experience talks
TRANSCRIPT
EXPERIENCE TALKS
Authors: Jeff Solheim, MSN, RN-BC, CEN, CFRN, FAEN, andAnnMarie Papa, DNP, RN, CEN, NE-BC, FAEN, Keizer, OR, Philadelphia, PA
Celebrating emergency nurses week
WHAT CREATIVE IDEAS HAVE YOU IMPLEMENTEDTO CELEBRATE EMERGENCY NURSES WEEK?
Answer 1:“It was personal” and “Wow!” These are just a fewresponses we heard about our 2010 Emergency Nurses’Week celebration.
While attending a leadership development course atour hospital, I listened to Human Resources ManagerBruce Wade describe how he recognizes his staff in waysthat are meaningful to them. For example, he knows thatSusan loves Snickers candy bars, so when he wanted toshow her his appreciation, he bought her a Snickers bar.When he wanted to recognize Tom, whose favorite coffeewas from Starbucks, he bought him a gift card there. Withthis approach in mind, ED Support Service Manager Car-men Pike and I started brainstorming ideas on “how tomake it personal” for Emergency Nurses Week. We knewwe were working with a budget of less than $250. In adepartment of 125 staff, this was not going to be easy.
We developed a spread sheet and started asking eachstaff member, “If you were your favorite snack food ordrink, what would you be?” Some answers we had toredirect, but most were doable, like diet Dr. Pepper, pop-corn, or even deviled eggs. We went shopping, did somebaking, and added some ribbon and a note card that said,“We value your individual contributions to this team.Thank You!” The management team passed out the treatslike elves during the next week. The staff were so appre-ciative, you would have thought we had given them ahundred bucks.
We have a popcorn-loving crowd in our department.When the department meets a goal and in celebration of
Emergency Nurses Week, we borrow the old-fashionedpopcorn machine from volunteer services. We make thepopcorn in the office but then push the whole thingaround the department for ambiance. We pass popcornout to staff, providers, and our customers and make surewe tout our purpose for the celebration. The cost is verylow, and the key is to do it on all shifts.
We also had our print shop make some nice bannersand took pictures of staff to put in the hallways. Media ser-vices printed them off so they would look nice.
The other big crowd pleaser was having a massagetherapist from physical therapy and one from our ownregistration department come and do 15-minute chair mas-sages. We set up a CD player with relaxing music, too. Noteveryone got a massage, but again, the key is making sureyou cover all your shifts. Many celebratory things at hospi-tals tend to occur Monday through Friday, from 8 AM to5 PM. The simple fact that you are willing to come in dur-ing an off-shift time is much appreciated in and of itself.Be creative and celebrate often!—Sarah Abel, BSN, RN,CEN, Night Shift Nurse Manager, Emergency Department,Bloomington, IN; E-mail: [email protected]
Answer 2:We kicked off Emergency Nurses Week with a trivia contest.Nurses submitted little-known facts about themselves andthen we had a “match the trivia to the nurse’s name” form.Some of my favorites were, “Whose prized possession is anautographed picture of Neil Diamond?” and “Who playedthe headless horseman for a haunted house all four years ofhigh school?” This contest was a great way for staff to havefun and get to know each other better. The prize was a giftbasket that included donated gift certificates from area restau-rants that our staff frequent.—Claire Scott, BSN, RN, CEN,Aultman Hospital, Canton, OH; E-mail: [email protected]
Answer 3:Every year, we have the local newspaper come and take apicture of the ED nurses for Emergency Nurses Day. Weuse the sample press release in the ENA resource area ofthe Web site. The picture and article are published bothin the local newspaper and our Shopper’s Digest. Commu-nity Relations is very helpful in contacting the local mediafor assistance. In addition, one year, we had the mayorissue a proclamation for Emergency Nurse’s Day, and hecame to the hospital and had his picture taken with thenursing staff. Another year we celebrated nurses who have
The opinions expressed are those of the respondents and should not be con-strued as the official position of the institution, ENA, or the Journal.
