Kathy McMillan, BS, RN joined SVMHS in 1991 as a discharge planner working in critical care areas. Discharge planning was later merged into case management and Kathy has been a case manager (CM) assigned to the Emergency Department (ED) since 2006. A Southern California native, Kathy graduated from Riverside College nursing school in 1973 and went on to earn a BS in entomology. When the family moved to Brawley in the Imperial Valley in the early ‘80s where her husband farmed, she took a job as a nurse at a small hospital there. “After working in critical care for a couple of years, they asked me to take on discharge planning,” she says. “It was a great opportunity for me to learn a completely different type of nursing.”
“Case management in the ED is different from case management on other units,” says Kathy. “While CMs typically have a day or two to work on a plan, we might have 15 to 30 minutes to identify needs and resources so our patients can be safely and appropriately discharged.”
“Many ED patients don’t require hospitalization, but still have significant needs,” says the 2009 Nurse of the Year nominee. “People who’ve just been diagnosed with diabetes, for example, need a lot of education so they can manage their condition. Much of my work is connecting people to resources.” Kathy’s day is filled with a variety of challenges from helping people without insurance find payment sources and connecting homeless individuals with resources for shelter and clothing to locating alternative living arrangements for elderly patients who can no longer safely stay in their homes and providing crisis management for patients and their families. “I love taking on the complex cases where I can dig in and find resources that lead to happy patients and family members, physicians and nurses,” she says. “I like knowing that I’m part of the team.”
Kathy and her husband have raised six children—one daughter and five sons, including three adopted children with special needs. They also have five grandchildren—all boys! “Having so many boys in the family, I’ve grown to enjoy sports of all kinds, especially water sports,” Kathy says. “I recently joined a “boot camp” exercise class and every day we do something different—just like my work in the Emergency Department.”
This year’s flu season brings with it the additional challenges of a new virus—novel H1N1 (swine flu). The World Health Organization, CDC and the California Department of Public Health have issued recommendations to help prevent the spread of H1N1 in the hospital environment. The SVMHS Infection Control Committee decided to adhere to the stricter guidelines of the CDC. Education and implementation of special precautions to prevent the spread of H1N1 involved collaboration between physicians, clinical staff, the Infection Control Department, administration and employees throughout SVMHS.
Plans to deal with staffing issues, surges in patient admissions, supplies and communications have been developed at the administrative and department director levels based on three tiers of pandemic influenza severity.
Tier 1—We are seeing an increase in number of patients, but not increased employee absenteeism and our operational level is at a near normal level
Tier II—We are seeing additional increases in number of patients with increased employee absenteeism, but can maintain efficient operation of the hospital with moderate interventions
Tier III—We are seeing a patient load that is straining operations combined with increased employee absenteeism
Some of the activities around H1N1 include:
Two RNs volunteered to work with Infection Control to educate healthcare staff on isolation and hand hygiene, and help with environment of care rounds and other issues that impact transmission of influenza.
Employee Health is providing both seasonal influenza and H1N1 vaccinations for all direct patient care providers and employees at high risk of influenza. These vaccinations are vital to infection prevention and protect healthcare providers in the hospital, at home and in the community.
Allen Radner, MD, a specialist in infectious diseases, presented a seminar for SVMHS staff and physicians about H1N1 that was taped and is currently available on the Physician Portal at svmh.com. He spoke at the Monterey County Health Education consortium on H1N1 held at the Monterey Institute of International Studies September 9. About 240 people attended including several nurses and respiratory therapists from SVMHS. He also sent a memo to all staff and physicians explaining some of the difficulties faced in dealing with the unknowns of this pandemic.
Patient Care Champions coordinated with Infection Control to educate nurses on enhanced isolation and screening processes to identify and isolate infected patients earlier.
Town Hall Meetings were held on Wednesdays in September to give employees the opportunity to ask questions of Jessica Hilburn, SVMHS Director of Infection Control and Prevention.
Forms, checklists, guidelines and other communications are available on MEMNET.
Each of us needs to continue to be diligent with hand hygiene and respiratory etiquette to prevent the spread of H1N1 between patients and staff at SVMHS.
Lindsey Macbeth Hymes, RN, CLC graduated from South College of Nursing in her native Glasgow in 1988. Visiting her brother in California in ‘97, she acted on his suggestion to relocate to the U.S. “I went home, quit my job, sold my house and moved here,” she says. She worked in pediatrics at SVMHS as a traveler before joining the staff full-time in 1998. “I’ve wanted to be a nurse as long as I can remember. During school, I did a rotation in pediatrics and loved it.” She went on to complete post-graduate courses in pediatrics at the York Hills Royal Hospital for Sick Children. “It’s especially rewarding to see kids get better and show their appreciation with hugs and with pictures they’ve drawn.” She enjoys educating parents and helping new moms learn how to breastfeed. Lindsey has served on the Pediatric Practice Council since July this year. “Pediatrics is a small, cohesive unit and I want to do what I can to improve things for our patients and nurses.” She and her husband live in Aptos with their children ages 5, 8 and 10.
