcer Prevention, and the works of the Cullman Institute and the Award and Recognition committees.

Also spotlighted was our Global Study Tour program in which we host a variety of nurses from other countries to show them our various clinical programs and Magnet level nursing practice. Mount Sinai Queens shared their “Tree of Life” Relationship Based Care initiative, Promoting Nursing Practice through Certification, hospital wide Quiet Time and Ask a Nurse program in which they provide designated times for patients and families to get information.

DID YOU KNOW?Having a doll seemed to do much more than just calm agitation. Patients became less fearful and anxious before tests or before discharge. They became more interactive with others and more willing to converse. They would talk about who the doll reminded them of or how the doll made them feel. One patient used the adjective

“serene” as how she felt when holding her doll. Patients were more cooperative, had increased participation in groups and activities, improved sleep and were noted to smile more readily. Dolls were helpful in feeding and toileting activities and in exploring patient histories.

Currently, we are beginning to use doll therapy in other settings. A NSICU Nurse, Natalie Etienne had recalled seeing 7 South’s presentation at Nursing Research Day. An elderly, non-English speaking woman was suffering from agitation and delirium after brain surgery.

The rounding critical care team was planning to start 1:1 observation since the patient was trying to climb out of bed and was clearly at risk for injury. Ms Etienne suggested giving her a doll. An ethnically matched doll was sent to NSICU and was immediately embraced by this patient. She calmed down and patted its back saying “baby, baby”. The patient was able to rest and sleep and did not require 1:1 observation.

A second successful response occurred on Guggenheim Pavilion 8 Center. A doll was given to an agitated patient suffering from dementia and acute delirium. They observed similar results. The nursing staff there was able to use the doll to administer medications more easily. The patient became more cooperative with other treatments to the great relief of her daughter.

Out of a therapeutic nursing moment came this effective, inexpensive and safe intervention. Patients benefit by the care and connection they feel when holding a doll. Other patients, visitors and staff are spared the delirious screams of these patients. And all members of the health care team can feel a greater sense of satisfaction and purpose.

The KCC 7South team plans on expanding the doll project within the next few months. They would like to examine the effect of the dolls on agitated patients on non-psychiatric units. More information to come soon.

The Doll Project (cont. from page 1)

Ms. Casey & Mr. Wagner (Centered with Maria Vezina) and members of Mount Sinai Hospital & Mount Sinai Hospital of Queens Nursing Leadership.

Carol Porter, DNP, RN, Chief Nursing Officer, Senior Vice President for Nursing and Associate Dean of Nursing Research and Education was honored by receiving the Edgar M Cullman, Sr., Chair of the Department of Nursing during our Nurse Week Celebrations. She holds the first endowed chair in the Department of Nursing.

The ANCC National Magnet Conference will be held in Los Angeles, CA on October 10-12, 2012. I have attended two Magnet conferences. They are memorable events that I felt recharged my professional battery. I came back to work excited and proud to be a Nurse in a Magnet Hospital and felt challenged to give the best care possible. I would encourage you to share in this remarkable adventure. http://www.anccmagnetconference.org/ Mount Sinai is revising our Dress Code Policy # 1208 which you can find in your Intranet Policies on the website. The goal is to make the Mount Sinai Nurse readily recognizable and visible to our patients and their families. The Dress Code Team would like to invite you to join in the final vote at the DRESS TO HEAL Fashion Show being held in the Annenberg West Lobby on Tuesday, August 7, 2012 from 0600-0800 and 1800-2000. The Dress Code Team is led by Maria Vezina and Linda Paxton and consists of other Nurse Leaders and Clinical Nurses from all departments. The uniform choices are being made with the idea of keeping them gender neutral, professional and comfortable.


Nursing Research and Evidenced Based ProjectsBy Sylvie Jacobs

If I am like many of you, I have yet to conduct Nursing Research or an Evidenced Based Project. I not only feel intimidated by the concept, but dread the thought of creating yet even more work for myself. Even though Florence Nightingale started Nursing Research in 1859 with her Nurses Notes, it’s only just recently that I am opening to the idea of conducting our own project. I am realizing that we have an obligation to our patients to establish best practices. I am beginning to appreciate the power of generating knowledge. It is no longer acceptable to do things because that’s the way we’ve always done them. Now, more than ever, we must use research supported evidence to guide our clinical practice.The difference between Research and EBPs is that research has global applications, while EBPs consider the patient’s preference and apply to a specific practice setting. The beginning step is to ask a question. Then wording the question in PICO format: that is

identifying and

describing the Population, Intervention, Comparison, Outcome and over what Time. Once you have your key words for framework you can do a database search. After searching the evidence you appraise it, integrate it into your practice change and then evaluate the outcome.Mount Sinai has many resources to help with Research Projects and EBPs. During our Nurse’s Week Celebrations I attended

a presentation by Sharon Wexler, PhD, RN Nurse Researcher from Mount Sinai of Queens and Assistant Professor at Pace University School of Nursing and Emerson Ea, DNP, RN Senior Manager EBP, Nursing Research at Mount Sinai and Clinical Assistant Professor and NYU College of Nursing. They spoke on writing Abstracts and developing Posters and made it all seem completely doable. They both extended themselves to assist and support any project, research or poster we may want to create. The Mount Sinai Nursing Research Committee invites proposals for EBP/ Nursing Research to

be forwarded to [email protected]. Prior to contacting him you should have discussed your idea and received approval from your clinical leadership. Also you need to have prepared a one page abstract that includes: Title, name and credentials of the Investigator and Co-investigators, description of the problem, significance to patient care, purpose and specific objectives and methods including setting, targeted sample, variables under study, measurement and proposed statistical analyses (as applicable).There are multiple resources from the Levy Library. The Levy Library’s mission statement is to support the clinical, educational and research programs of Mount Sinai. They can be accessed online at http://library.mssm.edu and your Mount Sinai email login name and password allows you to log on to most of their online resources from off-campus.

For questions about your Mount Sinai email login and password, please contact: Levy Library Computing by phone :(212) 241-7091 or via email at [email protected]. There is a knowledgeable and helpful librarian to assist you in the library.

What is prompting this thought is my recent shocking discovery that the patient rating of Mount Sinai Nurses showed that we don’t come

across as particularly friendly or courteous to many of our patients and their families. At first I

found this hard to believe, but then I took a good look in our collective mirror and came to accept that we

do have room for improvement in this area.

Many of us are friendly and courteous. After all, we want to instill trust and build a therapeutic relationship with our patients and their families. We know that this is the most effective way to create a healing and

learning environment. We need to be open and emotionally available

to our patients who are vulnerable, anxious and ill,

injured or dying.

But sometimes things get in the way. Sometimes it’s fatigue,

hunger and thirst as the long shift wears on. Or perhaps we are having a

disagreement or conflict with a colleague that sours our mood and makes us seem preoccupied with other things. Certainly commuting by subway, where beating someone out for a seat is viewed as a good

thing, can erode one’s sense of courtesy. Perhaps our relationships are being affected by our prejudices; are you more friendly and courteous to celebrities, young people, wealthy people, thin people, those of your ethnic group or from your native country or who practice your faith? Does that mean you are being less friendly to those of the opposite groups?

So how do we find our way back? How do we remind ourselves and each other of how vitally important being friendly and courteous is in a patient’s perception? I think we start with ourselves. Being aware of our states of mind, controlling our thoughts so they don’t overwhelm our experience, coming to work rested and prepared for a long shift with snacks , maintaining healthy relationships and seeking help when needed. Then we turn to our colleagues. Offering help when we can, being generous with supplies and resources, remembering that workplace manners may differ from how we act at home or with personal friends, Being polite, speaking softly, holding doors for people and not taking things personally. If a problem arises, address resolving it with the appropriate person, don’t just complain to the nearest listener, don’t be that negative whiner draining your colleague’s energy.

Now you are ready to present your best self to your patient. You are ready to smile, offer a welcoming touch and an open heart. Mount Sinai’s Friendliest; the Nurses.

New York’s Friendliest By Sylvie Jacobs

Your ideas to improve patient care and your willingness to share how you’ve created change in your practice can help shape care delivery across the globe.

Why not? We have New York’s Finest : Police and the Bravest : Firefighters. I think Mount Sinai Nurses could strive to be New York’s Friendliest.


Perioperative ServicesJefferson Aglipay, BSN, RN, CNOR,Clinical Nurse

The Mount Sinai Hospital of QueensPreciosa Basiao, BSN, RN

The Heart HospitalGerry Basler, MSN, RN, CCNRClinical Nurse, CCU

The Mount Sinai Hospital of QueensClaudine Brown, MSN, RN

Mary Mendes AwardPatricia BurkeNurse Clinician, Pediatric Outpatient

Advanced Practice: Nurse PractitionersMarisa Cortese, MS, RN, FNP, BC, The Tisch Cancer Institute

Rehabilitation NursingMarie Daniel, BSN, RN, KCC 2Rookie of the YearSofia Fleischman, BSN, RN Clinical Nurse, PICU

The Mount Sinai Hospital of QueensDechen Lama, RN

Medicine/Clinical Research Center/Ruttenberg Treatment CenterCathy Lin, BSN, RN Inpatient Dialysis

Psychiatry ServicesKrystal Locke, BSN, RN, Madison 6Clinical Nurse PreceptorKim Mayo-Smith, BSN, RN Clinical Nurse, KP 8

Emergency DepartmentLisa Menotti, BSN, RN, Clinical Nurse

Clinical Nurse ManagerLinda Pagan, MS, RN, CARN, Ambulatory

Specialized PracticePatricia Sterner, MSN, RN, CNS, IBCLC, Lactation

Surgical, Medical Specialties and Transplantation InstituteNicole Wells, BSN, RN, CMSRN, Clinical Nurse, GP 8E

Internal Medicine AssociatesMelissa Williams, BSN, RN

Women & Children ServicesStephanie Yabut, BSN, RNClinical Nurse, KP5

Departmental Winner:Pat Lang Award and overall Departmental WinnerSylvie Jacobs, BSN, RN, CPANClinical Nurse, PACU

NURSES WEEK 2012CLINICAL NURSE EXCELLENCE AWARDS

POSTER PRESENTATIONSMOUNT SINAI NURSE WEEK 2012

Mount Sinai Hospital, along with Mount Sinai of Queens Hospital, presented their posters showing us some excellent studies, EBPs, projects and interventions.

They gave us the opportunity to think about our own practices, learn from their hard work and explore possibilities for future projects and interventions. I have tried to summarize them for those of you who missed them. I hope I got most of it right. They were a strong representation of some of our best nursing collaboration.

See page 7 for descriptions of some of these outstanding posters.

Thirty two Nurses were honored by being nominated for Clinical Nurse Excellence Awards. Nineteen of thesereceived Awards on May 1, 2012: Congratulations to all.

Spotlight on GP 9CBy Sylvie Jacobs

Guggenheim Pavilion’s Nine Center is the location for the new Zweig Center for Living Donations in the Recanati/ Miller Transplant Institute. Barbara and Martin Zweig donated 5 million dollars to create this new Center and establish an Endowed Professorship.

They had their ribbon cutting on May 8, 2012. The Center consists of five beds, three private and one semi-private. Dr Dianne Lapointe Rudow is the director of the Zweig Center for Living Donation and it is hoped that this beautiful environment will contribute to the advancement of the Living Related Organ Donation program.

The mission of the Living Related Transplant Program is to provide high quality health care to potential and Live Organ Donors. Their goal is to create an environment focused on wellness through the latest medical advances, comprehensive evaluation, support and education before, during and after donation. They use a multidisciplinary approach to live donor transplant which requires the donor and recipient have two separate teams to provide an unbiased evaluation and ensure safety. There is a collaboration of care between these two teams. The Program offers an enhanced Independent Donor Advocacy Team (IDAT) which provides comprehensive patient focused medical and psychiatric care to promote long term wellness to donors.

