Caring February 2, 2006 - massgeneral.org to define characteristics, describe ... round-the-clock triage for critical-care and ... pital-wide mon-itoring of bed avail-

Inside:

Visiting Professor Program ..... 1

Jeanette Ives Erickson ............ 2Capacity Management

Martin Luther King Day

Observance ........................ 3

Wound Care Education

Program .............................. 4

Fielding the Issues .................. 6Quit Smoking Service

Ethics Committee Goes to

Washington, DC .................. 7

Clinical Narrative .................... 8Colleen Gillen, PT

Professional Achievements ... 10

Educational Offerings ........... 15

In Memoriam ........................ 16Paul Lindquist

Robin Holloway, RN

CaringCaringFebruary 2, 2006

H E A D L I N E S

Working to

MGH P

O

gether to shape the futureatient Care Services

n December 15, 2005, the KnightNursing Center for Clinical &Professional Development and the

Clinical Nurse Specialist (CNS)Wound Care Task Force hosted the

Inaugural Visiting Professor in WoundHealing Lecture, with guest lecturer, Dr.Courtney Lyder, a doctorally-prepared ger-iatric nurse practitioner and professor ofNursing and Medicine at the University ofVirginia. Lyder’s extensive research hasincluded ground-breaking studies on char-acteristics of Stage I pressure ulcers inpeople of color.

Lyder is a past president of the NationalPressure Ulcer Advisory Panel (NPUAP),which developed the current schema forstaging ‘top-down’ pressure ulcers. He is amember of a NPUAP task force, whichrecently suggested there may also be a ‘bot-tom-up’ process or Deep Tissue Injury(DTI) that may result in Stage III or IVpressure ulcers within a few days or weeksafter injury. Extensive research is still nec-essary to define characteristics, describedevelopment over time, and test strategiesto prevent DTI. This phenomenon willdramatically change the systems of stagingand reimbursement for care of pressureulcers.

As an expert on pressure ulcers, Lyderis one of many authorities to give testi-mony to the Center for Medicare and Med-icaid Services (CMS) on developing cri-teria for ‘avoidable’ and ‘unavoidable’pressure ulcers. These criteria have beenincorporated into regulation F-314, which

Visiting Professor sharesexpertise in wound healing

—by Virginia Capasso, RN, clinical nurse specialist

continued on page 14Dr. Courtney LyderDr. Courtney Lyder

Page 2

February 2, 2006February 2, 2006

Jeanette Ives Erickson, RN, MSsenior vice president for Patient

Care and chief nurse

Capacity management and thehuman factor: what we’re doing tofacilitate timely, high-quality care

henever humanbeings are involv-

ed in a process,there is always

an element of unpre-dictability. In health care,the potential for unex-pected events is evengreater because the hu-man factor affects bothsides of the equation(those providing care andthose receiving care).

In managing the flowof patients throughoutthe hospital, our goal isto minimize delays thatcan arise due to unex-pected events while

maintaining the higheststandards of quality,safety, and patient care.This is no small featwhen you consider themyriad factors impactingthe care of every patientwho comes through ourdoors. Bed availability,patient-specific needs, ahigh demand for diagno-stic testing, rapidlychanging clinical situa-tions, state- and JCAHO-mandated regulations,and operational issuesare only some of the con-siderations affecting a

W hospital’s ability to ad-mit, care for, and dis-charge patients in a safeand timely manner.

Everyone at MGH iscommitted to identifyingand overcoming obstac-les to the efficient flowof patients through thehospital, but we need thehelp of every clinicianand support staff memberin order to be successful.Clinical staff are in aunique position to beable to identify underly-ing barriers; facilitatetimely discharge; andwork collaboratively with

all disciplines to helpminimize or avoid un-scheduled delays. Goodcommunication is criticalto our ability to managepatient flow. Good com-munication and a solidinfrastructure are thecornerstones of effectivecapacity management.Yes, more space and morebeds would help, butexpanding our physicalenvironment is not thewhole solution.

Much has alreadybeen accomplished inour work around capa-

city management.Working closely withAdmitting, we’ve es-tablished a proactivecommunication systemto keep units and keypersonnel informedabout bed availabilityWe have expanded therole of clinical nursingsupervisors to provideround-the-clock triagefor critical-care andgeneral-care patientsWe’ve implementedthe flexible, highlyskilled Rapid ResponseTeam that deploysbroadly trained nursesas needed throughoutthe hospital to assistwith short-term emer-gencies, admissions,and general supportWe have modified theroles of patient careassociates and opera-tions associates to helpfacilitate patient flowWe opened the TraumaRapid Admission CareUnit (TRACU) onEllison 7 for short-term, observationalcare of trauma andemergency surgicalpatientsWe’ve implemented anumber of solutionsinvolving the creativeuse of space to alle-viate back-ups anddelays (such as theBigelow 12 dischargelounge and pre-admis-sion chemotherapyarea; several other pilot

programs have beenconducted, and otherswill be launched in thecoming weeks)In 2004, we added fivenew beds and ninebassinetsIn 2005, we added fourmore beds

As you can see, we’vedevoted significant time,energy, and resources toimproving patient flowand satisfaction. Andthere are more initiativesin various stages of plan-ning and process.

To increase capacityand efficiency in theEmergency Depart-ment and reduce theamount of time spenton divert, an ED Ob-servation Unit is beingplanned for Bigelow12The Pediatric IntensiveCare Unit will be re-locating, expandingfrom eight to 14 bedslater this yearAdopting a ‘Just sayyes’ policy, there iswork under way tohelp us understand

what can be done toallow us to accepttransfer patients fromother hospitals morequicklyA number of techno-logy-based improve-ments will soon beimplemented, and oth-ers are still under con-sideration

An on-line bed-management systemthat will allow hos-pital-wide mon-itoring of bed avail-ability is nearingimplementationCell phones andpagers will be usedto improve com-munication amongcaregivers and in-crease response timeto patients (alreadybeing piloted onsome inpatientunits)Wireless access toCAS and automatedgreen books areother initiativesbeing explored

Currently, MGH has902 adult beds and 44

continued on next page

Good communication is

critical to our ability to manage

patient flow. Good communication

and a solid infrastructure are the

cornerstones of effective

capacity management.

Jeanette Ives EricksonJeanette Ives Erickson

Page 3

Jeanette Ives Ericksoncontinued from previous page

bassinets. We consist-ently operate at a veryhigh level of occupancy,often 100% occupancywith more patients wait-ing to get in. You can seehow effective communi-cation and coordinationof services are imperativeif we’re to operate atpeak efficiency.

We need to be vigi-lant at every juncture.

Unanticipated delays inone area of the hospitalcan have repercussionsthroughout the entiresystem. Despite all thesteps we’re taking tominimize delays, there’sno substitute for goodcommunication. As I saidbefore, clinicians at thebedside and unit-basedsupport staff are uniquelypositioned to identify

impediments to timelycare. We’ve invested a lotof time and resources inaddressing the complexissue of capacity man-agement. And we willcontinue to do so.

As we move forwardwith these new initia-tives, I’m interested inhearing your thoughts,ideas, concerns, and sug-gestions. It really doestake a village.

Thank-you.

UpdatesMarie Leblanc RN, hasaccepted a position asstaff specialist supportinga number of projects with-in Patient Care Services.

Amanda Stefancyk,RN, has accepted the po-sition of nurse managerfor the White 10 GeneralMedicine Unit. Manythanks to Marita Prater,RN, for her managementof both White 8 andWhite 10 for the past twoand a half years.

Theresa Cantanno-Evans, RN, has accept-ed a 20-hour-a-weekposition as clinicalnurse specialist in Eth-ics in the Knight Nurs-ing Center for Clinical& Professional Devel-opment. She will offi-cially begin in thespring, sharing CNSresponsibilities withEllen Robinson, RN,giving the ethics CNSrole a full-time presencein PCS.


