Caring Headlines - African American Pinning Ceremony

Inside:Annual African AmericanPinning Ceremony .................. 1

Jeanette Ives Erickson ............ 2PCS Diversity Update

Fielding the Issues .................. 3Medical equipmentDiversity initiatives

Multi-Cultural StudentMentoring Program ............. 3

Medical Interpreters ................ 5

Exemplar ................................. 6Heather Kuberski, RN

Clinical Nurse Specialist ......... 8Diane Carroll, RN

Professional Achievements .... 9

International Patient Center ..10

Educational Offerings ........... 11

Working together to shape the futureMGH Patient Care Services

CaringCaringFebruary 21, 2002

H E A D L I N E S

n February 1, 2002, inO’Keeffe Auditorium,Patient Care Services andthe MGH communitycelebrated Black History

Month with the third annual Afri-can American Pinning Ceremony.The ceremony was created as ameans of reflection for AfricanAmerican women and men tocelebrate their organizational con-tributions, their cultural history,and their vision for the future.

Guest speaker and consultant,Ralph Frazier, presented, “Men-toring, the Gift of Relationships,”in which he described mentoringas a transfer of wisdomin a way that helps indi-viduals build abilitiesand self-confidence. Themessage fit perfectlywith the day’s observance.

The theme of this year’s cele-bration, “Hidden Treasures,” cap-tured the essence of this programthat honors the quiet, capableindividuals who consistently im-pact MGH through the effect theyhave on the lives of others. Hon-orees for 2002 were: Carol Wash-ington, Bigelow 13 operationscoordinator; Alfreda Whyte, RN,

African American PinningCeremony

Celebrating the rich culture and invaluable contributionsof African American employees

—by Deborah Washington, RNdirector of PCS Diversity

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continued on page 4

(Photo by M

ichelle Rose of the B

ulfinch Photo Lab)

Blake 6 staff nurse; Dorothy Bow-ers, RN, staff nurse on the Ellison8 Cardiac Step-Down Unit; HelenWarwick, patient care associate inthe Emergency Department; EdnaGavin, Bigelow 13 critical caretech; and Ivonny Niles, RN, White6 staff nurse.

Each honoree was introducedby the person paying her tribute.

Dawn Moore, RN, spoke aboutCarol Washington, the operationscoordinator on Bigelow 13. Moorewas first hired by Washingtonwhen she was a Protech student.“I was surprised she even gaveme a chance,” said Moore, “be-cause I was dressed in jeans andsneakers and had a flip attitude atthe time.” Washington mentored

Director of PCS Diversity Program, Deborah Washington,RN, pins White 6 staff nurse, Ivonny Niles, RN, at this

year’s African American Pinning Ceremony.

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February 21, 2002February 21, 2002Jeanette Ives EricksonJeanette Ives Erickson

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

and chief nurse

PCS diversity initiatives:creating an infrastructure

that works!ach year whenI sit down towrite PatientCare Services’

report on Diversity, I amamazed at how far we’vecome in such a shortamount of time. It rein-forces my belief that wewere right to take thetime necessary to edu-cate ourselves and reallycreate a solid infrastruc-ture to support this im-portant work.

Our diversity initia-tives are broad and all-encompassing; they mir-ror the definition of di-versity that we crafted toguide our efforts. Ouroperating assumptionsreflect the wisdom andthoughtfulness of a sen-sitive and informed or-ganization. They are theguideposts that ensurewe remain true to ourvalues as we move for-

E

PCS definition ofdiversity encompasses:

RaceEthnicityGenderEducationSexualityReligionAgeCulturePhysical abilityPersonal beliefsystemStage of life/careerOpinion

ward in our journey. Theoperating assumptionsthat drive our diversityprogram are:

Cultural competence isa process, not a desti-nationThe journey beginswith each individualknowing his/her owncultural values, beliefs,and lifestyle as theyinfluence our actions.It is critical to recog-nize the intra-culturalvariation among ethnicand diverse groups.We must be patient inour learning andknowing processes,including integratingsocial cultural factorswithin a culturalcontext.Knowing and improv-ing are inseparable.We must learn aboutthe illness and well-ness states of diverse

cultures to beable to providecare that isculturally com-petent.

ThoughMGH has al-ways welcomedpeople and cul-tures from allover the world, itwasn’t until wereally focusedour efforts, iden-tified specificgoals, and com-mitted resourcesthat we started to

achieve measurable out-comes in our work ar-ound diversity. Somerecent outcomes include:

incorporating diver-sity-assessment ques-tions into the StaffPerceptions Surveycollaborating withU.Mass Boston toenhance clinicalaffiliation experiencesdesigning processesand interventions toenhance the careersuccess of diverseemployeesworking with HumanResources and Com-munity Benefits toconduct focus groupsto gain insight intoother perspectivesabout the care deliv-ered at MGHdeveloping strategiesto positively impactyouth-service groupssuch as The GirlScouts, to raise aware-ness a bout careers inhealth care

And our goals for thefuture are equally ambi-tious. We are currentlyworking to:

implement a Foreign-Born Nurses LicensureProgram (see questionon page 3)create strategic allian-ces with academicinstitutions to supportnew graduate nurses’transition into practiceimprove access todiversity trend data

revise the PCS Diver-sity Leadership Fel-lowshipdesign an MGH Nurs-ing Image Campaignthat captures thediversity of our work-force and the oppor-tunities available atMGH

Providing competentmedical interpreters forour non-English-speak-ing patients has becomea top priority (see articleon page 5). The numberof requests for interpret-er services has tripled inthe past five years. Tomeet the demand, wenow employ 18 full-timeinterpreters who providecompetent medical inter-preter services in Span-ish, Khmer, Portuguese,Arabic, Vietnamese,Cantonese, Mandarin,French-Creole, Russian,and Italian. Over andabove that, there are 83interpreters on call sup-porting 34 languages.Interpreter services areavailable 24 hours a day,seven days a week.