The Living Related Transplant Program hopes to increase the number of live donor procedures performed by increasing awareness and to advance the science of living donation through innovation and psychosocial and outcomes research.In an effort to increase awareness The Recanati/Miller Transplant Institute partnered with the New York Organ Donor Network last April to celebrate National Donate Life Month. They staffed a table by the cafeteria where people could learn about organ donation, meet donors and recipients and register to become an organ donor.

Some of you may be asking what is so important about living organ donations. The answer is that they greatly increase organ availability. If you are interested as to what this means to individual people, just visit 9C and notice the many thank you cards from patients thumbtacked on their board. Then step into their visitors’ lounge and read the poetry of J Feller. He was a patient who wrote a poem before his transplant and then again, after. You can read about his anger, fear and smell of death and see how it is transformed into

joy, gratitude and a renewed zest for life. Other advantages to this form of organ donation is that the recipients experience less life threatening complications and the organs are not traumatized by temperature changes. Of course there are negatives, these being that a healthy person is faced with potential complications that could be long or short term. To minimize the risks to a potential donor the Federal and State government and UNOS requires an Advocate. It’s actually an Advocacy Team consisting of a Designated Live Donor Social Worker, RN, Administrative staff member, Psychiatrist, Nutritionist, Data Coordinator, Nurse Practitioner, Nephrologist or Hepatologist and Surgeon. The psychosocial evaluation includes a potential donor’s competency, assuring there is no coercion or monetary reward or any evidence of substance abuse or psychiatric disorders. A health care proxy is established to assure that the Care Team for the donor is separate from the recipients. The Care Team provides education on what to expect as well as emotional support both before and after surgery. Their follow-up continues for two years after donation.

The Nine Center Clinical Nurses volunteer to be Designated Donor Nurses for people who are planning to serve as live organ donors. His or her role is to accompany the patient through the pre-operative screening and testing process which takes approximately 1 ½ to 2 days. The Nurse then follows the patient through the post-operative period and their already established relationship benefits the patient during their recovery. This seems to be a rewarding and fulfilling experience for the Nurse since they have about 25% of their staff volunteering to serve as Donor Nurses. This opportunity comes up about once a month and the Nurses are reimbursed with overtime pay for their time and efforts.

Nine Center also provides care to transplant recipients. Post-operatively, Kidney transplant recipients spend four hours in the Post Anesthesia Care Unit before transferring to 9C. Liver transplant recipients go to the Surgical Intensive Care Unit directly from the OR before they are able to transfer to 9C. For stabilized patients requiring continued monitoring and more intense care, they have a TICU or Transplant Intermediate Care Unit. These are four bedded rooms

equipped with bedside monitors and an RN caring for those four patients. All transplant recipients require many various medications to protect the newly transplanted organ from rejection and to minimize complications from infection and medication side effects. Patients’ lab results must be carefully monitored. Close vigilance on intake and output monitoring and fluid replacement is important to assure adequate support and functioning


World Trade Center Health Program: had 2 posters, the first addressed respiratory status among the workers and volunteers post 9/11 and the second evaluated the effect of a stress reduction program on asthma symptoms among WTC workers and volunteers

Pediatrics, Psych peds and Neonatal were well represented with several posters:Pediatric Nutrition: Patrice Burke showed how simply translating patient education into native languages enhances learning surrounding pediatric nutritional needs in this vulnerable patient community

A team on Madison 6 explored using collaboration and less restraint and seclusion use on their child and adolescent unit

Kelli Ann Naughton investigated Sucrose and Non-Nutritive Sucking to help with procedural pain in the term and preterm neonate

A Child Life collaboration looked at how all kinds of creative arts therapy helped coping and depression in teen and preteen girls with chronic diseases

Pediatric Inflammatory Bowel Disease practitioners surveyed parental attitudes toward CAM for IBD children

Mount Sinai of Queens presented several posters:They implemented “Quiet Time” on an Inpatient Medical Unit to enhance the patient experience

Again on an inpatient medical unit, they implemented an “Ask a Nurse” program to promote Relationship Based Nursing Care.

Another Implementation to advance Relationship Based Nursing Care was to use the “Tree of Life”, also on an Inpatient Medical Unit, a personal diagram illustrating the patient’s interconnections between family, friends and caregivers

An initiative to promote professional practice through certification by personal invitations, providing resources for test preparation and application

The Mount Sinai Cardiovascular Institute was represented with:Guidelines for 90 minute door to Balloon time for STEMIPillars of Success in the Cath Lab with striving to elevate performance

Oncology examined Cultural Competency and Disease Awareness of Oncology Nurses caring for patients with Adult T –cell Leukemia and LymphomaMore cultural competency in Examining the Spiritual Practices and Relationship between well-being and depression among elderly Filipinos

A look at Patient Autonomy for Pain Management from our orthopedic nurses

Nurse Practitioner Roles and Competencies

How Hourly Rounding affects outcomes on HCAHPS from the Cullman Institute for Patient Care

Perioperative efforts to optimize efficiency in Operating Room Turn over between Cases

Alternative Interventions to Improve Patient outcomes in the Geriatric Psych patient ( see newsletter column on KCC 7 N and their “Doll Project”)

Transplant team who examines Collaborative Approaches for Transplant medication education ( see newsletter column spotlighting 9C)

The Mount Sinai Department of Nursing displaying The Mount Sinai Hospital Global Nursing Tours ( we hosted 28 study tours in the last 4 years)

POSTER PRESENTATION MOUNT SINAI NURSE WEEK 2012 (continued from page 5)


It was an impressive and inspiring glimpse into the dedicated work of many of our colleagues.

Hope to see yours next year.

As a nurse, I often found myself reflecting on how limited my geographical areas of practice seemed to be. Being a nurse- at

its core- means taking care of patients, and those patients were always located within some room or series of rooms within Mount Sinai Hospital. Sometimes I wondered what was going on in other parts of the hospital or in other hospitals in general, but the work in my individual unit often kept me so busy that the thought was fleeting at best. Reading nursing magazines like Advance or Spectrum gave me a glimpse into how nursing was being practiced elsewhere, and allowed me for a bit to see things on a bit more of a macro level. But the feeling of wanting to see more did peek through strongly from time to time.

This past year, I unexpectedly had a chance to not only see more, but to see more overseas in an entirely different country. My husband was offered a sud-den opportunity to work on a project in Israel for his company, and we decided to take that opportunity and experience what it would be like to live somewhere else for a year. I emailed the Director of Nursing at Hadassah Hospital, a big regional hospital in Jerusalem, and asked her if I would be able to shadow a nurse who worked in a unit similar to the one I was working in at the time- PACU. She was gracious enough to pair me up with a wonderful nurse who was originally from California, but had done her nursing training in Israel. Since Israel does not have a HIPAA- type law on their books, it was easier for me to gain access to the hospital and to the experi-ence of caring for patients first hand in an environment and language so different than what I was used to.The first idea that struck me was that no matter what the language or culture, patients’ needs for care remain the same. And that I could always fall back on my

knowledge of the mechanics of nursing to somewhat cushion the difference between how we did some things in the US versus how they were done here. A-lines were the same, even if PCA pumps looked different. I’d had Spanish or Chinese speaking pa-tients at Mount Sinai that I often couldn’t communicate so well with; my options then were to use the translator service (which I often did) or to have someone help me. Those options were still available to me here, once I learned some basic vocabulary words (urine, pain, blood pres-sure, etc.) in the predominant language of Hebrew. The nurses I met were of all dif-ferent nationalities: Russian, Arab, Israeli, Ethiopian, but there was a good working relationship among all of them. The nurse I shadowed, Stephanie, had come to work in the PACU straight out of nursing school, and was as competent and knowledge-able as any of the nurses I had been privi-leged to work with at Mount Sinai.Similar to the US, politics seemed to fade into the background while I was in the hospital, relegated to a far back burner while the business of taking care of sick people loomed large. Although the region has had its issues splashed across news-paper headlines for decades, the feeling of the hospital was professional and serious. Hadassah Hospital is an academic one, like Mount Sinai, and most of the rounds I participated in were conducted in English. Since healthcare is socialized, there is not as much fear about being sued or about malpractice suits and I found this very liberating as a nurse. There was less pres-sure to document and more opportunity to provide care. While some may say this compromises quality, I did not find that to be the case in the PACU I worked in. Nurs-es were just as attuned to a patient’s pain: rating it and treating it, just as attuned to lab results and medication administration, and just as attuned to follow up care as I had been accustomed to. I did wonder at times how the concept of Magnet certi-fication might go over in Israel, and if it would help improve the general climate for nurses and patients in any way.Although it wasn’t relevant for me as yet, I was contacted by an American-trained Nurse Practitioner who is employed at the hospital and has put together a work-ing committee to try and help certified NPs find their place in the Israeli medical system. At the present moment, the idea of “physician extenders” is not recognized within the Israeli healthcare environment. Hadassah Hospital has sent graduate students to observe NPs in practice in the States, including a group that visited

Mount Sinai, in the hopes that the role can be further developed within Israel. Like American hospitals, hospitals in Israel are overwhelmed and overcrowded. I arrived in a year that has seen numerous strikes take place by the doctors’ and nurses’ unions to protest difficult working condi-tions. Furthering nurses’ roles within the system in a formal way would certainly aid in reducing some of the patient care resources shortage. In the PACU I was in, the “charge nurse” on days was a fellow with so many years of experience that he basically functioned as an on-site NP for many issues that arose: allowing him to formalize that training would be very beneficial. They are Masters Degrees available at Hadassah University, and only recently have they become more practice-oriented as opposed to more academically oriented.I will always be grateful for the opportunity I had this year to “be a nurse” in a different country, with a different language and a

different milieu. I learned a lot about my own skills, and met some fellow nurses that I will always have great respect for. I gained in my cultural understanding, and my ability to see nursing as a true con-tinuum of care, crossing all borders and nationalities. I look forward to bringing this enrichment back with me to Mount Sinai, or whichever hospital I should land in going forward. I look forward to rejoin-ing my colleagues back in New York, and to learning even more about the wonderful profession of nursing with all its layers, vast possibilities, and unlimited potential for caring.

My Overseas Experience in NursingBy: Chaya Dickman BS, RN-BC, BSN


An opportunity to highlight the magnificent magnet moments that you experience in your daily practice.

Please contribute and share by sending in ideas, comments, critiques or articles to [email protected]

or contact the editor: [email protected]

We would like to thank our Magnet Newsletter advisor, Pat Matos, DNP, RN, Director of Nursing in Psychiatry and Magnet Program Director for her support.

The Magnet Newsletter Committee

Calling allMount Sinai Nurses

of the transplanted organ. Often these patients have been very ill for some time, weakened by their organ failure, requiring intense and comprehensive nursing care.So how does a busy unit provide this level of quality care to their Patients and maintain such excellent patient satisfaction scores? (Their only sub-par score was concerning the noise level at night). The Clinical Coordinator, Joel Valena and Clinical Nurse, Johanna Medina were quick with their answers. They have frequent daily to weekly huddles, monthly staff meetings, providing a strong focus on communication and on reinforcing positive coping strategies. They pre-empt conflict by counseling all their Staff on how to handle problematic situations. The Staff is collegial and supportive and frequently uses humor to deflect stress. They are respected and valued by their Nurse Leaders. As a matter of fact, the week after this interview they were scheduled to enjoy a visit from Pal Care, a company hired to provide fifteen minute massages for any who wished to participate.

The Nine Center Nurses expertly care for a challenging patient population. Their inter-disciplinary efforts with Doctors, Nurses, Social workers, Administrators and Coordinators, Mental Health Staff and Nutritionists all bring hope and second chances to patients and their families. Their efforts enable people to be able to donate gifts of life. Their remarkable work and dedication instills a sense of hope and redemption for us all.

Donee to DonorI never met you,But I love you.

Your signature on the back of your driver’s licenseBecame my license to live.

Now I can pass goNow I can collect $200

Now I can stumble on some finders keepers cash on the parking lotI can’t land on Park PlaceI can’t dance on Boardwalk,But Baltic Avenue is mine. I enjoy my simple life.

