CJW’s March of Dimes Nurse of the Year Winners

The March of Dimes annually awards Nurse of the Year in seventeen key disciplines to recognize exceptional nurses. These awards are derived from a highly competitive process that requires nurses to go through a comprehensive state-wide nominating and selection process.  Chippenham & Johnston-Willis was fortunate to have 3 of the 17 winners come from our hospitals. I asked the leaders of our winning nurses to share more about these exceptional women. Here is what they wrote:

Critical Care Nurse of the Year: Emily Mochan, RN

Emily Mochan

Emily Mochan

Emily is the Director of Cardiovascular ICU, Cardiovascular Step Down, and Interventional Cardiology Care Unit. Emily has been an employee at Chippenham Hospital for 4 years and has served in various roles: Central Resource Pool RN, Left Ventricular Assist Device (LVAD) Educator, Clinical Coordinator, and her current role of Nurse Director. In all roles, Emily consistently looks for innovative ways to transform the care of bedside clinical practice. Emily was instrumental in creating Chippenham’s LVAD program by forming a multidisciplinary team and numerous evidenced-based clinical guidelines to care for that high risk patient population. In Emily’s current role as the Director, she helped improve the outcomes of cardiac surgery patients by focusing on earlier extubation and a more collaborative coordination of care with nursing, respiratory therapy, pharmacy, and the Cardiac surgeons. Through this achievement, Chippenham has been recognized by the Society of Thoracic Surgery as a Top Performer in ventilator outcomes. In addition, Emily was recognized just recently by the HCA Division Office for partnering with Henrico Doctors’ to drive this performance improvement across the market. Emily is a member of the American Association of Critical Care Nurses (AACN) and the American Organization for Nurse Executives (AONE). Emily’s compassion and innovative approach to patient care makes her an invaluable member of our team.

Behavioral Health Nurse of the Year: Kim Wilson, RN

Kim Wilson

Kim Wilson

Kim is the Director of Clinical Services, Tucker Intake with extensive clinical and managerial experience in the field of Behavioral Health. Kim’s advocacy for the patients, families, employees and community is second to none. Kim serves on the Chesterfield Crises Intervention Training subcommittee team and serves as host site at Chippenham Hospital. Kim offers partnership to National Alliance for Mentally Ill (NAMI) Virginia which facilitates impactful programs at Tucker. Kim is also active with Family Advocacy Creative Education and Services (FACES), a local non- profit family support and education advocacy network. Kim sits on the Virginia Hospital & Health Association Behavioral Health’s state subcommittee for the 2014 Bed Registry and the Local Inpatient Purchase of Services task force. Kim’s leadership was instrumental in the implementation of the Crises Triage Center which opened in October 2013 at Chippenham’s Emergency Room. In this implementation, Kim partnered with Chesterfield Community Services Board , Richmond Behavioral Health Authority, local magistrates, police, and dignitaries to open the first multijurisdictional triage center in the Commonwealth. As a result of this work, Kim was awarded the Chesterfield Community Services Board service partnership award in 2013, along with Betsy Blair and Rich Shelton who also provided leadership for CTC implementation. Kim achieved certification in Mental Health First Aid in 2013. Above all competencies and expertise, the distinguishing quality that sets Kim apart is her absolute compassion for people who are impacted by mental disorders, whether that is the patient, their families, the physician, community advocacy groups, or her employees. Kim stops at nothing to get people connected to the services they need whether that is due to a crisis or a life- long chronic recovery journey.

Pediatric Nurse of the Year, Lori Stump, RN

Lori Stump

Lori Stump

Lori Stump has been an active member of Chippenham Hospital’s Pediatric Department since 1995. Lori has a passion for her patients and their families, staff education, and evidence-based process improvements.  Lori’s dedication to the PICU and Pediatric floor is evident in her projects; Lori leads the annual Pediatric Skills Fair, chairs the Pediatric Nurse Practice Council, and is an active member of the hospital-based Shared Governance Professional Practice Council for the greater Richmond area. Lori’s desire to advance practice at the bedside inspires many; she has been recognized the last two years as a nominee for March of Dimes Nurse of the Year, winning the title this year. Lori makes it a point to do the right thing for the patients and encourages others to do the same. Lori works with colleagues to provide education to families, Pediatric staff, and the community and evidence-based practice in our Pediatric policies. Lori has provided several lectures on pediatric critical care to pediatric ED staff, EMS providers, and even traveled to Hampton Roads to speak at the Tidewater Emergency Medical System Conference. It is Lori’s goal to continue to work at the bedside and care for pediatric patients and their families; she will continue to be an informal leader on the Pediatric Intensive Care Unit and Pediatric floors as a Clinician 5 (the highest level) as she helps us strive for excellence.