Editors’ note: The content, style, and mission of the Managers Forum remainsthe same, but the title of the section has been changed to “Experience Talks” toreflect the broader scope the column has taken in recent years.
J Emerg Nurs 2011;37:499-502.
Available online 18 July 2011.
0099-1767/$36.00
Copyright © 2011 Emergency Nurses Association. Published by Elsevier Inc.All rights reserved.
doi: 10.1016/j.jen.2011.06.012
E X P E R I E N C E T A L K S
September 2011 VOLUME 37 • ISSUE 5 WWW.JENONLINE.ORG 499
obtained their Certified Emergency Nurse (CEN) designa-tion by publishing an article with a photograph of ourcertified nurses.
In addition, every employee receives a small gift onEmergency Nurse’s Day. This year it was a gift card to alocal restaurant. We made a flyer wishing them a HappyEmergency Nurses Day and placed the flyer and gift cardin their mailbox. We also celebrate with food all week; theED physicians usually provide enough money for pizza forall 3 shifts, and sometimes we can persuade a drug repre-sentative to donate some goodies.
We always reserve a bulletin board in the hospital andpost something about Emergency Nurse’s Day, including acopy of the poster sent to the department by ENA. One yearwe placed pictures of all the CENs on the bulletin board.This year, we held a Hospital Emergency Response Trainingcourse and posted pictures from the course on the bulletinboard. It was very meaningful because several of our nursestook the Train the Trainer course and were able to teachtheir peers. We always try to have fun and enjoy the entireweek, and especially Emergency Nurse’s Day.—Sandra R.Bauman, MS, RN, CEN, NE-BC, Unit Manager, EmergencyDepartment, Ephrata Community Hospital, Ephrata, PA
Improving relations between emergency department
staff and prehospital personnel
WHAT EFFORTS HAVE YOU IMPLEMENTED TOIMPROVE RELATIONSHIPS BETWEEN EMERGENCYDEPARTMENT STAFF AND PRE-HOSPITALPERSONNEL?
Answer 1:A family friend of mine, Dr Leopold Hofstatter, was aninternationally awarded neuropsychiatrist. In the ninthdecade of his life, he was listening to a conversation abouthow entwined computers and technology have become inour businesses and asked, “How do you succeed in thiskind of environment?” A businessman said, “By knowingthe right people and having good conversations.” Leopold’sresponse was, “I’m glad to hear it’s still about relation-ships.” EMS personnel have become my friends as we haveshared personal stories over the years; they have become mycoworkers as we have worked as a team to achieve commonpatient care goals; and they have become my customers,because I would like them to bring patients to my emer-gency department and help my institution in a competitivehealth care market.
In my region, agencies with community interests inemergency care meet monthly to define and achieve goalsand iron out differences. My institution is medium sizedand is not trauma rated. A greater part of EMS educational
programs are facilitated through the larger trauma institu-tions. However, we still have our own opportunities to fostera productive EMS relationship in a cost-conscious economy.
We provide a conveniently located, clean, designatedhome base stocked with office materials and offer accessto the coffee, tea, and ice machines so EMS personnelcan refresh themselves and regroup while completingtheir documentation. One company created a companycollage that we have hung in the space. We teachAdvanced Cardiac Life Support and Pediatric AdvancedLife Support courses within the institution and offerEMS one free spot in the class for every instructor theyprovide. This exchange provides a resource to promoteprofessionalism within their ranks and certify new crewmembers at no cost. Teaching classes together also allowsus to build professional connections.