On Friday, January 18,2006, the MGH commu-nity came together in aninspirational and movingtribute to Dr. Martin Lu-ther King, Jr. and to cele-brate this year’s theme,“In the Spirit of Unityand Service: Remember.Celebrate. Act.”

Keynote speaker Mil-ton J. Little, Jr., presidentand CEO of the UnitedWay of MassachusettsBay, asked the standing-room-only crowd to fo-cus on the ‘act’ portion ofthis year’s theme. Hereflected on recent na-tional and internationaltragedies in ‘remem-brance,’ and recalledcivil rights milestones in‘celebration.’

“More than anything,Martin Luther King, Jr.was a man of action,”said Little as he calledupon the crowd to, “Act,

just a little bit differently.Talk to someone whodoesn’t look like you, orwho speaks a differentlanguage. You never know

what you’ll find. Beneathour differences are fund-amental similarities suchas the desire to live welland make a better world

CelebrationsCelebrationsMartin Luther King, Jr.

celebration ‘rocks’ East GardenDining Room

—by Cheryl Coss, program assistant, Training & Development,and treasurer of AMMP

for our children.”The second annual

Martin Luther King, Jr.breakfast, sponsored bythe MGH chapter of TheAssociation of Multicul-tural Members of Part-ners (AMMP), beganwith the debut appear-ance of the Voices ofMGH Choir. The choir,comprised of 19 MGHemployees from various

departments, ‘rocked’ theEast Garden Dining Room,according to MGH pre-sident, Peter Slavin, MD.Dressed in black withcolorful scarves and ties,each wearing a whiterose for peace, the choirwas a visual representa-tion of the unity and di-versity of our employeepopulation—a fittingtribute to Dr. King.

Voices of MGH Choir

Page 4

February 2, 2006February 2, 2006Education/SupportEducation/Support

or the past 17months, the Clini-

cal Nurse Special-ist (CNS) Wound

Care Task Force hasworked to educate and em-power unit-based clinicalnurse specialists and staffnurses to deliver contempo-rary, evidence-based woundcare throughout the hospital24 hours a day, seven days aweek. Some early outcomesof the task force include asection for wound assess-ment on the new generalcare patient flowsheet anddevelopment of a compre-hensive wound care educa-tion program.

The field for woundassessment on the generalcare patient flowsheet con-

sists of 13 parameters toassess a wide variety ofwounds. Parameters arederived from the 15-itemPressure Sore Status Tool(PSST), which was devel-oped and tested by Dr. Bar-bara Bates-Jensen of theUniversity of SouthernCalifornia, School of Nurs-ing. Parameters includelocation, shape, size (length,width, depth), type, char-acteristics of the skin alongthe margin of the wound,as well as other character-istics. A systematic approachto wound assessment al-lows detection of dramaticor gradual progress towardhealing or deterioration in awound bed.

Phase I of the

Wound Care Education Pro-gram will be launched thismonth and consists of pro-grammed instruction relatedto wound cleansing, as-sessment, anddocumenta-tion. Phase I isearmarked fornewly-hirednurses, butwill be com-pleted by allcurrent nurs-ing staff.

Phase II ofthe WoundCare Educa-tion Programwill be a two-day compre-

hensive nursing continuingeducation program. Morningsessions will feature didac-tic presentations by CNSexperts on topics pertinentto general wound care andcare of high-risk and high-frequency wounds, such aspressure ulcers, vascularulcers, atypical wounds,

burns, and radiation injur-ies. Afternoon sessions willfocus on description ofwounds, selecting appropri-ate treatments for wounds,and applying specialty dress-ings, such as multi-layercompression dressings andvacuum-assisted closure(VAC) dressings.

FBringing specialized wound-careeducation to all patient care units

—by Virginia Capasso, RN, clinical nurse specialist

Above: Jill Pedro, RN, clinical nurse specialist, demonstratesapplication of the VAC dressing. Below left: participant applies ‘Unna’s

boot.’ At right: participants practice application of VAC dressing.

jeb23

Text Box

Continued on next page

Page 5


Practice makes perfect!Practice makes perfect!

The program was testedby 60 enthusiastic clinicalnurse specialists and nursepractitioners in November,2005. The inaugural pro-gram for nursing staff wasoffered on January 11 and18, 2006. Response has

been overwhelmingly posi-tive. Nurses seek educationalofferings that provide anintroductory level of spe-cialty knowledge and skillsso they can troubleshootwound and skin-care issueson their units.

Phase II will be offeredfour more times in 2006:

Wednesday, March 1,and Wednesday, March 8Wednesday, June 7, andWednesday, June 14Friday, September 8, andWednesday, September 13

Wednesday, November 1,and Wednesday, Novem-ber 8Registration is limited to

60 people per session. Toregister, call the KnightCenter for Clinical & Pro-fessional

Above: Clinical nurse specialists, Joanne Empoliti, RN (left)and Ginger Capasso, RN, during the didactic portion of the

Wound Care Education Program. Below: participants display theirhandiwork after practicing dressing-application techniques.

Development (at 6-3111).For more information aboutthe Wound Care EducationProgram, contact VirginiaCapasso, APRN, co-chair ofthe CNS Wound Care TaskForce.

CNS Wound Care Task Force2004-2005

Virginia Capasso, APRN, co-chairJoanne Empoliti, APRN, co-chairAnn Martin, ARRN, co-chairTheresa Cantanno-Evans, ARNPJacqueline Collins, RNErin Cox, ARNPVivian Donahue, RNJoan Gallagher, ARNPSusan Gavaghan, RNCatherine Griffith, ARNPSioban Haldeman, RNMarian Jeffries, APRNSusan Kilroy, RNCynthia Lasala, RNMadeline Odonnell, RNJill Pedro, RNMarion Phipps, RNSusan Stengrevics, RN

Page 6

February 2, 2006February 2, 2006Fielding the IssuesFielding the IssuesSmoking: quitting might be

easier than you thinkf you smoke, quit-ting is the bestthing you can do

for your health.Every year, more

than 400,000 people inthe United States diefrom smoking-relateddiseases. That’s morethan the total number ofpeople who die annuallyfrom homicides, motorvehicle accidents, andfires.

Smoking is linked tocancers of the pancreas,stomach, kidney, bladder,cervix, lung, mouth, eso-phagus, head, and neck.Smoking is associatedwith lung diseases suchas chronic bronchitis andemphysema and aggra-vates asthma. It is a riskfactor in heart disease,vascular disease, stroke,ulcers, infertility, osteo-porosis, and impotence.Women who smoke aremore likely to have mis-carriages, premature orlow-birth-weight babies,or babies with suddeninfant death syndrome(SIDS.) While the percen-tage of people who smokehas dropped from nearly50% to 21% nationwide(19% in Massachusetts),smoking remains a majorconcern for healthcareproviders everywhere.

MGH has launchedan initiative to help iden-tify smokers among ourinpatient population andprovide them with adviceon how to quit smokingas part of our standard ofcare. The nursing assess-ment form has been re-

vised to help nurses ob-tain more detailed infor-mation about our pa-tients’ smoking practices.These changes meet ex-isting and future require-ments of JCAHO regard-ing the documentation oftreatment of hospitalizedsmokers. JCAHO requiresthat smoking-cessationinformation be providedto any patient with cer-tain diagnoses who hassmoked in the past year.The MGH Quit SmokingService (QSS) createdthe booklet, A Smoker’sGuide to Being in theHospital, which explainshow the QSS can helpwith smoking-cessation.If patients don’t wish toquit at that time, nicotine-replacement products areavailable to make themmore comfortable duringtheir hospital stay. Thebooklet has been verysuccessful, and a Part-ners-wide pamphlet, AGuide for Hospital Pa-tients who Smoke, will beavailable soon.