Congratulations, Emily, Lori and Kim. We are all very proud of your accomplishment and more importantly proud to have you on our exceptional clinical team.

Little Things Make a Difference

Mike Barrett

Mike Barrett

Sometimes it is the little things that make all the difference. I was touched this week by an example of one of our nurses, Mike Barrett, RN, finding a way to exceed the expectations of one patient’s special request. The type of personal connection that Mike made with this patient is one that will last long after the patient’s stay at Chippenham Hospital.

Beth Torres is one of our great nurse directors who rounds religiously to make sure that our patients are having a positive experience. While rounding this week she met Ada Carter. Subsequently, Ms. Carter gave us permission to share her story. During the visit, Beth asked Ada if she needed anything, she said, “No, but I want to show you something.” Ada went back to her bed and came to the door with a stuffed homemade Teddy Bear. This unique Teddy Bear was made from yellow hospital socks and the protective sleeves we use to cover IV sites. The bear had an ID badge made of a compass recognition card star, a badge holder, and a RN tag. The patient was beaming when she told Beth that her night shift nurse, Mike Barrett, had made it for her. Several of her friends had brought her frog stuffed animals (there were 3 on her bedside table). She commented to Mike that she wished she had something other than a frog. Mike took the time and showed great creativity in making her “Chipotle,” her name for the bear. Ms. Carter shared that it, “takes a lot to make me emotional. When Mike gave me the bear, I teared-up.” Beth asked for her permission to come back and take a picture of the bear. Ada stated that she wanted to be in the picture with the bear. When Beth returned with the camera, she was lying in bed cuddling with her bear—that is how she wanted her picture taken. She was so impressed with it, she even called her 19 year old son to tell him what Mike had done.

Ada Carter snuggling her bear

Ada Carter snuggling her bear

These are the moments that you could never script. Mike found a way to make a personal connection and create a lasting impression. I appreciate all of the little things and, of course, all of the big things that the teams at Chippenham & Johnston-Willis do each day to make staying in a hospital more personal. These real connections make all the difference in the world. Thanks Mike.

The Most Difficult Decision: Brittany Maynard’s Choice.

You couldn’t turn on the news this past month without hearing the heart breaking and controversial story of Brittany Maynard, a 29 year old woman from California who found out she had a terminal diagnosis of a stage IV, malignant brain tumor, called a glioblastoma multiforme. She was diagnosed shortly after her wedding in January 2014. It is hard to imagine a more difficult situation than being faced with your own mortality at such a young age. She and her husband moved to Oregon from California because it is one of five states that has a Dying with Dignity law (Washington, New Mexico, Vermont, and Montana are the others). In 1994, Oregon was the first U.S. state to make it legal for a doctor to prescribe a life-ending drug to a terminally ill patient of sound mind who makes the request. The patient must swallow the drug without help; it is illegal for a doctor to administer it. More than 750 people in Oregon have used the law to die as of Dec. 31, 2013. The median age of the deceased is 71, only six were younger than 35. Unfortunately, Brittany’s diagnosis has an average life expectancy of about 14 months. She made the decision to end her life after realizing she did not want the disease to control it. She had been suffering crippling headaches and then seizures; she wanted to end things on her own terms.

Brittany made a bucket list and accomplished her final goal on October 21st – to see Grand Canyon. She ended her life on Saturday, November 1st, the day after her husband’s birthday, by taking a cocktail prescription given to her by a doctor. She ended her life as she intended – peacefully in her bedroom, surrounded by her loved ones.

