L E A D E R S H I P • C O M M U N I T Y S E R V I C EC O M PA S S I O N • E X P E R T C A R E

SM

Nursing Annual Report

2010

N U R S I N G A N N U A L R E P O R T 2 0 1 0 1

Children’s Hospital Los Angeles

A 2010 OverviewOUR HOSPITAL

• Licensedpatientbeds:286

•Averagedailycensus:239.5

•Annualpatientadmissions:11,420

•Annualoutpatientsurgerycases:8,886

•Annualinpatientsurgerycases:6,575

• Patientdays:88,980

• Emergencyandtraumavisits:97,000

•Averagelengthofstayinthehospital:7.86 days

•Annualtransportpatients:1,937

•Annualoutpatientclinicvisits:approximately406,000

• PatientvisitsatcommunitysitesthroughtheDivisionofAdolescentMedicine:9,756

• Patientsundertheageof4yearsold:approximately50 percent

•Outpatientclinics:48

OUR NURSES

•68 percentofournurseleadershaveanationalcertification

•58percentofournurseleadersarecertifiedasAdvancedPracticeNurses

•Wehave79 NursePractitioners

•Wehave15ClinicalNurseSpecialists

•Wehave7NurseAnesthetists

•Averagelengthoftenureforournurses:10 years

•Ourexpertnursestaughtapproximately950nursingstudentsin2010

AnotheryearasaMagnet-designatedhospitalhasflownby!

Andsomuchhashappenedin2010.Ournursestruly

demonstratedtheirexcellentworkinsideandoutsidethehospital

walls.Nursestooktimeoutoftheirdailylivestohelpthoseinneed

inHaiti.Nursescontributedtheirknowledgeandexpertisetothe

decisionsmadeintheCollaborativeGovernanceStructure.They

alsochallengedthemselvestoachievecertificationandadvanced

degrees.Nursescontinuetomaintaincollegialrelationshipswith

alldisciplinestoensurethebestpatientoutcomes.Theseareafew

ofthemanyattributesfeaturedinthisAnnualNursingReportthat

definewhyWEAREMAGNET.

MargauxChan,RN,BSN,CPN

SusanCrandall,RN,BSN

In This IssueLetter from Magnet Managers . . . . . . . . . . . . . . . . . . 1

Letter from the Chief Nursing Officer . . . . . . . . . . . . . 2

Letter from the President and CEO. . . . . . . . . . . . . . . 2

Professional Development—Certification . . . . . . . . . . . 3

Professional Development—Education . . . . . . . . . . . . 8

Professional Engagement. . . . . . . . . . . . . . . . . . . . . 9

Commitment to Community Involvement . . . . . . . . . . 12

Recognition of Nursing . . . . . . . . . . . . . . . . . . . . . 15

Culture of Safety . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Professional Practice Model . . . . . . . . . . . . . . . . . . 19

Innovation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Nurse Week Essay Winner . . . . . . . . . . . . . . . . . . . 23

Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . 25

Nursing Mission and Vision . . . . . . . . . . . . . . . . . . 25

Cover:EdgarOrdonez,RN

CardiothoracicIntensiveCareUnitNurse

andVersant™RNResidencygraduate.

2 C H I L D R E N ’ S H O S P I T A L L O S A N G E L E S N U R S I N G A N N U A L R E P O R T 2 0 1 0 3

Professional Development: CertificationWelcome

ThenursesatChildren’sHospitalLosAngelesaresomeofthebest

anywhere.Astheyhelpuscreatehopeandbuildhealthierfutures

forthechildrenandfamilieswetreat,I’mconsistentlyimpressedby

theirskill,compassionandthoughtfulness.

AswereadyourselvesforMagnetre-designation,I’malsograteful

forournurses’professionalismandhardwork.Andweaskeda

lotfromthemthisyear.Preparingtomoveintoournew317-bed

inpatienttower,theMarionandJohnE.AndersonPavilion,involves

amonumentalamountofplanning,andinmanycasesournurses

areleadingthecharge.Thesedutiescomeinadditiontotheirwork

caringforourpatients,conductingresearch,achievingprofessional

enrichmentandadvancingnursingasaprofession.Wecannot

thankthemenoughforrisingtothischallenge.

Weekly,Ihearstoriesabouthowgreatournursesare—fromtheir

supervisors,theircolleaguesandthepatientfamiliesinourcare.

Ourhighly-skilledcorpsofnurseshelpmakethisplacemorethan

justahospital;itisawelcomingenvironmentofhopeandhealing.

Toallofournurses:Thankyouforthesupportandleadershipyou

provideatChildren’sHospitalLosAngeles.

Richard D. Cordova,FACHE

PresidentandChiefExecutiveOfficer

Children’sHospitalLosAngeles

Our certified nurses are the pride of Children’s Hospital Los

Angeles. The journey to certification requires intense discipline.

To prepare for the certification exam, some nurses take a

preparatory class and participate in study groups. Gloria Verret,

RN, CPN, studied with another nurse using nursing textbooks

and practice test questions. “It was like studying for the boards,

very intense and hard,” she says. Others choose to study alone

for countless hours. No matter the approach, the work pays off

when the nurse passes the exam.

However,thejourneydoesnotendthere.Certifiednursesmustfulfill

certainrequirementstomaintaintheircertification,dependingon

thecertifyingbody.Thiscreatesacommitmenttolifelonglearning

bystudyingforrequiredtests,attendingconferencespertinentto

theircertificationandreadingprofessionalliterature.

Forexample,tomaintainhercertificationinNeonatalIntensiveCare,

NicoleAinsworth,RNC-NIC,hastoaccumulate45Continuing

EducationUnits(CEU)insteadoftheminimum30CEUsrequired

forlicensurerenewal.Thus,theexpectationsofthesegoverning

bodiescreateahigherlevelofexpertise,contributingtonew

knowledgeinnursingpractice.

In2007,NiebuhrandBielconductedanAmericanBoardof

NurseSpecialties(ABNS)surveyamongcertifiedandnon-certified

nursestostudytheirviewsofnursingcertification.TheABNSsurvey

foundthat88percentofnursesagreedthatcertificationenhanced

personalconfidenceinclinicalabilities.Morethan90percentof

nursesagreedthatcertificationenhancesprofessionalcredibility

andvalidatesspecializedknowledge.

Ainsworthexpressedthisconfidenceafterpassingthecertificationexam.

“IfeltthatIknewthematerialwell,whichmadememoreconfident

whenItaughtorpreceptednewnursesintheNewbornandInfant

CriticalCareUnit,”sheexplains.

Thestudyalsofoundthat98percentofnursesagreedthat

certificationenhancesfeelingsofpersonalaccomplishment.

Theconclusionofthisstudyindicatesthatcertifiednursesare

differentiatedintheworkplaceasadeptandproficientleaders.

Verretfeltthissenseofachievementafterobtaininghercertification

in2005.Thismotivatedhertopursuemanynursingopportunities.

“BeingaCPNhasgivenmeprofessionalconfidenceandpride,”

shenotes.“Istartedtovolunteertobeonhousewidecouncils,

includingtheRecruitmentandRetentionCouncilandHouseof

Representatives.”Shehasevenstartedwriting,editingthe

newsletterfortheLosAngeleschapteroftheSocietyofPediatric

Nursing,writingfortheNurseWeekEssayContestand

contributingarticlestothehospital’s“RNRemedies”blogseries.

Nursescommonlyquestiontheneedforcertification:“Whyget

certified?”Theansweris,“Whynot?”Verretstartedatafacility

wheretherewasnomotivationtopursuecertificationor

professionaladvancement.SowhenshearrivedatChildren’s

Hospital,shewaspleasedtoseethatnursingknowledgeand

leadershiparevaluedhere.Shewasespeciallyimpressedthat

Children’sHospitaldemonstratesitshighregardforcertifiednurses

byofferingthemanhourlydifferential,abenefitnotofferedinmany

organizations.Thisdrovehertochallengeherself,personallyand

professionally,toaccomplishcertificationandtoadvanceupthe

clinicalladder.

Requirementstoupholdcertificationthroughcontinuingeducation

increasetheknowledgebaseofcertifiednursesandpromote

patientsafety.Certifiednursesaremoremarketableforprofessional

advancement,internallyandexternally.Theyalsoareempowered

tosharetheirknowledgeandexpertiseintheirworkplaceand

community.ConsumerswhochooseBoard-Certifiedphysicians

astheirhealthcareproviderswillsoonbecognizantofBoard-

Certifiednursesandwillexpectqualitycarefromthem.

Certificationisnotjustmerelettersafteraname;itidentifies

nursing’shighestvalueofprofessionalism.

Certified Nurses:•Haveprofessionalprideandachievement

•Areidentifiedbypatientsandfamiliesascredibleexpertsintheirfield

•Aremorelikelytogetoffersforprofessionalopportunitiestocontributetheirexpertise,suchasinvitationstojoincommittees,participateineducationalactivitiesandserveonspecialprojects

•Aremarketable,openingdoorsforcareeradvancement

•Arecommittedtocontinuingtheireducationtoupholdtheircertification

Reference:

Niebuhr,B.&Biel,M.(2007).Thevalueofspecialtynursingcertification.Nursing Outlook,55(4),176-181

2010wasayearofpreparation. Webegantheyearwithan

eyetowardthetransitionintotheMarionandJohnE.Anderson

Pavilion.Wespentmorethan10yearsintimatelyinvolvedinthe

planningofthebeautiful,family-centeredhealingenvironmentthat

wouldbecomeatrademarkofthenewbuilding.2010tookona

newlevelofdedicationthatincludedallofus.

Oncecomplete,thebuildingwouldbeourstocreateastate-of-

the-arthospitalforthechildrenandfamiliesweserve.Nursesand

allmembersofthehealthcareteamatChildren’sHospitalstepped

uptobeginthetransitionplanthatwouldbefullyimplemented

in2011.

Detailswereplanned,problemswereresolvedandexcellence

wasachievedoverandoveragain.Iwasproudeverystepofthe

way. EverymemberoftheChildren’sHospitalcommunitywasa

valuablepartoftheprocess.

2010alsowasayearofimpressivecollaborativegovernance

work.Itwasayearoflearningandproblem-solvingaswe

developedstructure,accountabilityandbroadprofessional

collaboration.Again,Iamproudofthesuccessweexperience

inourvisiontoempowerdirect-careproviders.

