The nominator has worked alongside the nominee for over 11 years.  While all the Duke values are exemplified by the nominee, this story about her passion for end-of-life care shows her commitment to do the right thing for her patients.  She cared for a dying patient who had three daughters at the bedside.  The nominee knew the patient was actively dying, and advocated for comfort medications once the nominee discussed the patient’s wishes with the providers.  The nominee had a very honest conversation with the daughters.  They had expressed how their loved one would not want escalation of care.  The nominee spent time with the daughters describing the changes in the patient that may happen in the coming hours.  “The daughters trusted me and my experience to help transition this special patient through the end-of-life experience.”

Throughout her career on our unit, she has been a resource to all staff because of her knowledge and experience in all the nursing roles.  She is a policy expert and is often consulted for clarification of nursing practice because of her active participation in the Clinical Practice Committee.  One of her Clinical Ladder projects included a 41% increase in compliance with initiating nursing care plans and personalizing patient interventions.  As a Skin Care Champion, she developed bulletin boards and provided staff in-services to improve care of our patients’ skin.  Her work with these two areas ultimately led to an invitation to serve on the DUHS Flowsheet Work Group, which improves the nursing flowsheets and documentation in the electronic health record (Maestro Care/Epic).

Our unit hires a high number of new nurses each year.  Our nominee developed a Survival Guide to help the new nurses transition from student to nurse.  This remarkable document shares “Who’s Who?” on the unit, and includes policy, medication and patient education resources.  The document provides information on dressing changes, drains and tubes common in our patient population, then gives documentation tips.  The document also includes a very helpful section on hospital safety.  The guide is not meant to discourage questions, but to encourage them!  Our nominee is so innovative that she is working with Information Technology colleagues to develop a unit app where this Survival Guide would be available online!

The nominee knows who to bring to the table when patient harms occurred too frequently on our unit.  Our unit welcomed a new Clinical Nurse Specialist (CNS) who wanted to find a way to engage with staff.  The nominee brought the CNS together with the Infection Preventionist (IP) to develop weekly rounds looking at the care of patients’ central lines.  Our nominee participates in the rounds to find the opportunities for improvement, and is a trusted member of the collaborative team who helps build communication between the CNS, IP and staff.  In just a few weeks, “wins” have outnumbered “opportunities” that we hope will reduce patient harms.

Our unit recently experienced a change in Nurse Manager.  The nominee assisted the new manager with developing a more efficient way of managing the staff schedule.  One of the biggest staff satisfiers is the flexibility of scheduling.  As a longtime member of our unit, the nominee was the trusted staff member who provided a collaborative bridge between staff and the new Nurse Manager, facilitating a smooth transition related to staff scheduling.

Our nominee provided many years of direct care for patients and mentored numerous new nurses as Preceptor.  The progression of her nursing practice is from intentional work.  As a result, she is an important resource on our unit … the one who knows.  In her current role as Assistant Nurse Manager, she collaborates with nurses to develop initiatives that improve the well-being of our staff.  Our unit experiences several patient deaths each month.  Many times, staff are unprepared for the grief they feel after losing patients.  Our nominee provided support by listening to their experiences, and arranging for hospital resources like group debriefings.  All these things enabled our nurses to process this grief.  Recently, a few nurses decided to form a unit-level Grief Support Group.  Our nominee is working with these nurses to set up regular “check-in” times with staff and experts to facilitate further discussions.  The nursing work of our unit is incredibly busy, so the support of this group by the nominee speaks to the supportive and positive impact she has on our staff.

Our nominee’s innovative approaches to nursing practice, and her caring spirit for patients and staff, make her a model of nursing excellence.