Her final goodbyes have gone viral and she has brought much awareness to end-of-life rights by working with Compassion & Choices and the Brittany Maynard Fund.

https://www.youtube.com/watch?v=Bt5usYlBxVc

I realize there are very strong opinions on the ethical implications of this decision. I, for one, don’t begin to judge as I haven’t lived that experience and am not sure what I would do if faced with a similar circumstance. I asked Susanne Colligon, Director of the Thomas Johns Cancer Hospital (located within Johnston-Willis Hospital), to share her insight and thoughts. Susanne has the unique opportunity to meet patients and family members every day who are on some part of the care spectrum from diagnoses to treatment and cures and, in some cases, death. Here is what she shared:

“The decision to end your life is a tremendously personal one. We first need to understand if the patient is depressed and not making this critical decision under the fog of melancholy. We have no idea the pain she was enduring and her thoughts of her continuing to live in pain, more seizures, and becoming incapacitated. So the question is- do you have the right to choose to end your life when you have a terminal illness? In my 24 years I have seen some awful, painful deaths that ended miserably for the patients and the families watching them die. I believe this is where Palliative Care and Hospice can be so critical in giving the family and patient a “Good Death”. A good death is whatever the patient deems it to be, keeping them comfortable decreasing symptoms and giving support.

I have been an oncology nurse for 24 years. I started my career in Pediatric Oncology and Bone Marrow Transplant at Children’s Hospital in Philadelphia and have seen many young people die with terminal illnesses. Treatment options have improved greatly in the last 24 years.

My father-in-law, John Fessick, was a Vice President of sales for IBM, he was a well-educated, stubborn, hardworking man. At the time of his diagnosis he was only a few months from retirement. He started slurring his words and had some weakness with swallowing. After many months of not knowing his diagnosis they finally realized he had Lou Gehrig’s Disease or ALS. He went from being completely independent to a person that could not go to the bathroom by himself or even eat any of his favorite foods. He suffered loss of speech, inability to swallow, and could only tolerate PEG tube-feedings. He constantly needed assistance with all his ADLs. He fought for any shred of independence he could get. For a man that controlled his entire world everything had been taken away from him. Hid mind was still sharp as a pin however he could not communicate his wants or needs to us except with a dry erase board. It was one of the hardest things to see a loved one go through. He never complained or asked “why me?” He knew the outcome would be that he would eventually suffocate in his sleep. And that is what happened one cold March morning. He fought till the end.

I would have respected him either way, for the fight to carry on or the will to let go. It was his decision, not mine, to make. The only consolation was that I knew he died the way he wanted, fighting all the way. Everyone is different and we need to respect their wishes. The family must live on with their choices for the rest of lives.

This is why the new state program “Respecting Choices” is so vitally important. Every individual needs to have a plan of what they want done in time of medical crisis. The Richmond Area Hospitals along with the Richmond Academy of Medicine are making this a reality in Richmond.”

To see more information go to: https://www.youtube.com/watch?v=kIO3MDtnHQU

I realize these are difficult conversations and difficult choices. I am proud of the compassionate care shown at Chippenham & Johnston-Willis Hospitals by the countless physicians and hospital staff. I strongly believe that healthcare is personal and as a provider of these services we need to find every way to support the needs of our patients and our care teams.

One Nurse Inspires Another

All of us can likely think of a significant event in our lives that changed us forever. For Jenni Johnson, RN on 4 East at Johnston-Willis Hospital, that event was the medical miracle of her only child’s, Wyatt’s, first year of life in 1995.

Baby Wyatt

Baby Wyatt

Jenni knew something was wrong with Wyatt’s breathing right away, but her pediatrician at the time suggested all was normal. Jenni insisted that more evaluation was needed so she brought him to Dr. Mary Falterman, Pediatric Cardiologist, who diagnosed Wyatt with a coarctation of the aorta, a congenital condition where the heart’s aorta is twisted like a sock, blocking 99% of the flow of blood. At the time Wyatt was 2.5 months old and weighed only 13 pounds. Jenni brought him to HCA’s Henrico Doctors’ Hospital where they cared for her baby for three months in the Pediatric Intensive Care Unit and, later, the Pediatric floor. During the long hospitalization, Dr. Gary Laughlin did the surgery to repair the aorta and put a band on his pulmonary artery.