Iknowoursuccessisbasedonourpassiontoalwaysbebetter.

Weallshouldfeelgratefulbecausewelearnfromeachotherevery

day.Jobsdon’tgetanybetterthanthat.

IamproudtoworkwiththenursesandPatientCareServicesstaff

tomakeChildren’sHospitalLosAngelesthebestandsafesthospital

forkidsandfamilies.

Mary Dee Hacker,MBA,RN,FAAN

VicePresidentofPatientCareServicesandChiefNursingOfficer

Children’sHospitalLosAngeles

Critical Care Registered Nurse (CCRN )CarolynDeLaCruzPasiwen 6NorthVirginiaA.Culla CardiothoracicICUElizabethSuzanneDaley CardiothoracicICUSylviaGomez CardiothoracicICUJulietChristineGoss CardiothoracicICUKathleenS.McIntyre CardiothoracicICULisaA.Rizzi-Wagner CardiothoracicICUSandraXShepard CardiothoracicICUVictoriaJ.Winter CardiothoracicICUDonnaGuadiz CardiothoracicTransplantMonicaHorn CardiothoracicTransplantMichelleAnneCostabile NeonatalICUNhuN.Tran NeonatalICUJosephineO.Ellashek CriticalCareServicesNancyAguirre PediatricICUFrancesBlayney PediatricICUAlejandraBriseno PediatricICUAgnesE.Bundac PediatricICURebeccaS.Cales PediatricICUSherryCauley PediatricICUSuzanneRoseChan PediatricICUCorinneM.Costley PediatricICUGenaM.Favero PediatricICUHeidiD.Geary PediatricICURondaN.Habaradas PediatricICUFereshtehKiani PediatricICUCatherineD.Klatzker PediatricICUSandraLee PediatricICULouisM.LuminariasIII PediatricICUKatherineM.Meyer PediatricICUJosephM.Ng PediatricICUMonicaNuss PediatricICUGarinehSelinaPetrosian PediatricICUMonicaLeeRice PediatricICUPacitaM.Sangalang PediatricICUDavidSchmidt PediatricICUDianaZ.Sepulveda PediatricICUSuzetteDeeSweeney PediatricICULindaA.Topper PediatricICULindaC.Young PediatricICUVictoriaJoanneDuncombe PediatricICUNancyBlake NursingDirectorNancyAnnPike CardiothoracicSurgery

Certified Pediatric Nurse (CPN)NoraA.Delgado 5EastGiulianaV.Fiore 5EastAmyJeanGirguis 5EastNatalieGoldman-Merritt 5EastMichelleM.Karlu 5EastJoleneMarieKnapp 5EastAngelaAdrianaMadrid 5EastSusanMartinez 5EastSarahG.Ramirez 5EastErinSchmidt 5EastAbigailBarbaraShetland 5EastMarcelaM.Solorio 5EastLesleyNaveaAbcede 5WestLindaB.Allen 5WestLeticiaAvram 5WestArnieB.Banez 5West

Our Certified Nurses 2010EmmaA.Clark 5WestSarahDuffy 5WestMargaret-EllenFrankel 5WestSusanL.Gonzalez 5WestFrancesH.Guzek 5WestSusanD.Jensen 5WestJustinAlbertMarkle 5WestCherylAnnMcCauley 5WestFrancisMombay 5WestJanayaMorgan 5WestSharleneC.Odhner 5WestJudithA.Tighe 5WestDonnaLeeVanca 5WestDianaH.Vaughn 5WestPolinYousefzadeh 5WestElaineButterworth 6EastDeAnnSabrinaCampbell 6EastAnneA.Casale 6EastEileenR.Duncan 6EastKristineN.Gawley 6EastLavondaR.Hoover 6EastElaineC.Iwamoto 6EastChristineS.Limann 6EastPatriciaMueller 6EastJohnRutland 6EastCarolineKeltonSanborne 6EastAftonNicoleSchrimpf 6EastFloraW.Yuen 6EastLoriL.Chan 6North–RehabYvonneM.Hughes-Ganzon 6North–RehabVanNgaT.Nguyen 6North–RehabAmandaEstherPrice 6North–RehabJulitaArceoReyes 6North–RehabVanessaRios 6North–RehabMeganSummers 6North–RehabGloriaN.Verret 6North–RehabJenniferL.Baldwin 6WestOliviaBanuelos 6WestMonicaM.Ciccarelli 6WestAileenDeGuzman 6WestDarceyLynnDiaz 6WestKayM.Gilmore 6WestTammyLynneJohnson 6WestMarciaLachelleMassey-Norfleet 6WestVictoriaAnnMiller 6WestTheresaTostado 6WestChrystalUy 6WestElysiaM.Weiner 6WestAshleiM.McCloud 6WestAileenYangaDeGuzman 6WestWilliamC.Kenny Allergy/Immunology-ClinicalAnnieYeremian Allergy/Immunology-ClinicalJamesConnard CardiothoracicICURaulinD.Feria CardiothoracicICUElisaD.Barrios CareCoordinationTereceCharme’Jones CCCRicaSharonProsperoMorzov CriticalCareServicesBethChristieClark EmergencyDepartmentAnabelEnriquezCosta EmergencyDepartmentJamesTomCottrell EmergencyDepartmentMariellaFlores EmergencyDepartmentArmstrongHao EmergencyDepartmentNicoleM.Magni EmergencyDepartment

VanessaB.Martinez EmergencyDepartmentJonM.McKinnon EmergencyDepartmentMoralesMonica EmergencyDepartmentIngeM.Morton EmergencyDepartmentAngelaM.Quijada EmergencyDepartmentLindsayQuirk EmergencyDepartmentDeniseM.Sherwood EmergencyDepartmentAmandaSilver EmergencyDepartmentValerieTripoli EmergencyDepartmentStephanieValenzuela EmergencyDepartmentRobinL.Wood EmergencyDepartmentJodyLeighCastrillon EmergencyDepartmentGeorgeDennisCruso EmergencyDepartmentTerriE.Stambaugh EmergencyTransportJulissaM.Forte Hem-OncNursingJulyeA.Henley NICCUKathleenElizabethKelts NeurologyPaulA.Ciriacks NursingResourcesJeanetteM.Goggins NursingResourcesRachelGuinn-Jackson NursingResourcesKimHodge NursingResourcesKerriHunter NursingResourcesKathyKelly NursingResourcesVelmaLeonGuerrero NursingResourcesLindaS.Loiselle NursingResourcesGayleC.Luker NursingResourcesMarisaMartinez NursingResourcesChristopherL.May NursingResourcesAllisonMcCune NursingResourcesChristinaNg NursingResourcesNancyO’Gorman NursingResourcesAmyOmuse NursingResourcesKimberlyPandoraHodge NursingResourcesJoanMarieFlomPritchard NursingResourcesMarthaSamuel NursingResourcesFeliciaTremmel NursingResourcesAnaBorde NursingResourcesLaurieF.Newton OutpatientRehabilitationServicesCynthiaK.Burrola PACUAllanJ.Cresencia PACUJessicaLawsonGarcia PACUErinL.Lowerhouse PACUMargauxChan PACU(ASC)JasonRobertVargas PACU(ASC)SherryNolan 5EastJenniferM.Huson PediatricICUSheilaKun Pulmonary-ClinicalOliviaJ.Brett PulmonaryFunctionLabVanessaGuerrero RadiologyNursingClaudiaMcCullum RadiologyNursingVeronicaWallace RadiologyNursingDebbieL.Hand SurgicalAdmittingJudithSherif TransportStaceyB.Adler CardiothoracicSurgery

Certified Pediatric Hematology-Oncology Nurse (CPHON) and Certified Pediatric Oncology Nurse (CPON)

IreneV.Aberin 4EastDaniaMarisaBourque 4EastStaciA.Castillo 4EastReneeA.Flores-Garcia 4EastHeatherJoyMehl 4East

JohannaNavia 4EastMarifelPagkalinawan 4EastSachaLaurenReis 4EastAfshidRoozrokh 4EastGinaMarieSantangelo 4EastKerryS.Vancura 4EastSonyaL.Williams 4EastMelissaStewartAguirre 4WestDianeRitaAltounji 4WestMichelleCastle 4WestSonaDaldumyan 4WestLizzeleJ.Dulay 4WestMeghanMeehan 4WestCourtneyA.Rogers 4WestLauraJ.Vasquez 4WestWillowVoytko 4WestCaraSuzanneWise 4WestPaulaJ.Ybarra 4WestJenniferC.Blaney BMTKristinaBrown BMTVilmaL.Evangelista BMTDawnP.Landery BMTPaulD.Liehr BMTMaryF.Moses BMTDonnaM.Quiroz BMTDannielleSeluta BMTShinyiTang BMTNgaireF.Wilson BMTSarahTobaZannella BMTAnnEldiseHart CareCoordinationGwendolynM.Kimball CareCoordinationAliceSanchez DialysisTracyEllenKruger EmergencyDepartmentJamieTrippBacani Hem-OncNursingStanaBogojevic Hem-OncNursingMargaretS.Bottcher Hem-OncNursingArmiF.Bui Hem-OncNursingSherriLynnCarcich Hem-OncNursingRhondaD.Cellura Hem-OncNursingShannaChristoffersen Hem-OncNursingKeiYunChung Hem-OncNursingNancyS.Hart Hem-OncNursingDeeImai Hem-OncNursingMaria-TheresaLapinid Hem-OncNursingAliceLoo Hem-OncNursingDeborahMarino Hem-OncNursingKathleenMcGinty Hem-OncNursingMakiOkada Hem-OncNursingTinaM.Patterson Hem-OncNursingMaLuzReyes Hem-OncNursingSusanL.Rhoads Hem-OncNursingPatriciaRios Hem-OncNursingMeaganElizabethSchiavone Hem-OncNursingAnneSchwartzNord Hem-OncNursingBelindaP.Sia Hem-OncNursingKarenFaithSidi Hem-OncNursingChristinaIzumiSmith Hem-OncNursingAnthonyOpimo Hem-OncNursingMariaL.Medina-Velasco PCSCancerCenterDianeM.Grade 4EastKellieA.Loera Hem-OncNursingRitaL.Secola NursingDirectorPeggyL.Townsend 4West/BMT