To better facilitatesmoking-cessation effortsamong our patients, theQSS developed a proto-col to help nurses andother healthcare provid-ers determine what mustbe provided to patientswho smoke or recentlyquit, and who can pro-vide it.

Question: How manysmokers are admitted tothe hospital each year?

Jeanette: MGH admitsmore than 47,000 pa-

tients per year. If 19% ofthe population of Massa-chusetts smoke, thenmore than 9,000 smokersare admitted to MGHeach year. Assuming thathalf that amount wouldbe interested in quitting,we could potentially helpmore than 4,500 peopleto stop smoking. Thebenefits to patients, fam-ilies, the hospital, andsociety are enormous.

Question: Why is quit-ting while you’re in thehospital a good idea?

Jeanette: Hospitalizationis a window of opportu-nity. Smoke-free hospi-tals require temporaryabstinence from tobacco;illness motivates manypeople to quit; and formalinterventions may helpthem succeed.

Question: Will patientsreally consider quittingjust because I give thema booklet?

Jeanette: Studies showthat any intervention canbe effective. Simply tell-ing your patient, “Quit-ting smoking is the mostimportant thing you cando for your health,” canmake a difference. Giv-ing her a booklet lets herknow that help is avail-able at MGH.

Question: Should I givea booklet to a patientwho doesn’t want to quit?

Jeanette: Yes. The book-let explains that nicotine-replacement therapy is

available for patients tohelp manage nicotinewithdrawal symptomsduring their hospitaliza-tion (when they can’tsmoke).

Question: How does theQSS help?

Jeanette: Counselorsspecially trained in to-bacco-cessation come tothe bedside and providea variety of services.QSS counselors take asoft approach. They canhelp provide relief fromsymptoms of nicotinewithdrawal for hospi-talized patients, and/orthey can work with pa-tients to create an in-dividualized smoking-cessation plan. They canalso provide follow-upthrough QuitWorks, thestate-sponsored tele-phone quit line.

Question: I’m already sobusy. How can I fit thisinto my schedule?

Jeanette: Initiating theprocess to help someonequit smoking is an im-portant intervention, andit only takes a few min-utes. Nurses are alreadyhelping by identifyingpatients who smoke onthe nursing assessmentform. Booklets shouldbe stocked and availableon each unit. Referralsfor QSS counseling areautomatically made whenthe order is entered inthe Provider Order Entry(POE) system. We’vecome a long way towardsimplifying the processand making it more effi-cient for you and yourpatients.

Question: What if mypatient doesn’t want toquit? Am I violating histrust by referring him tothe QSS?

Jeanette: Helping patientsto quit smoking is part ofour standard of care. QSScounselors are trained toapproach patients in anempathic, non-judgmentalmanner. Counselors respectpatients’ rights. Counsel-ors have found that pa-tients who appear to beresistant to counselingoften express concernsabout smoking and fearsabout quitting. Even ifthey’re not ready to quit,speaking to a counseloropens a door to thinkingabout quitting and letsthem know there’s helpavailable when they’reready. Patients benefitfrom many different levelsof intervention.

Question: How satisfiedare patients with the coun-seling they receive fromthe QSS?

Jeanette: The Quit Smok-ing Service conducts fol-low-up surveys with pa-tients who have been seenby our counselors.

88% find speaking witha counselor helpful94% say every smokershould see a counselorat MGH62% say that seeing acounselor increasedtheir interest in quittingOf patients surveyed,45% report not smokingsince being dischargedfrom MGH.

For more informationabout the Quit SmokingService or to receive aQSS protocol, call 6-7443.

I

Page 7


n October, 2005,a multi-disciplin-ary group from

the Patient CareServices Ethics in

Clinical Practice Commit-tee (EICPC) headed toWashington, DC, to at-tend the annual meetingof the American Societyfor Bioethics and Hu-manities. The theme ofthis year’s conferencewas, ‘Justice and Suffer-ing.’ The week-long con-ference brought togethera national audience toexamine and discussemerging issues in bio-ethics and the medicalhumanities. Topics ad-dressed by panels andindividual presentersranged from, “Abu Ghraib

and Guantanamo Bay:Medical Professionalism,Dual Loyalties,” to, “Is-sues that Just Won’t Die:Conflicts about DNR.”

Regina Holdstock,RPh, pharmacist and co-chair of the EICPC, pre-sented her poster, “TrueLife Stories: the Use ofDrama and Mini-Theateras a Method for Educat-ing Healthcare Providersabout Advance HealthCare Planning.” The playspotlighted in her posterwas presented monthsearlier to the MGH com-munity as an educationaloffering with members ofthe Ethics in ClinicalPractice Committee play-ing all the parts. Theprogram, “Advance Dir-

I

Members of the EICPC presentin Washington, DC

—by Gayle M. Peterson, RN, staff nurse

ectives: Humor, How Tos,and Hard Facts,” usesdrama as an educationaltool to engage performersand audience membersand emphasize the im-portance of advance dir-ectives in all care situa-tions, but especially end-of-life care.

During the week-longconference, Ellen Robin-son, RN, clinical nursespecialist, and Keith Perl-eberg, RN, nurse manag-er, presented a case studyto the Nursing AffinityGroup.

For more informationabout the work of theEthics in Clinical PracticeCommittee or advancedirectives, contact EllenRobinson, RN, at 4-1765.

EthicsEthics

Members of the

Patient Care Services

Ethics in Clinical Practice

Commttee attend meeting

of the American Society

for Bioethics and Humani-

ties in Washington, DC.

Pictured from left to right

are: Marion Parker, RN,

staff nurse; Gayle Peter-

son, RN, staff nurse;

Keith Perleberg, RN,

nurse manager; and

Ellen Robinson, RN,

clinical nurse specialist.

Regina Holdstock, RPh,

who also attended,

is not pictured.

Call For AbstractsNursing Research Day

May 10, 2006

Submit your abstract to display a poster onNursing Research Day 2006

Categories:Encore Posters (posters presented atconferences since May, 2005)Original ResearchResearch UtilizationPerformance Improvement*

* Two new conditions for acceptance ofPerformance Improvement abstracts:

Key personnel have been certified in theProtection of Human Subjects.(http://www.citiprogram.org/default.asp)Project has been reviewed and approvedor excluded by the Partners HumanResearch Committee (HRC). For moreinformation about the HRC review, con-tact your clinical nurse specialist; Cath-erine Griffith, RN, co-chair of the Nurs-ing Research Committee; Virginia Ca-passo, RN, coach; or Kathleen Walsh,RN, (pager: 3-1792)

For more information, visit:www.mghnursingresearchcommittee.org

Deadline for submission is March 1, 2006

(Photo provided by staff)

Page 8


Colleen Gillen, PTstaff physical therapist

M

continued on next page

Building trust and bridginggaps: one PT’s approach to

patient-centered careColleen Gillen is a clinician in the PCS Clinical Recognition Program

Clinical NarrativeClinical Narrative

Some portions of this text have been altered to make the story more accessible to non-clinicians.

y name is Col-leen Gillen,and I have beena staff physical

therapist atMGH for almost threeyears. My first encounterwith Mary was an un-forgettable one. I wasstruck by the thought thatMary looked far olderthan her stated age. Herface was as motionless asa mask. Wide browneyes, nearly panic-filled,stared up at me as I in-troduced myself as herphysical therapist. Thehiss of oxygen throughher nasal cannula and thewhir of her pressure-relieving mattress filledthe room. Mary told me,in her soft, high-pitchedvoice, “I just feel terrible.Nauseous and dizzy, real-ly dizzy.”