Three days after his operation, Wyatt was being cared for Lori Stump, RN. Today, Lori is a nurse at Chippenham’s Pediatric Intensive Care Unit after working for nearly 40 years in the profession. But on that day in 1995 Lori knew something was wrong with baby Wyatt. She called a Code Blue, signaling significant respiratory distress, and for 90 minutes she and the team worked to revive Wyatt and place a breathing tube to stabilize him. In the meantime, Jenni waited anxiously to hear an update on her baby’s condition. Lori eventually came to the waiting room, sat in the chair next to her, and said, “We got him back.” Even today, as Lori and Jenni shared their story with me, they get choked up relaying the details. It was as if they have been dear friends for many years. They both shared as a nurse you sometimes don’t realize the impact you have on your patients. This event was a great reminder.

Lori & Wyatt at Chippenham's PICU

Lori & Wyatt at Chippenham’s PICU

Eventually Wyatt fully recovered and has since led a healthy life. Recently he graduated from high school and is now attending John Tyler Community College with plans to transfer to Virginia Tech and graduate with a degree in nuclear engineering. Jenni always remembered how important Lori was to the care of her son so she orchestrated a surprise reunion where Wyatt dressed up in his cap and gown and showed up at Chippenham Hospital to celebrate his graduation with flowers and gifts. It was a perfect way to acknowledge Lori’s tremendous impact. Lori never forgets her patients like Wyatt. All these years later she recognized him from the infant she cared for in 1995.

Jenni & Lori

Lori & Jenni

Lori has done more than save Wyatt’s life. She inspires others. Jenni is quick to share that Lori is a role model for all nurses. Lori takes the responsibility of role model seriously and commented, “It is who you are, you have to nurture and create these bonds. Not everyone can do that.” In 2014, Lori achieved an elite certification as a RN Clinician 5, the highest achievement in skills at HCA.

Jenni shared her personal journey to becoming a nurse, which wasn’t until her late 30’s. She had dropped out of high school after the 9th grade and has lived on her own since she was 16. Eventually she got her GED. She always loved taking care of people and was managing an automotive shop where she was miserable in her career. She persevered and completed an associates RN program at J. Sargent Reynolds Community College while working full time to support her family. She was quickly promoted to clinical nurse coordinator by her Chief Nurse Officer, Sandy Aderholt, who saw something special during her first two years as an RN. Today, Jenni is actively working towards her Bachelor’s degree and plans to go on to get her Masters. She has her mind set on becoming a Chief Nurse Officer within 10 years.

I asked Jenni what she learned through the early experience with Wyatt’s health crises. She said, “Follow your gut instinct and always be an advocate for your own child.” Lori added, “Parents know best. A great nurse listens to the family. You really need to develop a personal relationship especially in pediatrics. You are taking care of not just the child, but also the mother and father. As a nurse you have to overextend yourself all the time. I will always be a bedside nurse taking care of patients. That is why I was put on this earth.”

It is an awesome responsibility to be a caregiver in an acute hospital setting. The 18 year story between Jenni and Lori is another reminder of the kindness, compassion, and excellence that embodies our nursing team at Chippenham & Johnston-Willis Hospitals.

Terry Harver: CJW’s Resident Artist

Recently, I was doing rounds to visit with staff and patients and had the opportunity to run 20141023 Terry Harver2into something totally unexpected – a spectacular mural covering the walls and ceilings of two pre-operatory rooms in same-day surgery. I was quickly greeted by some of the department’s nursing team who shared with me that one of their own nurses, Terry Harver, RN, painted these to brighten up the area for pediatric patients. It took her over 22 hours to paint it. It was a great reminder that we have so much hidden talent and creativity on the Chippenham & Johnston-Willis (CJW) team. I am fortunate to see the healthcare-related talents of our team every day, but I don’t often get to see a totally different talent like artistic ability.

Terry HarverTerry grew up nearby in Crewe, Virginia and has been a nurse with us since graduating nursing school in 1977. She has worked in several other areas of CJW including Chippenham’s ER and Johnston’s Willis’s Women’s unit. I asked her about her interest in painting and she shared that she wanted to go to art school when she was young but her father got sick and disabled so she had to change paths. She was inspired to become a nurse because her grandmother and role model, was an RN.

