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Initiating Together

Vol. 4 •Issue 11 • Page 20
Initiating Together

In winning essay, nurse details how her unit gets the job done — and more

Our RN Leadership Group won the 2002 Clinical Excellence Team award. The 8East team at Norwalk (CT) Hospital also won first prize for our "Safety First on 8East" initiatives during the first performance improvement poster contest.

Our PCT Development Group (unique to 8E) was recognized for its team building and leadership efforts, improving communication and enhancing relationships with RNs. Our "can do" attitude towards cost cutting received a commendation.

Our team spirit was also recognized when we won first prize during the 2003 Nurses Week Talent show. Our creativeness in showing nursing through the ages had numerous positive responses. Two of our nurses won the 2nd and 3rd prizes for the "Nurses are Everyday Heroes" essay contest.


Orthopedic and neurology/neurosurgical units were separate units few years ago. The staff adapted to all the changes and challenges as we merged the units and their functions.

Being an overflow unit — with its census variability — offers RNs from new grads to seasoned nurses a multidimensional experience. We embraced new ideas and supported the change.

We have exemplary attendance in meetings and in-services. Our unit always has a voice! Our unit pilots new forms and equipment before it goes hospital-wide. Currently, we are piloting a DC checklist to improve DC process/flow of surgical patients. We participate in new undertakings with open arms.


We pride ourselves on our teamwork! Our team motto says it all –TTWIST! That stands for "Today, tomorrow, we initiate success together."

We develop annual goals, regularly examine them and make adjustments prn. When a year ends, we celebrate, write our wish list for the upcoming year and restart with new goals. We believe in the power of purpose.

Our team believes in being partners in change. When RNs and PCTs are assigned consistently, teamwork is enhanced and patient care is more consistent. Our biweekly staff meetings help promote adequate communication, making everyone an "informed employee." Everyone rallies and assists new staff members.

The multicultural diversity of our team mirrors our community. It's one of the things that allows us to better serve our patients. We have team members from the United States, Canada, the Philippines, Australia, El Salvador, Jamaica, Haiti, Costa Rica, Switzerland, Italy, Puerto Rico and Russia. We strongly believe in the "ethics of coexistence" — respecting and celebrating our differences, making your concerns my own and remembering that we are all in this together.

We make it a point to go out every other month with our colleagues. We try a local restaurant, go to the theater or just hang out at the home of one of our team members.

Recruitment & Retention

We have no vacancies on our unit. We filled all our additional positions for staff/patient ratios in a record time of 3 weeks. There are other nurses both in-house and at neighboring facilities waiting to come and join our team. This is thanks to the positive word-of-mouth our unit receives. We participate in student internships and nursing program rotations. The average years of service for a staff member is 11 years; four nurses have more than 30 years experience. Retention is very high.

We encourage and support our PCTs to fulfill their nursing aspirations. Four are currently pursuing their RN degrees, and one just graduated.

When new staff come on board, we arrange a welcome breakfast and make sure their lockers and mailboxes are ready for their use. We want them to feel they belong to a team already.

We believe in recognition activities and a sense of family. We are the first nursing unit at our hospital to have comprehensive recognition activities. Efforts include monthly/.immediate recognition, a suggestion book (that we call our there-is-always-a-way-if-we-are-committed book and a memory book (otherwise known as 8E Great Times Book) where we put photographs. We have our version of a "wall of fame," where our "star staff" awards are permanently displayed.


We schedule regular "lunch-and-learn" sessions. Observing orthopedic/neurosurgical procedures has become a part of our new RN/PCT orientation curriculum. Our staff shares new ideas from conferences they attended. We've learned we can be good speakers as well!

Our unit-based educational binder allows staff to bring in and share articles that may benefit us and our patients. When we go to conferences, we buy books and share them with our colleagues, patients and families. The staff is encouraged to attend in-services and conferences in and outside the hospital. Ortho/neuro certification and membership are encouraged and supported.


Our RN team was instrumental in developing the post procedural form and med/surg flowsheet that is now being used hospital-wide. We've received great feedback from other interdisciplinary teams.

We are in the process of developing an ortho/neuro DC instruction sheet. The PCT shift report and signed 3-11 expectations are great tools especially for floating staff.

Our own signed safety contract shows our commitment to each other and in establishing a culture of safety. Our "101 Ways to Our Patient's Hearts in 101 days" initiative, which we launched in September 2003, received commendation. It shows how we continually strive to find ideas to improve patient care and customer satisfaction.

Our action plans to raise Press-Ganey scores were recognized and shared with other units. Two years ago, our unit began giving thank you cards. Other units are following our initiative. Our commitment to keeping our patients/families informed helped us build a patient information center right in our unit.

Above & Beyond

Community outreach is important to our team. We are involved in the Stroke Support Program, the Joint Replacement Program, Shadow-a-Nurse, a high school internship and volunteer programs. This spring, we are visiting elementary/middle schools to promote the nursing profession. We are passionate in promoting the nursing profession, and what a sure way to start with young kids!

Last year, we visited nursing homes to visit our patients and to meet staff on the other end. The smiles on our patients' faces made the visit worthwhile.

Staff members bring in motivational books and quotes to share with everyone including patients and families. We have a mini-library in our lounge. We provide monetary assistance for patients to buy a newspaper, soda or stamps. We do mini-celebrations with signed cards for our long-term patients or when patients come off traction. Staff members also bring new or used clothing for needy patients. During the holidays we adopt families in need, donate toys, clothing, household items, etc.

Our biggest compliment was when a patient's son, who's now attending nursing school, told us, "The way you all take care of my mother gave me the inspiration to pursue nursing."

I hope you can see our enthusiasm and the difference we are making with patient care, job enrichment and staff satisfaction. We are achieving all these by forming great relationships, which in turn allows us to do great work!

Nimfa B. Orpeza is patient care manager for 8E at Norwalk (CT) Hospital.


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