The everyday joys of breathing; walking; talking; smelling; eating; sleeping, etc

I have a vibrant, loving life again.No, not again, life is sweeter,

Tastier on this second go aroundYet and still there is a glitch

I am here because you are not.You and your families are heroes.

Saying Thank You seems trite.Yet….Thank you!!!

I look up to “The Higher Powers”As I breeze on by.

By patient: Jeff Feller

“Their remarkable work and dedication instills a sense of hope and redemption for us all.”


Spotlight on GP9C(cont. from page 6)

In 2007, with input from a broad representation of stakeholders, the COM developed a Model for Magnet that reflected current research on organizational behavior. This Model guides the transition of Magnet principles to focus healthcare organizations on achieving superior performance as evidenced by outcomes. Evidence-based practice, innovation, evolving technology, and patient partnerships are all evident in the Model.

Magnet Recognition Program® Model


Magnet Newsletter

Between reviewing discharge medications and prepping your patient to go to the OR it might be the last thing on your mind to consider agreeing when someone comes up to you and asks, “Hey, would you like to let a high school student shadow you around while you work?” Now, before you give your answer, please finish this article.

Mount Sinai’s Center for Excellence in Youth Education (CEYE) led by Dr. Lloyd Sherman, has a very energetic educational coordinator, Eboni Jones, as their scout for finding healthcare professionals in the hospital to serve as mentors for New York City high school students. For over 40 years, CEYE has partnered with area schools to help students who have an interest in healthcare careers get real life experiences in a hospital setting. Students go through an application and interview process and then best attempts are made to place each student in an area of the hospital in which he or she has expressed a specific interest.When I was approached by Ms. Jones, at first I thought to myself, “Oh I have several research projects and the Magnet committee, do I have time for this?” Then I thought, “Will a high school student really be interested in what I do?” Despite my initial hesitation, I am so glad that I decided to say yes.

“I realized that taking a student with me through the day offers many opportunities to share what it is we actually do and how different a nurse’s role is from one area to another. I found myself helping students translate what was learned in the labs and classrooms into daily patient care. I could enable students to witness firsthand how complex healthcare can be.”

I enjoyed the challenge of finding new experiences to engage the students. I thought about what I, myself, would have liked to learn about before working in a hospital and I asked the students what it was that they hoped to get from this experience. Goals and objectives for the students were planned out. By being a good role model and promoting students’ interaction with patients and other members of the healthcare team I hoped it might lead students into careers in healthcare.This mentoring opportunity made me see that one can be a leader without working in a traditional leadership position. I wanted to see how the students were influenced by their mentors and learn how the nurses felt about their experiences as leaders. As graduation was approaching, I talked with them and I was touched by the responses.

Leon, a student in GI, said that he learned about the aspects of being a nurse

This Month’s Issue:Taking The Lead

Congratulations to Carol Porter

Onboarding New Nursing Staff

Save the Date/Calling All Nurses

Relationship Centered Care in Action

Safe Patient Handling Program

What I Did On My Summer Vacation

Making A Defference Overseas

Chatting with Maria Vezina

Horizontal Violence

Joseph F Cullman Jr Institute for

Patient Care & Patient Service Center

Fall 2012 / Volume 1 / Issue 4

Taking the LeadSubmitted by Christine Seidler BSN, RN-BC

Transformational Leadership

SAVE THE DATEANNUAL NURSING RESEARCH DAY: DECEMBER 7, 2012

Please plan to attend and see the inspirational research done by your colleagues. The Nursing Research Committee Meetings are held the third Friday of every month, contact Dr. Emerson Ea to apply.

[email protected]

Christine Seidler (Middle) with Ilan Mandel (left) and Shakira King (Right)

(cont. on page 3)

Ever meet a nurse that doesn’t get back pain from time to time? I thought not. Let’s face it, our job entails physical and emotional wear and tear while needing to be mentally alert and ready to rock and roll at an instant’s notice. The need for education, training, specialized equipment and support to prevent health care worker injury as well as safeguard the patient was identified by the American Nurses’ Association who has been “leading the fight on behalf of RNs, health care workers and patients to eliminate manual patient handling” for almost two decades.

In 2008, NYSNA proposed a Safe Patient Handling Program. This was negotiated and an agreement was reached with Hospital Administration. Our present NYSNA- Mount Sinai contract covers this on pages 39- 40. In 2008 a task force was created which evolved to a committee by November 2009. Mount Sinai Queens Campus joined the committee in 2010. It is a collaborative, interdisciplinary effort involving many departments. Representatives from Nursing, Rehabilitation, Transport, Building Service, Radiology,

Risk Management, Infection Control, Environmental Health and Safety, NYSNA, 1199 and Hospital Administration all work together to ensure the safety of its workers. The Safe Patient Handling Committee is a subcommittee of the Medical Center Safety Committee. The goals of the program are to reduce the risk of staff and patient injuries, educate staff, evaluate equipment and devices for moving and transferring patients, and make recommendations for purchase of equipment. A look at pages 39-40 of our NYSNA- Mount Sinai contract will bring you to Health and Safety Employer and Employee Obligation.

The committee began by conducting an equipment survey to identify what was needed in different areas. They developed Safe Patient handling Guidelines and Education. Purchases for lifts and transfer devices were made. A training Powerpoint is now available on the Mount Sinai Intranet. Members of the Safe Patient Handling Committee have visited several areas in the hospital for specific onsite training of personnel. They are available for consults

for areas in need. Committee members have participated in the Safety Day Fair. Safety Advocates have been identified for several clinical service areas. Their role is to assist in educating staff at the unit level and serve as a resource. Anyone interested in becoming a Safety Advocate is encouraged to inform your manager and contact Lavonia Francis (x57211 or [email protected]). Lavonia Francis, Senior Director for Ambulatory Care Nursing is the Site Coordinator for the hospital and Audrey Ludmer, Clinical Nurse, Endoscopy Unit and our NYSNA president is the interim co-chair for the committee. Program goals for the upcoming year are to continue to raise awareness, increase the number of Safety Advocates and integrate Safe Patient Handling with Falls Prevention and Skin Care. Becoming a Safety Advocate would give you the information, skill and resources you need to avoid injury, help you to assist your colleagues avoid injury and empower you to provide safe handling for your patients.

The Joseph F Cullman Jr Institute for Patient Care and the Patient Service Center is a department set up to support patients and their families, to promote a patient-centered culture of care, to ensure safety, service and compassion throughout the patient’s entire hospital encounter. The Cullman Institute works in partnership with the Board of Trustees, hospital leadership, doctors, nurses, social workers, dieticians and staff members from all disciplines to raise awareness that we all play a role in how the patient experiences their hospitalization or outpatient care. They use volunteers and community members in addition to help maintain programs such as The Ambassador Program and assist in waiting rooms.

Their office is located in the space many of us know as the “old gift shop” on first floor of the Guggenheim Pavilion across from the Starbuck’s kiosk. Under their umbrella of ‘Commitment to Quality’, they address patient safety, infection prevention, hand hygiene (there is a fun video on hand hygiene made by the Division of Training and Education on the Mount Sinai Internet page, I’m waiting for it to go viral!) as well as patient complaints

and comments. Patient Representatives and a stellar administrative support team work together with other departments such as security to deal with lost patient property and an interpreter coordinator to assist in providing appropriate language and communication assistance. They work with the Recognition Committees to provide acknowledgement and support for the many Mount Sinai employees.

The Centers for Medicare and Medicaid (CMS) uses a healthcare survey known as HCAHPS to assess a patient’s hospital experience in all United States Hospitals. HCAHPS stands for Hospital Consumer Assessment of Healthcare Providers and Systems survey. The questions ask about the communication between doctors and nurses, staff responsiveness, cleanliness and quietness of the environment, pain management, communication about medicines and discharge information. Many of our patients choose to offer feedback independent of these surveys. Their comments, positive and negative,

are crucial to our better understanding their experience.

I met with Erica Rubinstein, LCSW who informed me that their reports of compliments about nursing care have decreased. Not because our level of care has declined or that our excellent care is less appreciated, but because there seems to be a less visible presence of the

need for reporting these compliments. Mount Sinai keeps a central repository of patient reports and the data generated from patient communication is highly valued and used to further our plans for care improvement.

Please forward any patient compliment to Box 1515 or email [email protected]. Please continue to let the patients know that we value their comments and encourage them to share ways in which we can better care for them.

Safe Patient Handling Program Submitted by Sylvie Jacobs, RN,BSN,CPANStructural Empowerment

Joseph F Cullman Jr Institute for Patient Care & The Patient Service Center Submitted by Sylvie Jacobs, RN,BSN,CPANExemplary Professional Practice

The Mount Sinai Magnet Newsletter Fall 2012

The Cullman Institute works in partnership with the Board of Trustees, hospital leadership, doctors, nurses, social workers, dieticians and staff members from

all disciplines to raise awareness that we all play a role in how the patient experiences their hospitalization or outpatient care.

manager. He saw how busy the job is and how the manager needed to be strict and strong when it came to issues of scheduling and staffing. He also saw this paired with a need to greet each patient by name and give each patient a hug or embrace at discharge time, small gestures that really meant so much to each patient.

Another student, Koi, said that when he expressed an interest in learning about Hepatitis C, the nurse practitioner sat down with him and discussed this condition and explained how it affects the body. He was surprised that nurses knew and did more than he ever imagined.

Jessica, a student in psychiatry, said originally she had hoped to get a rotation in pediatrics but was open-minded when presented with a rotation in inpatient psychiatry. She was excited that she learned about the admission processes of patients to psychiatry (from history taking to body searches) from the nurses. She said that she improved her communication skills with patients and even said that this experience changed her outlook on what she wants to do. She is now considering a career in pediatric psychiatry.

Shakira, a student I worked with, reflecting upon her experience said, “I thought I would be shadowing doctors and seeing surgeries and when I found out I wasn’t, I was disappointed. But when I met you, you changed my opinion about roles in the hospital.”

A student in GI, Esther, saw the sadder and more difficult parts of caregiving and how staff work together to deal with these moments. She was on the unit when a patient was leaving for what she believed to be the last time the staff would see the patient and how sad, teary and upset the whole unit felt. She saw how the staff worked to cheer each other up with a joke or hug here and there. Esther said she realized that caring for patients could get very personal.

The students had example upon example of the things that were learned from the mentors. From understanding the importance of nurses counting up gauze pads during a C-section to determine blood loss, recognizing the importance of paperwork and documentation to patient care, comprehending patient’s rights, to learning how to confidently approach a patient, it was clear that through observing the nurses and other mentors, their perceptions of nursing care had been transformed.

Connie Tadeo, RN on KCC 6 South was very enthusiastic to talk about her experiences working with Jessica. Connie said that she believed nurses are asked to help students because we are “nurturing and approachable.” When she worked with Jessica she tried to help her student understand that the label of “psych” patient is very misleading. She wanted to help her student see that the patients in psychiatry are really like all of the rest of us but have had difficulty dealing with a particular crisis.

Connie said that she enjoys teaching the students and getting to see the difference in perspective brought by each of them. Her goals when mentoring are to teach students how to approach patients, to improve the students’ communication skills, and to teach students how to diffuse situations.

Gretchen Hodge-Penn, RN of GP 10 East said that her goal is to get the students “interested and passionate about nursing and healthcare.” When the students come to the floor and see how we take care of the sick and how much people depend on us, then come back to say to her that they want to do the same thing, that’s “gratifying.”

Each one of the students in this program was changed by their experiences. Each one learned valuable skills that will be taken on whatever career path he or she chooses. Nurses don’t necessarily recognize what it is that we are doing that really makes us leaders. I hope that you can see how each gesture, each medication you teach about, and each student you introduce to your patient and get involved in patient care is seeing a leader in action. So the next time someone says, would you mind if a student shadows you, I hope that you choose to take the lead.

Students participate in summer, fall and spring programs. For information on getting involved as a mentor, please contact Alyson Davis at the Mount Sinai Center for Excellence in Youth Education (CEYE) at 212-241-7655 or [email protected]. The CEYE program website is www.mssm.edu/ceye.

