Nurses Making a Difference Jose Santos Martinez Melena, RN, CRN, Diagnostic Imaging
Born and raised in Mexico, Jose Santos Martinez Melena (“Santos”), RN, CRN, Diagnostic Imaging (DI), graduated from Veterinary school in 1987. When he came to the U.S. two years later, he had to learn English as well as decide on a career. “I talked to a counselor at Hartnell and she suggested I consider nursing,” he says.
Santos came to SVMHS in 1993 where he worked in housekeeping and then as a clerk in the Emergency Department. At the same time, he attended Hartnell’s nursing school, graduating in 1998. After working at Natividad for two years, he rejoined SVMHS as a nurse in the Cancer Center. It was there that Gail Babcock, MSN, RN suggested he become a Reiki practitioner. “I didn’t even know what Reiki was and wasn’t interested,” he remembers. “I finally said yes and after the first day of class, my whole view of it changed.” Santos has been a Reiki master—the highest level—since 2004. “I use Reiki with my patients and co-workers to reduce anxiety and help them relax,” Santos says. “It also keeps me centered.”
A profound influence on Santos’ life was a tragic car accident in 2003 that took the life of one of this three children—eight-year-old daughter Katherine. “The next year I was invited to assist in a Reiki masters course on Maui,” he recalls, “and I decided to take my family with me. During an exercise, another participant asked if I’d recently lost a loved one, a girl. When I told him about my daughter, he said, ‘she’s standing right by you and wants me to tell you that she’s with you all the time.’ That changed my world and helped take care of the grief.”
Santos has gained broad nursing knowledge and experience by caring for patients in several hospital units including telemetry, endoscopy, the Heart Center, the Cancer Center and DI. “The more I learn, the more I’m prepared to provide the best care to my patients.” He moved to DI in 2008 and became a certified radiology nurse (CRN) in November 2009. “Certification is a great way to grow in your specialty and it makes you more of a leader,” he says. He also joined the Association for Radiologic and Imaging Nursing.
Santos is the co-chair of IMAGE, Diagnostic Imaging’s Unit Practice Council. Last October he joined a team led by Laura Bomarito, RN on a mission to Malawi. “I’m ready to learn and take on new experiences whenever opportunities come up.”
No One Dies Alone (NODA)—now available at Salinas Valley Memorial Hospital—is a program for patients who are within 48 to 72 hours of death and do not have family or friends in the area. It was developed by a nurse at Sacred Heart Medical Center in Eugene, Oregon following her personal experience with a dying patient. One of seven patients she was caring for that day was a man who was very near death and had a DNR. During her initial rounds, he asked barely audibly, “Will you stay with me?” The nurse replied, “Sure, as soon as I see my other patients.” Checking vital signs, administering meds, checking charts and doing assessments for her other six patients took about 90 minutes. By the time she returned to the man who had made the request, he had died. “He had a DNR, no family, was very old and was dying of multi-organ disease,” the nurse recalls. “It was time for him to die, but not alone. I created NODA so this would not have to happen to another patient.”
Today, there are NODA volunteers throughout the country—including eight at Salinas Valley Memorial—who provide comfort and support for people who are in the process of dying. SVMHS NODA volunteers complete specialized training and have access to a variety of resources such as music CDs and readings they can use with patients. The current group of volunteers range in experience from a woman whose husband recently died to a faith-based nurse practitioner. They share a commitment to ensuring that no one dies alone.
When a NODA code is called by the nursing administrative supervisor, a call goes out to the volunteers. Volunteers are then scheduled to provide around-the-clock coverage for the following 48 to 72 hours for the patient. If you have a patient within 48 to 72 hours of death who has no family or friends nearby, please ask your administrative supervisor to activate a NODA code. If you are interested in volunteering for the NODA program during your non-work hours, please contact Volunteer Services at 755-0772.
