2023 AWARD WINNERS
Nicole “Nicki” Murray Coates
Nicole “Nicki” Murray Coates
BSN, RN, OCN
Clinical Nurse III
Duke Cancer Center of North Durham
Duke Regional Hospital
DNP, NP-C, AACC, FAANP
Nicki is the most tenured nurse at the Duke Cancer Center of North Durham. With 30 years of nursing experience, she is a wellspring of knowledge. And, she knows everything about how our unit functions, provider preferences and staff strengths. She is truly the glue that keeps our patients and their treatment plans together. A story to illustrate the impact this nurse has on a very vulnerable population: A longtime patient was sent from the clinic to the ER, and was actively dying. The patient was admitted, and then paged the Physician at 6:30 a.m. When the doctor answered the page – the patient was actually trying to find a way to say “Goodbye” to Nicki; of course, Nicki went upstairs to visit the patient.
This nurse comes to work every day with the patients at the front of her mind. She is as selfless as they come, and treats every patient like her own family member who is dealing with a life-threatening illness. She will stop at nothing to ensure the patients are well informed and receiving the best care. To provide an example: I once walked to her desk to find her listening to a voicemail from a patient. The message was garbled and made no sense whatsoever. To me as an outsider, it sounded like a misdial, and people were talking in the distance. But this nurse knew from the caller ID that this patient did not sound right. She knew this patient had a history of strokes, and that they were experiencing new aphasia. While the nurse tried to talk to the patient, she had another nurse call the patient’s family to make sure the patient got emergency care to her home. This is an example of how crucial it is that this nurse knew her patient and was able to spot — even through telephone triage — that something was dangerously different. She has expert assessment skills and will always do the right thing for the patient.
This nurse is a CNIII with 30 years of nursing experience. She is working to finish her BSN (completed May 2023). She has an Oncology Nursing Certification and Chemotherapy/Biotherapy certificate. She is the unit’s Infection Prevention Champion and a Preceptor. Above all of this, she is the most tenured nurse in the department and is a catchall for information. She is a teacher and supporter of all. She is constantly looking for ways that things can be done better and to improve efficiencies. She will take new staff under her wing to ensure they are comfortable, and teaches in a way that meets people where they are. She is knowledgeable about how our unit functions, provider preferences and staff strengths. You can ask a question and it’s very likely the answer will be “Ask ___!”
This nurse is currently working on a project where she is studying oral chemotherapy patient assistance programs. The goals are to identify barriers to learning, and teach staff how to counsel patients and assist them in applying for free oral chemotherapy drugs. Since chemotherapy can cause “financial toxicity” for patients, this is truly a project that can save lives and livelihoods. She identified this need on her own and asked if she could start this project.
She was also the inspiration for a project, which was then expanded by our Clinical Nurse Specialist (CNS). She would perform a “vein assessment” on patients needing to start chemotherapy, as she is the clinic’s go-to for IV placement. This helped the MD determine if the patient could start their treatment with peripheral access, or if they should be sent for an implanted port. When the CNS saw this process, she implemented this practice at our other facilities at Duke.
When asked about this nurse, one Physician said “She is EVERYONE’S nurse, no matter their diagnosis!” Our department serves five specialty areas, and she is only technically hired into one. However, any team member can approach her for a question, and she is eager to inform and give the answer. With a department that has so many specialty areas, it is common that our patients are being seen by multiple providers in different departments at the same time. This nurse never lets a ball drop on even the most complex cases. She is the contact person for getting our patients anywhere they need to go. She has a contact for just about everything in the hospital. She has a task list to keep track of which patients need follow-up, and will check in with them without prompting from the Physicians. She is truly the glue that keeps our patients and their treatment plans together.
Caring is this nurse’s specialty. They are the first to enter the building and the last to leave. They make the patient feel as though they are the only priority. This nurse is an advocate for patients and gets to know them so they can be best served by our team. An example of this is when a Physician ordered an ultrasound to rule out a deep vein thrombosis (DVT) for a patient. Once the DVT was confirmed, the patient needed to be started on an anticoagulant. The nurse knew the patient had concerns with cost/insurance. At 5pm, the nurse was calling all of the local pharmacies to determine which would offer the cheapest rate, and then was able to inform the Physician and patient of these findings. This was above and beyond and certainly not part of their responsibility. This nurse understands that navigating health care is a real challenge and uses their expertise of the “system” to serve patients and ensure they get what they need.
This nurse is doing the boots on the ground work every day to ensure that patients with cancer have more birthdays.