We truly have createda new reality at MGH, areality where diversity isone of the many inter-woven threads in thefabric of Patient CareServices. Isn’t it wonder-ful that at any given timewe can attend an educa-tional offering on:

Caring for Gay &Lesbian PatientsGender Roles in theMuslim CultureCommunicating Ef-fectively with Deafand Hearing-ImpairedPatientsSpecial Issues inHealthcare for Jeho-vah’s Witnesses andChristian Scientists

We have come far. Icommend each and everyone of you for your com-mitment to, and supportof, our diversity initia-tives. The more we do. . .the more we achievetogether. . . the strongerwe become. It’s exhila-rating to think what wewill accomplish in thenext 5 years!

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February 21, 2002February 21, 2002

Medical equipment andon-going diversity initiativesThe Fielding the Issues section of Caring Headlines is an adjunct

to Jeanette Ives Erickson’s regular column. This section givesthe senior vice president for Patient Care a forum in which

to address questions presented by staff at meetings andvenues throughout the hospital.

Fielding the IssuesFielding the Issues

Multi-Cultural StudentMentoring ProgramWelcome Reception

eresa Wong received a royal welcome as thefirst nursing student accepted into the MGH-U Mass Boston Multi-Cultural Nursing Stu-dent Mentoring Program at a special recep-

tion held in her honor on February 1, 2002. Speakersat the reception included: Rosalie Tyrrell, RN, MS,project manager; Marion Winfrey, RN, EdD, associ-ate dean for Undergraduate Studies, U Mass BostonSchool of Nursing and Health Sciences; DeborahWashington, RN, director of PCS Diversity; and RonGreene, RN, chair of AMMP (and a volunteer mentor).

Associate chief for The Center for Clinical & Pro-fessional Development, Trish Gibbons, RN, DNSc,presented the scholarship to Wong. Several nurseswho have volunteered to be mentors for the programwere present, including: Rischa Mayes, RN; PhilipWaithe, RN; Angelleen Peters-Lewis, RN; and MaryWilliams, RN.

Wong has begun her orientation to become a part-time patient care associate on Phillips House 21.

Question: I heard aboutan incident recently (atanother hospital) where apatient died after receiv-ing a dose of nitrousoxide. Is it advisable foroxygen-delivery equip-ment to be modified foruse with other gas mix-tures?

Jeanette: This is a ques-tion that relates to allmedical equipment in allareas of the hospital.Under no circumstancesshould patient-careequipment be modifiedor used for any purposeother than its intended

use. We have a lot ofvery sophisticated ma-chinery that enables usto utilize the latest inhealthcare technology.We use this equipmentaccording to manufactur-er’s specifications, andonly the manufacturer isqualified to modify oradapt that equipment.

This is particularly im-portant in the case ofgas-delivery equipment.In the United States inthe past 12 months twopatient deaths have oc-

curred as a result of mod-ification of gas-deliveryequipment. Machinesdesigned for use with aspecific gas should neverbe modified or used withsubstances other thanthose they were intendedfor.

Question: We’ve beentalking about making adifference with diversityfor a long time. I do seechanges, but what ex-actly is the hospital do-ing?

Jeanette: I think thechanges you’re referringto have to do with ourincreasingly multi-cul-tural, multi-ethnic staff,and our on-going effortsto ensure that all staffdeliver care that is cul-turally competent andsensitive. Increasing thediversity of our staff hasbeen a long-held priorityof Patient Care Services.We have made greatstrides in providing andsupporting educationalopportunities with grantsand scholarships. Wecelebrate employee con-tributions through recog-nition and award cere-monies. Through schooland other affiliations, wepromote MGH as thehealthcare employer ofchoice. It is encouragingto hear that our manyefforts are being noticed.

Question: Did I hear thatthere’s a mentoring pro-gram for foreign-bornnurses interested in pur-suing a license to practicein the United States?

Jeanette: Yes, we arepiloting a program toassist nurses licensed inother countries to fulfillthe necessary require-ments to obtain a profes-sional license in this coun-try. Many MGH employ-ees working in assistiveroles are fully licensed topractice nursing in theirown countries. These in-dividuals have been val-uable employees, and it’simportant that they besupported in their effortsto maximize their ownpotential and continue tomake valuable contri-butions to our patientsand their families.

Above: Wong at receptionwith senior vice presidentfor Patient Care, Jeanette

Ives Erickson, RN.

Above right: Wong withWashington and Waithe.

At right: Wong withTyrrell and Greene.

T

(Photos by Michelle Rose)

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February 21, 2002February 21, 2002Black History MonthBlack History MonthCover Storycontinued from front cover

(Photos by M

ichelle Rose)

MGH Cancer CenterMusic and Healing Program

Wednesday, March 6, 200211:00–11:45am (harpist) Radiation Oncology

(Cox LL)12:00–12:45pm (staff in-service) Cox 8

(Social Work office suite)1:00–1:45pm (harpist) Cox 2 Waiting Area

Thursday, March 7, 200211:00–11:45am (harpist) Bigelow 12 Infusion

Unit12:00–12:45pm (staff in-service) Radiation

staff lounge1:00–1:45pm (harpist) Blake 2 Infusion

UnitFor more information call Joelle Reed

at 6-2689

Moore throughout highschool, attended Protechmeetings with her, andhelped her prepare forcollege. Moore, who is amember of the Interna-tional Medical DisasterTeam, started as an as-sistant on the unit tenyears ago, and in June ofthis year will graduatewith a master’s degree inScience as a family nurse

practitioner. Said Moore,“I have achieved thesegoals and much morebecause of Carol.”