4 C H I L D R E N ’ S H O S P I T A L L O S A N G E L E S N U R S I N G A N N U A L R E P O R T 2 0 1 0 5

N U R S I N G A N N U A L R E P O R T 2 0 1 0 76 C H I L D R E N ’ S H O S P I T A L L O S A N G E L E S

Our Certified Nurses 2010

Neonatal Intensive Care Nursing (RNC-NIC)SusanCline EmergencyDepartmentNicoleC.Ainsworth NICCUSonjaAlli-Casella NICCUSusanV.Bugsch NICCUCarolE.Cadaver NICCUBeverlyS.Drummond NICCUSandraLuzEspinosa NICCUJohannaConstanceGaeta NICCURobertFredGiesler NICCUAnneB.Gleeson NICCUDoloresM.Greenwood NICCUHeatherAnnHackett NICCUCarrieLeighJennewein NICCUKyongRanKim NICCULauraA.Klee NICCULorieJ.Pagado NICCUVictoriaPniel NICCUDianeE.Real NICCULisaMarieRosik NICCUSuetChingSham NICCUCarolynS.Waddell NICCURobinB.White NICCUElsaM.Yedinak NICCUMaxineOriejiOgbaa NICCUDeniseNavarroWeibel NICCUCynthiaDianeAtkinson PCSEducationDepartmentPamelaLynnCosta InstituteforMaternal-FetalHealthJenniferJordan NICCUKarenElizabethHeltonRapoport InstituteforMaternal-FetalHealth

Certification in Nursing (RNC)SusanR.Benson EndocrinologyCherylEstepaBarton CardiologyMarleneBeranek InstituteforMaternal-FetalHealthEmiKotoh InstituteforMaternal-FetalHealth

Certified Clinical Nurse SpecialistSherryNolan 5EastMeghanSullivanMiddleton PainManagement

Certified Clinical Transplant Coordinator (CCTC)StephanieJohnson LiverTransplantDonnaGuadiz CardiothoracicTransplantMonicaHorn CardiothoracicTransplant

Certified Diabetes Educator (CDE)AnnaGastelumBitting EndocrinologyMeredithMaeBock EndocrinologyLouiseA.Brancale EndocrinologyEulaliaCarcelen EndocrinologyNancyChang EndocrinologyBarbaraHollen EndocrinologyMaryT.McCarthy EndocrinologyDebraDeeMiller EndocrinologyVanessaLizzetMansilla Endocrinology

Certified Gastrostomy NurseValerieGordon Urology

Certified Nurse Operating Room (CNOR)KristiM.Brandt OperatingRoomNancyBridges Peri-operativeServicesRandallCook Peri-operativeServicesMelindaR.Dizon OperatingRoomVerzhineFodolyan OperatingRoomAngelaM.Hartley OperatingRoomMeredithReneeJohnson OperatingRoomJanetJ.Quigley OperatingRoomFlorenceE.Rivera OperatingRoomDawnaLeeWillsey Peri-operativeServicesMinakoYasumura OperatingRoom

Certified Neonatal & Pediatric Transport (C-NPT)SusanL.Cesinger EmergencyTransportMarthaA.Martinez EmergencyTransport

Certified Pediatric Emergency Nurse (CPEN)RussGill EmergencyTransportClaireMeyer EmergencyDepartmentNicoleD.Sheppard EmergencyDepartmentSusanD.Jensen 5WestNicoleM.Magni EmergencyDepartmentNancyO’Gorman NursingResources

Certified Professional in Health Care Risk Management (CPHRM)

KarenPrommer RiskManagement

Certified Rehabilitation Registered Nurse (CRRN)RachelBlackburn CareCoordination

Certified School NurseMichelePaige MedicalGenetics

Certified Wound, Ostomy, Continence Nurse (CWOCN)BethHarrison AmbulatoryCare

Certified Nurse Administration (NEA-BC)NancyBlake CriticalCareServicesBeverlyS.Drummond NICCU

Certified Nurse Administration (NE-BC)CatherineD.Kissinger 6EastTeresaL.Loera PediatricICU

Orthopaedic Nurses Certification (ONC)AnnM.Wakulich Orthopaedics

Certified Nursing Professional Development (RN-BC)MarilynDeonMills RadiologyNursingSuzanneTaylor NursingDirectorSylviaGomez CardiothoracicICUFrancesBlayney PediatricICU

Certified in Pain ManagementMeghanSullivanMiddleton PainManagement

Certified Lactation Educator/Counselor (CLE)ChristineS.Limann 6East

Certified Registered Nurse Infusion (CRNI)JohannaNavia 4EastStanaBogojevic Hem-OncNursing

Certified Adult Nurse Practitioner (CANP)RoyVillenaTatlonghari EmployeeHealthServices

Certified Family Nurse Practitioner (CFNP)ConstanceC.Gallardo RadiologyMarilynHarris AdolescentMedicineAnthonyHernandez SurgicalAdmittingCarolineKwong CardiothoracicSurgeryVanessaLizzetMansilla EndocrinologyMelanieT.Moya EmployeeHealthServicesCarolA.Okuhara CardiothoracicSurgeryLillianVickyRosu CardiothoracicSurgeryNancyAnnPike CardiothoracicSurgery

Primary Care Certified Family Nurse Practitioner (CFNP-PC)

YvonneJ.Olive SurgicalAdmitting

Certified Pediatric Nurse Practitioner (CPNP)TizitaAmde-Michael UCEDD–DMHCherylEstepaBarton CardiologySusanM.Carson Hem-OncNursingKirstiCatton CardiothoracicSurgeryMargoCoon RadiologyNursingJenniferN.Donkin Hem-OncNursingKristenEthridge CardiothoracicSurgeryAnnaChristineEvans Hem-OncNursingKarlaAurineHaynes PlasticSurgery/CraniofacialHelenLau PlasticSurgery/CraniofacialPatriciaA.McMahonPeterson Hem-OncNursingJenniferL.Murray PainManagementKaberiMozumder CardiothoracicSurgeryMaryBaronNelson RadiologyNursing/AnesthesiaDonnaNowicki PediatricSurgeryLisaOda 5WestMakiOkada Hem-OncNursingPaolaI.Pederzoli Hem-OncNursingKaseyRangan Hem-OncNursingMariaD.Reyes PulmonaryYaelL.Rosenthal Hem-OncNursingBiancaM.Salvetti PediatricICUNanoraThompson AdolescentMedicineKynnaNicholeWright Hem-OncNursingVanessaRios 6North–RehabJenniferL.Baldwin 6WestDavidSchmidt PediatricICU

Acute Care Certified Pediatric Nurse Practitioner (CPNP-AC):

MaryMcCulley CardiothoracicSurgeryAndreaLynneParker PediatricSurgeryGinaZambetti PediatricSurgeryCarolA.Okuhara CardiothoracicSurgeryLillianVickyRosu CardiothoracicSurgeryNancyAnnPike CardiothoracicSurgeryStaceyB.Adler CardiothoracicSurgeryLeticiaR.Boutros SurgicalAdmittingBeatriceL.Chun SurgicalAdmittingDebraA.Rannalli SurgicalAdmittingMaryVirgallito RadiologyNursingMarifelPagkalinawan 4East

Primary Care and Acute Care Certified Pediatric Nurse Practitioner (CPNP-PC/AC)

SusanneMatich(Carvajal) RadiologyNursingPamelaMichelleFaire CardiothoracicSurgeryMelanieGreen CardiothoracicSurgeryDeborahG.Harris Hem-OncNursingDennaJung RadiologyNursingDeborahL.Jury PainManagementMeghanSullivanMiddleton PainManagement

Primary Care Neonatal Nurse Practitioner (NNP-PC)MarleneBeranek InstituteforMaternal-FetalHealthPamelaLynnCosta InstituteforMaternal-FetalHealthSharonFichera NICCUJenniferJordan NICCUEmiKotoh InstituteforMaternal-FetalHealthBonnieLee InstituteforMaternal-FetalHealthKarenElizabethHeltonRapoport InstituteforMaternal-FetalHealthJohannaConstanceGaeta NICCU

Certified Registered Nurse AnesthetistsMelissaBailey AnesthesiologyPaulaBelson AnesthesiologySaraGlasser AnesthesiologyMaryIwaszewski AnesthesiologyJudyKoempel AnesthesiologySarahPolkinghorn AnesthesiologyShinnyThomas Anesthesiology

Total number of certified nurses: 312Total number of certified nurse practitioners: 57Total: 369

N U R S I N G A N N U A L R E P O R T 2 0 1 0 98 C H I L D R E N ’ S H O S P I T A L L O S A N G E L E S

Professional EngagementProfessional Development: Education

Advanced Degrees

Children’s Hospital Los Angeles values nurses with

advanced degrees, offering a degree differential and

opportunities for professional growth and promotions.

To increase the number of BSN-, MSN- and PhD-prepared

nurses, Children’s Hospital strongly supports and

encourages nurses to pursue advanced degrees. Nurse

leaders allow flexible scheduling to accommodate school

and home life. The hospital offers financial support for

education and informs nurses of opportunities for

advanced degrees at local colleges and universities.

These opportunities include:

•Tuitionassistanceprogram

•RNtoBSNprogramgrant

•TerryVarattaScholarshipsfornursinggraduatestudents

•NursingcollegeanduniversityinformationsessionsatChildren’sHospital

Thinkingofgoingbacktoschool?Justdoit!

New Advanced Degrees in 2010

Bachelor’s Degree

VictoriaDuncombe,RN,(PediatricIntensiveCareUnit)

receivedaBSN

TeresaEsquivel,RN,(4West)receivedaBSN

LibertyGarcia,RN,(4West)receivedaBSN

KhadijahKhan,RN,(Rheumatology)receivedaBSN

VanessaRios,RN,(6North)receivedaBSN

TylaVecchiarelli,RN,(PostAnesthesiaCareUnit)receivedaBSN

Master’s Degree

CherylFranco,RN,(ClinicalCareCoordinator)receivedan

MSN(NursingEducation)

JamieLin,RN,(PediatricIntensiveCareUnit)receivedanMSN

(LeadershipandManagement)

JessicaMoller,RN,(BoneMarrowTransplantation)receivedan

MSN(NursingLeadershipandManagement)

SashaReis,RN,(4East)receivedanMSN/PNP/CNS

DesireeRitter,RN,(NursingResources)receivedanMSN

(HealthAdministration)

KimTull,RN,(5West)receivedanMSN/FNP

Nurse Leaders

54%Master’s Degree

42%Bachelor’s Degree

1%DoctorateDegree

3%Associate’s

Degree

Collaborative GovernanceAfteranotheryearandachangeinmembership,theCollaborative

Governancestructurecontinuestomeetitsgoals:toensuredecision-

makinghappensatthestafflevelandtoimproveefficiency,coordination

andcommunicationamongthehospital’sPatientCareServices(PCS)

initiatives.Thefollowingarecouncilaccomplishmentsfor2010.

