Ciarra Ashley

FON Photos edited x Ashley

Ciarra Ashley


Nurse Manager

Cardiothoracic Stepdown Unit DMP 6 East

Duke University Hospital


Heart Center Award for Excellence in Cardiovascular Nursing in Recognition of Mary Ann Peter
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Congratulations to Duke University Hospital’s 2021 Friends of Nursing Excellence Award Winners


Ciarra became the Nurse Manager of the Cardiothoracic Stepdown Unit in August 2021.  She has worked on the unit since 2012, first as a staff nurse, and then as a Clinical Lead.  She is dedicated to incorporating evidence-based care onto the unit, and takes time to explain the “why” to staff and patients.  She empowers staff, mostly by being a facilitator for the Clinical Ladder process.  A supportive leader, she brought new and seasoned staff together to build a positive work culture.  She has always felt that 6 East is her family; and she guides her staff to be the best that they can be.  Ciarra has been a true change agent, ensuring the unit’s forward progression.


This nurse is a role model of integrity, she is always honest, gracious and trustworthy – not  just with patient care, but with staff as well.  When a tough situation is presented, she approaches it with grace, respect and patience that we all strive for.  She always highlights her team members’ accomplishments and continuously encourages others to get to their goal.  She prioritizes the accomplishments of others even more so than her own. This nurse is also a reliable leader, staff can always count on her to be there for them in times of need, whenever staff have a question, and is always accountable for her actions.


For her CNIV project, she created the Dual Skin Assessment where two nurses assess the skin of a patient upon arrival to our unit – including procedures that require the patient to be off the unit for more than four hours (e.g., dialysis).  This process is used across many units within our specific patient population and has prevented many pressure injuries and prompted care for skin wounds that may have been noticed later.  After implementation, the unit went more than two years with zero avoidable pressure injuries as a result of this assessment process and collaborating with our wound care nurses for prevention methods.  She went on to become manager of the unit and has made great changes with staff retention, staff well-being, improving unit leadership communication with staff, and building trust with staff members.


During her involvement on the Unit Orientation Committee, she recognized that new nurses were having difficulty understanding specific topics related to patient care.  When she became the Clinical Lead and was fully responsible for onboarding new staff, she created the unit’s passport.  This passport guided new hires to meet with champions from multiple committees as well as CNIIIs to review patient topics such as diabetes, hospital-acquired infections (HAIs), falls/MOVES, scheduling, etc.  The staff reported having a better understanding after utilizing the passport, and it is still used with new hires today.  She also recognized that new hires didn’t find the large notebook supplied to them with orientation documentations helpful.  She created a QR Code that is used to easily reference the notebook without the physical papers.


This nurse is always willing to help out anyone in need. When she walks the halls, she  stops whatever she is doing if someone in need. This is a very busy unit and the patience and willingness to stop and help anyone speaks to the integrity of her collaboration.  She makes an impression on the patients she speaks to.  She is always so great at making those who are nervous or scared feel at ease.  When she interacts with the staff, she is so personable that she can get even the most introverted person to open up and talk.  This nurse also has strong relationships with interdisciplinary colleagues.  Many times, a provider will ask her for an opinion or advice on a problem.  She makes herself available and is always approachable by all disciplines.


As the unit manager now, this nurse takes great care in listening to the needs of each and every staff member.  She has come to understand that each person has a different way of processing, accepting, learning and receiving feedback.  She can sit with five different people, each with a completely different personality and at the end of the conversation each person will feel that their needs were met.  She has a way of listening to a person, relating to them, giving them praise and constructive criticism all while focusing on their personal and career goals.  She is welcoming, approachable and staff feel supported by her.


This nurse exemplifies the values of a Duke Nurse through her caring nature, positive spirit and culture of safety.


Friends of Nursing Gala 2021

Friends of Nursing Gala 2021

Friends of Nursing Gala 2021