After working as a traveler at SVMHS, Ludy Lim, MSN, BSN, RNC, Mother/Baby joined our nursing staff part time in late 2007. “I thought I would stay for one contract and move on,” remembers Ludy. “But I really love it here. Nurses are regarded as true professionals and we are invited and expected to be involved in improving care and safety for our patients.”
Born in the Philippines and growing up with brothers who are doctors, the 2009 Nurse of the Year nominee always knew she wanted to be in the medical field. She decided on nursing and earned her BSN from Medina College, Ozamiz City, Philippines in 1989 and moved to the U.S. in 1991. Five years later, she graduated from Texas Woman’s University, Houston with her MSN.
Ludy says she was drawn to her specialty because she enjoys caring for babies—her area of focus for 17 years. “The night shift team works well together,” she says. "We rely on each other, especially when it gets hectic.”
She has served on the Medication Safety Committee since January. “eMAR-BMV has improved medication safety a lot, but there’s always more to do,” says Ludy. In her spare time, she enjoys running and often participates in marathons.
With the upcoming change to Meditech Client Server 6.0, all SVMHS email access is moving to Outlook. As soon as everyone at SVMHS—staff, volunteers and physicians—has been issued an Outlook account and trained in its use, MOX will no longer be available. Since nursing is the largest hospital department, special testing and training efforts were needed. A team including Doreen Faiello-Burnett, RN, MHA, Ginny Williams, MSN, RN and Alicia Lerma, IT project coordinator developed a process to educate nursing staff. Staff nurses Molly McCarty, BSN, RN-SNIII, Kim Stewart, RN, Laurence Perras, RN and Edel Hernandez, RN worked closely with IT to test the process. Several technical issues were discovered and IT was very responsive, making adjustments to smooth the nursing staff’s transition to Outlook. Gloria Lochridge, MSN, RN, FNP and Jeff Sevey, RN of the education department are assisting with house-wide training efforts and Annie Gonzales, IT project coordinator is working to make sure everything goes smoothly from an IT perspective. Super-users are being identified and will help with training and answering questions. We anticipate completion of the transition by end of May 2010.
IMAGE – Practice Council for DI
Diagnostic Imaging formed IMAGE—I=Improve, M=Maintain, A=Accountability and Awareness, G=Growth, E=Excellence—its Unit Practice Council in December 2009. IMAGE has four members including Cee Cee Alejandro, RN, chair; Jose Santos Martinez Melena, RN, CRN, co-chair; Laura Ruff, RN and Marylou Castro, RN. The initial focus of the Council is to standardize patient criteria for PICC lines and create a pop up window that a line should be ordered. Since DI nurses do PICC lines for all patients, they are also working to raise awareness among all patient care staff of the lab values and criteria that indicate the need for a PICC line.
SSOP Launch of eMAR-BMV
The SSOP department implemented eMAR-BMV in October 2009. The conversion from the former method of medication administration using a paper system to the eMAR-BMV system was successful. “It has been amazing to see the value and the safety that this system provides for our patients,” says Debbie Ralph, RN, AHN of SSOP. It’s exciting to explain to our patients how using this electronic system prevents the most common medication errors and provides an additional level of safety.”
International Ortho Nurses Day
Last year’s Orthopedic and Spine Education Faire, held October 30, drew 93 people—including nurses from ONS and other units as well as many Hartnell nursing students. Participants enjoyed informative presentations on Trends in Spinal Surgery by Christopher Carver, MD; Lumbar Stenosis by Theodore Kaczmar, MD; and Gender-Specific Joint Replacement Surgery by William Parker, MD. A Q&A session followed each presentation and vendors showcased the latest innovations in spine, hip and knee care technologies. Also in celebration of International Orthopedic Nurses Day, ONS nurses presented a card and a flower to their patients. With a donation from physicians at Precision Orthopedics, a meal was provided for ONS staff who were working on the unit and could not attend the Faire. Meghan Kelly, BSN, RN, Lourdes Escolta, MSN, RN, CMSRN, ONC and Tanya Osborne McKenzie, MSN, MBA/HCN, BSN, RN, CCRN, teamed up to organize the successful event.