Alfreda Whyte, RN,was honored by RonaldGreene, RN, who said inhis introduction, “WhenAlfreda decided to go tonursing school, she work-ed full time and went toschool full time. When Iasked her what the hard-est thing was during thattime in her life she said,‘It was the exhaustion.’ ”Whyte graduated two

years ago and is nowworking as a nurse onBlake 6. What’s hergreatest challenge thesedays? Says Whyte, “It’sthe whole idea that nowI’m the responsible one.There’s no nurse to go toanymore. I’m the nurse.”

Helen Warwick, pa-tient care associate in theED (unable to attend),was also recognized byGreene. “Helen’s jobtitle has changed severaltimes in her thirty yearsat MGH,” said Greene.

“But no matter what hatshe wears, she alwaysmakes a difference whe-ther it’s mentoring newemployees, helping in-terns get oriented, or justgenerally helping pa-tients and families feelmore comfortable.”

Dorothy Bowers,RN, staff nurse on theEllison 8 Cardiac Step-Down Unit, was intro-duced by Lois Masters,RN, who shared that,“Dorothy came to us as anew graduate nurse, thenshe worked as a patientcare associate. It waseasy to see her potential.‘Excellence’ is the wordthat best describes her.”

Edna Gavin, criticalcare tech on Bigelow 13,was introduced by MaryWilliams, RN. Gavin,who has worked at MGHsince 1969, was the firstperson to become a burntechnician when the rolewas initially created.Said Williams, “Whenyou think of the Burn

Unit, the first personwho comes to mind isEdna. She is firm butgentle. She has a greatsense of humor. Andsometimes you may evenhear her singing!”

Ivonny Niles, RN,who started as a phle-botomist at MGH in1979, was introduced byDeborah Washington,RN. Niles, who is now astaff nurse on White 6,proudly self-identifies asa Latina and an AfricanAmerican. Said Niles,“Being honored at thisAfrican American Pin-ning Ceremony meansI’m somebody. It’s easyto get lost in such a largehospital, but this pinsays: ‘this person exists. . . this person has some-thing to offer.’ ”

Indeed, each of theseindividuals has much tooffer. We’re happy tohave the opportunity torecognize them andmake their contributionsa little less ‘hidden.’

Lois Masters pins Dorothy Bowers

2002 Pinning Ceremony honorees (l-r): Dorothy Bowers, Ivonny Niles, Edna Gavin,Carol Washington, and Alfreda Whyte.

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patients with whom theycannot effectively com-municate.

Qualified medicalinterpreters improveunderstanding betweenpatients and caregivers.It has been shown thatenhanced communica-tion and understandingimproves compliancewith the care plan andtreatment regimen, andultimately results in bet-ter outcomes. Using med-ical interpreters also en-sures that patients areaware of ancillary testsand follow-up appoint-ments, reducing the am-ount of missed appoint-ments.

It can betempting toask familymembers orother staffmembers tointerpret dur-ing encount-ers with non-English speak-ing patients.State law andMGH policyprohibit theuse of un-qualified staffor familymembers as areplacementfor competentmedical inter-preters. Fam-ily and staffare often un-

familiar with medicalterminology and mayhave difficulty remainingunbiased and unemo-tional when interpretingmedical information.Family members espec-ially may subconsciouslyscreen the patient’s an-swers, add their owninformation, or contri-bute medical advice thatdid not come from theprovider. This jeopar-dizes the accuracy ofcommunication and se-verely undermines pa-tient confidentiality.Using bi-lingual staff asinterpreters contributesto decreased productiv-

ity, resentment amongstaff who must cover forthem in their absence,and increased turnoveramong bi-lingual staff.

MGH medical inter-preters follow the stand-ards of practice estab-lished by the Massachu-setts Medical InterpretersAssociation and aretrained to be accurateand unbiased.

Patients have theright to choose who willinterpret for them, but allpatients must be giventhe option of using atrained MGH medicalinterpreter. Only the pa-tient has the right to ac-cept or refuse a qualifiedmedical interpreter. Pro-viders should documentin the patient’s medicalrecord when a medicalinterpreter is used orrefused by the patient.

The MGH InterpreterServices Office is openweekdays from 7:00am

Medical InterpretersMedical InterpretersMedically speaking:

the importance of usingmedical interpreters

—By Andrea Beloff,administrative fellowoing to a hos-

pital as a pa-tient can beunsettling un-

der the best of circum-stances, but being in ahospital and unable tocommunicate with any-one can be absolutelyterrifying. This is theunfortunate reality formany non-English speak-ing patients and theirfamilies across the coun-try.

In July of 2001, theMassachusetts legisla-ture passed a new statelaw ensuring effectivecommunication betweenhealthcare providers andall non-English-speakingpatients. The law speci-fies that competent inter-preter services be avail-able at no cost to all non-English speaking emer-gency and psychiatricpatients. Because MGHis committed to provid-ing the highest-qualityculturally competentcare, our policy calls forthe provision of compe-tent interpreter servicesto all patients.

The US Civil RightsAct prohibits discrimina-tion by federally fundedentities based on race,color, or national origin,particularly as it pertainsto individuals with lim-ited English proficien-cy. Hospitals and indi-vidual healthcare pro-viders could face seriouslegal charges for treating

G

to midnight, and week-ends from 10:00am to10:00pm. Not all inter-preters are on-site whenthe office is open, so itis strongly recommend-ed that you request aninterpreter in advance.