Mary was a 67-year-old wife and mother oftwo grown daughters.Her complicated medicalhistory included recur-ring aspiration of fluidsfollowing placement of aJ tube, and most recently,gastric surgery to correcther chronic reflux. Maryhad transferred to MGHfrom an acute-level rehab-ilitation hospital with afever of unknown originand increased non-pro-ductive cough. Her mostrecent hospitalization atMGH had been six weeksin duration, and includedmassive aspiration treat-

ed with antibiotics; re-current hypotension anda slowed heart rate ofunclear etiology; inter-mittent chest pain despitea normal stress test; andinflammation of the gall-bladder. This time, Maryhad been admitted to theMedical Service for con-tinued work-up for sus-pected aspiration pneu-monia. She was put onIV antibiotics, supportivenebulizers, and the PainService was consulted toassist in managing hernewly worsening chronicpain.

Mary had undergonea below-the-knee ampu-tation on her right legthree years ago due tocomplications from mul-tiple surgeries trying tostabilize a compoundright femur fracture.Mary had sustained thefracture during a fall athome and was known tohave severe osteoporosis.Six years earlier, Maryhad experienced a strokewith residual weaknesson her right side. She hadrestrictive lung diseasefrom scoliosis. Her sen-sory input was obscuredby cataracts and peri-pheral neuropathy. Twoyears before, Mary hadbeen diagnosed withreflex-sympathetic dys-trophy and struggledwith chronic pain. Shehad an internally im-planted spinal-cord stim-

ulator with an opiatepump.

For the first severaldays, anxiety took holdof Mary and limited thescope of our intervention.Mary was very distract-ible, requiring frequentcues for redirection to thetasks at hand. For thisreason, I tried my best toensure that her environ-ment was free of excessnoise during our treat-ment times. Mary neededa good deal of extra timeto complete simple tasks.‘Setting up’ for treatmentoften took a long timeand involved donning herprosthesis, interruptingher tube feedings, coor-dinating her portableoxygen source, settingup the chair, deflating thebed, etc. As I got to knowMary’s husband, Art, Iinvolved him more inpreparing Mary for herphysical therapy treat-ments. Art had a very drywit, and had been a kindand devoted partner toMary for 42 years. Hewould often chime inwith remarks like, “Ohsure, what would youladies do without me?” Ibelieve Art was gratefulto be able to contribute tohis wife’s complex medi-cal stay during which, upuntil now, he’d had littledirect involvement. Atthe conclusion of everymeeting, Mary and I ag-reed on a time for our

next appointment. Thisallowed Art to assist indonning her prosthesisand shoes. It gave Mary a‘mental rehearsal’ and anelement of control overher care that she neededto succeed.

I quickly learned thatin Mary’s case, successwould not be measuredin inches and feet, but inmilestones of confidence.Mary was progressingslowly but steadily; de-monstrating emergingtorso control for improv-ed sitting balance andincreasing ability to clearher airway to improveventilation. However, ourgreatest difficulty reveal-ed itself when we strayedfrom the bed to beginworking on balance ex-ercises while standing.Due to her chronic neur-opathy, Mary had lostjoint-positioning sense inher left foot, and waswithout position sense onthe right due to her amp-utation. For this reason,she was extremely anxi-ous upon standing as shestruggled to establish hercenter of gravity over her

base of support.Mary would shout,

“I’m afraid, Colleen. I’mafraid I’m going to fall.”Yet, the more physicalassistance I gave her, themore anxious she be-came. Mary lacked theability to self-correct ather ankle or hip level,and her trunk and armsweren’t yet strong en-ough to compensate. Ilistened to her explain, “Ineed to get my balanceby myself. When some-one tries to help me, I getunsteady.”

To overcome the‘mountain’ that sitting-to-standing had become,I learned to let Marycount aloud prior to ini-tiating the sit-to-standmotion. I asked her to sayaloud the steps she wentthrough to adjust herprosthesis and transitionto standing so the aideand I could provide theassistance she needed,when she needed it, andnot in excess. I oftenneeded to let her ‘fail’ tohelp her learn the limitsof her balance and center

Page 9


Clinical Narrativecontinued from previous page

herself more effectively.At the end of each

session, I’d ask Mary toreflect back on our timetogether and let me knowif there was anything sheor I could have donedifferently. Through thisprocess of self-reflection,she was able to learnfrom her trials and makesmall modifications tohelp next time. Mary wasreceptive to this informalway of gathering feed-back to shape our inter-

ventions and focus on thework we needed to do.This helped us build trustin each other as team-mates. Because of herstruggle with depressionand a lack of a noticeablechange in her facial ex-pressions with moodchanges, it was importantto get this information inthis explicit way.

Trouble arose whennew members were add-ed to Mary’s team. Per-haps because Mary re-

quired additional time,attention, and specializedset-up, some cliniciansmeeting Mary for thefirst time were hesitant toassist in her transfers outof bed.

Later, Mary told me,“I feel like I’m imposingon people, but I’d like tobe able to walk to thebathroom.” I facilitatedimproved communica-tion by placing a signdetailing Mary’s needson the wall in her room.With Mary’s input, Ihighlighted the processof donning her prosthe-sis, described the steps oftransfer, drew pictures todisplay proper position-ing, and included a goalfor frequency. These stepsled to greater ease oftransfers and empoweredMary to assume a moreactive role in directingher care.

Mary’s unique com-munication style oftenimpacted her ability togive and receive accurateinformation to and fromthe medical team. One

Brian A. McGovern, MD,Clinical Excellence Award

In 2004, the Massachusetts GeneralPhysicians Organization (MGPO) established

the Brian A. McGovern, MD, ClinicalExcellence Award in memory of Dr. Brian

McGovern. The award recognizes physicianswho demonstrate the qualities that

characterized McGovern: clinical excellence,commitment, and compassion. The 2006

McGovern awards will be presented at thePhysician Recognition Dinner in the spring.

Any employee may submit a nomination.Deadline for submission is February 16,

2006. To nominate on-line, please visit theMGPO website at: http://is.partners.org/

mgpoonline/mcgovern.asp. For moreinformation, call Beth LaRossa at 724-4549.

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example that led to in-creased anxiety for Marywas a break-down incommunication thatprompted her to ask,“What’s happening? AmI going to rehab for sur-gery or am I having sur-gery here?” Mary was anextremely intelligent,insightful, and compas-sionate woman, but thesetraits were not readilyapparent at first, second,or even third meeting. Itwas only after many hourstogether that I began topick up on her subtlechanges in body lang-uage, breathing patterns,and vocal tone that let meknow how she was feel-ing or responding to treat-ment. For this reason, Idid my best to take anactive role in relayinginformation betweenMary and members of theteam regarding her cur-rent symptoms, concerns,or medical plan of care.

Reflecting back onmy time spent workingwith Mary, I am struckby how important it is to

really ‘know’ the patient.As with all patients, com-munication barriers needto be overcome in order tomaximize the quality ofmulti-disciplinary care.Knowledge of the indi-vidual gained througheach patient interactionneeds to be integratedimmediately by caregiv-ers. As we come to agreater understanding ofthe unique person in ourcare, we’re better able toselect individualized in-terventions, better ourpractice, and ensure truepatient-centered care.

Comments by JeanetteIves Erickson, RN, MS,senior vice presidentfor Patient Care andchief nurse

This is a wonderful ex-ample of the power ofknowing your patient.Mary had a complex med-ical history as well as aunique way of interactingand communicating withpeople. By getting toknow Mary and her hus-band, Colleen was able tocustomize creative inter-ventions and adapt hertreatment plan to meetMary’s needs.

Colleen involved Maryin directing their timetogether by encouragingher to share her feelingsafter each treatment ses-sion. This was not only aconstructive reflectiontechnique, it was a trust-building opportunity thathelped bolster Mary’sconfidence. And by shar-ing her insights with othermembers of the team,Colleen enabled others toprovide optimal care forMary, as well.