This article was written prior to the untimely death of Dr Lloyd Sherman. We feel the huge loss of not only a great physician, but a champion for youth involvement, opportunity, education and supporter of our nursing community. Our heartfelt condolences go out to his family and friends.

Taking the Lead(cont. from page 1)


Making a Difference Overseas:

The Granada Carriacou and Petite Martinique Nurses’ Association of America

By Raheeman Frederick, RNGlobal Issues in Nursing and Healthcare

This year our mission tour to the Tri-Island State was meant to make a difference. We began with a Sunday church service followed by a brunch. The following day we travelled by boat to the Carriacou and Petite Martinique where we delivered medical supplies and patient information in the form of brochures on diabetes, hypertension and kidney diseases that presently plague the Tri-Island State. On Tuesday, we held a conference attended by forty nurses and nursing assistants. The focus was on Customer Relations and Effective Communication. The attendees found this to be relevant to their practices and were eager to learn. The next day we did BCLS training in two different areas of Grenada and we

certified some forty plus people. Our group worked alongside the Grenadian nurses on Wednesday and Thursday while some of us, me included, did the BCLS training. We followed this up by distributing more medical supplies and patient information brochures around the island. The week ended up with a sightseeing tour and a beach party in which we celebrated, reflected, relaxed and enjoyed some local foods. Wednesday of the following week we ended our mission with the presentation of a large amount of medical supplies to the Nation Main Hospital. This included equipment for their operating theatre, a portable suction machine for their ambulance, pulse oximeters to the male and female surgical wards among other things.

They were very grateful and broadcasted this gift on national television. We were surprised with being honored for our service to the Tri-Island State for over thirty years. It left us feeling gratified and accomplished and ready to do it all over again next time.

Dr Maria Vezina, our Senior Director of Nursing Education and Professional Practice, met with me in her office at 35 E 102nd Street. This is the home of Nursing Education where you probably know it best from recertifying in BCLS, ACLS, PALS or Conference and Tuition reimbursement. She shared with me her journey in nursing that brought her talents and wisdom to us.

Maria was introduced to nursing by her mother, who was a teacher and an OR Nurse. She showed me a picture of her in mask, cap and scrubs alongside several surgeons. What little I could see showed me a beautiful woman standing very comfortably over the OR table. In her teaching capacity, her mother would bring home case studies, which Maria would

read and sometimes “grade” as a school age child. This informed me that Maria’s mind was always precociously ahead of her time. Her father was a physician, although ill most of his adult life. Her mother cared for him too, alongside her family. Caring became a family theme.

Maria began her own career as a medical surgical nurse and I identified with her reminisces of feeling overwhelmed coming out of a BSN program in the 1970’s in upstate New York. We were well prepared in theory and concept, less so in the day to day, hands on of medical surgical nursing. She said how she desperately wanted to be a proficient, expert nurse and to never harm anyone. Once she got her grounding, though, she described her captivation with the “detective”

work it takes in dealing with unknown diagnoses and the wide variety of patients and their presenting symptoms. She fondly described enjoying her hard work alongside a group of supportive and fun nurses who all decided to return to school to pursue their masters, once arriving in New York City. Maria chose to follow in her mother’s footsteps and obtained her masters in Nursing Education taking courses part-time while working full time at New York University. She describes loving teaching and how it took her to new levels of competency and a higher level of learning. Her years teaching undergraduates at Lehman College made her acutely aware of the great responsibility she had to her students and the rigor of an undergraduate degree in nursing.


Chatting with Maria: A Look at Leadership Submitted by Sylvie Jacobs, RN, BSN,CPANTransformational Leadership

When one envisions a bully, it conjures up images of a schoolyard child taunting and pummeling a weaker, besieged child. The prototypical behavior of bullies is to prey on the vulnerable. What happens when it is not on the playground, but in the workplace? This is called Horizontal Violence.

The purpose for this article is to bring awareness to the socialized culture of Horizontal Violence which is defined as a conflict among nurses within the workplace. It can involve belittling a fellow staff member, withholding pertinent patient information or freezing a colleague out of group activities. Horizontal Violence is considered to be a form of disruptive behavior by the Joint Commission for Accreditation of Health Organizations (JCAHO) (Joint Commission, 2008). It emanates as superiority and dominance which creates disenfranchised work practices, invoking negative emotions of low self - esteem in victims (Weinand, 2011). Oftentimes, when issues arise where there is a victim and a perpetrator, it is human nature to try and assign blame to the victim – often done by victims themselves - “what did I do to bring this upon myself?”

Feeling threatened and unsupported around certain coworkers affects one’s interaction with all nurses. To combat Horizontal Violence, we need to become empowered to seek understanding on how this became a socialized culture within

the professional body of nursing. This phenomenon seemed so far removed from the profession established by Florence Nightingale in 1854 to provide quality care to casualties of war (Hood, 2010). It seems as though nurses began to wage war amongst their own ranks, creating casualties of Horizontal Violence. These casualties are high staff turnovers, nurses leaving the profession, burnout from inadequate staffing, sleep disturbances and sometimes suicide. Horizontal Violence adversely affects patient care with occurrence reports of medical errors of 71% and patient mortality of 27% (Seller, 2009).

Any victim of Horizontal Violence should seek immediate help. Mount Sinai has the Employer Assistance Program (EAP) where they can get therapy. The New York State Nurses Association (NYSNA) and nursing and hospital administrators are available for advice and assistance. Family and friends can be a lifeline for assisting emotional and spiritual healing. Nurse mentors, usually respected senior nurses, can be a source of guidance.

Nurses spend approximately twenty percent of their time dealing with conflict and acquiring conflict management skills (Weinand). However some nurse leaders have not mastered these skills, which can escalate the problem, leaving the victims to suffer in silence (Porter-O’Grady & Malloch, 2011). The opportunities that arise from these situations are to learn

conflict resolution skills, to empower each of us to stand up for a change and to create an environment of zero tolerance for the mistreatment of others.

One out of every three nurses subjected to Horizontal Violence will leave the profession (Weinand, 2011). I have made it my mission and commitment to bring attention to the unsettling and socialized culture of Horizontal Violence. To any nurse experiencing Horizontal Violence - Bullying in the workplace, I leave with you an inspirational story from my late father Augustus O’Sullivan regarding one of his favorite legends, Winston Churchill, a man known for his rousing speech. Mr. Churchill was asked to speak to a graduating class. Everyone waited with great expectations, and to their surprise Winston Churchill stood on the podium and bellowed two sentences; “Never, never, never give up! Never, never, never give in!”

References• Hood, L. J. (2010). Conceptual Bases of Professional Nursing (7th ed.). Wolters Kluwer Health Lippincott Williams & Wilkins.• Joint Commission on Accreditation for Health Organizations (JCAHO, 2008) Sentinel Event Alert Behaviors that undermine a culture of safety. Retrieved from http://www.jointcommission.org •Sellers, K., Millenbach, L., Kovach, N., & Yingling, J. K. (2009-2010, Fall/Winter). The Prevalence of Horizontal Violence in New York State Registered Nurses. Journal of the New York State Nurses Association. Retrieved from http://www.ebscohost.com•Weinand, M. R. (Ed.). (n.d.). Horizontal Violence in Nursing: History, Impact, and Solution. Retrieved from http://www.ebscohost.com•Porter-O’Grady, T., & Malloch, K. (2011). Quantum Leadership Advancing Innovation, Transforming Health Care (3rd ed.). Sudbury, MA: Jones & Bartlett

Horizontal Violence - Bullying in the WorkplaceSubmitted by Darciann O’Sullivan, BSN, OCN Transformational Leadership and Structural Empowerment

(Continues on Page 9)

While we are going about our daily routine, miracles happen all around us. This miracle was created by the CCU (Coronary Care Unit) Nurses who, in their interpretation of Relationship Centered Care, affected the lives of their patient and his family forever.

The patient was a 66 year old male who had received a Ventricular Assist Device in February 2012. He was transferred to the CCU from 5C sometime in March 2012. He was still there in August and with no improvement in prognosis, his girlfriend of 29 years and he decided to get married in the hospital. This decision was made on a Friday afternoon, around 1:30 pm. The bride obtained a marriage license and retained a judge who would come to Mount Sinai to conduct the ceremony. Kathleen McCollum, Clinical Nurse Manager, reached out for help. Linda Paxton, Senior Director of Mount Sinai Heart, in turn, contacted Laureen Nowakowski , Administrative Manager of Nursing Operations, who caught the ball and

ran with it. Laureen bought a cake, sparkling water, balloons, flowers, decorations and everything you’d need for an impromptu celebration. She even bought a card and a gift of a picture frame for the staff to give the newlyweds to preserve the memory. Then the CCU nurses got to work. They decorated the unit. They prepared the groom with a bath, shave and shampoo.

The momentous day arrived. Several staff members came in on their day off to attend. Family members arrived from out of town. The wedding party, which consisted of the groom’s sister and niece, family members, hospital staff, presiding judge and the bride, all wore Isolation Yellow. The bride tossed the bouquet and everyone avoided catching it.

They even had a wedding crasher as the visitor of a neighboring patient enjoyed the event as well as a piece of wedding cake. Everyone cried. The patient passed away approximately three weeks later.The ‘bride’ continues to stay in touch

with the staff. She has invited them to her home and has corresponded with Kathleen, CNM. She was traveling into Manhattan the third week of September and Kathleen was planning to meet with her to share photos and memories.

This is a striking illustration of how Relationship Centered Care can lead us to playing life changing roles in people’s lives. Because the staff and leadership allowed their hearts to open to these people, they were able to elevate the care they gave to way beyond “standard and customary”. The length of stay allowed a strong bonding, allowed the nurses to include them in their family composite and allowed them to do what one does for family: bring meaning, love and joy into their lives. The couple will never return to their favorite past time of sailing together or share the sufferings of old age, but the bride and the remaining family will always have the experience of this couple joining their lives together amongst loving family and friends. Thank you, CCU, for being those caring friends.

Relationship Centered Care in Action Submitted by Sylvie Jacobs, RN,BSN,CPAN

Exemplary Professional Practice


Picture with permission

For those of us unfamiliar with endowments, this is a position permanently funded by an individual or group. In this case, the endowment is a bequest from Edgar M. Cullman, Sr. who was an enthusiastic supporter of nurses at Mount Sinai. Edgar Cullman, Sr had a special affinity towards Mount Sinai’s nurses. He appreciated and valued nursing that would help patients and families feel well cared for and safe. His family has continued his vision through their generous support.

This first endowed chair of the Department of Nursing in Mount Sinai’s 160 year history is in honor of the late Edgar M Cullman, Sr. Carol Porter plans to use it to support nursing research and education, leading to initiatives, policies and improvements in providing quality health care.

The very first endowed chairs were established in ancient Rome and given to Plato, Aristotle and their contemporaries. The practice continued up through the ages and was adapted to the modern university system in the 1500s at Oxford and Cambridge.

Receiving this Chair will not only honor Mr Edgar M Cullman,Sr and his family, but will also bring opportunities for nurses

to affect health care. These nursing driven improvements, innovations and new knowledge will impact not only our patients, but will reach around the world to enhance health care globally.

The collaboration between the Mount Sinai School of Medicine and the Department of Nursing led to the creation of the Center for Nursing Research and Education (CNRE). Carol Porter’s innovative vision for this Center is to engage nurses in translational research as part of multidisciplinary research teams and to integrate these research findings into nursing education, innovations and best practices.

We will soon need to add FAAN to this title as Carol Porter is to be inducted into The American Academy of Nursing on October 13, 2012 as a Fellow. The American Academy of Nursing is an independent affiliate of the American Nurses Association.

Its purpose is to serve the public and the nursing profession by generating, creating and disseminating nursing knowledge and advancing health policy and promotion. Known as Fellows, the members of the Academy, which number less than 2000, are nursing’s most accomplished leaders in education, management, practice and research.