In recent years Terry has spent a lot more of her free time painting mostly still-life with pets and landscapes with oils and pastels. She especially enjoys doing murals for children’s bedrooms and other locations. Her artwork has been shown in the Chesterfield and Amelia libraries. Recently, she donated a piece to the March of Dimes auction that helped fund scholarships. She was quick to share that as she gets older her abilities have gotten better and she plans to do this in retirement as both a hobby and a business.

Terry was inspired to paint the CJW murals to create a comforting and distracting wall artatmosphere because she knows that children often come in afraid and anxious. Patients get to choose which of the two rooms they would like to wait in for their surgery. Her hope is that it gives them something else to think about during that stressful time. The response has been incredible with people quickly becoming a fan of her work and the new look in the department. Her next project in same-day surgery is a “tree of knowledge” in the staff rooms. She is asking the staff to tell her which kind of bird they would like to be represented by on the mural.

I asked her why she likes to paint and she responded simply, “I like the creativity. It is an amazing opportunity to give of yourself and allows me to leave a legacy for my children.”

So this week Cheers to Terry for contributing to CJW in a way that we will enjoy for many years to come. If you are interested in talking to her about her work she can be reached at 804-356-1306.

Barbara Stannard, Her Personal Journey Fighting Breast Cancer

You can’t watch NFL football this month without noticing the bright pink shoes in honor of breast cancer awareness month. Most of us have someone in our own family or immediate group of friends who has been challenged with this disease. Thankfully, early detection is better than ever with enhanced diagnosis and treatment. A recent technological advancement is the new state-of-the-art Tomosynthesis 3D imaging which is a notable upgrade to traditional digital, 2D mammography. This technology is able to assess dense breast tissue and identify potential abnormalities better than ever before. HCA’s Johnston-Willis and Henrico Doctors’ Hospital are the first and only hospitals in Richmond metropolitan area to have this technology.

This week I wanted to make breast cancer more personal so I asked for an employee who would be willing to share their personal story. RN Barbara Standard’s name quickly came to light not only for her personal fight against breast cancer, but also because of her role as our Chippenham & Johnston-Willis Breast Cancer Nurse Navigator. She has been in this role for 6 years and been an oncology nurse for over 30 with HCA. As the Navigator, Barbara reaches out to women who have initial abnormal findings in their mammogram to ensure they get linked into additional screening and treatment when necessary. The fact is about 30% of mammograms come back abnormal. Thankfully, only 15-20% of those are actually positive for breast cancer.

Barbara Standard

Barbara Standard, RN

In Barbara’s case she was having her routine mammogram on her birthday in 2011. The results came back abnormal and they asked her to come in to have additional imaging views. Dr. Jackie Hogg, radiologist, was intimately involved in the case and coordinated with Dr. Ruth Felson, breast surgeon, to make the final diagnosis of invasive ductile cancer – one of the most common forms of breast cancer. Barbara eventually had six surgeries, including a lumpectomy and mastectomy, in addition to radiation and chemotherapy for a year. Barbara shared with me that as an employee she always knew what a good place Johnston-Willis (JW) Hospital was for care. But after becoming a patient she soon came to realize that it was a really a great place when you are a patient too.

She said, “Once you become a cancer patient it is humbling because what you thought you knew about cancer was really not that much. It was very enlightening and gave me a different perspective. Coming to an advanced breast cancer center like JW was really important.  It puts in place all the right people and the latest technology in one place and walks the patient though all the important steps of getting diagnosed and treated. I was always someone who would schedule my life way in advance. I now know that each day is a blessing. Every day that I get up and put my feet on the floor is a good day. It helped me prioritize my life.”

She emphasized the advice we hear so often but sometimes fail to follow: “Do your mammogram every year and be sure to conduct breast self-exams routinely as recommended by American Cancer Society”. Today, every abnormal mammogram patient gets a personal call from Barbara to talk about next steps. In the past, patients would receive a letter (sometimes on weekends) and be left to figure out what to do next. Thankfully, they now always have Barbara to call.

Barbara emphasizes the importance and power of a strong support network. Through her experience, she came to realize that the employees and doctors at Johnston-Willis were like family. She believes in the importance of getting involved in support groups, like the ones held by Robin Yoder at Johnston-Willis every Wednesday. The first group is for newly diagnosed patients and the second is for long term support.