House of Representatives (Chairs: Nicole Ainsworth, RNC-NIC, and Shannon Duffy, MPH, RD, CNSD)

•ProposedthatapplicantsfortheVersant™RNResidencyberequiredtohaveabachelor’sdegree.

•InstitutedUnitHuddleswithinPCS(Seepage18formoreinformationonUnitHuddles).

Recruitment and Retention Council (Chairs: Vanessa Guerrero, RN, BSN, CPN, and Carola Mendez, Child Life Specialist)

•ConductedaPCSNeedsAssessmenttounderstandtherecruitmentandretentionneedsofstaff.

•ImprovedbilateralcommunicationbetweenHumanResourcesandPCSstaff.

•ImplementedtheElectronicEmployeeSuggestionBoxincollaborationwithHumanResources.

•CollectedinformationfromdifferentPCSdisciplinesregardingrecruitmentandretentionactivities.

•CoordinatedallPCSdisciplinerecognitionweeksandensuringrecognitionandactivitiesareincludedinstaffe-newsletterandcalendar.

•IntroducedtheHuddlesconceptanditsapplicationforallworkareastotheHouseofRepresentatives.

•RecommendedtheusethePESscaleforthe2010Children’sHospitalLosAngelessurvey.

•Implementedtheplacementofthecommunicationboardatemployeeentrance.

•ContributedsuggestionsfortheEmployeeTimeOffChanges.

•CoordinatedactivitiesforNurseWeek2010Quality Council (Chairs: Jennifer Baldwin, RN, CPN, and Kristine Gawley, RN, CPN)

•DevelopedtheNPO(Nilperos,Latinfor“nothingbymouth”)projectaimedatimprovingpatient/familysatisfactionscoresrelatedtotheNPOpolicy/procedurewhichinvolvedsurveyingparentsofchildrenwhorequiredNPOstatus.Providedsuggestionsrelatedtopolicychanges,incorporatingchangesinKIDSorderingprocessandstaff/physicianeducationandanalysis.

•Developed“MedicusInterruptus,”amulti-unitperformanceimprovementproject,whichaimstodecreaseadministration-relatedmedicationerrorsby80percentbyminimizingworkinterruptionsandstandardizingthemedicationadministrationprocess(Seepage17formoreinformationonMedicusInterruptus).

•DevelopedFallsPreventionproject,withagoalofareductioninthenumberofpatientfallswhileusingamultidisciplinaryapproach,updatingcurrentpolicyandcareplanandmaking

MembersoftheHouseofRepresentatives.

TheAmericanNursesCreditialingCenterMagnetRecognitionProgramGuidelinesfor2013statethatallnursemanagersmusthaveabachelor’sdegreeinnursing—agoalthatChildren’sHospitalLosAngelesalreadyhasachieved.

10 C H I L D R E N ’ S H O S P I T A L L O S A N G E L E S N U R S I N G A N N U A L R E P O R T 2 0 1 0 11

Professional Engagementrecommendationsforprovidingnon-slip,circumferentialfootwearforpatients.Alsoimprovedsignageregardingtheriskofpatientfallsanddevelopedpatient/familyteachinginformation.

•DevelopedtheIntravenous(IV)InfiltrateReductionplan,amultidisciplinary/multi-councilcollaborationwiththegoalofreducingallgrade3and4IVinfiltratestozero.ProvidedmodificationoftheIVinfiltrationIncidentReportForm,initiatedahouse-widepilotofanewIVsecurementdeviceanddevelopedrecommendationsforeducation.

•DevelopedtheHandHygieneProject,asystemthatwillrequireimplementationofthehandhygieneperformanceimprovementprojectifanyunit/clinichastwoconsecutivequartersoftotalcompliancedatathatarebelowthebenchmarkof90percent.Alsoimplementedpublicdisplayofhandhygienedataforallinpatientunits.

•Providedinputregardingtheselectionofnewisolationgownsrelatedtocost/usageissueofthecurrentgownsupply.

•ConductedUnitTracerPresentationsforthecouncil,whileprovidinginputregardingdeficientareas,theirfishboneanalysisandactionplans.

•Reviewedvariousperformanceimprovementprojectpresentationsforevaluationsandfollow-up.

Clinical Practice Council (Chairs: Nida Oriza, RN, BSN, and Terrie Ballard, RN, CPN)

•UpdatedtheaudittoolforMultidisciplinaryPlanofCare(MPC),Data-Action-Response-Plan(DARP)andeducationpowernotes.

•Analyzedunitgenericbiannualauditstoensure90percentcompliance.

•ImplementedanewaudittoolforLicensedVocationalNursedocumentation.

•ImplementedPediatricEarlyWarningScore(PEWS)systems,basedonvitalsignsandbehaviors.PEWSisdesignedtohelpidentifykidsatriskofgettingsickerandpreventtheneedfora

transfertoahigherlevelofcare.AlsodevelopedPEWSauditform,andunitauditsaredoneforcomplianceandimprovementoftheprocess.Complianceratesareincreasingthroughoutthehospital.

•Tohelpresolvecommunicationissues,the“Situation,Background,Assessment,Recommendation,Questions”(SBARQ)processforhand-offcommunicationwasimprovedbydevelopingtheTicket-to-Ridecommunicationtool,utilizingtheKIDSelectronicmedicalrecordssystemforreal-timeinformationatreport,whencommunicatingwithdoctorsorwhencallingreportstootherunits.

•UpdatedTicket-to-RideformandworkedwithSuperKIDSteamtomoveformintoKIDS.

•ReviewedallcurrentcareplanstoaidinthedevelopmentoftheElectronicMultidisciplinaryPlanofCare(eMPC).

•Improvedtheprocessforgeneratingdischargeinstructionsforpatientsandfamilies.

•ApprovedandimplementednewMultidisciplinaryPlansofCare

(MPCs)forend-of-lifecareandheart,lung,kidney,liverandsmallboweltransplants.

•EmergencyReviewFormandfeedbackprocessafterRapidResponseTeam/CodeBlue.

•PreparedContrastScreeningFormtobeuploadedintoKIDS(computerizedcharting).

•Workedwithhospitalpolicycoordinatorstofacilitatereviewandapprovalprocess.

•Completed360PeerReviewforperformanceevaluationforimplementationinJuly2011.

•CompletedScopeofPracticegridsforPCSdisciplines,includingUnitAssistants,PatientCareServiceAides,Pharmacy,SpiritualCareServices,SocialWork,SpeechPathology,outpatientmedicalassistantsandDiversityandLanguageServices.

•CollaboratedwithPatientFallsTaskForce.

Education, Research and Development Council (Chairs: Edahrline Salas, RN, BSN, MA, and Sandra Hall, RN, BSN)

•ScheduledandfacilitatedthePCSGrandRounds.

•OrganizedthehousewidePCSEducationFair.

•Implementedandrecommendededucationplansandevaluationson:

°Epiduralpolicyupdateeducation

°PEWSEducation

°IVInfiltrateForms:re-educationofstaffrelatedtouse

°SBARQ:re-educationandevaluation

°MedicationErrorReductionPlan(MERP)preparedness

°Sterillium/Remedyhandlotion °Positionalcarseattesting

°Formulapowderpointers

°Codeevaluationprocessupdate

°Nasogastric(NG)andtracheostomypolicyupdateeducation

°Ultrasorbpads/linenusage:educationtoworkareasregardingproductchange

°Point-of-caretestingreagentandsuppliesupdateeducation

°Centralvenouscatheter(CVC)teachingrecommendations

°InfectionControlpolicyupdates:educationtoworkareasregardingpolicychanges

•SelectedrecipientsfortheTerryVarattaScholarshipfornursinggraduatestudents.

•ResearchInfrastructure:advisedandidentifiedneeds,includingaresearchclass,incoordinationwithFelicitasdelaCruz,RN,DNSc.

CarolaMendez,ChildLifeSpecialist(left),andVanessaGuerrero,RN,withRichardD.Cordova,FACHE,presidentandchiefexecutiveofficer,Children’sHospitalLosAngeles.

HouseofRepresentativesmemberslistentoapresentation. GloriaVerret,RN,(left)andJoanClark,RN.

AileenDeGuzman,RN,(left)andKimKaloustian,PT.

EdahrlineSalas,RN,enjoysalightermomentduringapresentation.

12 C H I L D R E N ’ S H O S P I T A L L O S A N G E L E S N U R S I N G A N N U A L R E P O R T 2 0 1 0 13

Commitment to Community Involvement

Morethanhalfofthe1,000nursesatChildren’sHospital

LosAngelesregularlyvolunteerinthelocalandglobalcommunity.

Intandemwithphysicians,surgeonsandotherpediatricexperts,

nursesfromthehospitalreachthousandsofchildrenayearfrom

aroundtheworld.

Theirdedicationtoprovidingcareforchildreninunderserved

areasoftheglobe—bothathomeandabroad—istheresultof

knowledgeablestaffbackedbyanorganizationthatvaluesand

respectsdiversitywhileactivelyaddressingchildren’shealthbarriers

anddisparities.

“CulturallysensitivenursingcareisbusinessasusualatChildren’s

HospitalLosAngeles,”saysNoreenClarke,RN,MSN,who

directstheInternationalCraniofacialChildren’sFund(ICCF)atthe

hospital,whichhelpsprovidetreatmenttointernationalpatients.

“We’reusedtodealingwithchildrenfromavarietyofcultures

andwehavetheinfrastructuretosupporttheirspecialneeds.”

Thoseimportanttoolsincludediversestaff,extensivetrainingin

culturalcompetency,yearsofexperiencewithdiversepopulations andaDiversityServicesDepartmentthataidsininterpretationand

otherkeycommunications.Together,thesetoolsensurethatthe

hospitalisreadyandpreparedtohelp.

Pre-andpost-operatingroomnursesandnurseeducators,among

othersfromthehospital,regularlydonatetheirmuch-neededskills

internationallythroughprogramssuchasOperationSmile,

MendingKidsInternationalandInterplast.