During officehours, call 6-6966 torequest an interpreter.After hours, please call4-5700 and enter pagernumber:

3-0001 for a Spanishinterpreter3-0003 for a Portu-guese interpreter3-0005 for an Arabicinterpreter3-0009 for all otherlanguages or author-ization to use tele-phone services

Look for anotherarticle focusing on theimportant work of med-ical interpreters in theMarch 21st issue ofCaring Headlines.

Spanish-speaking medical interpreter, Isa MariaDeputy, assists pediatric pulmonologist, BernardKinane, MD, in communicating with 2-year-old,

patient, Sonia Henriquez and her mom.

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Heather Kuberski, RN, BSNstaff nurse, Blake 2

ExemplarExemplar

y name isHeatherKuberski,and I am a

staff nurse on the Blake2 Infusion Unit. When Ibegan caring for Beth, Iwas a new graduatenurse, only 22 years old.I was a newcomer tonursing and to Oncology.Beth was only 18 yearsold when I first met her(at that time, I was nurseon Ellison 14). She hadbeen newly diagnosedwith a rare form of can-cer, called sarcoma, thatwas believed to havestarted in her left groinand spread to her lungs.She had been admitted tothe hospital for her firstround of chemotherapy.

I’ll admit, I was alittle intimidated at theidea of treating a patientso young, practically myown age. I’ll never forgetthe frightened look in hereyes when I first mether—that fear of theunknown. Her parentswere with her and seem-ed very supportive oftheir daughter, who wastheir only child. I intro-duced myself to themand told them I’d betheir ‘primary nurse.’They seemed grateful toknow that they would beseeing a familiar facewith each of Beth’s ad-missions. . . and therewould be a lot of themover the next four and a

half years.The first memory I

have of developing atrusting nurse-patientrelationship with Bethwas when her hair beganto fall out from the che-motherapy treatments.She was devastated byher hair loss. She des-cribed it as, “really see-ing herself as sick.” Icomforted her and assur-ed her that when hertreatments were complet-ed her hair would growback. I even helped hershave what was left ofher hair, as she said itwas “itching her.” Bethand I had begun a bondthat would continuethroughout her fight withcancer.

Beth tolerated thefirst two years of herchemotherapy treatmentsquite well. She wouldcome to the hospital withher midnight snacks toshare with the nursingstaff and entertain us lateat night with her wonder-ful sense of humor. Nev-er during this time didshe think she would notget better. She copedwith her illness by sleep-ing through her treat-ments. We all knew notto disturb her, unless ofcourse, her favorite show,Days of our Lives, wason.

As time went on,Beth’s disease continuedto win. She would have

her rounds of differentinpatient chemotherapiesand CAT scans. Thoughcertain chemotherapiesworked for a little while,and her lung diseasewould get better, after awhile treatments stoppedhelping and her diseasestarted to grow again.Beth would plead withher oncologist, asking,“When am I going to bebetter? When am I goingto be able to live a nor-mal life?” Of course herdoctor had no answersfor her. He didn’t knowif or when her diseasewould ever fully respondto treatments. In additionto the grueling chemo-therapy treatments, Bethhad been through twosurgeries on her left groinand leg where doctorsbelieved her primarycancer site was.

After standard che-motherapy had ceasedworking, Beth went onto try investigationalprotocols on an outpa-tient basis. Coincident-ally, that’s when I trans-ferred from the inpatientOncology unit to theoutpatient unit, so I wasable to remain her pri-mary nurse. These pro-tocols kept the disease inher lungs stable for aperiod of time.

One day I received aphone call that Beth hadbeen taken to the emer-gency room. She was

somnolent and confused,and doctors weren’t sureof the cause. She wastaken to Ellison 14, whereshe remained for morethan six weeks. We allthought this would bethe end of Beth’s longbattle with cancer. Wesaid our good-byes, andher parents kept a vigil ather bedside. Beth wasmostly unresponsive. Asa last resort, her oncolo-gist decided to try onelast medicine, Decadron.Miraculously, Beth wokeup! I was amazed when Icame to visit her andfound her sitting up inbed asking for a ham andcheese sub. She said,“Heather, what did youexpect? You know I loveto eat.” I smile now atthe memory. Everyonewas ecstatic at her re-covery. She was transfer-red to rehab, where sheremained for severalmonths. But Beth’s re-mission was short-lived

When Beth returnedto MGH, we continuedto try different chemo-therapy treatments, which

weren’t effective againsther aggressive disease.She would continue tocome to the clinic to seeme for hydration, bloodproducts and lab work.Every time I saw her, shelooked a little thinner, alittle more pale, and mostimportantly, a little moresad. She would tell me,with tears rolling downher face, how much shehated coming into thehospital.

Her parents remainedsupportive of Beth, but itbecame obvious thatBeth’s care was taking atoll on them as well,emotionally and physic-ally. Beth could no long-er walk, she could onlystand and pivot with awalker. She had beensleeping in her livingroom at home, as shewas unable to go upstairs to her bedroom. Ithought it was time for adiscussion about pallia-tive care with Beth andher family.

I met with Beth’ssocial worker (who had

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Long-term nurse-patientrelationship, a treasured gift

for Blake 2 nurse

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been there throughoutBeth’s entire illness) andher oncologist. We dis-cussed Beth’s care andwhen we thought itwould be appropriate tomention, ‘hospice.’ Upuntil this time, Beth andher family had been un-willing to accept the factthat she was nearing theend of her illness. Afterall, she had come backafter having been givenonly six months to live.We knew we had to ap-proach this subject withgreat care. We slowlyintroduced the PalliativeCare team back into theirlives (they had been in-volved when Beth hadhad her previous crisis).They reluctantly accept-ed this. Beth and herfamily did not like “allthis talk about death anddying.” They wanted tofocus on the positive,which we could under-stand. Beth was an onlychild and part of a veryclose circle of friendsand relatives.