EMS crews want successful outcomes for their patientsas much as we do, so achieving benchmark goals andimproved patient outcomes within our institution reflectson the work they do as well, and gives them confidence tobring their clients to us. The best relationship builder handsdown is telling their patients on arrival the good job theirresponders did. My ride-along experiences taught me howwell-packaged patients are in spite of the chaotic scenes inwhich EMS personnel work. If I promote their professionalskills, wouldn’t they want to bring patients to a place they areappreciated when they do have a choice?—Laura Kleeman,BSN, RN, Clinical Educator, St Luke’s Hospital, Chesterfield,MO; E-mail: [email protected]
Answer 2:A member of our management team has attended depart-ment meetings of prehospital providers to try to build rap-port. “They have enjoyed having us come and listen totheir concerns. We are communicating our priorities andour current initiatives,” says Day Shift Nurse ManagerJason Crouch, RN, ASN, CEN, of the Bloomington Hos-pital Emergency Department. Essentially, we are roundingwith prehospital personnel. The process has been wellreceived, and we have had a decrease in complaints fromour staff and prehospital services.—Sarah Abel, BSN, RN,CEN, Night Shift Nurse Manager, Emergency Department,Bloomington, IN; E-mail: [email protected]
Answer 3:The hospital participates in a cooperative with several localEMS groups. Several years ago, when we were having pro-blems between the ED staff and the EMS, I began attend-ing their monthly meetings at the hospital. They were ableto express their concerns directly to me as the ED manager,and I also could express ED staff concerns with them. Wedeveloped a better communication method for basic life
EXPERIENCE TALKS/Solheim and Papa
500 JOURNAL OF EMERGENCY NURSING VOLUME 37 • ISSUE 5 September 2011
support and advanced life support patients; it was as simpleas putting up a white board with the ambulance numberand room to which they were assigned. In addition, if con-flicts occurred, I spoke directly with the staff and workedwith them to resolve the issues. The last 2 meetings Iattended, no issues were raised by the EMS staff regardingthe ED staff.—Sandra R. Bauman, MS, RN, CEN, NE-BC,Unit Manager, Emergency Department, Ephrata CommunityHospital, Ephrata, PA
Answer 4:First and foremost, we respect our EMS colleagues. Theyare on the front lines of patient care. We welcome them tothe emergency department. When in the past I was anEMT and EMT-paramedic, I received some very negativeattitudes from staff in some emergency departments. Wehave an open-door policy with any EMS director and sharedata that we collect. They are invited to any of the conti-nuing education programs we have here. We also have aquarterly EMS dinner where case studies are presented.The case studies follow patients from prehospital carethrough their ED stay and then onto the inpatient unit(eg, in the cardiac catheterization laboratory and intensivecare unit). We also invite the physician and the patient andhis or her family to attend these dinners. During EMSweek, we intend to have one meal provided for EMS per-sonnel in the emergency department and snacks through-out the week.—Philips Adams, BSN, RN, TSN, CEN,Emergency Department Education Coordinator, WesternBaptist Hospital, Paducah, KY; E-mail: [email protected]
Answer 5:In working with our ST segment elevation myocardialinfarction program, the hospital has developed a feed-back system to provide prehospital personnel with thetimes and outcomes for our patients with ST segmentelevation myocardial infarction. We also have allowedmembers of the EMS team to participate in our traumafellowship. They teach a few of the sessions in the fel-lowship, and we send our fellows with them to ridealong in both ground ambulances as well as on flights.—Jessica R. Chadwick, MSN, CCNS, ACNP-BC, ClinicalNurse Specialist, Inova Fairfax Hospital, Falls Church, VA;E-mail: [email protected]
Answer 6:This year, in observance of Nurse’s Week, Hospital Week,and EMS Week, we decided to celebrate Emergency Ser-vices Spirit Week. Each day, a different activity will cele-brate our team and allow us to have a little fun.
Monday: Celebrate the Team. We will wear our favor-ite sports team shirt, amateur or professional. It’s not
important who the team is—what’s important is celebrat-ing one’s team.
Tuesday: “We’re all in the same boat—climb in!” beachday. We will wear a Hawaiian or beach theme T-shirt, forexample.
Wednesday: I’ve got a secret. We will share a littleknown fact about ourselves and have a contest to determinewho’s who. A special prize will be awarded to the winner.
Thursday: Build a memory. We will bring in a pictureof ourselves at work or out with the ED crew (eg, at aChristmas party or a wedding) and will build a new EDscrap book.