WhentheHaitianearthquakestruckin2010,nursesfrom

Children’sHospitalwereamong20hospitalvolunteerswho

traveledtothedevastatedcountrytoprovidemedicalsupport.

ThegroupofferedhelpthroughProjectMedishare,anonprofit

organizationcommittedtoimprovinghealthconditionsinHaiti.

Duringthetwo-weekdeployment,nursestendedtowounds,

sepsis,severedehydrationandrespiratorydistressbroughton

bythequake.

“Iwantedtohelpthroughaction,”saysAnneVitug,RN,whoworks

inthePediatricIntensiveCareUnit(PICU)atChildren’sHospital

andtraveledtoHaiti.“Ithinkthat’swhywedowhatwedoas

doctorsandnurses.Wecanusewhatknowledgewehaveand

makeadifference.”

Nurses’timeandtalentsalsoaredeployedathomewhen

internationalpatientscometoChildren’sHospitalfortreatment.

In2010,nursestookpartinthecareof34childrenfrom16

countriesthroughICCF,theprivatelyfundedorganizationClarke

directsatthehospital.

OnespecialcasewasHashimZareef,a10-year-oldboyfromIraq

whocametoChildren’sHospitalforlife-savingsurgerythrougha

collaborationbetweenICCF,MendingKidsInternationalandthe

ChildrenofWarFoundation.

Injuredbyanimprovisedexplosivedevice(IED)inBaghdad,

HashimwasbroughttotheU.S.fortreatmentforheadtraumain

August2010.HethenunderwentaseriesofsurgeriesatChildren’s

Hospitaltoplaceatitaniumplateoverhisinjuredskull.Nurses

assistedeverystepofthewayduringtheboy’smonths-long

recovery.Nowhealthy,HashimhasreturnedtoIraq.

“Thebottomlineisthatweareprepared,”Clarkesays.“Whether

it’sachildfromBangladesh,EthiopiaorChristmasIsland,weare

well-preparedtotreattheirmedicalandsurgicalneedsina

culturallysensitivemanner.”

More than half of the 1,000 nurses at Children’s Hospital Los Angeles regularly volunteer in the local and global community.

International Help

JaceVargas,RN,(left)andAnneVitug,RN.

WhentheHaitianearthquakestruckin2010,nursesfromChildren’sHospitalwereamong20hospitalvolunteerswhotraveledtothedevastatedcountrytoprovidemedicalsupport.

Duringthetwo-weekdeploymenttoHaiti,nursestendedtowounds,sepsis,severedehydrationandrespiratorydistressbroughtonbythequake.

NancyAguirre,RN,(fromleft)AlannaRowley,RN,andAlejandraBriseno,RN,inHaiti.

ThepediatricwardinHaiti.

VolunteersofferedhelpthroughProjectMedishare,anonprofitorganizationcommittedtoimprovinghealthconditionsinHaiti.

14 C H I L D R E N ’ S H O S P I T A L L O S A N G E L E S N U R S I N G A N N U A L R E P O R T 2 0 1 0 15

Commitment to Community Involvement

Institute for Maternal-Fetal Health

When expecting parents discover that their unborn child is

not healthy, the stressors they experience include coping

with their unfortunate reality while simultaneously

figuring out how to get help. It’s not easy to find medical

services that will try to assist in the need of both the

mother and fetus, as well as promote open communication

and collaboration between health care teams.

Toresolvesuchfragmentedcare,Children’sHospitalLosAngeles

andtheUniversityofSouthernCalifornia(USC)partneredto

establishtheCHLA-USCInstituteforMaternal-FetalHealth(IMFH).

Thisprogram,uniquetoSouthernCaliforniawithonlyafewsimilar

programsnationwide,providescomprehensivecaretomothersand

theirunbornchildren.Theprogramrecognizesthatitmusttreatboth

themotherandthefetusseparatelybecausetheyrequiredifferent

therapies.Buttheprogramalsoensuresthatspecialistscollaborate

andcoordinatecareforoptimalhealthandasafedelivery.

TheIMFHteamismadeupofaninterdisciplinarygroupof

obstetricians,specialtyphysicians,nursesandpsychosocial

counselors.TheofficeislocatedatHollywoodPresbyterian

MedicalCenter,adjacenttoChildren’sHospital.Themother

comestoreceiveobstetricalcareandmeetwiththeChildren’s

Hospitalteamofspecializedphysicians,includingneonatologists

andsurgeons.Theteamandparentsdiscusstherecommended

planofcarefortheunbornchild,basedonspecializedtestsand

diagnostics.OncethechildisdeliveredatHollywoodPresbyterian,

thebabyistransportedtoChildren’sHospitalviatheChildren’s

HospitalTransportTeam.

Theparents’journeytotheIMFHbeginswiththeirobstetrician.

DoctorsreferpatientstotheIMFHiftheydetectafetalanomaly.

ThesereferralsgenerallycomefromtheLosAngelesarea,buthave

comefromasfarasBakersfieldandtheInlandEmpire.Oncethe

motherarrives,sheisfurtherevaluatedbyoneoftwonursecare

managers:SheilaPerez,RN,BSN,andIreneKlecha,RN,MSN.

PerezandKlechahaveaspecialandcomprehensiverolein

coordinatingcareforboththemotherandunbornchild.Perez

explainsthatherinitialrole,whenshemeetsthefamiliesforthefirst

time,isto“introducemyselfandexplainwhatIdo.Ispendtime

withthemtobestexplainthedefectanditspathophysiology.Then

Ilistenandsupportthememotionally.”

Currently,PerezandKlechacoordinatecareformorethan

90patientsatatime.“Italktotheperinatologist,obstetrician,

neonatologist,geneticists,surgeonsandtheunitacceptingthe

patient,”saysPerez.Thiscoordinationisvitaltotheteam’s

communicationsothatnoinformationisleftout.Theyprepare

packetscompletewiththemother’sinformation,thephysician’s

notes,labanddiagnosticresultsanddeliverthemtotheaccepting

units,usuallytheNewbornandInfantCriticalCareUnitor

CardiothoracicIntensiveCareUnit.Theyalsonotifytheteam

ofthemother’sexpecteddeliverydateandcoordinatetheneonate’s

transfertoChildren’sHospital.

Inaddition,theyoffercomforttoparentsbygivingthemtheir

pagernumbersforanyquestions,concernsoremotionalsupport.

Theyeventrytoattendthedelivery,toprovidetheparentswith

reassuranceandtoensurethecontinuityofcareafterbirth.

Thesenursecaremanagerstrulyembracethespiritofnursing.

Theyareteachers.Theyareautonomousandcriticalthinkers.

Theyarepatientadvocates.Theyprovidepsychosocialsupport.

Theyareinterdisciplinaryfacilitators.Withouttheirnursingservice,

thecontinuityofcarewouldbebroken.

PerezdescribesherroleintheIMFHwithpride.“Itisahardjob,

butitisrewarding,”shesays.“TheIMFHisnurse-driven;we

coordinatethecare.Wearethepatientadvocates.”

SheilaPerez,RN,BSN IreneKlecha,RN,MSN

Recognition of Nursing: The 2010 DAISY Awards The DAISY Awards, which recognize nurses who

exemplify excellence in patient care, have become a

celebrated tradition at Children’s Hospital Los Angeles.

BonnieandJ.MarkBarnesfoundedtheDAISY(DiseasesAttacking

theImmuneSystem)Foundationinmemoryoftheirson,J.Patrick

Barnes,whodiedofcomplicationsfromhisautoimmunediseases

(idiopathicthrombocytopenicpurpura)atage33.Intributeand

appreciationofthenurseswhocaredfortheirson,theDAISY

Foundationwasestablishedtohonornurseswhopositivelyimpact

thelivesoftheirillpatientsandcopingfamilies.

Children’sHospitalisoneofmorethan50hospitalsinthe

UnitedStatesthathavepartneredwiththeDAISYFoundation.

RecipientsoftheDAISYAwardreceiveacertificate,aDAISYpin,

Cinnabon®cinnamonrollsandauniquehand-carvedstatuecalled

“TheHealer’sTouch,”createdbyartisansinZimbabwe,Africa.

JanuaryKerryMoller,RN

FebruaryAliceLoo,RN,MSN,CPON

MarchCathyFoster,RN,MSN,PNP

AprilMiguelAventino,RN

MayMariaLapinid,RN,BSN,CPON

JuneMariaDakan,RN,BSN

JulyMargauxChan,RN,BSN

AugustLindsayQuirk,RN,BSN

SeptemberDonnaQuiroz,RN,BSN,CPON

OctoberStephanieBrown,RN,BSN

NovemberCherylBarton,RN,MSN,NP

DecemberChristinaSmith-Cruso,RN,BSN,CPON

16 C H I L D R E N ’ S H O S P I T A L L O S A N G E L E S N U R S I N G A N N U A L R E P O R T 2 0 1 0 17

Recognition of Nursing

Mary Dee Hacker Inducted as a Fellow into the American Academy of Nursing

The “GEM” (Going the Extra Mile) Award

TheGEMAwardrecognizesindividuals,

includingnurses,whoexemplifythe

valuesofChildren’sHospitalLosAngeles:

Excellence,Teamwork,Service,Respect

andKnowledge.Thesearethevalues

thatmakeChildren’sHospitaloneofthe

tophospitalsinthenation.

Culture of Safety

New Project Aims to Reduce Medication ErrorsAcross the country, medication errors account for most

mistakes made in hospitals.

AtChildren’sHospitalLosAngeles,anewprogramaimsto

changethatnorm.BasedontheMedRiteprogramcreatedby

KaiserPermanente,theMedicusInterruptusprojectseeksto

decreaseinterruptionsthatmostnursesexperiencewhilegiving

patientsmedication.

“Thegoalistoreducedistractionsfornursesandanyoneelsewho

administersmedication,”saysSherryNolan,RN,MSN,CNS,

clinicalmanagerof5East.“Lotsofresearchshowsthatyouhave

tofocus.It’sacomplextask,andit’shardwhenyou’reinterrupted

allthetime.”

NolanworkedontheprojectwiththePatientSafetySubcommittee,

partoftheQualityControlCouncilatChildren’sHospital.

Asadviser,sheandCherylMcCauley,RN,CPN,committee

chairwomanandanurseon5West,serveasgroupcoordinators.