Thank-you, Colleen.


Zollfrank receives CedarleafAward

Rev. Angelika Zollfrank receivedthe Len Cedarleaf Award at the national

conference of the Association for ClinicalPastoral Education in November, 2005.

Klein presentsAimee Klein, PT, physical therapist,

presented, “Diagnostic Imaging: AppliedInformation for the Physical

Therapist,” at Columbia University,October 20–21, 2005.

Brush appointed to DisasterCommittee

Kathryn Brush, RN, clinical nursespecialist, Surgical Intensive Care Unit,

has been appointed to the DisasterCommittee for the Society of Critical

Care Medicine.

Brien, Dunbar, and Goodwinpresent

Barbara Brien, RN; Colleen Dunbar, RN;and Liz Goodwin, RN, Medical IntensiveCare Unit, presented, “Nursing Strategies

to Change End-of-Life Care in theIntensive Care Unit,” at the New England

Hospice and Palliative Care EducationConference on November 1, 2005,

in Marlboro, Massachusetts.

Capasso presentsVirginia Capasso, APRN, clinical nursespecialist, The Knight Nursing Center

for Clinical & Professional Development,presented, “Leg Ulcers,” at the Compre-

hensive Update on Vascular DiseaseConference, in Waltham, Massachusetts,

November 3, 2005.

Duffy, Perry, and Read

Cole certifiedElizabeth Cole, PT, physical therapist,

was certified by the Lymphedema Asso-ciation of North America, in Seattle,

October, 2005.

McCormick and Sullivanpresent

Talli McCormick, GNP, nursepractitioner, and Patricia E. Sullivan, PT,physical therapist, presented their paper,

“An Update on Fall Prevention andExercise,” at the Oxford Round Table on

Successful Aging in Oxford, England,August 11, 2005.

Brush co-authors chapterKathryn Brush, RN, clinical nurse

specialist, and Ulrich Schmidt, MD,authored the chapter, “Prophylaxis,”in the Critical Care Handbook of the

Massachusetts General Hospital.

Carroll, Hamilton, and Kenneypresent

Diane Carroll, RN, clinical nursespecialist; Glenys A. Hamilton, RN; and

Barbara K. Kenney, RN, presented,“Changes in Fears and Concerns in

Recipients of the Implanted CardioverterDefibrillator,” at the American Heart

Association Scientific Sessions inDallas, November 16, 2005.

Cohen and Nalipinski presentAudrey Cohen, CCC-SLP, and Paige

Nalipinski, CCC-SLP, speech-languagepathologists, presented: “Speech-

Language Pathologists in Acute Care:Maintaining the Breadth of our Practice,”at the 2005 American Speech, Language

and Hearing Association Convention,November 17–20, in San Diego.

Prater on panelMarita Prater, RN, nurse manager,

General Medicine, was part of a panelpresentation on, “Transforming the Work

Environment—Best Practices,” at theMassachusetts Hospital Associationmeeting, in Waltham, Massachusetts,

November 16, 2005.

Brush presentsKathryn Brush, RN, clinical nurse

specialist, presented, “Advanced BedsideProcedures: Impact on Nursing,” at the

New England Regional TraumaConference, November 10–11, 2005,

in Burlington, Massachusetts.

Brackett co-authors chapterSharon Brackett, RN, Surgical IntensiveCare Unit; Rae Allain, MD; and WilliamE. Hurford, MD, authored the chapter,

“Ethical and End-of-Life Issues,”in the Critical Care Handbook of the

Massachusetts General Hospital.

Connors and Ulles publishPatricia M. Connors, RNC, Obstetrics,

and Monica M. Ulles, RN, CysticFibrosis Center, published, “The Physical,Psychological, and Social Implications of

Caring for the Pregnant Patient andNewborn with Cystic Fibrosis,” in the

Journal of Perinatal and NeonatalNursing, October–December, 2005.

Morash presentsSusan Morash, RN, nurse manager,

General Medicine, presented, “Bringingit All Back Home: Creating a Conflict-Wise Workplace,” at the Associationof Conflict Resolution, New England

Chapter Annual Meeting inTyngsboro, Massachusetts,

in November, 2005.

Professional AchievementsProfessional Achievements

Page 10

publishMary Duffy, PhD, nursing

faculty, Boston College; Donna Perry, RN,professional development co-ordinator,

The Knight Nursing Center for Clinical &Professional Development; and Cathy

Read, RN, nursing faculty, Boston College,published, “Design and Psychometric

Evaluation of the PsychologicalAdaptation to Genetic Information Scale,”

in the third quarter, 2005, issueof the Journal of Nursing

Scholarship.

MGH nurses presentKathleen Grinke, RN, General Clinical

Research Center; Catherine Griffith, RN,clinical nurse specialist; Kathleen Walsh,

RN, case manager; Mary Larkin, RN,diabetes nurse coordinator; and Virginia

Capasso, APRN, clinical nurse specialist,presented “Promoting Research Utiliza-

tion—The MGH Nursing Committee,” atThe Journey to Nursing Excellence and

Magnet Designation, in Boston,November 17–18, 2005.

Nurses publishCarolyn Hayes, RN; Patricia Reid Ponte,

RN; Amanda Coakley, RN; EscelStanghellini, RN; Anne Gross, RN;

Sharon Perryman, RN; Diane Hanley, RN;Nancy Hickey, RN; and Jacqueline

Somerville, RN, published the article,“Retaining Oncology Nurses: Strategies

for Today’s Nurse Leaders,” inthe Oncology Nursing Forum,

November, 2005.

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Gonzalez certified

Colleen Gonzalez, RN, Coronary CareUnit, passed the Medical-Surgical

Clinical Nurse Specialist certificationexamination.

Michel publishes

Theresa Michel, PT, physical therapist,published the chapter, “Physical

Therapy,” in the MGH Handbook ofPain Management.

Pain advocates featured

Mary Lou Kelleher, RN; KatherineDiMare, RN; Tom Quinn, RN; and ElenaCliff, RN, were featured in the October,

2005, On Call magazine article,“Going After Pain.”

NICU nurses certified

Anita Carew, RNC; Stephanie Trombalee,RNC; Eileen Jones, RNC; Tina Staffier,RNC; and Susan Worden, RNC, of the

Neonatal Intensive Care Unit, werecertified as neonatal intensive

care nurses.

Nunn presents

Danny Nunn, CCC-SLP, speech-languagepathologist, presented, “Oral PharyngealLaryngeal Motor Exercises for Swallow:

Controversial Subject,” at the 2005American Speech, Language and Hearing

Association Convention, November17-20, 2005, in San Diego.

Brush joins Steering CommitteeKathryn Brush, RN, clinical nurse

specialist, Surgical Intensive Care Unit,has been named to the University Health

Consortium Steering Committee onCentral Venous Catheter Line-Related

Bacteremias.

Colleagues publish

Elizabeth Hiltunen, RN; PatriciaWinder, RN; Michelle Raitt, MA;

Elizabeth Buselli, RN; Diane L. Carroll,RN; and Sally Rankin, RN, published,

“Implementation of EfficacyEnhancement Nursing Interventions with

Cardiac Elders,” in RehabilitationNursing, November/December, 2005.

Peterson named president-electGayle Peterson, RN, staff nurse, GeneralMedicine, has been appointed president-

elect of the Massachusetts chapterof the American Society of PainManagement Nurses (ASPMN).

Bonander presentsEvelyn Bonander, MSW, director

emerita, MGH Social Services, presentedthe break-out session, “The Innovation

of Social Work: The Best Way to Explainit is to Do it,” at Innovation at 100,

October 27–28, 2005,in Boston.