CongratulationsCarol Porter, DNP, RN

Edgar M Cullman, Sr. Chair of the Department of Nursing, Chief Nursing Officer and Senior Vice President

The Mount Sinai Medical Center, Associate Dean of Nursing Research and Education

The Mount Sinai School of Medicine and Senior Nursing Leadership.

The Mount Sinai Medical School confers the very first

Edgar M Cullman, Sr. endowed Chair of the Department of

Nursing to Carol Porter.

This exceptional honor will allow our nursing community a better opportunity for growth through

research and education and to elevate the quality of patient

care everywhere.

Submitted by Sylvie Jacobs, RN,BSN,CPAN

Transformational Leadership Carol Porter, DNP, RN with Kenneth L. Davis, MD at Convocation Ceremony on September 27th in Stern Auditorium.

(Pictured from Left to Right) John Kirby, Susan Cullman, Carol Porter, Louise Cullman,

Lucy Cullman-Danziger.

RN SATISFACTION SURVEYMount Sinai Nurses participated in an anonymous, voluntary survey

to learn more about the “climate” in which we work and patients receive care. The Department of Nursing values the clinical nurses’ opinions and feedback.

The survey was conducted by Healthstream Research from September 10 to October 7, 2012. Aggregated results of this survey will be shared with the Department of Nursing, so stay tuned.

On-Boarding for New Nursing StaffStructural EmpowermentAs a way for nursing staff to welcome and support new nurses, the onboarding program is being introduced by Nursing Recruitment. In addition to orientation and preceptorship, this program is designed to welcome new nursing staff and help them feel that they are connected and accepted to our community. The goal is to provide a supportive structure that reaches beyond the clinical platform, and includes such elements as local resources, social information and generalized information of life in and around Mount Sinai. Diane Poulious, Manager of Nurse Recruitment, shares a beautiful poem which most accurately describes the intention of this new program: The Bridge Builder by Will Allen DromgooleAn old man, going a lone highway,Came, at the evening, cold and gray,To a chasm, vast, and deep, and wide,Through which was flowing a sullen tide.The old man crossed in the twilight dim;The sullen stream had no fear for him;But he turned when safe on the other side,And built a bridge to span the tide.“Old man,” said a fellow pilgrim near,“You are wasting strength with building here;Your journey will end with the ending day;You never again will pass this way;You’ve crossed the chasm, deep and wide-Why build you this bridge at the evening tide?”The builder lifted his old gray head;“Good friend, in the path I have come,” he said,“There followeth after me today,A youth, whose feet must pass this way.This chasm, that has been naught to me,To that fair-haired youth may a pitfall be.He, too, must cross in the twilight dim;Good friend, I am building this bridge for him.”


CALLING ALL NURSESMount Sinai Committees are searching for your support.Joining a committee is the best way to get to know people who work at Mt Sinai other than the ones you work with day to day. You will be able to see the structures that have been thoughtfully put in place to support your daily practice. Being a committee member does not mean you will have extra work to do, it is voluntary and your participation is valued and appreciated. Your presence at meetings and your opinions are what are important. You may join a committee by filling out an application form from the committee tab on the Intranet’s Nursing site. Most meet monthly and it is a wonderful way to find out what is going on at Mount Sinai and get to learn how very special and dedicated our nursing leaders are. It will inspire and energize you and open your eyes to the many foundational structures provided to support and guide our nursing practices.

Nursing Practice Committee: examines our nursing practices, our policies and standards of care that reflect best practice, current regulatory standards and evidenced based nursing care. They are instrumental in creating the procedures and policies that guide the clinical nurses’ and administrators’ daily practice.Nursing Peer Review Committee: reviews and assesses Occurrence Reports in the Nursing Department, adverse events and outcomes and citations from regulatory and review agencies for deviations in standards of care and related professional performance.Nurse Recognition Committee: creates programs that recognize professional achievements by nurses and other professionals for outstanding contributions to the Hospital and the Community. They also develop strategies to promote nurse retention. All nurses know the work of this group through the many

Nursing Week activities they organize.

Once I’d taken my son up to Albany and bought a gazillion things that are essential for a college junior to survive off

campus, I returned home to begin my stay-cation. Kitchen cabinets needed cleaning out, doctors’ appointments needed to be attended and then there was the free continuing education courses offered by Mount Sinai. They are held monthly and are open to all Mount Sinai Clinical Nurses. I registered to attend via the Mount Sinai Intranet and I received continuing education credits for attending. I met another Magnet Champion there, Melody Cubas from psychiatry, who also reinvigorates her practice by keeping current and continuing to learn. I also met Benjamin, who is the son of my PACU friend and colleague for many, many years, Naty Cerezo.

The first class was a Webinair led by Patti Page Cannonier from NYSNA and the computer voice was Betsy from Latham, New York. Betsy is on the Education, Practice and Research (EPR) Committee which is run by Advanced Practice Nurses. We played a fun game, similar to Cash Cab, where we each got to answer and discuss a question. The subjects covered the legal scope on Nursing in New York State, how it applies to clinical practice and how accountability enters into delegation and assignment. I was reminded to review my Policies and Procedures (found on the Mount Sinai Intranet), to take care with documentation (workshops are available), keep current, be an active NYSNA member and carry personal liability insurance. My second class was an Evidence Based Practice Workshop held in Levy Library. Michele Galbo, Nurse Education Specialist, did an excellent job in explaining how EBP differs from research and why it is crucial to our nursing practice in 2012. The old “because we’ve always done it that way” doesn’t fly anymore. It is essential as Nursing continues to evolve, that our practice produces the best outcomes for all patients. Evidence Based Practice has proven to yield those outcomes. EBP also stimulates us to ask more questions, find better ways to do things and continue growing as professionals. The second part of this class was taught by a Nurse Librarian named Polly Beam. She is the Information and Education Services Librarian. She showed us how to search the literature for research that

uses strong study designs and produces valid answers about meaningful outcomes. Useful evidence should be easy to access, current and relevant to our clinical setting. Books are one source of evidence and Levy Library houses 30,000 print books, but also has over 100,000 ebooks. We learned how to use STAT!Ref and Books @ Ovid to find specific information from books. More current sources of evidence are obtained from clinical topic reviews such as UpToDate and DynaMed. Clinical Topic Reviews are authored by experts, peer reviewed and regularly updated. A third source of evidence is found in journal literature and we found information using PubMed, Google Scholar and CINAHL which is the Cumulative Index to Nursing and Allied Health. I was amazed at the vast amounts of information available at the click of a button.

The third and last class I attended was Culturally Competent Nursing Care given by Deon, originally from Namibia and Paule, originally from Venezuela. They are both nurses, Deon currently works here at Mount Sinai and Paule returns to the Mount Sinai Nursing Education monthly to give these classes. They made the learning fun through use of games and gave us the opportunity to interact with everyone. The class covered the value of diversity, cultural self-assessment, and awareness of the dynamics when cultures interact, cultural knowledge and the importance of addressing every patient individually. We LEARNed to Listen, Explain, Acknowledge, Recommend and

Negotiate in our patient interactions. We were reminded of the meaning of culture and its influence in patient care, how to effectively use interpreter services, be aware of four own biases and assumptions, the importance of respecting patient’s beliefs, values, meaning of illness, preferences and needs. We were reminded that the care we provide affects patients’ outcomes, quality of care and patient’s satisfaction. The final message was, “Patients should never feel like we are passing judgment.”I loved the opportunity to interface with the other nurses. I met many new graduate nurses on orientation. They jogged my memory of what it was like to come to the melting pot of Mount Sinai when I was a new grad from a homogeneous place in Ohio. They were like sponges soaking up the information. Having attended school so recently, they were impressive in their knowledge of theory and concept. It was refreshing to have so many bright, energetic nurses eager to jump in and test out the water. There were also a few others of us, some were transfers, some were advancing their positions and then there were nurses like Melody and me. We were there to learn, to grow and to nourish our practice.

Just so you don’t think I’m some kind of Nerd who just takes classes and writes newsletter articles I will tell you what else I did on my summer vacation. I saw the new Woody Allen movie which left me feeling like I had traveled to Rome for a day. I read the latest John Irving novel, In One Person, which allowed

What I Did On My Summer VacationSubmitted by Sylvie Jacobs, BSN, RN, CPAN

New Knowledge, Innovation and Improvement and Structural Empowerment

(Continues on Page 9)

In pursuing her doctorate, Maria found an even greater progression in critical thinking. She attended Columbia University’s Teachers College and learned strategies and tools which changed her thought processes, finishing a second Masters in Education in Communication and Instructional Technology and then a Doctorate in Nursing Education. The content she had previously learned came together in a more insightful form in terms of scope and universality. She found it to be an important part of growth to explore beyond her comfort zone and diversify her talents. In 2006, Carol Porter promoted her to her current position as Senior Director of Nursing Education and Professional Practice. Dr. Porter has also provided Maria with a variety of challenges and opportunities for growth and expansion of responsibility ever since and provided mentorship in understanding the accountability involved in executive leadership and how a complex medical center really operates. She appreciates the opportunity to be able to work with other nursing, physician and hospital leaders and continues to learn new things every day.

She shared that she takes time, daily, to reflect and evaluate if there were things

she could have done differently. This struck a note with me since I know this is something intrinsic to my day as well. I recognize this process in the tired faces of nurses I pass on their way home from a long night at work. Maria shared her borrowing of President Obama’s quote in his 2009 inaugural speech when she makes mistakes to “pick yourself up, dust yourself off and begin again…”. Maria had directed the Student Nurse Intern Graduation earlier this particular August day and spoke of the joy and rewards she felt in hearing both the Nurse Mentors as well as the Student Nurses share their experiences and learning. She mentioned the exceptional speeches that were heartwarming and touching, sharing how the Nurses and Students “made a difference” and how the experience of mentoring brought a higher level of professional fulfillment.

I asked Maria what she would like to say to the Mount Sinai Nurses and she thoughtfully responded how very important it is that we take pride in our work. That to have a sense of professionalism we have to earn it, grab it and give our whole self to it. That every minute counts and in order to achieve and maintain a professional status we need

to train for it similar to any professional player. That nurses transform health care, but that we need to be focused and disciplined.

I found myself feeling very close to Maria. I’m thinking it’s because we share a mutual Mount Sinai longevity: she will celebrate her 30th anniversary at Mount Sinai in December and I am here 33 years. That she is also launching two sons into manhood, one of whom was in the same pre-school / day care with mine 20 some odd years ago. And her mother, for whom she had a great love and respect, had also passed away. But it was more than the coincidence of circumstances that made me feel this way. I felt as though Maria is willing to share so fully because her heart is as big as her brain.

While Maria is one of our longest steadfast, dedicated nursing leaders, my impetus for interviewing her in the first place came after overhearing her saying “Learning is not an Event, it’s a Process”. To me this was an amazing thought, ringing true in all phases of life. I have a feeling that Maria has more of these Maria-isms up her sleeve.


me to visit the lives of transgender and bisexual people. I saw the Spider exhibit at the Museum of Natural History which helped me appreciate their beauty and recognize that my “fear of spiders” was really just a fear of not knowing if they would jump on me. I enjoyed a barbeque with a group of people who I didn’t know (the host was a colleague of my husband’s), were a generation younger and who lived a different lifestyle than me (suburban/exurban versus metropolitan). In all these situations I stumbled on cultural diversity. Perhaps this came to mind because of the recent workshop I had just attended. Certainly reading about horizontal violence and bullying as well as watching bits of the televised Republican and Democratic Conventions brought the awareness of cultural diversity to a head, so to speak.