New uses of eMAR-BMV
eMAR-BMV is now used to document patient education when anticoagulation medications are administered. “When we give these mediations, a screen appears to record the patient education,” says Kathryn Maurer, RN, Float Pool, who helped implement and test the education application. If the nurse wants the patient to have a conference with a dietitian or a pharmacist, a message is sent electronically to that department. Patient Care Champions were trained on the anticoagulation education documentation in January. Another new use of eMAR-BMV is to document the date of pneumonia vaccine administration. The date the vaccine is given is recorded or, if the pharmacy determines the patient already received it, a different entry is made on the eMAR. The RN documents this with the date the pharmacy provides. Because this is an electronic record, if that patient is readmitted to the hospital, the retained information is easily accessed. “These first steps use technology to improve patient safety,” Kathryn says. This patient care improvement is the result of collaboration between the pharmacy, nursing and IT.
Nursing Grand Rounds Lecture Series
A new Nursing Grand Rounds (NGR) lecture series—coordinated by the Evidence Based Practice Council’s Grand Rounds Committee is being spearheaded by Lorraine Shields, RNC, CNS and Julie Vasher, MSN, RNC-OB. The inaugural speaker, Dorothy A. Jones, EdD, RNC, FAAN, Director of the Yvonne L. Munn Center for Nursing Research at Massachusetts General Hospital and a Professor at Boston College William F. Connell School of Nursing, was held February 25. The presentation was titled, Communicating the Voice of Nursing: Linking Nursing Language, Evidence Based Practice and Knowledge Development. NGR lectures draw on the expertise of renowned nursing leaders to advance nursing knowledge on topics applicable to SVMHS. The NGR lectures include a brief overview on how the speaker’s topic is being addressed at the hospital, followed by the guest lecturer who will highlight related research perspectives.
National Nurses Week Poster Expo
Once again this year National Nurses Week at SVMHS will feature a Poster Expo. The posters will highlight some of the performance improvement and research projects led by SVMHS nurses. Here are just a few of the subjects to be showcased:
Strategy for Improving Outcomes for Non-English Speaking Patients
Improving Pediatric Patient Care Through Enhancements to Staff Awareness: The Broselow Crash Cart Initiative
A Model Decreasing Patient Falls and Nursing Calls Through Collaborative Rounding
Join us in honoring nurses during National Nurses Week—May 6 to 12—and celebrating the great work of nurses here at SVMHS. More information is coming soon.
NICU move to towers
Our Neonatal Intensive Care Unit (NICU) has moved to the Towers. The NICU will be located here for the next 18 months while construction is completed on the third floor.
Parking for staff of SVMHS and medical offices adjacent to our campus is now in the “Blue Lot” on Abbott Street. A shuttle service runs on a regular basis between the Blue Lot and the SVMHS campus. On street parking in the neighborhoods that surround the hospital campus—one-quarter mile in all directions—is now limited to residents who have been issued parking permits. Click here for shuttle schedule.
Michelle Limo, RN, MSMIT, CCDS and Susan Borrego, RN, MSN, CCDS, Clinical Documentation Specialists at SVMHS, earned the Certified Clinical Documentation Specialist (CCDS) credential in May 2009. Michelle and Susan are two of the first to earn CCDS and among only 128 certified Clinical Documentation Specialists nationwide.
Susan Hall, RN graduated from nursing school at Cabrillio College in 2007 and came to SVMHS the same year. “I interviewed several places and found SVMHS to have the best training program,” says Susan. “I thought it was exceptional…and still do.” She works in the 4th/5th Towers and gets to float to Level II and Heart Center. “I love the change, meeting new people and gaining new patient care experience that floating provides.”
Born and raised in Alaska, Susan was the caregiver for several family members who had cancer. “The chief of hematology where my relatives were treated suggested I consider being a professional caregiver,” recalls Susan. That profession has taken her to many states and other countries. “I’ve moved 27 different times and still love traveling and exploring other cultures.”