Medicus Interruptus works like this:•Nursespreparingandadministeringmedicationwearareflectiveyellowsash.

•Yellowandblacktapearoundmedicationcartsindicatesthatthenurseinthe“squareofsilence”shouldnotbeinterrupted.Thestepsofmedicationadministrationarepostedaswell.

•Signsoncartsread,“MedsBeingGiven,PleaseDoNotInterrupt.”

Inadditiontotrainingprograms,postersandfliersweremadefor

otherhospitalgroupsandparentstoexplaintheproject.“When

you’reoutinthemiddleofthehall,peoplecatchyouandask

questions,whetherthey’rephysiciansorparents,”Nolansays.

“Nursesthoughtthisideawasalittlehokeyatfirst,butnowthey’re

seeingthattheycangetreallyfocused.”

Observationsthroughoutthehospitaldemonstratedtheneed

forsuchaprogram,Nolansays.Both5Westand5East

beganservingaspilotunitsfortheerror-reductionprogram

inMay.

Thegoalwastodecreaseadministration-related

medicationerrorsby80percentbytheendofAugust,

whilestandardizingtheprocess.Medicationerrorratesfrom

theparticipatingfloorswerethencalculatedbytheQuality

Department.Theprogramwasrolledouttotheentire

hospitalinthefall.

TheMedicusInterruptusprojectseekstodecreaseinterruptionsthatmostnursesexperiencewhilegivingpatientsmedication.

NurseSandraEspinosa,NNP,washonoredwithaGEMawardinMay2010.

MaryDeeHackerreceiveshercertificatefromAmericanAcademyofNursingpresident-electJoanneDisch,PhD,RN,FAAN.

HumanismAwardwinnerLisaHatter,RN,BSN,withRichardD.Cordova,FACHE,presidentandchiefexecutiveofficer,Children’sHospitalLosAngelesandEyalBen-Isaac,MD.

MaryDeeHacker,MBA,RN,FAAN,vicepresident

ofPatientCareServicesandchiefnursingofficeratChildren’s

HospitalLosAngeles,receivedtheprestigioushonorofbeing

inductedasaFellowintotheAmericanAcademyofNursing.

HackerwasinductedNov.13,2010,duringtheAcademy’s

37thannualMeetingandConferenceinWashington,D.C.The

Academy’sFellowsrepresentthenation’smostaccomplishednurse

leadersineducation,management,practiceandresearch.

“Receivingthisrecognitionistrulyanhonorforme,”saysHacker,

whobeganhercareeratChildren’sHospitalin1975asastaff

nurse.Herdistinguishedcareerincludesmanyachievementsand

honors,includingleadingthehospitaltoMagnetRecognitionin

2008andbeingthedrivingforcebehindtheinnovativeVersant™

RNResidencyinPediatricsProgram,createdin1999inresponse

tothenationalnursingshortage.HackeralsoreceivedtheDiane

CooperLifetimeAchievementAwardfromNurseWeekmagazine

in2009,andwasrecognizedin1997byCalifornia Medicine

magazineasoneof“California’s100MostInterestingand

InfluentialHealthcareLeaders.”Afrequentspeakeratstate,

regionalandnationalmeetings,Hackersayssheiscommittedto

beingastrongadvocateforthenursingprofessionandimproving

thenation’shealthcaresystem.

The Morris and Mary Press CHLA Humanism AwardSince1973,Children’sHospitalLosAngeleshasupheldthe

traditionofhonoringindividualsandadepartment/workarea—

allofwhomhavebeennominatedbytheirpeers. 

TheMorrisandMaryPressCHLAHumanismAwardshonor

workersandaworkareaordivisionwhogobeyondtheirdaily

jobexpectationsindemonstratingsuperlativeandconsistent

kindnessandthoughtfulnessintheirinteractionswithco-workers,

patientsandguests.The2010NursingwinnerwasLisaHatter,

RN,BSN,and6WestwontheWorkAreacategory.

Theirrespect,service,excellence,knowledgeandteamworkin

customerrelationsandcarealsomakeChildren’sHospitalLos

Angelesawarmer,friendlierandmorecompassionateplace.

18 C H I L D R E N ’ S H O S P I T A L L O S A N G E L E S N U R S I N G A N N U A L R E P O R T 2 0 1 0 19

Culture of Safety

6 North Unit Huddles

Professional Practice ModelThe Magnet Recognition Program envisions health care as a

dynamic entity, continually evolving into a better system of

care. This is why the program stresses that hospitals must

“raise the bar” to achieve high-quality patient outcomes.

In2006,agroupofnursesofalllevelscreatedtheProfessional

PracticeModeltoillustratenursingpracticeatChildren’sHospital

LosAngeles.Itwaspresentedhouse-widefornursestoembrace

andwasincludedintheMagnetdocumentsubmittedin2007.

SM

Now,aswegothroughtheprocessofMagnetre-designation,the

applicationrequestcallsfortheorganizationtodemonstratehow

nurseshaveanalyzed,evaluatedandmodifiedtheProfessional

PracticeModel.

Infall2010,agroupofnursescalledtheMagnetChampions

cametogethertore-evaluatethemodelandmakerevisionstofitthe

currentvisionofChildren’sHospital.Theyalsobroughtthemodel

totheirownunits/departmentsformorenursinginput.Afterallthe

nurses’collaborativeefforts,thenewProfessionalPracticeModel

wasfinalizedinthespringof2011.

The building blocks represent what nurses do at Children’s Hospital Los Angeles.

They capture what is essential in our practice. Teamwork and lifelong learning

are key to providing family-centered care to our patients. The continuous circle

represents our ongoing efforts to acquire and share knowledge, to provide

service, to give respect to our patients, families and colleagues and to improve

and sustain quality in our practice.

A6NorthnightshiftHuddle.

Merriam Webster’s definition of huddle is “to come

together closely in a group.” This definition perfectly

describes the concept behind Unit Huddles at Children’s

Hospital Los Angeles. The Huddles have a simple goal:

to increase communication and teamwork.

In2008,beforeUnitHuddleswereimplementedon6North,an

internalsurveygatheredfeedbackonteamworkandcommunications.

Theresultsshowedroomforimprovement.

PhanDang,RN,broughtuptheideaofHuddlesattheunit

leadershipretreatinJanuary2008;Huddleshadbeenused

effectivelyatherpreviousjobandincreasedteamworkand

communication. Theleadershipteamembracedandsupported

theconcept,andHuddleswereofficiallyimplementedon6North

onFeb.12,2008.

Children’sHospitalisateachingfacilitywithconstantchange.

Achallengetoanyteachingfacilityistocommunicatethese

changestostaff.Itissometimesdifficultforstaffmemberswho

donotworkdailytokeepupwithemailupdates,policyand

procedurechangesandanyneweventsorrequirements—

especiallyonesthataffectpatientcare.Thissameconcernalso

wasexpressedinthePatientCareServicesRecruitmentand

RetentionSurveydoneinJanuary2010.

What are Unit Huddles?

AUnitHuddleisafive-minute-or-less“huddle”—agatheringofall

on-comingstaff.Theseshortmeetingsoccurateverychangeof

shift,sothatallon-comingstaffcanhuddlewhilethecurrentstaff

arecaringforpatients.Theon-comingchargenurseleadsthe

HuddlesandannouncestheupdatesfromaHuddleannouncement

sheetthatisupdatedbymanagerseveryMonday.

Thefocusistocommunicateanyupdatestostaffbeforetheystart

theirshift.InformationontheHuddleannouncementsheetincludes

howmanypatientsareexpectedforthatparticularshift,staffing

situations,anycriticalpatientstatuschanges,eventshappeningin

thehospital,neworupdatedpolicies,requirementdeadlineslike

CHEXandwhichmanagerisoncall.Huddlesalsocanbeusedto

recognizestaffforachievements,thankpeopleforworkingovertime

andintroducenewstaff.

Overcoming Challenges

TherewerechallengestoimplementingUnitHuddlesbecausethey

representedchange.Forexample,somewereconcernedthat

Huddleswouldcausestafftostartreportslate,makereportstake

longer,increaseovertimeorwastestafftime.Therealityisthat they

areshort—fiveminutes—anddecreaseovertime.Theyalsomake

reportsmoreefficientbecausestaffalreadyhaveanideaofhow

theirshiftisgoingtogo.

Withconsistenteffortandsupportfromthe6Northmanagers

andleadershipcommittee,huddlingisnowapositivereality

on6North.

Positive Change

Huddleshaveimprovedstaffawareness.Becausechangesare

constantlycommunicatedtostaffviaHuddles,compliancewith

newhospitalandunitrequirementshasimproveddramatically.

Tardinessalsohasbecomeaveryrareissuebecauseeveryoneis

requiredtohuddleatthebeginningofeveryshift.Huddlessetthe

toneforthebeginningofeveryshiftandincludeeverystaff

member: RNs,LVNs,patientcareserviceaides,unitassistants

andevennursingstudents.Thishasdefinitelyledtoincreasedstaff

satisfactionwithteamworkandcommunicationbecauseeveryone

knowsthattheyarepartoftheteam.

ExactlyoneyearafterUnitHuddleswereimplemented,thesame

internalsurveywasgivento6Northstaff.Theresultsreflectedvery

positiveimprovementsinthestaff’sperceptionofcommunication

andteamwork.Huddlesareanexcellenttoolthatwillbeusedfor

yearstocome.

20 C H I L D R E N ’ S H O S P I T A L L O S A N G E L E S N U R S I N G A N N U A L R E P O R T 2 0 1 0 21

Innovation

As a pediatric nurse, Kelli Anderson, RN, BSN, (Cardiac

Catheterization Lab) is accustomed to family members,

neighbors and friends asking her all types of child-related

health and safety questions. As a mom of two teenage

boys, the 22-year veteran nurse also has firsthand

experience with topics that concern parents most. Now,

Anderson and a select group of other Children’s Hospital

Los Angeles nurses are sharing their vast knowledge in a

more global and Internet-savvy way: by blogging.

Anderson,JenniferBuchanan,RN,MSN,(Cardiology)and

DeborahBraidic,thehospital’smanagerofWebcontent,launched

theinnovativeRNRemediesblogseriesinNovember2010.

Blogposttopicsrangefromcommonchildhoodconditionsto

safetytipsforinjurypreventionandissuesregardingteenhealth.