It’s really about respect. Sing it, Aretha! R-E-S-P-E-C-T. How very important it is to be aware of differences, appreciate the world’s diversity and to come to a place of mutual understanding, acceptance and respect. It’s something that sounds good on paper, but I think

is hard to accomplish in real life. I think

as practitioners we do much better with accepting and respecting our patients and their families. It’s something we are trained to do from day one. We are taught that we must respect the cultural differences of our patients and their families in order to be able to help them reach their goals in their health care experience. We are reminded that this is the ethical way to practice. But when it comes down to our colleagues, the team members we are supposed to be supporting, I sometimes think we

fall short of accomplishing this. I think that sometimes our own needs seem to supersede those of people in other areas, that we view the performance of other people from how it looks from our perspective and that our pressures, real or perceived, always seem to need more immediate attention than those of others. It’s my hope that we can take the time to appreciate the hard work of our coworkers, perhaps acknowledge that they, too, have pressing needs to address and that we can arrive at a place of understanding and negotiation. That we can separate the person from the circumstance and listen, explain, acknowledge, recommend and negotiate in ways that don’t include bullying, blaming, frustration or deception.Irving finished his novel by addressing the son of a former adversary and object of desire; “My dear boy, please don’t put a label on me-don’t make me a category before you get to know me!” I am ready to return to work tomorrow, hopefully with eyes wide open, and looking forward to the opportunity to practice respecting cultural diversity with everyone I encounter.

Chatting with Maria: A Look at Leadership (Continued from Page 4)

What I Did On My Summer Vacation (Continued from Page 8)

Information and Education Services Librarian Polly Beam

In 2007, with input from a broad representation of stakeholders, the COM developed a Model for Magnet that reflected current research on organizational behavior. This Model guides the transition of Magnet principles to focus healthcare organizations on achieving superior performance as evidenced by outcomes. Evidence-based practice, innovation, evolving technology, and patient partnerships are all evident in the Model.

Magnet Recognition Program® Model

The MounT Sinai hoSpiTal

MagneT newSleTTer

Barbara Nichols, RN, DHL, MS, FAANRecognized Living Legend of the American Academy of Nursing

Nursing Grand Rounds: A History of Nursing, Including the Pivotal Contributions of Mount Sinai Nurses, October, 2012

Barbara Nichols, DHL, MSN, RN, FAAN Barbara nichols, Dhl, MSn, rn, Faan serves as a Visiting Scholar and associate professor in the College of nursing at the university of wisconsin-Milwaukee. She is the former Chief executive officer of CgFnS international. prior to that, Ms.nichols served as a professor of nursing at the university of wisconsin School of nursing and Director of nursing for wisconsin area health education Center System. She serves on the Board of Directors for the american national Standards institute (anSi) and is on their personnel Certification and accreditation Committee.

She held a cabinet position in wisconsin State government, is a former international Council of nurses (iCn) Board Member and a past president of the american nurses association. as Secretary of the Department of regulation and licensing for the state of wisconsin, she was responsible for 17 Boards that regulated 59 occupations and professions.Ms nichols is the author of over 70 publications on nursing and health care delivery including her contribution as a guest editor, “policy, politics and nursing practice”, in the august 2006 edition of Building global alliances iii The

LIVING LEGENDSTransformational Leadership

submitted by Sylvie Jacobs, RN, BSN,CPAN

This Month’s Issue:�� Living Legends

�� Advanced Practice ... Transforming Lives

�� Visiting Nurse Scholars Signapore

�� Visiting Nurse Scholars Hong Kong

�� Spiritual Care, Relationship Centered Care

�� Transpersonal Caring

�� NICU: Caring for the Most Fragile

�� Mind

�� A Review of the Magnet Conference, 2012

�� New York TImes : A Tribute to Nursing

on this day i had “first lunch” since i had started work on the earliest of our many staggered paCu shifts. i eagerly went to the gp lobby and found our nursing colleagues’ posters of research they had conducted. i wandered around looking at the many amazing projects and ran into a friend of mine, Kathy hofstadter-Thal, an np in pediatrics. She saw i was scribbling down information about the posters and told me they publish a booklet which is available at the presentation. Since i couldn’t very well ask for a second break, she said she’d bring me the booklet. at 6pm, i was squinting at my wow when she popped into the paCu

with it. Since it was so well written, i’m going to copy the introduction, in case some of you missed the presentation, also. and you can be sure that next year i’ll arrange to be available for the presentation.The Center for Nursing Research & EducationMount Sinai has long recognized the importance of nurses in health care-the hospital established on of the first nurse training schools in the united States in 1881-and its nursing staff has a distinguished reputation in the healthcare community. in 2004, Mount Sinai earned the designation of the prestigious american nurses

“Advancing Practice…Transforming Lives”Annual Nursing Research Day: December 7, 2012New Knowledge, Innovations and Improvementsubmitted by Sylvie Jacobs, RN, BSN, CPAN

WINTER 2013

(continues on Page 5)


Visiting Nurse ScholarsNurshifa Shaik Hussein & Ma Yi Mon Soe from Singapore

Structural Empowermentsubmitted by Sylvie Jacobs, RN, BSN, CPAN

one of Mount Sinai’s programs which positively impact global nursing is its Visiting Scholars program. i met with two Singapore nurses who had spent a month visiting Mount Sinai. we shared stories and ideas and found out that despite our diverse cultures, we are more alike than different.Shifa and Yi Mon met with me in the guggenheim 9 east Conference room where they had been invited to observe our hepatobiliary care in guggenheim pavilion 9 Center Surgical and guggenheim pavilion 10 Center Medicine units. They had the opportunity to meet with many nurses and with excellent english skills, could absorb much and share their impressions.

They were captivated with our strong nurse leaders at all levels. They spoke about how our (Transformational) leadership supports the direct care nurses in our work, make actions transparent and accessible and strive to create a learning environment wherein everyone feels comfortable bringing up conflicts and challenges. They were impressed to see how our nursing leadership works so closely with our labor union to create a professional and equitable work environment.

we discussed how this serves everyone’s best interest, since higher nurse Satisfaction Scores lead to higher patient Satisfaction Scores and more positive outcomes overall.

They enjoyed the review of nursing research and evidence Based practice which reinforced their practices from Singapore. The energetic and engaging teaching methods drew their attention and they noted how this encouraged class participation. They felt the greatest differences were how Mount Sinai nurses were so vocal. Since we hale from different cultures, they were not used to the confident manner in which we present ourselves to our peers and superiors.

we spoke about how clinically our practices are similar, their nursing hierarchy is much the same as ours, with nurses delegating to assistant and ancillary staff. They are moving towards the electronic Medical record, their hospital, also values furthering education and they award scholarships from baccalaureate to doctorate nursing degrees. one area that differed dramatically was their strong focus on nursing image. They have a strict dress code which includes hair and makeup styles and it is culturally frowned on to laugh loudly in public.

while we are using relationship Centered Care @ Mount Sinai for our nursing delivery system, they use roper-logan-Tierney. i was unfamiliar with this nursing Theory and so explored the internet. The short version is that roper-logan-Tierney Model for nursing is a theory of nursing care used widely

in the united Kingdom. it is based on how the patient can maintain their activities of daily living with the goal being maximal independence. The nurse’s role is to determine what interventions will lead to increased independence as well as what ongoing support is needed. Since Shifa and Yi Mon were unfamiliar with relationship Centered Care i was able to explain that it was a return to basic nursing care with attention to mindfulness and interpersonal

connection. i described how an evening backrub would prepare a patient for a more restful night and how active listening or what we used to call Therapeutic Communication could bring deeper meaning into nurse-patient interactions.

i was able to share some past issues of our Mount Sinai Magnet newsletter and promised to email them the fall and winter issues. we had met as strangers but were parting as friends. we knew that our hands, although on different sides of the globe, were delivering the same care with the same intention. it was a wonderful feeling.

Shifa and Yi Mon holding Dolls from “The Doll Project”

Nurshifa Shaik Hussein & Ma Yi Mon Soe (centered) with GP 9C Nursing Staff

Visiting Nurse Scholars from Hong Kong Global Issues

submitted by Sylvie Jacobs, RN, BSN, CPAN

our Visiting nurse Scholar program brought four intelligent and articulate nurses from hong Kong through our doors. Yeung York Mui, also known as iris, from Queen elizabeth hospital in Kowloon Central Cluster is a pediatric advanced practice nurse. lee Yuk Mun, also known as Cathy, is a Department operations Manager in the Department of Tuberculosis & Chest in Twghs wong Tai Sin hospital in Kowloon west Cluster. Chan Ming Fung, or Maggie, works in the Department of Clinical oncology in the pamela Youde nethersole eastern hospital of Chai wan, hong Kong. She is also a Department operations Manager. and Maria, or Tsang hing ling, is a Department operations Manager in psychiatry at the united Christian hospital in Kwun Tong, Kowloon. They were eager to learn, quick to smile, bright and energetic.

My inquiry as to their initial impressions of Mount Sinai was answered by an appreciation for our warm welcome, good practices and being open and willing to share. as we spoke, we explored relationship Centered Care and how it has helped us return to the basics in nursing. They were familiar with our use of press ganey and hCahpS to try to improve our delivery of care. as they had just attended our Magnet Champions meeting, they asked how the MCs were chosen. i explained how our nursing leadership honors their Clinical nurses who have leadership qualities to become Magnet

Champions. That these nurses are collaborative, model excellence in their daily practice and look for opportunities to make positive change. The Magnet Champion’s responsibilities include advocating for the Magnet program, educating and energizing colleagues, bringing feedback and suggestions back to the committee and implementing unit based initiatives to promote Transformational leadership, Structural empowerment, exemplary professional practice, new Knowledge, innovation and improvement and empirical Quality results.

iris, Cathy, Maggie and Maria were friendly and kind. They helped me understand the nursing approaches they were used to back home. The hong Kong system uses oreM as

their Care Delivery Model. after looking this up, i found out that the orem Self-Care Theory originated from an american nurse Theorist, Dr. Dorothea orem (1914-2007). She

received her diploma from providence hospital in washington, DC, her BSn ed. in 1939 from Catholic university of america, her MSn ed. in 1945 and an honorary Doctor of Science degree in 1976 at the age of 62. greatly simplified, orem’s Theory looks at self-care, self-care deficits and how nursing, as an action, can wholly meet the patient’s self-care needs, assist the patient to meet their self-care needs or support the patient via therapeutic relationship to maintain human integrity and functioning.

The hong Kong systems use Case Managers and are aiming efforts at restructuring their practice to be less task- oriented. They were

highly impressed with our electronic Medical record: epiC and appreciated its ability to detail patient care; its checkpoint system which they felt would prevent medication errors and its universal accessibility.

it was such a pleasure and honor to meet these four dynamic hong Kong nurses who traveled so far from family and home to learn about our nursing care. Their dedication to the nursing profession, their patients and their hospitals was inspiring. Their energy and eagerness to learn was contagious. i hope you got a chance to welcome them to Mount Sinai. if not, look for the next group of Visiting nurse Scholars. it’s a great opportunity to learn and make new friends.

their initial impressions of Mount

Sinai was answered by an appreciation for

our warm welcome, good practices and

being open and willing to share.

Visiting Nurse Scholars from Hong Kong addressing Magnet Champions at their monthly meeting.

what is Transpersonal Caring and its applicability to nursing and patient care? in simple terms, it is the worlds of physical awareness and spiritual energy beyond human awareness. (welch, 2012) it goes beyond the separate individuals to create harmonious moments in time.