Quinn elected to NominatingCommittee

Thomas Quinn, RN, project directorfor MGH Cares About Pain Relief, has

been elected to the Nominating Committeeof the American Society for Pain

Management Nursing.

Capasso presentsVirginia Capasso, APRN, clinical nursespecialist and co-director of the MGH

Wound Care Center, presented, “WoundVolume Measurement: The Challenges of aBiometric Pilot,” at the Faculty Research

Colloquium, MGH Institute of HealthProfessions, on December 2, 2005,

in Charlestown.

NICHE Committee receives grantThe NICHE Committee (Networkingto Improve the Care of Healthsystem

Elders) has been awarded a $5,000 grantfrom the Hartford Institute for Geriatric

Nursing to be used to promote gerontologycertification for nurses. Kate Barba, RN;

Sheila Golden-Baker, RN; and Mary EllenHeike, RN, submitted the proposal on

behalf of the NICHE Committee.

Gundersen and Konnerpresent

Natascha Gundersen, LICSW, andKaron Konner, LICSW, Social Services,

presented, “Social Work’s Role in DisasterMedical Response,” at the Massachusetts

chapter of The National Association ofSocial Work’s quarterly meeting of the

Disaster Response Committee,November 21, 2005,

in Waltham.

Brier presentsMarilyn Brier, LICSW, Social Services,

presented, “Developing a Prostate CancerSupport Group,” at Innovation at 100,

October 27–28, 2005, in Boston.

Hazelwood and Joycepresent

Michelle Hazelwood, LICSW, and EileenJoyce, LICSW, Social Services, presented,“It Takes a Village,” at Innovation at 100,


Social workers presentSheryn Dungan, LICSW; Eileen Joyce,LICSW; and Michele Lucas, LICSW,

Social Services, presented, “When DoesCare End: Providing Bereavement Care in

Cancer Centers,” at Innovation at 100,October 27–28, 2005, in Boston.

Horne-Mebel and Zuckermanpresent

Leigh Horne-Mebel, LICSW, andFredda Zuckerman, LICSW, Social

Services, presented, “Every Mother, EveryBaby, Every Family... CompassionateCare for All,” at Innovation at 100,October 27–28, 2005, in Boston.

Nurses and social workerspresent

Mary Connolly, RN; Susan Fisher,RN; Joan Monahan, RN; Paula Murphy,

LICSW; Barbara Olson, LICSW; andAlice Rotfort, LICSW, Social Services,presented, “Community Care Programs:Social Worker/Nurse Teams Bring Careinto the Home,” at Innovation at 100,


Dahlin presentsConstance Dahlin, APRN, palliative

care nurse practitioner, presented, “TheImpact of Clinical Guidelines in PalliativeCare for Gerontological Nursing,” at theNational Association of Gerontological

Nursing Conference, on October 22, 2005,in Myrtle Beach, South Carolina.

Dahlin presented, “Advanced PracticeNursing: Practical Aspects of Palliative

Medicine,” on October 21, 2005,in Boston, and she presented, “Oral

Complications in End-of-Life Care,” at theHospice and Palliative Care Federation ofMassachusetts Conference, on November

2, 2005, in Marlborough.

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Essig presentsDebbie Essig, LICSW, Social Services,presented, “Can This Marriage Work?Weaving a Clinical Perspective into an

Oncology Website,” at Innovation at 100,October 27–28, 2005, in Boston.

Clair-Hayes and Levin-Russmanpresent

Kathy Clair-Hayes, LICSW, and ElyseLevin-Russman, LICSW, Social Services,

presented, “Take Good Care Packs:Promoting Communication and Comfortfor Children with Cancer,” at Innovation

at 100, October 27–28, 2005,in Boston.

Multi-disciplinary teampresents

Katie Binda, LICSW, Social Services;Elizabeth Alterman, BS, administrative

director, Clinical Programs, CancerCenter; and Barbara Cashavelly, RN,

nurse manager, Cancer Center, presented“Meeting the Needs of Support Staff at aPatient- and Family-Centered Oncology

Center,” at Innovation at 100,October 27–28, 2005,

in Boston.

Social workers presentEvelyn Bonander, MSW, director

emerita, Social Services; Catherine Carlo,LICSW; Kitty Craig-Comin, LICSW;Susan Fisher, LICSW; Leigh Horne-

Mebel, LICSW; Lisa Mortimer, LICSW;and Barbara Olson, LICSW, SocialServices, presented, “Pioneering a

Profession: a History of Social WorkInnovation at the MGH 1905-2005,”at Innovation at 100, October 27–28,

2005, in Boston.


Ellen Abele, LICSW; BarbaraSarnoff Lee, LICSW; Tami May,

LICSW; Fredda Zuckerman, LICSW;Social Services, Shannon Bennet; Brett

Litz, PhD; and Shira Maguen, PhD,presented, “The Perinatal Loss Project and

the Boston Perinatal Loss Initiative: aMulti-Center Study to Understand the

Psychological and Social Consequencesof Pregnancy Loss,” at Innovation


Lucas presentsMichele Lucas, LICSW, Social

Services, presented, “The Unique Needsof the Primary Brain Tumor Patient Popu-lation,” at Innovation at 100, October 27–

28, 2005, in Boston.

Diversity Council presentsMembers of the MGH Social Work

Diversity Council presented, “The Exper-ience of a Diversity Council,” at Inno-vation at 100, October 27–28, 2005,

in Boston.

Coreas, Troncoso, and Vegapresent

Marisol Coreas, Niza Troncoso,and Carolyn Vega, HAVEN advocates,

presented, “De Mujer a Mujer: Woman toWoman,” at Innovation at 100, October

27–28, 2005, in Boston.

Murphy and Wise presentRebecca Murphy, LICSW, and Marilyn

Wise, LICSW, Social Services, presented,“Getting to Know Patients who Cannot

Speak on Their Own Behalf: Commitmentto an Ethic of Care,” at Innovation at 100,



Susan Lipton, LICSW, Social Services;Beth Holleran, LICSW, Social Services;

Alice Newton, MD, Pediatrics and SocialServices; Andrea Vandeven, MD, Social

Services; and Mark Sapp, MD, Pediatrics,presented, “Child Protection Team: Work-

ing Toward a Safer Future for Childrenand their Families,” at Innovation at 100,



Marilyn Brier, LICSW, SocialServices; Regina Holdstock, RPh,

oncology pharmacy supervisor; DianeDoyle, APRN, Hematology/Oncology;

Evelyn Malkin, LICSW, Social Services;Katie Binda, LICSW, Social Services; and

Stacey Paiva, MBA, HOPES programmanager, presented, “Living with Cancer,

Moving Forward After Treatment: aMultidisciplinary Collaboration,”

at Innovation at 100, October 27–28,2005, in Boston.

Professional AchievementsProfessional AchievementsGioiella, Wise, present

Marie Elena Gioiella, LICSW, andMarilyn Wise, LICSW, Social Services,presented, “Narratives in Social Work:

Illustrating Our Clinical Practice,”at Innovation at 100, October

27–28, 2005, in Boston.

Wolf Dresp presentsChristine Wolf Dresp, LICSW,

Social Services, presented, “Dreamworkin Clinical Practice,” at Innovation


Zwirner presentsMary Zwirner, LICSW, Social Services,

presented, “A Case Study: InterdisciplinaryCare of the Patient with Brain Injury of

Unknown Etiology Experiencing Sympa-thetic Storming,” at Innovation at 100,


Dahlin and Goldsmithpublish

Constance Dahlin, APRN, palliativecare nurse practitioner, and Tessa Gold-

smith, clinical specialist, Speech,Language & Swallowing Disorders,

authored the chapter, “Dysphagia, DryMouth, and Hiccups,” in Oxford Textbook

of Palliative Nursing, second edition,Oxford University Press,

New York, 2005.