In the months thatfollowed, Beth wentthrough an array of emo-tions, ranging from angerto sadness. She wouldask, “Why me? I seeeverybody around megetting good news andgetting better. When is itmy turn to get a break?When am I going to getmy life back? I am sosick of being sick.” Iwould comfort Beth dur-ing these times and try tocheer her up. Sometimes,

I would succeed andother times I would fail,but I never stopped try-ing. I had been there forBeth since the beginning,and I wasn’t going tostop now.

One day, Beth cameinto the clinic, as she didevery week, but this timewas different. Beth hadhad a bad fall over theweekend, and was bruis-ed and in severe pain. Iimmediately called herdoctor and we arrangedto have some x-rays tak-en. Luckily, nothing wasbroken, but the pain inher left leg would notstop. The decision wasmade to admit her forpain management andphysical therapy as shehad almost no movementin her left leg. I helpedher to the inpatient unit.I felt terrible leaving thatnight, as she pleadedwith me not to leave her.I promised that I wouldbe back to see her thenext day and assured herthat she was in goodhands.

When I came backthe next day, I was reliev-ed to see her lookingmuch more comfortable.They had started contin-uous pain medicine. Shewas very glad to see me,and assured me that shewas feeling much better.Then, something happen-ed that had never hap-pened between us in thepast. She began to openup to me in a way shenever had before. Shetold me she thanked Godevery day that I was hernurse. She told me it wascomforting to have a

nurse her own age toconfide in. She remindedme of the fact that I hadbegun treating her whenI was the age she wasnow, 22. She told me sheconsidered me one of herbest friends, as we hadspent so much time to-gether over the past fouryears. She told me shehad been talking to Goda lot lately, asking Himwhy she was still here,what His purpose wasfor her. She said He musthave a reason to havekept her here so long,when others with herdiagnosis had alreadypassed away. She toldme she was tired of be-ing in pain, she wantedto feel normal again,wear her hip clothes andput on makeup. I listenedto her words with a fullheart. I knew I should goback downstairs, but Istayed. Somehow, I knewthat this visit was veryimportant.

When she finishedtalking, her parents andsome family friends camein to visit. They broughtpastries, and Beth askedfor a cheese danish. Shehadn’t eaten anything inmore than a month, sothis request was a sur-prise. We asked if sheonly wanted half, but sheexclaimed, “No! I’mgoing to eat the wholething!” I had a wonder-ful visit that day withBeth. I told her I wouldbe off the next day, but Iwould see her soon. Igave her a hug good-byeand headed back downto care for my other pa-tients.

When I came back towork four days later,Beth was gone. She haddied peacefully just afew hours before myshift started. I was shock-ed. How could the ‘catwith nine lives’ havedied? I broke down intears. I felt in my heart asif I had lost a very dearfriend. Then I realized, Ihad. I felt terrible that Ihadn’t seen her againbefore she died. But as Ipondered, I realized thatwe had said all that need-ed to be said in our lastvisit. And I began to feelgood about how we hadleft things with eachother.

I attended Beth’sfuneral service and wasoverwhelmed by thenumber of people whowere there. Beth’s par-ents told me that day thatI was like part of theirfamily, and I realizedjust how important I hadbeen to them. Caring fora long-term patient is notonly about treating theirmedical needs, it’s aboutmeeting their social andemotional needs as well.I will never forget Beth

Exemplarcontinued from page 6

and her family. Our re-lationship will alwayshold a special place inmy heart.

Comments byJeanet te IvesErickson, RN, MS,senior vice presidentfor Patient Care andchief nurse

I’m sure this narrativebrought back memoriesfor a lot of clinicians—remembering the firsttime we cared for a ter-minally ill patient, per-haps a patient, like Beth,who was close to ourown age. These are pre-cious experiences in ourdevelopment as care-givers, learning how tointegrate our human re-sponses with our pro-fessional acumen.

Heather’s four-yearjourney with Beth was agift for both these youngwomen. Beth receivedthe benefit of Heather’scompassion and nursingskill. And Heather ex-perienced for the firsttime the true power ofbeing present as a nurse.

Thank-you, Heather.

MGH-Timilty Partnership seeks penpals for Timilty students

Through letter-writing, The Promising Pen PalsProgram bridges generations, matching Timilty

students with adult pen pals at MGH.The Promising Pen Pals Program helps

enhance literacy and writing skills, and providesan opportunity for young people to meet positiverole models. Students and their adult pen pals

commit to correspond by letter or e-mail at leastfour times from January through May.

For more information contact Norma Soto [email protected]

or call 617-635-8109.

Page 8


vide evidence that a par-ticular practice is appro-priate. Over the past fewdecades, more and morenursing practice is sup-ported by evidence gen-erated from nursing re-search. This research isused by CNSs to supportcurrent practice or as animpetus for change.

Every CNS can helppromote the use of nurs-ing research. For example,nursing research hasprovided us with empir-ical evidence regardingthe practice of instilla-tion of saline lavage pri-or to suctioning patients.Nurse researchers fromthe University of Roch-ester, found that salinelavage caused an adverseeffect on oxygen satura-tion (O2 sat) compared tono instillation, and thisreduction in O2 sat lastedfor up to ten minutesafter instillation. Therewas little evidence thatsaline instillation loosen-ed secretions or that sa-line actually mixed withsecretions to thin them.Others learned that sa-line lavage and a suctioncatheter dislodged a sig-nificantly large numberof bacteria compared tojust a suction catheter.This dislodgment of bac-teria from the upper air-way into the lungs usingsaline lavage again dem-onstrated that saline la-vage should not be rou-tinely performed. CNSs,through review and pre-sentation of these find-ings, have led the effort

to reduce the use of rou-tine saline lavage in nurs-ing practice.