Transpersonal Caring conveys a concern for the inner life and involves searching for meaning and perceptions. it requires going beyond the ego self and beyond the given moment, reaching to deeper connections to spirit and with the broader universe. (watson, 2007) The transpersonal provides the spiritual elements of our existence, transporting us through cycles of birth and renewal. (Karasu, 1999)

The common thread among the varied definitions of transpersonal is the spirit beyond our physical being, described in a quote by Teilhard

de Charding, “we are all spirit beings having a human experience”. The transpersonal is a vehicle of awareness carrying human beings between the spiritual and physical realm of existence. The discovery of transpersonal is described since in ancient times in records dating back over 4000 years ago in China, thousands of years in ancient

egypt and during the golden age of greece (welch,2012). in the twenty first century, transpersonal brings new meaning and dignity to the world of nursing and patient care. it defines the selfless art of nursing which connects with the being of a patient by embracing their spirit and physical ailments through the healing processes of transpersonal caring. (watson, 2007)

The attributes of transpersonal care is to connect the various roles of scientist, scholar and clinician with the harmonious state of mind, body and soul of the patient. The desired outcome is to create a calm, nurturing and healing environment. Transpersonal caring is universal, surpassing cultural differences. we see the origins of transpersonal care

in human reflexes, responsiveness and instincts. animals tending to one another during illness and the instinctual attachment to mother’s breast immediately after childbirth are examples of our primordial energy to energy connection. Tapping into this energy to energy connection is the basis for transpersonal caring. it results in patients feeling less fearful in the healthcare environment. it

“The desired outcome is to create a calm, nurturing and healing environment. Transpersonal caring is universal,

surpassing cultural differences.”

part of our delivery of relationship Centered care to our Mount Sinai patients requires attention to Spiritual Care needs. epic, our electronic medical record, allows for a spiritual needs assessment. a question is raised as to how these spiritual needs are identified amongst the many other assessments that are needed to be done.

i had the pleasure of meeting with rabbi h. rafael goldstein, BBC who is the Director of the Department of Spiritual Care and education. in collaboration with the nursing teams gp 8east and gp 9east there is a pilot program exploring having a chaplain coach nurses in active listening. active listening is the process of listening to the entire message, not merely the words that are spoken. it requires focusing on the speaker without being distracted

by internal or external activity. it helps to verify the speaker’s meaning and acknowledge their message by encouraging nods or words. re-capping the message helps make sure their meaning was conveyed.

active listening promotes the nurse-patient bond which allows the patient to feel safe in opening up and sharing vulnerable needs. The importance of recognizing spiritual care needs is seen in a patient’s will to get better or accept an inevitable prognosis. Since we are the first line of contact with the patient and their family members, we are the most likely to discover and explore what spiritual needs they have. The Department of Spiritual Care and education is available to visit all inpatients including patients waiting for placement in the emergency Department.

They represent Christian, Catholic, Jewish, Buddhist and Muslim faiths and can be reached by calling (212) 241-7262 or X 47262.

rabbi goldstein is attuned to diverse needs for any faith and is currently forming ideas to meet the needs of our rapidly growing Muslim population. There are services available for Catholic and Jewish patients, a hasidic run Kosher hospitality room and interdenominational and Jewish Chapels available for use. he is always looking for ways to enhance and expand the relationship between nursing and Spiritual Care. he hopes we will continue to consider and refine how we assess our patients’ spiritual needs and collaborate with his team to provide the excellent care that for which we all strive.

Spiritual Care, Relationship Centered Care at Mount SinaiExemplary Professional Practicesubmitted by Sylvie Jacobs, RN, BSN, CPAN

Transpersonal CaringExemplary Professional Practicesubmitted by DarciAnn O’Sullivan RN, BSN, OCN


Credentialing Center (anCC) Magnet award- and in 2009, became the first full-service hospital in new York City to learn redesignation for an additional four years. Magnet designation is considered the gold standard for nursing excellence: only six percent of hospitals in the u.S. have earned it, and just two percent have achieved redesignation. The aim of the center for nursing research and education at Mount Sinai (Cnre) is to tap into that excellence, using the talents and expertise of nurses in the service of effective translational research- a two-way process in which scientific discoveries are translated into practical applications, and those applications yield new information to be studied and analyzed.

The Cnre under the leadership of Dr. Carol porter, a center within Mount Sinai School of Medicine, will accomplish its goal through “bench to bedside” research. Clinical nurses play an integral role in Cnre’s research projects, bringing their experience in patient care- and their insights into how patients respond to treatment – into the process of research. The results of the Cnre research will continually be integrated into nursing education, which informs the innovations and best practices of clinical care. in this way, the quality of nursing and patient care outcomes at Mount Sinai- and at hospitals and clinics across america, and around the world- will be greatly enhanced. To fulfill this visionary agenda, the Cnre supports and evolving archive of best

nursing and health care practices in five targeted areas: Cancer, information Technology, pain and palliative Care, resiliency and work environment. The Cnre will play a major role in Mount Sinai’s Clinical and Translational Science award (CTSa), a $34.6 million, five-year national institutes of health (nih) grant dedicated to fostering patient-oriented research and applying it to clinical practice. The CTSa aims to transcend the traditional boundaries of research; collaboration with researchers in different disciplines is welcomed and encouraged. The Cnre fits perfectly into this context, as nurse researchers bring their strong clinical, patient-centered perspective to the work of the CTSa.

“Advancing Practice…Transforming Lives”(continued from Page 1)

Posters from 2013 Poster Session: Baraldi: Screening Mammography utilization among women with physical DisabilitesBichoupan: effectiveness of hCV Triple Therapy with Telaprevir in new York CityCarrazone: Development of a Culture of evidence-Based practice (eBp) in a large Metropolitan hospitalCortese: implementing an e-learning intervention to improve oncology nurses’ Cultural Competency and Disease awarenessDerevnuk: Three hiV post-exposure prophylaxis (pep) regimens for health Care workersDrury: Through a Different lens: integrating eBp into Specialty nursing practiceEa: a Step toward understanding the Cardiovascular health of Filipino registered nursesFu: proactive approach to risk reduction and early Detection of Breast Cancer-related lymphedema; The role of Symptom report in Detecting and Diagnosing lymphedema Hickson: nursing hostility and Job Satisfaction as perceived by new graduates: Magnet versus non-Magnet hospitalsJakkubowski: where Does granulocyte Colony Stimulating Factor use Stand Following allogenic hematopoietic Stem Cell Transplant in 2012?Kowalska: advancing relationship Based nursing Care though the implementation of “Tree of life” on an inpatient Medical unitNinos: promoting professional nursing practice Through CertificationOliver: Structural empowerment and Job Satisfaction of Clinical nurse ManagersPaguirigan: Sacrificing Something important: The lived experience of Compensated Kidney Donors in the philippinesRenteria: oral glutamine and probiotics on enteral Morbidity following autologous Stem Cell Transplantation for plasma Cell DyscrasiasRolston:advancing relationship Based nursing Care Through implementation of “ask a nurse” on an inpatient Medical unit; engaging associate Degree Student nurses in eBp at a Community hospital; enhancing the patient experience through

implementation of Quiet Time on an inpatient unit; Student nurse “ambassadors of Caring” Student nurse eBp internship programRudow: personality Traits and resilience among live liver and Kidney DonorsSussman: Job Satisfaction and Support for Transitions in the nursing academy: a Qualitative Study of Tenured nursing Faculty who Stay in academia?Weiss: initial Validation of the psychosocial readiness evaluation to prepare for hepatitis C Treatment (prep-C)Wexler: nurse Faculty eBp rounds in a Community hospital

“As you can see, the topics are wide and varied. There were many reminders that Nursing is both a science and an art.

The topics presented provoked many questions. I am already looking forward to next year.”

Nurses and Students at the 2013 Nursing Research Day Poster sessionDecember 7, 2013

allows the patient to experience the sanctity of being in the hospital, clinic and conversion of their homes into a medical environment through home care or community nursing. This is aided by the transpersonal care relationship between the nurse and patient, as seen in press ganey Scores, a statistical survey tool created in 1985 by Dr. irwin press and Dr. rod ganey to assist health care organizations in improving the health care experiences of patients. a two year study trended an overcrowded emergency department in a teaching hospital. press ganey scores were used to improve the transpersonal care experience of patient encounters. (pines, 2008).

one example of transpersonal caring is how Florida nps established a culturally sensitive relationship with their multicultural patient population at a primary care center. The patients felt reassured by being treated like individuals instead of just a human body system. (rexroth & Davidhizar,2003). The cultural and language barriers dissolved with the nurses’ efforts. a second example is how in the dark days of the outbreak of hiV/aiDS a group of patients were able to express the healing forces that transpersonal caring created. They were able to finally find acceptance and dignity in living with their diagnosis.

prior to exposure to transcultural caring, they had felt stigmatized, isolated and unwelcome. (Shroeder,1993). Transpersonal care is the human dimension of nursing (watson, 2007), as illustrated in the response of patients with hiV/aiDS at an outpatient hiV/aiDS clinic. These patients were able to experience acceptance for the nursing team, which provided them with the courage to overcome the stigma of their disease. This allowed them to connect to living with hiV/aiDS and not to death, essentially creating unity and harmony with the mind, body and spirit. Transpersonal care gives the nursing profession a language which transcends customs and cultures (watson, 2007). The nurse can then emanate a presence of harmony to patients with various cultural backgrounds. Transpersonal care validates the authentic patient experience of being in totality with person, not just their illness.Transpersonal care is the heritage of a spirited lineage of the profession of nursing articulated by Dr. Jean watson in her human Science and human Caring Theory. Transpersonal care reaches deep within the energy beings of all nurses, connecting with the same energy of all patients, because in the totality of transpersonal care; we are all energy beings having human experiences.

Transpersonal Caring (continued from Page 4)

here, now, present, awake in the Moment, Mindfulness. we keep hearing these concepts, but do we know what they mean or what benefit they bring us?

practicing mindfulness creates a fuller, richer experience. it allows for deeper understanding and helps us reach levels of more authentic communication. an exchange in which mindfulness is practiced produces feelings of appreciation and gratification, a sense of understanding and of being understood.

i know that when i give my full attention to someone, really listen to them, time goes away. There is no past thought or future thought. There is no, “oh oh, did i remember to chart that?” or “what if my vacation isn’t approved, i already booked my flight”. There is just you and me. eye to eye, there are the five senses, the meaning of the words chosen, the inflection of what is said, perhaps the other meaning of what their body or facial expression is saying. That is when we connect, when i am awake to them, present with them, really hearing them.

it is easy to get used to multi-tasking and being dissatisfied with focusing on a single thing. our society and culture seems to demand it of us. Smart phones are constantly at the ready making us continually connected to colleagues, friends, family, loved ones.

we never have to get lost anymore with our gpS apps or feel lonely since we have so many Facebook friends. even at work we are expected to monitor our patients, chart on epic, answer the phone and address family concerns simultaneously. Most of us have experienced trying to pour our hearts out to someone who is checking

their messages or downloading something. we know when we are not getting their full attention. it makes us feel insignificant, as though our worries or concerns are not important. This is how our patients feel when we rush through a dressing change, when we hurry through an explanation, when we dash by for a quick pain assessment: unimportant, insignificant, and certainly not understood.

i am sure that is not the fulfilling experience we hope to have when we come to work, nor what we wish to impart to our patients in their struggle to regain health or complete their lives.

Mindfulness is a choice. it is a skill to be learned and practiced. it is an awareness of our state of mind. it is an obligation we have to our patients. in many of the recent holiday seasonal readings, a lot of focus was placed on gift giving and generosity. one quote grabbed me. Thich nhat hanh wrote: “perhaps the greatest gift we can offer anyone is the gift of our full attention.”

MIND Exemplary Professional Practicesubmitted by Sylvie Jacobs, RN, BSN, CPAN

Cheryl peixoto, a niCu nurse, has been attending Magnet Champion meetings with me for years. her passion for her patients made her stand out and so i asked her how i could find out more about her unit and colleagues. She gave me the name of one of her clinical coordinators, Deborah hutchison, and my meeting with her gave me insight as to the source of this passion.

The niCu is filled with undersized, underdeveloped babies who are cared for by a staff of compassionate, concerned nurses, dedicated doctors, devoted social workers and big hearted volunteers.

niCu graduates are celebrated in a reunion every two years. graduates are babies who are successfully dis-charged from the niCu. This year it was held on Sunday, october 7, 2012 and was attended by about 60 families. it included the graduates, from the last two years who were in the niCu for over two weeks. entertainment was provided by the Starlight Children’s Foundation who contributed a face painter. Zev haber, who is a proud niCu graduate dad and an award winning children’s musician, donated the musical entertainment. it was an interdisciplinary effort of nurses, nurse practitioners, Social workers, Doctors and

Volunteers who all joined together to provide a fun celebra-tion of life and success for these babies and their families.