Susan has been chair of the Towers Clinical Practice Council since its October 2009 inception. “We surveyed everyone who works at the bedside,” she says, “and are now in the process of choosing our EBP projects based on that input.”
In her leisure time, Susan enjoys traveling, hiking, practicing Yoga, cooking and spending time with friends and family.
One local family got early Christmas presents last year—triplets. The boys were born December 21, 2009 at 32 weeks gestation. Highly trained practitioners from throughout SVMHS participated in the planning and delivery including NICU nurses and NICU respiratory care practitioners (RCP), labor and delivery nurses, surgical nurses, physicians, RCPs, educators and pharmacists. While it wasn’t the first time triplets have been delivered at SVMHS, it was the first time all three infants were able to stay in our NICU. NICU nurses and RCPs trained on the SimNewB™—the infant simulator in our Experiential Learning Center—and were well prepared to handle the babies’ special needs.
A multi-disciplinary team—led by Robert Castro, MD, Director of our NICU—worked together for several weeks to plan, coordinate and participate in the scheduled delivery. We’re proud of all of the professionals who helped bring the triplets safely into the world.
Robert Castro, MD, Neonatologist, NICU Director
Greg Glasscock, MD, Neonatalogist
B Watkins, MD, Obstetrician/Gynecologist
Norman Nelson, MD, Obstetrician/Gynecologist
Richard Sugar, MD, Anesthesiologist
Letter from Dr. Castro to Sharon Roberts
I am deeply grateful to the entire NICU staff for their professionalism and expertise during the planning, admission and delivery of premature triplets on December 21, 2009. And to my colleagues, Greg Glasscock, MD and Carl Yaeger, MD, who made themselves available during the preceding few weeks in the event an emergency delivery was necessary. Dr. Glasscock attended the deliveries with me and he was invaluable. I also want to acknowledge and thank Operating Room, Labor and Delivery and Mother/Baby staff who were important members of this team.
Afterward, I remember telling our nursing and respiratory care educators that it was if I were at a teaching hospital overseeing the work of experienced staff and fellows. And I told myself how fortunate I am to be working with such a diligent group of healthcare practitioners.
Robert Castro, MD
Director, Neonatal Intensive Care Unit
Last year, we initiated the first phase of the Healing Zone—new visitor policies that help prevent the spread of H1N1 and other infectious diseases as well as create an environment of healing for our patients. Here are excerpts of comments we’ve received from our nurses about the visitor policies:
The new visiting policy benefits both nurses and patients. Patients have a quieter, more healing environment that speeds their recovery. Nurses are able to get more done so the care we provide is improved. —Serena Ramirez, RN, ONS
With infection rampant in the community, we need to protect our patients as well as our own staff. It creates a quieter atmosphere that gives patients a chance to rest and recover. —Sandra Bear RN, BSN, Clinical Data Team
The new visiting policy is the “best thing since sliced bread.” I love it. It affords us a way to keep a safe, clean environment for the patients and staff. I think the community understands and appreciates it. —Tonia Giampaoli, BSN, RN, AHN, Heart Center
The new visiting policy is exceptional as a way to decrease infection and raise community awareness. Certain cultures consider visiting sick family members an important way to show love and support. As nurses, it’s important for us to let family members know that the visiting policy is in place to aid in their loved one’s recovery and healing; that it is ultimately in the best interest of the patient. —Susan Hall, RN, 4th/5th Towers
The environment during the PM shift is wonderful with the addition of the new visitor policy. Each night we all comment on how quiet the floor is and what a HUGE difference it has made for our patients, and for us. Thank you. —5th floor nurses, PM shift
In this and future issues of SVMHS Nurse e-newsletters, you’ll find links to information that is good for you and your patients—from support groups, education classes and key healthcare services that you can use to extend the continuum of care for your patients and their family to news, events and volunteer opportunities for you.
For information on support groups, classes, community lectures and more, click on