CNSs assist nurses infinding answers to thequestions that arise frompractice. To begin, aliterature review may beappropriate. TreadwellLibrary is an excellentresource for searchingand scanning literature.CNSs can assist in eval-uating the literature andassessing the strength ofthe evidence that sup-ports practice. In caseswhere there is no evi-dence, you might decideto generate a researchproposal to further in-vestigate your question.The CNS can assist inthis process.

For years on Ellison9, the Coronary CareUnit, iced injectate wasused to measure cardiacindex (CI). There was adesire to move to a room-temperature injectatebecause it was less cum-bersome and less costly.In 1993, nurse research-ers from Texas determin-ed that for patients witha high or low CI, use oficed injectate for mea-surement of CI was, infact, needed. This recom-mendation was based ona small sample, so theauthors recommendedfurther research. A groupof MGH staff nurses ledby Maryanne Kiely, RN,with a CNS as a mentor,took up this question tovalidate the need for icedinjectate to measure CIin patients with low CI.

The American Associ-ation of Critical CareNurses funded the studyand the results were pub-lished in 1998, in theAmerican Journal ofCritical Care. We foundno difference in resultsusing iced or room-temp-erature injectate in oursample of 50 subjectswith low CI. These re-sults supported the nurs-ing practice of usingroom-temperature injec-tate to measure CI evenin patients with low CI.Therefore, iced injectateis no longer used on Elli-son 9 to measure CI.

Two groups of staffnurses interested in alter-native therapies to im-prove patients’ experi-ence developed clinicaltrials to measure the ef-fects of music and backmassage on cardiac pa-tients on strict bedrest.With the CNS as men-tor, one group of nurses,led by May Cadigan,RN, found that patientswho received 30 minutesof music as a treatment,had significantly lowerblood pressure, respira-tory rate and psycholo-gical distress scores.

Another group led byMaryEllen McNamara,RN, looked at the effectsof back massage andfound a significant de-crease in blood pressure.Based on these studies,music and back massageappear to be successfulnursing interventions tomanage negative humanresponses to hospitali-zation. The music-thera-py results were publish-ed in Progress in Cardi-ovascular Nursing andthe back-massage resultsare being published inAlternative Therapies inHealth and Illness.

A CNS with specialpreparation in research,based in a practice set-ting, is focused on ident-ifying and solving clini-cal problems that arise innursing practice. Thisresearch-prepared CNScan offer assistance inidentifying evidence thatsupports practice, canformulate the clinicalquestions and design theprotocol to answer theclinical questions, andthen promote the dis-semination of this newnursing knowledgethrough presentation andpublication.

Diane Carroll, RN, PhD,clinical nurse specialist

CNS as researcher—by Diane L. Carroll, RN, PhD

clinical nurse specialist

Clinical Nurse SpecialistsClinical Nurse Specialists

he main focus ofa clinical nursespecialist (CNS)is nursing prac-

tice and its primary goalof delivering optimalpatient care. In order toadvance nursing prac-tice, a CNS needs todevelop a deep under-standing of the contextof nursing practice, iden-tify the elements thatinfluence patient care,and foster the changesthat need to be made toimprove the quality ofpatient care.

As a CNS, I utilizeresearch methods everyday to evaluate nursingpractice and patient out-comes, and identify orgenerate knowledge tosolve problems that oc-cur in practice. I attemptto reduce the practice-research gap and assiststaff in the generation ofnew knowledge to sup-port excellent patientcare. The developmentof knowledge relevant tonursing practice has hadmany roots. Much ofnursing practice is basedon tradition, trial anderror, expert opinion,and logical reasoning.Therefore a lot of whatnurses do in practice hashad very little systematicevidence, until recently.

As a profession, nurs-ing needs to move towarda practice that is ground-ed in scientific evidencethat has been developedthrough research. Thismeans that our clinicalpractice must be system-ically evaluated to pro-

T

Page 9


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

Services at Massachusetts General Hospital.

PublisherJeanette Ives Erickson RN, MS,

senior vice president for Patient Careand chief nurse

Managing Editor/WriterSusan Sabia

Editorial Advisory BoardChaplaincy

Mary Martha Thiel

Development & Public Affairs LiaisonGeorgia Peirce

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

Materials ManagementEdward Raeke

Nutrition & Food ServicesPatrick BaldassaroMartha Lynch, MS, RD, CNSD

Orthotics & ProstheticsEileen Mullen

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 PathologyCarmen Vega-Barachowitz, MS, SLP

Volunteer, Medical Interpreter, Ambassadorand LVC Retail Services

Pat Rowell

DistributionPlease contact Ursula Hoehl at 726-9057 for

all issues related to distribution

Submission of ArticlesWritten contributions should be

submitted directly to Susan Sabiaas far in advance as possible.

Caring Headlines cannot guarantee theinclusion of any article.

Articles/ideas may be submittedby telephone: 617.724.1746

by fax: 617.726.4133or by e-mail: ssabia @partners.org

Please recycle

Next Publication Date:March 7, 2002

Professional AchievementsProfessional AchievementsIves Erickson

recognized by MONEJeanette Ives Erickson, RN, MS,senior vice president for PatientCare Services, and chief nurse,

received The Mary B. ConcesionAward from the MassachusettsOrganization of Nurse Leaders

on June 7, 2001. The awardhonors nursing leaders who are

recognized by colleagues,physicians, and healthcare

executives for implementingcollaborative and innovative

professional practice, who arearticulate spokespersons on

healthcare issues, andfor developing future

nursing leaders.