Sinceitslaunch,sevenmorenursebloggershavejoinedthe

RNRemediesteam,supportedbythehospital’sin-houseblogger,

WebContentCoordinatorLisaTimmons.Inaddition,regular

contributorsGloriaVerret,RN,CPN,(SurgicalandKidney/

LiverTransplant)andTereJones,RN,CPN,(Medical/Surgical)

havejoinedAndersonandBuchananasfeaturedbloggersby

consistentlycontributingblogpostsduringtheprogram’scrucial

firstsixmonthsofexistence.

“Alargepartofourjobiseducatingtheparentsofourpatients,”

saysBuchanan,whohasbeenworkingatChildren’sHospital

forthepastfouryearsandalsoisacertifiedlactationeducator.

Buchananhasbeenworkingwithchildrenherwholelife,enjoying

previousrolesasacampcounselor,snowboardinstructorand

patientcareassociate.

“Thisblogallowsustogettheinformationouttothecommunity

beyondourpatientsandtheirfamilies,”addsBuchanan,who

beganhernursingcareerintheNewbornandInfantCritical

CareUnitatChildren’sHospital.

AsGallup’snationalsurveyindicatesyearafteryear,nursesare

amongthemosttrustedprofessionalsinthenation.Meanwhile,

Children’sHospitalnursesareattheforefrontofcontinuing

educationandcutting-edgeresearch.Soit’snotsurprisingthatthe

RNRemediesblogseriesisaccumulatingasteadycoreoffollowers.

FeaturinganewposteachMondaymorning,theseriesreceives

approximately1,000hitseachmonth.Readersareencouragedto

emailquestionsorpostcomments,creatinganintimateconnection

betweenthenursebloggersandreaders.

“We’reworkingondevelopingtheblogandexpandingittoreach

abroadercommunity,”explainsBraidic.“Ournurseshavesuch

greatpassionanddedication,andwe’resoproudofthem.This

uniqueprogramreallyallowsournurses’voicestobeheard.”

Asthesitegrows,Buchanansaysshehopestoseemorenurses

startblogging.“Wehavesomanyexpertsatthishospital.We

canbeagreatsourceofinformationforfamilieseverywhere.”

Anderson,whoalsoteachespubertyclassesatelementary

schoolsinhercommunity,sayssheneverthoughtshewouldbea

“blogger,”butlikestheopportunitytoreachouttopeople,educate

thecommunityandmakeadifference.

“It’sawholenewworld,”shesays.“Iwaswalkingdownthehall

theotherdayandsomeoneyelledoutthattheyhadjustreadmy

blog…that’sagreatfeeling.”

VisitWearechildren’s.orgfortheRNRemediesblog.

Research

Lectures

Karen Rodriguez,RN,gaveanoralpresentation,“Nurse

PractitionerChampioned:PediatricTraumaContinuityClinic

Utilizingthe‘MedicalHome’Concept,”attheAmericanPediatric

SurgicalNursesAssociationinOrlando,Fla.,inMay2010.

Laura Klee,RN,participatedinthepaneldiscussion,“ECMO:

theSouthernCaliforniaExperience,”forthefirstCoastalCalifornia

AssociationofNeonatalNurseseducationalconferencein

February2010.

Debbie Jury,RN,gaveaguestlecture,“PrinciplesofPediatric

Pain,”attheUCLASchoolofNursing.

Jennifer Murray,RN,lecturedonthesubjectofpediatricpalliative

careandnursingeducationatthe2010AmericanAcademyof

HospiceandPalliativeMedicine,andattheHospiceandPalliative

NursesAssociationAnnualAssemblyinBoston.

Colleene Young,RN,gavelectureson“HemofiltrationCase

Studies”and“ScVO2Monitoring:RevealingWhatTraditional

VitalSignsMayNot”atthePediatricCriticalCareNursing

ConferenceinSanDiegoinOctober2010.

Colleene Young,RN,gaveapresentationon“NurseResponsibilities

andClinicalDecision-MakingWhenCaringforCriticallyIll

PediatricPatientsRequiringContinuousRenalReplacement

Therapy”attheEuropeanAcademyofPaediatricSocietiesin

Copenhagen,Denmark,inOctober2010.

Fran Blayney,RN,presentedalecture,“AcuteKidneyInjury:

InvestigatinganOldCriminalwithaNewTool,”atthePediatric

CriticalCareNursingConferenceinSanDiegoinOctober2010.

David Schmidt,RN,presentedtwolectures,“CVVHDF:ANurse-

RunProgram”and“BustingBSIinthePICU,”atthePediatric

CriticalCareNursingConferenceinSanDiegoinOctober2010.

Noreen Clarke,RN,andSusan Cline,RN,presented“Maka’s

Story:BringingInternationalHealthCaretoourHometown,”atthe

NationalMagnetConferenceinPhoenixinOctober2010.

Sandra Watcher,RN,presentedalecture,“MakingtheComplex

Simple:TeachingourPediatricPatients,”attheAmericanCollege

ofRheumatology’s(ACR)ScientificConferenceinAtlantain

November2010.Shealsowasafacilitatorfortheconference’s

InfusionTherapyNetworkingSessionandservedasamoderator.

Inge Morton,RN,presentedalecture,“PediatricTrauma:

LateOnsetComplications,”attheEmergencyNursesAssociation/

EmergencyDepartmentApprovedforPediatricsConference

atPresbyterianIntercommunityHospitalinWhittier,Calif.,in

October2010.

Victoria Winter,RN,presented“FamilyMaking:AGrounded

TheoryStudy”attheSigmaThetaTauConference,Nursing

Odyssey2010,inSanDiegoinOctober2010.

Anna Evans,RN,presentedacarereport,“PregnancyinaPatient

withAnaplasticOligodendrogliomaTakingTemozolomide,”atthe

SocietyofNeuro-OncologymeetinginMontreal,Canada,in

November2010.

Posters

Karen Rodriguez,RN,hadaposterpresentation,“Implementation

ofaPediatricTraumaContinuityClinicUtilizingthe‘Medical

Home’Concept,”attheSocietyofTraumaNurses(STN)in

Orlando,Fla.,inApril2010.

Diane Altounji,RN,Monica Grover,RN,andPeggy Townsend,

RN,presentedtheirposter,“CaringfortheCaregiver:Supportive

CareforNurses,”attheAssociationofPediatricHematology/

OncologyNursesconferenceinMinneapolisinOctober2010.

Jessica Klaristenfeld,RN,andEdahrline Salas,RN,presented

theirposter,“PosterPresentationProjects:AnInnovativeMethod

forDynamicallyBridginganRNResident’sJourneyfromStudentto

ProfessionalNurse,”attheNationalNursingStaffDevelopment

OrganizationConferenceinSanDiegoinJune2010.

RN Bloggers Create Dynamic Community Education Forum

KelliAnderson,RN,(left)andJenniferBuchanan,RN.

EdahrlineSalas,RN,(left)andJessicaKlaristenfeld,RN,nexttotheirposterattheOrganizationofHealthcareEducatorsProgram.

22 C H I L D R E N ’ S H O S P I T A L L O S A N G E L E S N U R S I N G A N N U A L R E P O R T 2 0 1 0 23

Research

Posters (continued)

Laura Vasquez,RN,andRita Secola,RN,presentedtheirposter,

“DevelopingaNursingEducationToolforAdministrationof

ChimericAntibodyinHighRiskNeuroblastomaPatients,”atthe

AssociationofPediatricHematology/OncologyNursesconference

inMinneapolisinOctober2010.

Peggy Townsend,RN,Maria Velasco,RN,Kellie Loera,RN,and

Rita Secola,RN,presentedtheirposter,“CapturingtheEducational

NeedsandPreferencesforGenerationalDifferencesinHematology/

Oncology/BMTNursing,”attheAssociationofPediatric

Hematology/OncologyNursesconferenceinMinneapolisin

October2010.

Jennifer Blaney,RN,Donna Quiroz,RN,Hazel Kolpak,RN,

Jasmin Uy,RN,andKristin Malicse,RN,presentedtheirposter,

“UtilizingaPatient-CenteredMedicationCalendartoImprovethe

DischargeProcessintheBMTPopulation,”attheAssociation

ofPediatricHematology/OncologyNursesconferencein

MinneapolisinOctober2010.

Dawn Landery,RN,Mary Moses,RN,andShinyi Tang,RN,

presentedtheirposter,“DevelopinganAllergyProtocolKardex

fortheHematopoieticStemCellPatient,”attheAssociationof

PediatricHematology/OncologyNursesconferencein

MinneapolisinOctober2010.

Maki Okada,RN,andKathleen Meeske,RN,presentedtheir

poster,“OperationalizingExerciseGuidelinesforAnthracycline-

TreatedCancerSurvivorsatChildren’sHospitalLosAngeles,”

attheAssociationofPediatricHematology/OncologyNurses

conferenceinMinneapolisinOctober2010.

Fran Blayney,RN,Cindy Rowlett,RN,Sue Bugsch,RN,Fran

Guzek,RN,Jessica Klaristenfeld,RN,andDebbie Reid,RN,

presentedaposter,“ImplementingPreceptorsBestPractices:

TeachingandSupportingtheModelPreceptor,”atthe

OrganizationofHealthcareEducatorsProgramin

Pasadena,Calif.

Publications

Meghan Middleton,RN,andDebbie Jury,RN,co-wrote

anarticle,“MyAchingBack,”forTherapy Times Magazine.

Catherine Goodhue,RN,co-published“DisasterandMass

CasualtyEventsinthePediatricPopulation”intheNovember2010

issueofSeminars in Pediatric Surgery.

Catherine Goodhue,RN,co-wrote“DisasterPreparednessAmong

MedicalStudents:ASurveyAssessment”intheSeptember/

October2010issueoftheAmerican Journal of Disaster Medicine.

Catherine Goodhue,RN,co-published“DisasterOlympix:

AUniqueNursingEmergencyPreparednessExercise”inthe

January/February2010issueofJournal of Trauma Nursing.

Karen Rodriguez,RN,andCatherine Goodhue,RN,published

“PediatricNursePractitionerImplementationofaPediatricTrauma

ContinuityClinicUtilizingthe‘MedicalHome’Model”inthe

Summer2010issueoftheJournal of Trauma Nursing.

Victoria Winter,RN,wroteachapter,“ExcellenceinPractice:

AResident-CenteredCarePrograminaLong-TermFacility,”inthe

Artinian Intersystem Model: Integrating Theory and Practice.