I asked Barbara what the biggest misconception is about breast cancer and she said, “People think when they hear ‘cancer’ that it’s a death sentence. Once they realize how many survivors there are they get hope. They often think they won’t be able to work but the fact is a lot of people will be able to work through much of the treatment.”

If you want to call Barbara for advice she is willing to help at 804-267-6243. I am pleased to report that today, she is healthy and doing great. If you are a woman over 40 years old, I encourage you to make sure you get your annual mammogram as that is the best way to stay informed about your personal health.

If you would like to share your breast cancer story or experience, please feel free to do so as a reply to the blog.

Imagine a Heart Attack Overseas

Imagine being an experienced, Virginia-based, ICU nurse and finding yourself overseas with a sudden, life-threatening medical crisis. This is exactly what happened to DeWitt Wert. Dewitt has worked for HCA for almost 2 decades, most recently in our Medical/ Surgical ICU at Chippenham Hospital. Prior to his trip, he was overall healthy with no known cardiac issues. That was about to change.

Min & Dewitt in Guangzhou, China

Min & Dewitt in Guangzhou, China

DeWitt and his wife, Min Zhang, an Echo tech at Chippenham, have been married for 6 years. They decided they would make the 23-hour journey to her homeland in Guangzhou, China. This would be his first time meeting his in-laws. After several days of enjoying the culture and sites, Dewitt noticed he was having some discomfort which he thought was related to a previous history of mild esophageal spasms. It turns out these symptoms can mimic some of the classic signs of a heart attack. He thought the discomfort might have been related to all of the touring and enjoying foods he was not accustomed to eating.

Towards the end of the trip, the symptoms became more pronounced after a day with sudden weather changes where the temperature went from 60 to 90 degrees. He took the elevator up to 15th floor and realized he was very hot and felt nauseated. After trying to get the AC on he started getting dizzy and more exhausted. Something wasn’t right. DeWitt assumed he was dehydrated and suffering from heat exhaustion. His wife wanted him to go see a doctor but he delayed. By morning he hadn’t improved and, after taking his blood pressure and heart rate, he realized he needed to go to a public hospital ER. Imagine how scary it would be to go to a hospital in a different country with a significant language barrier. One of the first things the hospital asked DeWitt for was cash before they would treat him. His bill would end up being over $13,000. He shared that during his stay they wouldn’t even give him a bed pan until he paid for it first. He also had to sign a legal waiver to remove his ability to sue them if things didn’t go well. They gave him a choice of signing the document or taking an aspirin and going home.

They proceeded to take blood samples and an EKG; their initial impression was that he was fine so they didn’t do the whole set of cardiac enzymes. Time passed and they eventually did more tests and started to suspect a Myocardial Infarction (heart attack). Ultimately they would find that he had a 100% blockage in his right coronary artery. Evidence shows that treating a heart attack within 90 minutes is key to survival. Dewitt knew this as an ICU nurse and realized that it had been much longer than that. In fact, he didn’t go into the cath lab for close to 9 hours. He had to make a final decision to pay for the Chinese catheter or pay 10x more for the USA manufactured catheter (he opted for the latter). As Dewitt was wheeled into the get the cardiac cath, which is inserted through the arm, and the balloon pump, which is inserted through the groin, he came to understand that they don’t use any anesthetic for the procedure. In the United States, you are put under an IV-conscious sedation so you don’t feel discomfort and don’t remember the experience. Communication about medication and treatment continued to be a big issue as his Chinese wife only spoke Mandarin not Cantonese, the predominate language at the hospital.

In describing his experience to me DeWitt shared, “At one point I thought I was dying in the hospital prior to getting any treatment. I had a tremendous sense of doom. My wife was praying in my ear. I am not particularly religious but something changed. She told me she didn’t want me to go. I knew I felt a deep and profound love for her. Something changed and I suddenly found peace. I can’t explain it. It felt really good and I knew I was okay with moving on no matter what the outcome. I wanted my wife to come back to tell my unit at Chippenham Hospital just how much they meant to me. It changed me. I am more focused on my kids, my family and now when I am in the unit I take a little extra time to think about what I am saying to be respectful of feelings more so than I ever was before. ”

He is quick to acknowledge that while their care model is very different, they saved his life. They enabled him to come back and continue being a great nurse at our hospital. We are lucky to have him.