Duffy, Reilly and Whitakerco-author monographSheila Duffy, RN, BSN, staff

nurse, Central Resource Team,Jayne Reilly, RN, BSN, and DebWhitaker, RN, BSN, CNN, staffnurses on the Blake 6 TransplantUnit, were contributing authors

on a monograph for the PalliativeNurses Association in November,2001. The monograph dealt with

“The Treatment of End-StageNon-Cancer Diagnoses,” as they

relate to liver disease.

Magee presents posterKristine Magee, RN, BSN,

CPSN, staff nurse, Bigelow 13Plastic and Reconstructive

Surgical Unit Poster, presented aposter at the American Societyof Plastic Surgical Nurses, inNovember, 2001, in Orlando,Florida. The presentation wascalled, “The Use of Medical

Leaches with PlasticSurgical Patients.”

Whitaker certifiedDeb Whitaker, RN, BSN, CNN,staff nurse, Blake 6 Transplant

Unit, received her certification inNephrology Nursing

in June, 2001.

Giese certifiedNancy Giese, RN, BSN, StaffNurse, Bigelow 13, Burns andPlastic Reconstructive SurgicalUnit, received her certification

in Plastic Surgical Nursing(CPSN) in November, 2001.

Matthews receives MaryMalone Award

Margaret Matthews, RN, White11, received the Mary Malone

Award for the Pursuit ofExcellence, on October 19,

2001, at the Blue Hills CountryClub in Canton, MA. The

award recognizes individualswho have set the higheststandards for themselves,and who are committed to

excellence in the professionalservice they provide.

Giampapa, Mott andSmith certified

Ellison 12 staff nurse, HeatherSmith, CNRN, and White 12

staff nurses, Mary Mott,CNS, CNRN, and DeborahGiampapa, CNRN, all havereceived their Neuroscience

certification.

McGrath certifiedJulie Ann McGrath, RN, staffnurse, Bigelow 13 Burn Unit,received her CCRN, CriticalCare Nurse certification in

January, 2002.

Carroll appointed toeditorial board

Diane Carroll, RN, PhD,clinical nurse specialist, has

been appointed to the editorialboard of the Journal of

Cardiovascular Nursing.Carroll will review submissions

and have input intojournal content.

Dahlin publishesConstance Dahlin, RN,facilitated the Fourth

Monograph by the Hospice andPalliative Nurses Association,

called “End-Stage Treatment ofNon-Cancer Diagnoses.

Contributors from the MGHCancer Center included: Noreen

Leahy, NP, Ellison 12; DottieNoyes, NP, CHF; and Debra

Whitaker, Blake 6.

Dahlin co-authored a chapterwith Tessa Goldsmith, SLP,entitled, “Dysphagia, Dry

Mouth, and Hiccups,” for theOxford Textbook of Palliative

Nursing.

Dahlin’s article, “SupportingAlternative Families,” appearedin the May/June, 2001, issue ofClinical Journal of Oncology

Nursing.

Capasso, Jones,Kwiatanowski and

Martin receive grantVirginia Capasso, RN, PhD,

Dorothy Jones, RN, EdD, KarenKwiatansowski, RN, BSN, and

Ann Martin, RN, MSN, receiveda grant for $750 from the

Harvard Institute for NursingHealthcare Leadership to fund a

qualitative research studyentitled, “The Lived Experience

of the VAC Dressing.”

Ellison 12 nursespresent poster

A poster has been accepted forpresentation at the AANN

Annual Meeting in March. Theposter, entitled, “Invasive

Epilepsy Monitoring: NursingExcellence with Assessment andSafe Monitoring of the SeizurePatient,” was created by Jean

Fahey, RN, MSN, CNRN;Nancy J. Meehan, RN, BSN;

Holley Engel, RN, BSN; SandraIarossi, RN, BSN; Julie Cafasso,

RN, CNRN; and ColleenGonzalez, RN, MSN.

Page 10


n your travelsthroughoutMGH, you mayhave noticed a

little office on Blake 1across from O’KeeffeAuditorium. It’s a small,unassuming office, setback from the maincorridor, but its doorsopen a portal to a veryspecial place; a placethat is alive with differ-ent languages and dia-lects. Exotic clothing,headdresses and jewel-ry tell of a vast array oforigins and cultures.People gather here fromall over the world. Youhave just entered theMGH International Pa-tient Center (IPC).

On one couch a cou-ple from The UnitedArab Emirates fills outa form that will allowan international patientcoordinator to completetheir registration pro-cess.

A family from Ar-gentina speaks with aninternational billingcoordinator to help pro-cess their financial rec-ords.

A woman drops offx-rays for her cousinwho lives in Greece.She asks if the IPC canarrange for a physicianto review the films andlet her know if MGHcan help her.

A billing coordina-tor explains to a youngCanadian woman howher insurance coveragewill be handled at MGH.

A family from Indiashakes hands with theconcierge coordinator,and thanks him for help-ing them find afford-able housing in Bostonwhile their father re-covers from surgery.

A coordinator es-corts a Saudi Arabianpatient to his doctor’sappointment where amedical interpreter willmeet them. Anothercoordinator goes to visit

a patient from Kuwaiton an inpatient unit,and another returnsfrom walking two Col-ombian patients to thesubway station, whereshe helped them pur-chase tokens and ex-plained how to get toHarvard Square.

The InternationalPatient Center has cre-ated a thriving, func-tional, world-friendlycommunity within thewalls of MGH. Patientsfrom all nations aregreeted by IPC staffmembers. Children rushto show their IPC co-

ordinator the toys theygot from one of theirnurses. Parents settle ona couch and read a news-paper printed in theirnative language. AnIPC staff member com-pliments a Japanesecancer patient on hernew wig, and a Ven-ezuelan family comesin and starts chattingwith a Brazilian familywith whom they’ve be-come friends.