The parents Sharing newsletter provided details and pictures. The newsletter is uJa sponsored and supports families of babies in the Mount Sinai niCu. Jill winston, lCSw, is the editor and welcomes input of niCu families, staff and friends. The newsletter included an informative, accessible article about breathing and how the premature infant deals with incomplete lung development and how to combat insufficient surfactant production. This was writ-ten by Dr. ian holzman, who is the chief neonatologist, the parents Sharing newsletter advisor, Contributor and Baby photographer. The newsletter informed me that novem-ber was prematurity awareness Month. november 17th is world prematurity Day and the empire State Building is lit in purple to honor world prematurity Day.

The March of Dimes and worldwide partner organizations work to raise awareness on the serious problems of prema-ture birth. last Spring many niCu nurses helped support the March of Dimes by walking downtown with the organi-zation to raise money.

Neonatal Intensive Care Unit: Caring for the Most FragileExemplary Professional Practicesubmitted by Sylvie Jacobs, RN, BSN, CPAN

Despite feeling overwhelmed by its magnitude, Johanna Medina, the Magnet Champion from gp 9 Center found the experience of attending her first Magnet Conference “electrifying”. The 2012 anCC Magnet conference was held in los angeles in october 2012. True to form, it presented many opportunities for learning, professional growth, networking and reenergizing. Johanna enjoyed many interesting, educational sessions. She particularly appreciated the sessions on patient Satisfaction and Discharge innovations since these two themes are highly relevant to her practice on gp9C. her transplant patients require considerable amounts of teaching to learn new drug regimens before discharge. her unit closely tracks their patient Satisfaction scores via press ganey Survey results to measure outcomes and influence unit initiatives.

Johanna reported that another outstanding component were the

celebrity speakers. They spoke about how their encounters with nurses frequently ended with “oh, just doing my job”. This would be in response to an expression of gratitude. They elaborated how a nurse has a huge impact on patients and their families and that the nurse contributes to a patient’s experience in so many ways. why then, do we minimize our value, our efforts and our accomplishments?

Florence Badoy, an or nurse whizzed by me in the paCu until i grabbed her and slowed her down. She said she’d had a superb Magnet Conference experience in los angeles. She had been used to large conferences from her experiences with aorn, the operating room nurses’ professional organization. Florence felt that the Magnet Conference was well-organized and filled with inspiring lectures. She said she was able to meet her goal of learning more about Magnet philosophy and implementation. She was pleased to

have had the opportunity to attend.patricia Matos, our Magnet program Director as well as Director of psychiatric nursing found that the conference was full of many motivating sessions. an example of one was about ethics and how nurses have to make on-the-job ethical decisions often and instantaneously. i had not attended this year’s conference, but i recall from previous Magnet Conferences that they were engaging and revitalizing. There is something for whatever you are looking to learn, whether it’s about evidenced Based practice strategies/ research, the Magnet process, improving patient and nurse Satisfaction Scores, examples of posters and projects or simply inspirational, morale-boosting nurse camaraderie. i hope you will consider attending a Magnet Conference in the future, organize your contact group and find the experience as moving and transformative as you need it to be.

A Review of the Magnet Conference, 2012 Structural Empowermentsubmitted by Sylvie Jacobs RN, BSN, CPAN

Continued on page 9

i had the prestigious honor to be the recipient of the 2012 new York Times Tribute to nurses leadership award. as i stood with the other many award finalists and winners i felt how very transformative our nursing actions are in people’s lives. it was so rewarding to see the acknowledgment, recognition and appreciation from the nursing leaders who took time out of their busy schedules to nominate, encourage, support and promote all of us. having an outside entity, Journalism, paying tribute to nurses was just an incredible feeling of human appreciation and gratitude.Taking place in the new York Times Building, in and of itself, was special. located at 620 eighth ave in the heart of Times Square, which i found out was named after the new York Times, brought clarity to the fact that the paper is there to reflect the world around them. The building, which opened in 2007, is 52 stories and has walls made up of windows, so you really feel surrounded by the City. arthur Sulzberger, Jr. the new York Times Company Chairman and new York Times publisher wrote”

This building is designed from the ground up to reinforce the values of the new York Times Company. The open plan and ease of communication, both vertically and horizontally, represent our culture of collaboration and transparency. The dazzling design represents our commitment to constant innovation.” These concepts rang a bell with me. here at Mount Sinai we are also striving for a culture of collaboration and transparency with a commitment to constant innovation. Could it be that these health care goals reflect global and evolutionary strivings in all fields? The walls on the 15th floor displayed the pulitzer prize winning journalists over the decades. Some stories i recalled, some were new. as i was leaving i saw the memorial to the fallen journalists from world war i who were killed while covering the war. i thought about the incredible dedication and commitment it takes to be willing to risk one’s life for their profession. The nurses were, by definition, outstanding representatives of the best of us. There were nurse researchers,

educators, administrators and Clinicians. They had accomplished things such as over-riding international embargos to bring in chemotherapeutic agents from Cuba and revamping the hospital’s practice on Deep Vein Thrombosis (DVT) prevention. Some exemplified going above and beyond the call of duty and crocheting hats for women who experience hair loss after chemotherapy or caring for a particularly challenging patient; bringing him through a poor prognosis and following up to keep him progressing towards the best health possible. a nurse practitioner and researcher is involved in a 4 year study on investigating compliance in hope to improve quality of life, a Clinical nurse Specialist has successfully decreased incidence of pressure ulcers (pu) through education, a Vice president at the Visiting nurse Service has created a Behavioral health program which is remodeling how we treat psychiatric disorders. These award winning nurses had encouraged their colleagues to become involved

These are the success stories portraying positive outcomes, involved staff and reassuring structures for coping parents. what happens when, despite all efforts, the battle is lost? The grieving parents are encouraged to hold their babies and are allowed to spend as much time in a private space with them as needed. The babies are prepared in whatever special clothing and religious articles the parent wishes. Diverse cul-tural approaches to grieving and death are expected and provided for. parents are given a white, quilted hand-sewn cloth envelope which contains a lock of hair and a photograph taken by the staff. if they are unable to deal with the loss at that moment, the Social workers safeguard these keepsakes, sometimes for years, until the parents request them. Child-life personnel are used to help siblings cope in dealing with the loss. religious leaders are called in for support as well.and what of the staff who have formed attachments to their

babies as well? The niCu nursing leaders are sensitive to nurses’ emotional and spiritual needs regarding poignant events. They share during learning conferences and do their best to support each other. in one in-stance, the nursing leadership recruited a counselor from the employees assistance program (eap) to discuss a sensitive loss ”Small Moments of peace” was a debrief-ing offered to staff for help in dealing with their grief.i came away with the impression that the niCu is the happiest/saddest place in the hospital. They have boards covered with smiling happy babies and children, holi-day cards from grateful families and an expected delivery of fifty stuffed animals that comes in every year from an ap-preciative family. They also have a stack

of quilted white envelopes waiting for locks of hair and photographs. The awareness of the preciousness of life, the random turn of tides that nature can take and the resil-ience of the human spirit is depicted on every face.

Neonatal Intensive Care Unit: Caring for the Most FragileContinued from page 7

New York Times Tribute to NursesStructural Empowerment/ Exemplary Professional Practicesubmitted by Sylvie Jacobs, RN, BSN, CPAN

NICU Picture Board, Pictures from parents who children were in the NICU

Continued on page 9

impact of global nurse Migration on health Service Delivery. She holds a diploma in nursing from Massachusetts Memorial hospital, Boston, Massachusetts, a baccalaureate degree from Case western university, Cleveland, ohio and a master’s degree in Behavior Disabilities form the university of wisconsin, Madison.what is it like to meet a living legend? Carol porter invited her friend, Barbara nichols, to present a nursing grand rounds on october 3, 2012. her focus at the nursing grand rounds was to mainly give a historical look at nursing and chronicle some of our own Mount Sinai nursing contributions. This event was followed up by a breakfast meeting the next day.During her nursing grand rounds, Ms. nichols recounted the ancient greek myth of Sisyphus, the moral was that if we don’t examine our past and learn from mistakes we would be destined to repeat them over again. Ms. nichols’ handout was a nursing Timeline from the Mount Sinai archives beginning with 1881 and the incorporation of the first Mount Sinai Training School for nurses through 2012 with Carol porter receiving the first endowed chair in nursing in an american medical school, the edgar M Cullman, Sr. Chair in nursing.

at the breakfast, Barbara nichols delivered a personal perspective speaking about how things have changed since her graduation from nursing school in 1969. it was a time of social reform, a dawning of technological advances and an educational evolution in nursing academics. She was able to compare that period in history with her meeting the day before of a 28 year old patient with an artificial heart here in Mount Sinai. Ms. nichol’s naturally inquisitive mind allowed her to ask many technological questions, since she had worked in cardiac surgical iCu and also as a pump technician. But it was her insight that struck me strongly. in speaking to this patient, she was able to glean that his attitude toward having an artificial heart played a crucial role in his coping. She heard him imply how very precious life is, however short it might be and that he would embrace it however he could.

Ms. nichols was the first african american president of the ana in its 100 year history. She shared how her success depended on her learning the ropes and discovering

the hidden agendas. it was evident, as she spoke, that her self-confidence, courage, innate intelligence, huge personality, her openness to learning, willingness to work hard and respect for the rules helped her as well. her era was a time of prejudice and low expectations for african americans. She found that people did not expect her to succeed, scrutinized her for any imperfections and were taken aback when she exerted the power of her position. She expressed empathy with president obama on this. She still has sensitive antennae to prejudice and readily identifies when there is a lack of respect, however subtle, for the few ethnic minority leaders today. in her 50 years as a nurse, she is the only ethnic minority Ceo she’s worked with.

as globalization expands, she urged us “to think globally, while acting locally”. She urged us to make a commitment to incorporate understanding and acceptance in our approach and develop and adhere to strategies to raise awareness in our community. Ms. nichols reminded us of the difficult journey that foreign born nurses have in order to work here in america. The education and american licensing are just part of the process of immigration. The country of origin and the uS each have regulations and processes to be navigated in order to obtain visas, language mastery and requirements to be met and educational assessments to be made. Ms. nichols acknowledged the elephant in the room and spoke of the myth that “foreign nurses were here to take away our jobs”. She brought to light our need to appreciate our foreign born colleagues, to take advantage of their skills, knowledge and drive, to respect our differences and dispel our prejudices so that we all can achieve the highest levels of contributions to nursing.

Ms. nichols advised us to develop a depth and breadth of understanding. Doing this would to benefit our patients, strengthen our collegial relationships and encourage our nursing leaders to bloom from the most fertile soil. She encouraged us to be globally relevant by looking at our unique Mount Sinai ethnic mix of nurses. She asked us to share our metrics and measures. She suggested we learn more about and celebrate our differences. as she’s been known to do, Barbara nichols made some waves, this time in our local waters.

LIVING LEGENDS(Continued from page 1)

in returning to school and become certified in their specialties. They were models of nursing excellence, mentored colleagues, promoted cultural competence and performed community service. a nurse Manager from new York university langone hospital described their hurricane Sandy evacuation effort and the superb, professional care that safeguarded so

many critically ill patients. The December 9th new York Times Sunday Magazine published the nurses’ names and their hospitals and health care agencies. There were eleven finalists and five winners in categories of research, education, innovation, Service and leadership. There were many family members, hospital and health care agency administrators, colleagues and new York Times staff sharing a generous and delicious breakfast overlooking our vibrant and dynamic City. Meanwhile, back in those hospitals and health care agencies, were countless numbers of nurses providing meaningful, compassionate care to patients who depend on us for safety, quality and advocacy. let your patient’s smile, expression of gratitude and peaceful rest be your well-deserved tribute to your excellent nursing care. it gets less publicity, but is by no means any less significant.

Sylvie Jacobs, BSN, RN, CPAN 2012 New York Times Tribute to Nurses Winner

New York Times Tribute to Nurses

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