Friday: Celebrate each other day. Each team memberwill draw a name and then write something nice about thatperson. Everyone has something to celebrate. This activitywill ensure that no one is missed.—Terri DeWees, MSN,RN, CEN, Director of Emergency Services, Carteret GeneralHospital, Morehead City, NC; E-mail: [email protected]
Interdepartmental collaboration during trauma
resuscitation
DO YOU UTILIZE NURSING STAFF FROM OTHERDEPARTMENTS TO ASSIST WITH TRAUMARESUSCITATIONS IN THE EMERGENCYDEPARTMENT?
Answer 1:Our Trauma ICU (TICU) responds to all of our adultcode blues (the sicker traumas). This practice has been agreat advantage to the resuscitation. The ICU registerednurse has specific duties to perform in the trauma bay,which has allowed for great collaboration not onlyamong the nursing staff but among all of the membersof the trauma team. I believe one of the biggest benefitsis with regard to the patient hand-off. The TICU regis-tered nurse is present for the entire resuscitation andtransports the patient to the operating room or to radi-ology for computerized tomography; therefore, they havealready completed their complex assessment, and hand-off from the emergency department to the ICU is seam-less.—Jessica R. Chadwick, MSN, CCNS, ACNP-BC,Clinical Nurse Specialist, Inova Fairfax Hospital, FallsChurch, VA; E-mail: [email protected]
Answer 2:I have worked in facilities where an ICU nurse responds totrauma activations. The ICU nurse who would be receivingthe patient or the charge nurse from the ICUwould respond.The role of the ICUnurse would be to obtain amanual bloodpressure and assist the physician with procedures such as theinsertion of chest tubes and central lines.Heor she alsowould
Solheim and Papa/EXPERIENCE TALKS
September 2011 VOLUME 37 • ISSUE 5 WWW.JENONLINE.ORG 501
set up the monitoring for arterial lines and central venouspressure lines. If the patient was stable on arrival, the ICUnurse might be released immediately, but if the patient wasunstable, the ICU nurse would serve as a much-needed pairof hands. The other advantage was that since the ICU nursehad participated in the resuscitation, when the patient wastransferred to the ICU, he or she was already familiar withthe patient. It gave the ICU nurse the opportunity to makeany staffing adjustments or procure any specialized equip-ment prior to the patient’s arrival in the unit.—Beth Conrey,MSN, RN, CEN, Staff Nurse, Val Verde Regional MedicalCenter, Del Rio, TX; E-mail: [email protected]
Reducing boarding in the emergency department
WHAT MEASURES HAVE YOU INTRODUCED TOREDUCE BOARDING OF INPATIENTS IN THEEMERGENCY DEPARTMENT?
Answer 1:Several years ago we developed a system known as “CodePurple.” Code Purple occurs when we have patients in the
emergency department who are to be admitted but havenot yet been assigned to an inpatient room.
“Code Purple Watch” is initiated when 4 admittedpatients are present in the emergency departmentwithout inpatient rooms assignments. “Code Purple”occurs when 8 or more admitted patients are presentin the emergency department without inpatient roomassignments.
This information is sent out to all employees and phy-sicians via E-mail blasts and overhead pages. The codeinitiates a house-wide response. Bedside nurses and nursemanagers work with physicians to see which patients canbe moved to step-down units or non-monitored beds,and housekeeping prioritizes to get these beds cleaned ina timely manner.
When we know beds are getting tight, we work withthe admitting physicians to ensure that the only patientsadmitted to telemetry are the ones who truly need it.The physicians generally are very understanding and willprioritize their admissions as such.—Tonya Whitaker,RN, CEN, Assistant Manager, Gaston Memorial Hospital,Gastonia, NC; E-mail: [email protected]
EXPERIENCE TALKS/Solheim and Papa
502 JOURNAL OF EMERGENCY NURSING VOLUME 37 • ISSUE 5 September 2011