Mary Dee Hacker,MBA,RN,FAAN,publishedanarticle,

“MagneticallyCharged,”inADVANCE for Nursesin

October2010.

Catherine Goodhue,RN,hadanarticle,“MedicalHome

Model,”publishedintheApril/June2010issueofJournal of

Trauma Nursing.

Nurse Week Essay Winner

During nursing school, I remember always hearing that nursing was not a profession, that it was an art, a passion even. Partofmewroteitoff,dismissingitasoverzealousnursingprofessorsobsessedwiththeirprofession.Sure,Ienjoyednursing,butwasitapassion?ItwasnotuntilIstartedworkinginthePediatricIntensiveCareUnitatChildren’sHospitalLosAngelesthatIrealizedthoseprofessorsmightjustbeontosomething.Duringmyrelativelyshortcareer,IhaveseenmoreonmyunitthanIeverthoughtIwould.Mypatientshaverangedfromnewbornsto25-year-olds.Theyhavehadeverythingfromchronicillnessesthathavemadeitimpossibleforthemtoleavethehospitaltoanaccidentaltraumathathaslandedtheminourcare.Aspediatricnurses,wefocusnotonlyoncaringforourpatientsbutontheirfamiliesaswell.Ihaveseenparentsandfamiliesattheabsoluteworsttimeintheirlives,anditdidnottakemelongtorealizethatthisunitwasnotforthefaintofheart,orthosewholackedpassion.MaybeIdidhaveapassionfornursing.MaybeIwasnotgivingmyselfenoughcredit.

Buttherecameamomentwhenitbecameutterlycleartomethatnursingwasmypassion.Inorderforyoutounderstandit,Iwouldneedtotellyouastory.ItishardtoexplainthepurejoythatIfeelrememberingit.It’sastoryaboutababyboyandthenighthegotanewheart.Thereisadiseaseknownascardiomyopathy,whichliterallymeansheartmuscledisease,andasyoucanimagine,itisnotverycompatiblewithliving.Theonlycureisahearttransplant.Thatiswhereourstorybegins.

Duetohisdisease,thebabyboyhadbeencallingthePediatricIntensiveCareUnitatChildren’sHospitalLosAngeleshishomesincehewasborn...ninemonthsbefore.Ourmissionfortheninemonthswastokeephimaliveuntilwefoundaheartfor

him,andsinceinfantheartsarehardtocomeby,wewaited...andwaited.Heneededamachinetobreathe,andasmallpharmacyofmedicationsgivenaroundtheclocktomaintainhisoptimalhealth.Almosteverysinglenurseontheunithadbeenhisnurseatleastonce.Manyofushadcaredforhimmoretimesthanwecanremember.Allofushadourupsanddownswithhim,fromrockingouttosoftrockallnightlongwithhim(hisfavoritesongbeing“CarelessWhisper”byGeorgeMichael,atleastthat’swhatIliketothink),towatchinghimextubatehimselffourtimesonfourseparateoccasions,withamereflickofhishead(whichwasalmostcutebecauseyougottoseehimwithoutatubeinhismouth,butweweretoobusybeingscaredoutofourmindsandrunningaroundtryingtogetreadyfortheemergentre-intubation).Butnomatterwhat,healwayshadanendearingqualitytohim.Hewasonlymonthsold,beingputthroughmorethanmostofuscouldeverimagine,yethekeptontruckin’along.

What About the Nursing Profession Makes You Passionate?By Adam Brenneman, RN, BSN Pediatric Intensive Care Unit

As pediatric nurses, we focus not only on caring for our patients but on their families as well.

ChairoftheDepartmentofPediatrics,VicePresidentofAcademicAffairsandDirectorofTheSabanResearchInstituteD.BrentPolk,MD,withNurseWeekessaywinnerAdamBrenneman,RN,BSN.

24 C H I L D R E N ’ S H O S P I T A L L O S A N G E L E S

Nurse Week Essay Winner

WhenIwalkedontotheunitthatnighttherewasarumor,awhisperintheair,sosoftasthoughwedidnotwanttojinxhim,thatthislittleboywasfinallygettingaheart.Youcouldliterallyseeeverynurse’sanddoctor’sfacelightupasthewordssunkin.

Itwassostrangeseeinghismompackingupallhisbelongingsthathadaccumulatedoverthepastninemonths.Shewascryingtearsofjoywhileconstantlybeinginterruptedbyhugsfromthemanyhealthcareproviderswhoweresooverjoyedbythismoment.Hismotherwaseternallygratefulforeveryoneofus,nomatterhowsmallofapartweplayedinherbabyboy’slifehereatChildren’sHospital,fromhousekeepingtoattendings.Weallwereafraidtoleaveonourbreaksforfearofmissingthesend-off.

AsthemomentarrivedandtheORstaffpreparedfortransport,weallbegantogather,overwhelmed,knowingthathistimehadcome.Wenursescomfortedhismother,whowascryinguncontrollably,hereyesredandfacesoakedwithherowntearsofjoy,manyofustearingupaswell.Herbabyboywasgettinganewheart.Inaflurryofgoodwishesandtears,hewascartedawaythroughatunnelofnurses,doctorsandhealthcareproviderswithsuchpompandcircumstanceworthyofroyalty.

Asthetravelmonitorfadedintothedistance,IrealizedthisisthereasonwhyIampassionateaboutwhatIdo.Nursingismoreimportantthanmostrealize,moreimportantthanIhadeverrealized.Inthatmoment,IunderstoodifithadnotbeenfortheeffortofallofthePICUnursingstaff,thatbabyboywouldnothavemadeittothismomentandwouldnotbegettinganewheart.Ifinallycomprehendedthatitwasbecausehis

motherhadustoleanon,shehadhopeandthesupportsheneededtobestrongforherbaby.AsIwatchedthatbabyboyrollaway,Ifinallyappreciatedthepassionthatwasnursing.IfinallygraspedwhyIwasanurse.

Igetaskedallthetime,“Howcanyouworkwithsickchildren?”Itisasimpleresponse:becauseIampassionateaboutit.Yes,thisjobcanbeintense,andyes,sometimesitseemslikethebadoutweighsthegood.Butsometimes...yougettostandinahallway,anhourafteryouhavealreadyclockedout,andhearthesoundsofaheartmonitorgettingcloserandcloserwithachild’smotheryou’vecometoknowoverthepastninemonths,andyougettoseeherfacelightupassheseesherbabyboyforthefirsttime...withhisbrandnewheart.

Thetinmanbeggedforaheart,andallhegotwassomevelvetstuffedwithsawdust.Thatnight,ababygotanewheart,andIhavetoadmit...therealthingisfarmoremagical.

What About the Nursing Profession Makes You Passionate?(continuedfrompage23)

In a flurry of good wishes and tears, he was carted away through a tunnel of nurses, doctors and health care providers with such pomp and circumstance worthy of royalty.

Magnet OathAsamemberofthisMagnetHospital,IpledgetoupholdtheChildren’s

HospitalLosAngelescultureofdistinction.Iwilladvocateandsupportthe

furtheradvancementofexcellenceinmypractice.Asanintegralpartofthe

Children’sHospitalLosAngelescommunity,Iwillcontinuetopromotecollegial

interdisciplinaryteamwork.UtilizingtheForcesofMagnetism,Iwillstriveto

provideevenhigher-qualityfamily-centeredcare.Iwillconstantlyendeavorto

advancemyexpertisethroughlifelonglearning.Lastly,Idosweartodoallin

mypowertomaintainthehigheststandardsandpracticesofmyprofession.

Nursing Mission StatementWearecommittedtoadvancingtheprofessionalpracticeofNursingby

creatingopportunitieswhichsupportanenvironmentofexcellent,integrated,

innovativeandevidence-basedNursingcareforchildrenandtheirfamilies

inadiversecommunity.

Nursing Values•AtChildren’sHospitalLosAngeleswevalueadvancementandinnovation

inNursingpractice,professionalismandmeaningfulrecognitionforquality

Nursingoutcomes.

•Weprovidefamily-centeredcareinvolvingmultidisciplinarycollaboration.

•Weembracetheculturaldiversityoffamiliesandstaffinourpracticeof

caringforchildren.

Nursing Guiding PrincipleChildren’sHospitalLosAngelesNursesembodytheprinciplesofintegrity,

respect,leadershipandadvocacyinourdailywork.

Nursing PhilosophyWe,theNursesofChildren’sHospitalLosAngeles,embodyindividualized

family-centeredcare.Research,evidence-basedpracticeandlifelong

learningarethefoundationsforourpractice.OurNursingdecisionsintegrate

soundclinicaljudgment,ethicalresponsibilityandcompassiontooptimize

patientoutcomes.

Nursing VisionNursingcareatChildren’sHospitalLosAngelesisrecognizedinternationally

asamodelforNursingexcellence.Byutilizingbestpractice,weprovide

outstandingfamily-centeredcareinanenvironmentthathonorsitsdiverse

community.Westronglypromotelifelonglearningandcollaborative

interdisciplinaryrelationships.Inaddition,ouremphasisonNursingresearch,

leadershipandprofessionaldevelopmentmakesChildren’sHospitalLos

Angelestheorganizationofchoiceforacareerinpediatricnursing.

Acknowledgements:

We would like to thank the following people

for contributing to this report:

Richard D. Cordova, FACHE

Mary Dee Hacker, MBA, RN, FAAN

Carolyn Kendrick

Doris Lymbertos

Robin Moore DeCapua

Leslie Neuman

Suzanne Taylor, RN-BC, MSN, EMT

Elaine Verdugo

Adam Brenneman, RN, BSN

Tracy Kumono

Matthew Pearson

Jim Deeken

Chandra Broadwater

Sarah Brown

Sheila Perez, RN, BSN

Jennifer Buchannan, RN, MSN

Kelli Anderson, RN, BSN

Phan Dang, RN

Margaux Chan, RN, BSN, CPN, and

Susan Crandall, RN, BSN

Magnet Program Managers

Creative Direction:

Jim Deeken

Design:

Wendy Byle

Editors:

Sarah Brown

Chandra Broadwater

Matthew Pearson

N U R S I N G A N N U A L R E P O R T 2 0 1 0 25

NurseWeekessaywinnerAdamBrenneman,RN,BSN.

SM

CHLA.org