Max Zabala, BSN, RN
Right after graduating from San Diego State with a BSN in 1979, Max Zabala, BSN, RN joined the staff of our Emergency Department (ED). Three years later, he left to serve in the U.S. Air Force where he was a nurse at a military hospital. Max returned to Salinas Valley Memorial’s ED in 1985 while serving in the USAF Reserves as a flight nurse. He was called to active duty and served in Desert Storm December 1990 to April 1991. Max moved to the Post Anesthesia Care Unit (PACU) in 1987. “Critical care experience is essential to working in the PACU,” says Max, who shares AHN responsibilities with Jeanne Hayashi, RN and Debbie Avilez, RN. “These skills are especially important during the first five to ten minutes after a patient’s surgery and because the number of patients can change quickly from one or two to ten or more in the space of an hour. The nurses on the unit are very close and watch out for each other. We have to be ready for anything.” One of Max’s two daughters, Arica Lagasca, LVN, also works at SVMHS and will graduate from Cabrillo College’s nursing school December 20. He enjoys mountain biking, traveling and throwing tailgate parties at football games.
SVMHS Nurse takes the gold
Earlier this year, SVMHS Nurse was honored with a gold Aster Award for Excellence in Medical Marketing. This award is a testimony to the creativity and dedication of the nurse-led newsletter committee that works year-round to showcase the accomplishments of our nursing team. Congratulations!
NICU Receives Grant
Our Level III NICU received a $100,000 grant from The Hearst Foundation, thanks to the efforts of Sam Downing, Bev Ranzenberger, Dr. Perrott, Dr. Glasscock, Sharon Roberts and John Meyer. “We will use the funds to purchase stabilization equipment, including a specialized ventilator, for use with newborns,” says Sharon Roberts, MSN, RNC, CNS, Director of NICU and Pediatrics. “We are proud to collaborate with the Respiratory Care department whose professionals will provide care using this ventilator. This new equipment enables a variety of modes of ventilation that we didn’t have before.”
Trail Rides Benefit Experiential Learning Center
This spring the Salinas Valley Memorial Hospital Foundation presented its 20th annual Men’s and Women’s Trail Rides, raising thousands of dollars to support hospital services. The $108,572 raised through the 2009 rides was given to the SVMHS Education Department’s new Experiential Learning Center. “This extremely generous donation allows us to purchase equipment to be used in training nurses and other SVMHS staff,” says Rachel Failano, MSN, RN, Clinical Simulation/Skills Lab Coordinator. Some of the equipment to be purchased includes a Laerdal SimMan 3G—a totally remote-operated adult patient simulator; a fully stocked training crash cart and a Workstation on Wheels. “We are very grateful to the Foundation and to everyone who joined in the 2009 events.”
SVMHS earns Get With The Guidelines Award for third year
For the third year in a row, Salinas Valley Memorial was honored with the Get With The Guidelines, Coronary Artery Disease Gold Performance Achievement Award by the American Heart Association. This award recognizes the dedication and success of our heart care team in providing excellent treatment for our patients with coronary artery disease. Congratulations to our nurses, medical staff and other professionals who work to achieve this higher standard of care every day.
This summer, the NICU Unit Based Practice Council (UBPC) began the process of developing a cue-based feeding protocol for babies in the NICU. “As part of our Level III California Children’s Services certification, we reviewed many of our practices,” says UBPC member Debbie Thorpe, BSN, RN. Julie Akin, RN, also a member of the UBPC, took the lead in gathering the evidence and organizing the information presented in the literature. Occupational/Physical therapists and Lactation Consultants are working closely with the UBPC to draft the protocols that will soon be presented to SVMHS neonatologists. “Development of nipple feeding is a complex skill and progression to full oral feedings requires an individualized approach based on the infant’s physiologic and behavioral status,” says Julie. “Development of a cue-based feeding protocol will allow the infant to determine his readiness to nipple feed. Evidenced based literature shows that feeding protocols reduce the number of days babies need to stay in a NICU, increase the success rate of breastfeeding, and can affect development well into the baby’s future.” The approved protocols will be implemented in 2010.
Q:What are the major benefits of eMAR-BMV to your professional nursing practice?
A: Using eMAR-BMV is like having someone watch my back when I’m administering medications. It’s a systematic way to double check everything and I’m alerted when I need to check something further. The system enhances both nurse and patient safety and it is very efficient. Patients have commented that they can see we’re taking special care to make sure they’re safe. With eMAR-BMV, I spend more time at the bedside with my patients, talking to them while providing medications. It gives me a safety check before giving medications with pop-up alerts on recent lab values, asking me to check blood pressure and heart rate before giving blood pressure or cardiac medications. It also reminds me to do a double independent check with another nurse for high alert medications. —Maybelle Peters, BSN, RN, Ortho/Neuro/Spine
A:eMAR-BMV is a great patient safety tool that helps us avoid medication errors. And it streamlines the process which helps with time management. Using eMAR-BMV still requires our critical thinking and full engagement in the process. Last week I had a patient who was prescribed extended release blood pressure medication. When I scanned it, the system alerted me that it was not extended release so I was able to get the correct form of the medication. It picks up everything. As a RSU on several units during the roll-out, I was adept at helping other nurses identify errors and solve problems. I found it interesting that when I started using it myself, I had the same challenges. The fact that we had nearly 100 percent of our nurses scanning both the medications and patient IDs in the first two days was impressive. It shows the dedication of our nurses and their commitment to their patients. —Maryanne Conklin, RN-SNIII, PCCN, Level II