Dahlin, Giansiracusa,publish

Constance Dahlin, APRN, and DavidGiansiracusa, MD, Pain and PalliativeCare Center, wrote the chapter, “Com-

munication,” in Oxford Textbook ofPalliative Nursing, second edition,

Oxford University Press,New York, 2005.

Jagodynski Samatis, Pittman,publish

Kristen Jagodynski Samatis, BS,health educator, and Taryn J. Pittman, RN,patient education specialist and manager,Blum Patient & Family Learning Center,published the article, “Consumer Health

Within an Academic Medical Center:State-of-the Art Services and

Technology,” in the Journal ofHospital Librarianship, 2005.

jeb23

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February 2, 2006

Page 13

February 2, 2006

Next Publication Date:

February 16, 2006

Published by:

Caring Headlines is published twice eachmonth by the department of Patient Care

Services at Massachusetts General Hospital.

Publisher

Jeanette Ives Erickson RN, MS,senior vice president for Patient Care

and chief nurse

Managing Editor

Susan Sabia

Editorial Advisory Board

ChaplaincyMichael McElhinny, MDiv

Development & Public Affairs LiaisonVictoria Brady

Editorial SupportMarianne Ditomassi, RN, MSN, MBAMary Ellin Smith, RN, MS

Materials ManagementEdward Raeke

Nutrition & Food ServicesMartha Lynch, MS, RD, CNSDSusan Doyle, MS, RD, LDN

Office of Patient AdvocacySally Millar, RN, MBA

Orthotics & ProstheticsMark Tlumacki

Patient Care Services, DiversityDeborah Washington, RN, MSN

Physical TherapyOccupational Therapy

Michael G. Sullivan, PT, MBA

Police & SecurityJoe Crowley

Reading Language DisordersCarolyn Horn, MEd

Respiratory CareEd Burns, RRT

Social ServicesEllen Forman, LICSW

Speech-Language-Swallowing DisordersCarmen Vega-Barachowitz, MS, SLP

Volunteer, Medical Interpreter, Ambassadorand LVC Retail Services

Pat Rowell

Distribution

Please contact Ursula Hoehl at 726-9057 forquestions related to distribution

Submission of Articles

Written contributions should besubmitted directly to Susan Sabia

as far in advance as possible.Caring Headlines cannot guarantee the

inclusion of any article.

Articles/ideas should be submittedby e-mail: [email protected]

For more information, call: 617-724-1746.

Please recycle

Dacunha certifiedShannon Dacunha, RN, staff nurse,

General Medicine, became certified as amedical-surgical nurse, in December 2005.

Otis certifiedLeann Otis, RN, staff nurse, on the

Cardiac Access Unit, was certified as acardiac-vascular nurse.

Edwards certifiedErica Edwards, RN, Cardiac CriticalCare Unit, passed the cardiac nursing

certification exam given by the AmericanAssociation of Critical-Care Nurses.

Peterson certifiedGayle Peterson, RN, staff nurse,

General Medicine, was certified in painmanagement nursing by the American

Nurses Credentialing Center.

Feldman presentsEllen Feldman, LICSW, Social Services,

presented the break-out session, “Workingwith Couples Undergoing Assisted

Reproductive Technologies,” at Innovationat 100, October 27–28, 2005,

in Boston.

McSheffrey presentsCarol McSheffrey, LICSW, Social

Services, presented the break-out session,“Getting Up to Speed: A Review of

Clinical Interventions in Couples Therapy,”at Innovation at 100, October 27–28, 2005,

in Boston.

Madigan, Moore, publishJanet Madigan, RN, PCS Information

Systems, and Karen Moore, RN, publishedthe article, “MARN Supports the PatientsFirst Initiative,” in Massachusetts Report

on Nursing, Volume 3, Number 4,December, 2005.

Binda, Clair-Hayes presentKatie Binda, LICSW, and Kathy Clair-

Hayes, LICSW, Social Services, presentedthe break-out session, “Creating InnovativeSupport, Education and Wellness Program-

ming for Patients, Families and Staff,”at Innovation at 100, October 27–28,

2005, in Boston.

Forman presentsEllen Forman, LICSW, Social Services,

presented the break-out session, “HelpingPatients Navigate the Crazy Quilt System,”at Innovation at 100, October 27–28, 2005,

in Boston.

McCorkle, McLaughlinpresent

Chuck McCorkle, LICSW, and SandyMcLaughlin, LICSW, Social Services,

presented the break-out session, “HIV/AIDS:Changing Needs Means Changing Practice.

What Do We Know 20+ Years In?”at Innovation at 100, October 27–28,

2005, in Boston.

Social workers presentNatascha Gundersen, LICSW; Karon

Konner, LICSW; and Kristen Prendiville,LICSW, Social Services, presented the break-

out session, “Supporting Lives and Spirits:Tsunami Relief in Indonesia,” at Innovation at

100, October 27–28, 2005, in Boston.

Social Services teampresents

Bonnie Zimmer, LICSW; Patti Rosell,LCSW; Sandra Elien; and Erin Gibson, LCSW,

Social Services, presented the break-outsession, “Domestic Violence Advocates andSocial Workers: Teaming Toward Safety,”

at Innovation at 100, October 27–28, 2005,in Boston.

Social workers presentKathy Clair-Hayes, LICSW; Carla

Cucinatti, LICSW; Nancy Leventhal,LICSW; Rebecca Murphy, LICSW; andMarguerite Hamel-Nardozzi, LICSW,

Social Services, presented the break-outsession, “I Don’t Know What to Say to My

Child—How Therapeutic Backpacks Can HelpStart the Conversation Between Parentsand Kids,” at Innovation at 100, October

27–28, 2005, in Boston.

Levin-Russman presentsElyse Levin-Russman, LICSW, Social

Services, and Parent Members of the Pediatric-Oncology Family Advisory Committee,

presented the break-out session, “Partneringwith Families to Enhance Clinical Services:

The Development of a Family AdvisoryCommittee,” at Innovation at 100,

October 27–28, 2005,in Boston.

Page 14


Magnet calendarsavailable

(featuring MGH nurse, Katie Fallon)

The inaugural issue of the MagnetRecognition Program’s annual calendar

is now available.

The 2006 calendar highlights excellencein nursing service at Magnet hospitals with

photos depicting the 14 forces of magnetism.The calendar is not available for purchase,

but may be viewed and printed from theMagnet website at:

http://www.nursecredentialing.org/magnet/forms/Calendar2006.pdf

For more information, contactGeorgia Peirce at 4-9865.

governs reimbursementto long-term care (LTC)facilities. Reimburse-ment may be reduced if apatient develops a newpressure ulcer or if anexisting pressure ulcerworsens while in the careof the LTC facility ornursing home. Lyderreports that a similarregulation may be enact-ed related to reimburse-ment for acute care hos-pitals in the near future.Other consequences mayinclude reluctance ofLTC facilities and nurs-ing homes to accept pa-tients from acute carefacilities if they havenew or worsened pres-sure ulcers. There hasbeen an increase in liti-gation against hospitalsand nurses by family

members in cases wherepressure ulcers develop,especially following thedeath of a loved one dueto complications of pres-sure ulcers, which wereperceived as avoidable.Lyder recommends:

documenting the pre-sence and status of allpressure ulcers at timeof admission, periodi-cally throughout thehospital stay, and upondischargedocumenting, whenappropriate, that a newor worsening pressureulcer was unavoidableand why (for example,prolonged immobilityassociated with sepsisand hemodynamicinstability) documenting how theplan of care changed in

order to prevent addi-tional pressure ulcersor worsening of exist-ing pressure ulcers.using a wedge at thefoot of the bed to pre-vent shear forces andpressure ulcers in pa-tients who are mech-anically ventilated andrequire the head of thebed to be elevatedconsidering micro-shifting in patientswhose conditions pre-vent turning

Lyder’s visit consistedof four sessions. Thefirst was a standing-room-only dialogue withcritical care nurses onavoidable and unavoid-able pressure ulcers. Aluncheon session withthe CNS Wound CareTask Force focused on

Visiting Professor in Wound Healingcontinued from front cover

strategies to help educatestaff about pressure ul-cers. Nursing GrandRounds focused on theimplications of DTI andF-314 for acute care. Theclosing session, whichfeatured a mock depo-sition in a lawsuit againsta hospital where a patient

had developed pressureulcers, illustrated the im-portance of complete nurs-ing documentation in de-fending nursing practice.The Visiting ProfessorProgram revealed opportu-nities for advancement inour skin and wound careprogram.

