The Wind Beneath Their WingsBWH Nurse - For and about the Nursing Staff of Brigham and Women's Hospital
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April 18, 2001
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In This Issue:
The Wind Beneath Their Wings
Dear Nurse Colleague:
Editorial Advisory Board
BWH Converts to a New Dialing System
Materials Management Spotlight
Beyond The Walls Of BWH
Senator Kerry Visits BWH
Starfish Award Recipients
New Staff Members
Lunch with Matt Van Vranken April 26 • 12-1 p.m.
ON MY SHIFT
In Support of an Ethical Opinion
Web Delivery for New Arrivals
“Organize, prioritize and be accountable,” is the message that nurses often hear from veteran preceptor Ellen Russell, RN. She is among the many nurses at BWH who have taken new nurses under their wing, teaching them standard BWH procedures as well as excellent clinical practices. Last year, nearly 350 new nurses were oriented.
Ellen Russell, RN
Russell’s motivation is focused solidly on the patient. “When patients come to a hospital, they hope and pray that the staff is able to take care of them in the best way possible,” she said. “You must meet the patients’ needs, listen carefully. Maybe you can’t solve everything, but you can reach out and get the doctor, resident, social worker or chaplain involved.” For more than a decade, Russell has served as one of BWH's most highly regarded preceptors, orienting up to 12 nurses a year. Working at BWH for the past 34 years since arriving in Boston from Ireland, she currently is the nurse in charge for 7A (general surgery and telemetry) and 15D (general surgery and orthopedics). Her pearls of wisdom are delivered at a fast clip, keeping pace with the activity of a busy tertiary-care hospital. She counsels nurses how best to manage their time. “First, get organized,” she said. “After report, look in on all your patients to say ‘I’m here, and I’ll be back,’ then go to the computer to review orders. Next, prioritize your patients to determine the best order of care. For example, you might start with a kidney transplant patient who critically needs his urine output monitored, then move to the gastrointestinal patient with an open cholecystectomy with high pain, and finally to the patient with a total hip replacement, whose surgery can be complex, but whose pain may be controlled more with a PCA pump.” According to Diane Hanley, RN, MS, program manager of Nursing Staff Development, learning from a preceptor is the second part of a nurse’s orientation. The first part is devoted to assessing the nurse’s learning needs though tests that measure critical thinking, clinical understanding and interpersonal skills. A customized action plan is developed to guide the person’s individual learning curve. After becoming grounded in equipment use or other clinical skills necessary to the new assignment, two-thirds of the recruits are linked with a preceptor and begin training on the floor.
Martha Griffin, RN
The other third is directed into the new “faculty model” pilot program, headed by Martha Griffin, RN, CS, PhD, also of Nursing Staff Development. This program is designed to teach experienced nurses from other institutions basic computer skills and universal systems at BWH. “For one week, we take the nurses to the unit and teach how to use the SureMed drug dispensers, enter orders, compose text, retrieve laboratory values and do discharges and referrals,” said Griffin. The nurses then join their preceptor on the unit.
Susan Delaney, RN
Susan Delaney, RN, staff nurse and long-time preceptor on the medical units of 14AB and 15C, found the faculty model program invaluable in orienting her latest trainee, Robert Cullenton, RN. “He already had his computer key code and could maneuver through the system fluidly,” she said. “It allowed us to focus immediately on patient needs. At BWH, this can be quite a steep learning curve because, compared with community hospitals, our patients are quite sick.”
Judy Brown, RN
Being a preceptor sometimes involves orienting people from another part of the hospital. “The dynamics of the new unit can be quite different,” said Judy Brown, a night postpartum nurse on the 8th floor of the Connors Center for Women’s Health. “For example, someone who typically cared for four to five critically ill patients in the surgical step-down unit needs to adjust to having six mother-child couples-a total of 12 patients—and that can mean new challenges in time management. How the nursing staff and physicians interact also may be different. Not having residents readily available on the floor, we ask our nursing colleagues to verify our judgment, contacting a physician only for more urgent situations,” said Brown. Brown has been a nurse for four years and a preceptor during the past year. “I really enjoy it,” she said. “It requires patience and sometimes knowing when to step back to allow the trainee to think about the issue at hand. It's also important to understand that everyone learns differently—by reading, watching and doing.”