Staff of the IPCknow these patients,their families and theirchildren. The IPC is aplace where interna-tional families can seekhelp, information, andunderstanding, or justto relax in a caring en-vironment.

In the IPC the term,‘caring environment’goes far beyond itsclinical interpretation.

Anyone who has everbeen sick or in needof help knows howoverwhelming thehealthcare system canbe. Even for an Eng-lish-speaking Ameri-can citizen, the pro-cess is daunting: theinitial search for adoctor, planning avisit to the doctor’soffice, finding theoffice, waiting for testresults, treatments,not to mention rehabi-litation and the expenseof treatment and insur-ance coverage. Nowimagine that you musttravel to another coun-try and navigate acomplex healthcaresystem where youdon’t even speak thesame language. Thisgives you some senseof the challenges andobstacles that interna-tional patients faceevery day.

The InternationalPatient Center is de-signed to help interna-tional patients movemore easily through avery complex system.IPC staff understandthat while patients arecoping with the fearand stress of illness,they need to focustheir energy on heal-ing, not worrying. Weare their advocates.

So the next timeyou’re in the neigh-borhood, stop by theInternational PatientCenter. You may besurprised at the ‘world’you find there.

International PatientsInternational Patients

I

Welcome tothe MGH International

Patient Center—by Sarah Jay

international patient coordinator

International patient coordinator,Sarah Jay, welcomes you to the

International Patient Center

2002

2002

February 21, 2002February 21, 2002Educational OfferingsEducational Offerings

Page 11

DescriptionWhen/Where Contact Hours

For more information about any of the above-listed educational offerings, please call 726-3111.For information about Risk Management Foundation educational programs, please check the Internet at http://www.hrm.harvard.edu

A Diabetic OdysseyO’Keeffe Auditorium

7.8March 18:00am–4:30pm

16.8for completing both days

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

March 4 and March 118:00am–5:00pm

Conflict Management for OAs and PCAsPre-registration is required. VBK 607

---March 41:30–2:30pm

Chemotherapy Consortium Core ProgramWolff Auditorium, NEMC

TBAMarch 58:00am–4:30pm

CPR—American Heart Association BLS Re-Certificationfor Healthcare ProvidersVBK 401

- - -March 77:30–11:30am,12:00–4:00pm

Nursing Grand RoundsO’Keeffe Auditorium

1.2March 71:30–2:30pm

Care of the Person with Cancer: Back to BasicsO’Keeffe Auditorium


Mentor/New Graduate RN Development Seminar ITraining Department, Charles River Plaza

March 138:00am–2:30pm

6.0(mentors only)

OA/PCA/USA Connections“Safety & Self Care: Taking Care of Ourselves in Times of Stress.”Bigelow 4 Amphitheater

- - -March 131:30–2:30pm

Advanced Practice Nurse Millennium SeriesO’Keeffe Auditorium

1.2March 135:30–7:00pm

Caregiver Skills for the New MillenniumTraining Department, Charles River Plaza

7.2March 148:00am–4:30pm

Pediatric Cardiac Series IIVBK 601

---March 157:30–11:30amand 12:30–4:30pm

CPR—American Heart Association BLS Re-Certificationfor Healthcare ProvidersVBK 401

- - -March 187:30–11:30am,12:00–4:00pm

Introduction to Culturally Competent Care: Understanding OurPatients, Ourselves and Each OtherTraining Department, Charles River Plaza

7.2March 218:00am–4:30pm

Operations Associate Preceptor Development ProgramTraining Department, Charles River Plaza

---March 218:00am–4:30pm

Nursing Grand RoundsO’Keeffe Auditorium

1.2March 211:30–2:30pm

Taking Care of the Cardiac Patient: Knowing the BasicsO’Keeffe Auditorium


ICU Consortium Critical Care in the New Millennium:Core ProgramMount Auburn Hospital

45.1for completing all six days

March 25, 27, 28 (Note: days notconsecutive) and April 1, 2, 37:30am–4:00pm

Care for Patients at the End of Life: Clinical & EthicalConsiderationsWellman Conference Room

4.5March 258:00–11:00am and12:00–3:00pm

Page 12


CaringFND125

MGH55 Fruit Street

Boston, MA 02114-2696

CaringH E A D L I N E S

Call for Nominations!

The Susan and Arthur DuranteAward for Exemplary CareAnd Service with Cancer

PatientsThe MGH Cancer Center is now acceptingnominations for the 2002 Susan and Arthur

Durante Award for Exemplary Care and Servicewith Cancer Patients. The award recognizes

clinical caregivers and support staff whose workwith cancer patients reflects compassion,

caring, exemplary performance, andoutstanding work.

EligibilityNon-physician staff and leadership who

interact with cancer patients throughout MGHare eligible for this award. Awards are grantedannually to recognize one clinical person and

one support staff member.

Recipients receive $1,000 each (award may besubject to taxes) to be used for activities that

promote their own relaxation and respite.

Deadline for nominations isFriday, March 15, 2002

For more information or assistance with thenomination process, please contact

Joelle Reed at 6-2689.

Timilty PartnershipTimilty Partnership

Timilty 7th-grader, Steve Fleureus, explains his science project, “Which Breath Mint FightsGerms Best?” at the Scientific Advisory Committee poster session held Wednesday,

February 6, 2002, in the Wellman Conference Room.Other Timilty students who displayed posters were: Sherilee Joyner (8th grade); Sashida Rodriguez

(8th grade); Jean Paul Morais (8th grade); Alexander Mestre (7th grade); and Jesse Winfrey (7th grade).

Timilty students presentscientific posters

Documents

Caring Headlines - African American Pinning Ceremony