Call for NominationsCancer Nursing Career

Development Award

The Cancer Nursing Career DevelopmentAward recognizes an MGH staff nurse who

consistently demonstrates excellence indelivering care to patients with cancer,who is a role model to others, and who

demonstrates a commitmentto professional development.

Staff nurses whose primary responsibility isdirect care of cancer patients and their

families (inpatient or outpatient) are eligiblefor nomination. Recipient will receive $1,000

to advance his/her professionaldevelopment.

Colleagues, patients, and family memberscan nominate a staff nurse.

Nominations are due by February 24, 2006

For more information, please contactLin-Ti Chang, RN, at: 617-643-2995

When should handhygiene be performed?Hand hygiene should be performedbefore any contact with patients orpatients’ environments.

(Before handshakes, pulse checks, phy-sical examinations, giving a boost up inbed, touching the bedside table, trans-porting equipment, laundry, etc.)

Hand hygiene should be performed betweentasks if a clean site is to be touched after a con-taminated site.(Between redressing a wound and checking an IV site; betweenhandling a bedpan and refilling the water pitcher; between collect-ing used lunch trays and preparing a snack in the kitchen)

Hand hygiene should be performed after patient care, before touch-ing anything in the non-patient environment.

(After administering an injection, before charting it in the patient’srecord)

Hand hygiene should be performed before donning gloves andafter glove removal (both sterile and non-sterile gloves).

Stop the Transmissionof Pathogens

Infection Control UnitClinics 131726-2036

Page 15

Educational OfferingsEducational Offerings February 2, 2006February 2, 2006

2006

2006

For detailed information about educational offerings, visit our web calendar at http://pcs.mgh.harvard.edu. To register, call (617)726-3111.For information about Risk Management Foundation programs, check the Internet at http://www.hrm.harvard.edu.

Contact HoursDescriptionWhen/Where- - -Advanced Cardiac Life Support (ACLS)—Provider Course

Day 1: O’Keeffe Auditorium. Day 2: Thier Conference RoomFebruary 10 and 278:00am–5:00pm

16.8for completing both days

Oncology Nursing Society Chemotherapy-Biotherapy CourseYawkey 2220

February 16 and 238:00am–4:00pm

New Graduate Nurse Development Seminar IITraining Department, Charles River Plaza

5.4 (for mentors only)February 228:00am–2:30pm

Natural Medicines: Helpful or Harmful?FND626

1.8February 231:00–2:30pm

Building Relationships in the Diverse Hospital Community:Understanding Our Patients, Ourselves, and Each OtherTraining Department, Charles River Plaza

7.2February 248:00am–4:30pm

Nursing Grand Rounds“Anti-Coagulation.” O’Keeffe Auditorium

1.2February 161:30–2:30pm

Phase II: Wound Care EducationTraining Department, Charles River Plaza

TBAMarch 1 and 88:00am–4:30pm

Assessment and Management of Patients at Risk for InjuryHaber Conference Room

TBAMarch 18:00am–4:00pm

Oncology Nursing Concepts: Advancing Clinical PracticeYawkey 10-640

TBAMarch 28:00–4:00pm

CPR—American Heart Association BLS Re-CertificationVBK401

- - -March 77:30–11:00am/12:00–3:30pm

New Graduate Nurse Development Seminar ITraining Department, Charles River Plaza

6.0(for mentors only)

March 88:00am–2:00pm

Nursing Grand Rounds“Lymphedema.” Haber Conference Room

1.2March 811:00am–12:00pm

OA/PCA/USA ConnectionsBigelow 4 Amphitheater

- - -March 81:30–2:30pm

Greater Boston ICU Consortium CORE ProgramNEBH

44.8for completing all six days

March 9, 10, 16, 17, 27, 307:30am–4:30pm

- - -Advanced Cardiac Life Support (ACLS)—Provider CourseDay 1: O’Keeffe Auditorium. Day 2: Thier Conference Room

March 10 and 278:00am–5:00pm

- - -A Safer Start: Empowering Pregnant Women Living with DomesticViolenceTraining Department, Charles River Plaza

March 159:00am–3:30pm

More than Just a Journal ClubThier Conference Room

1.2March 154:00–5:00pm

Workforce Dynamics: Skills for SuccessTraining Department, Charles River Plaza

TBAMarch 168:00am–4:30pm

BLS Certification for Healthcare ProvidersVBK601

- - -March 208:00am–2:00pm

Pain Relief Champion DayThier Conference Room

1.2March 20 and 227:30am–4:30pm

Nursing Grand Rounds“Provoking Ischemia, Risking Infarction: Stress Testing.” O’KeeffeAuditorium

1.2March 161:30–2:30pm

Page 16


CaringCaringH E A D L I N E S

Send returns only to Bigelow 10Nursing Office, MGH

55 Fruit StreetBoston, MA 02114-2696

First ClassUS Postage Paid

Permit #57416Boston MA

Patient Care Servicesremembers cherished

friendshe MGH com-

munity was sad-dened to learn of

the passing oftwo long-time Pa-

tient Care Services em-ployees last month whenPaul Lindquist and Ro-bin Holloway passedaway within days of eachother.

Lindquist, a memberof the MGH family formore than 32 years, diedon January 15, 2006,after an extended illness.During his tenure at MGH

Lindquist worked as aunit coordinator and ad-ministrative coordinatorfor Clinical Admini-stration and NursingSupport Services.

In 1990, he joinedPatient Care ServicesManagement Systems asa financial analyst, theposition he held until hisdeath.

Colleagues rememberLindquist as, ‘a quietfriend and caring men-tor.’ He had a great senseof humor and knew the

organization inside andout. You could go to himwith questions and he’dalways know where to goto get answers. He wasalways willing to help.

Lindquist had a nat-ural appreciation for cus-tomer service. He wasthe ‘go-to’ person in hisareas of expertise; highlyregarded for his know-ledge and insight. Heapproached issues withan open mind and a ‘can-do’ attitude; he was re-spectful of others and

In MemoriamIn Memoriam

T

always willing to provideassistance and support.

Says Christina Graf,RN, director of PCS Man-agement Systems, “Fam-ily was very important toPaul. He was a proudhusband, father, andgrandfather. He loved theocean and being near thewater. He loved spendingtime on his boat on LakeWinnipesaukee. He wasa very important part ofour family, and he willbe missed.”

Holloway worked atMGH since 1978, first asa Northeastern Univer-sity co-op student, thenafter receiving her BSN,as a nurse on the MedicalService. Most of Hollo-way’s career was spent

working in the MedicalIntensive Care Unit.

Holloway’s advancedirective captures the wayshe wanted to be remem-bered:

“If anyone asks, pleasetell them:

l love lifeI love adventureI love exploring.

I love giving of myselfin my joband in my life.

I love making a differ-encehowever largeor small it may be.”

According to friendsand colleagues, Hollowaydid make a difference, andshe will be missed by many.

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Caring February 2, 2006 - massgeneral.org to define characteristics, describe ... round-the-clock triage for critical-care and ... pital-wide mon-itoring of bed avail-