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4NE Is Where to Be

Nurses seek out opportunities to work with this close-knit team

Vol. 7 • Issue 9 • Page 12
4NE Internal Medicine Unit

Froedtert Hospital, Milwaukee

Nominated by Carissa Wittig, BSN, RN

Every now and then, a patient tests the resources of a nursing team. "'Tom' was a really challenging patient who was on our floor for about 4 weeks," said Michele Hepner, BSN, RN-BC, nurse manager of 4 NE, an internal medicine unit specializing in gastrointestinal and endocrine disorders at Froedtert & The Medical College of Wisconsin in Milwaukee. "He was bedridden and had a dressing change that needed to be done twice a day. It took four nursing staff about an hour and a half of their time, 2 times a day, to handle his dressing changes"

But while such a challenge can wreck havoc on a nursing unit, Hepner said her team handled it with flair. "All the nurses worked together as a team," she said. "They always had a plan. They'd take the time and decide who was going into his room and who was going to stay and make sure the rest of the patients were well cared for."

That kind of teamwork is par for the course for the nurses of 4 NE. Working together, the nurses have implemented a number of changes that not only improve patient care but also create a pleasant working environment.

Hourly Rounding

When initiatives are introduced at Froedtert, 4 NE is often the first to volunteer, said Carissa Wittig, BSN, RN. "We have a reputation for starting projects with intensity and following through successfully," she noted.

4 NE was the first unit in the hospital to implement hourly rounding, a process in which nurses check in on each patient every hour and perform eight key behaviors, including repositioning, toileting and assessing patient comfort.

"We read some research articles about hourly rounding," said Hepner, who noted more than 30 percent of her RNs are currently advancing their education, "and our staff were excited by the results, so we decided to try it out."

The results speak for themselves. 4 NE reported a 78 percent increase in patient satisfaction after implementing hourly rounding, as well as a 40 percent decrease in call light usage.

Recruit & Retain

At a time when many hospitals struggle to attract and retain qualified nurses, 4 NE has no shortage of interested applicants.

"We are a fun, energetic and positive group of nurses," Wittig said. "Because of our friendliness and teamwork, 4 NE is the most coveted unit to work on. Our recruitment numbers are high and 4 NE nursing retention is among the best in the hospital."?

"Even nurses who float through comment on how our staff works really well together," Hepner said.

Students appreciate their hospitality as well. Froedtert & The Medical College of Wisconsin is a teaching hospital, so it's not uncommon to find students on the unit. But contrary to the long-held myth of nurses eating their young, the nurses on 4 NE welcome students with open arms.

"We're excited about students," Wittig said. "When there's something interesting happening on the unit, we'll pull a student in to educate them, because we've all learned that these will be our future co-workers. If we want them to know what they're doing, we've got to show them."

Cross-Shift Bonding

The nurses of 4 NE, like all the nurses at Froedtert & The Medical College of Nursing, work a unique 7/70 schedule; they work 10-hour days for 1 week, then have 1 week off.

That schedule allows for a certain amount of shift bonding - when you're with your co-workers 10 hours a day for an entire week and share time off, it's easy to build connections - but it also creates other challenges. How do you stay connected as a team when you hardly ever see the other half?

The nurses at 4 NE often use their time off to get to know "the other half."

"One of the nice things about our schedule is that picking up a day or two on the opposite week isn't a big burden," said Annie Delaney, BSN, RN.

Cross-shift bonding is also nurtured through a written and verbal method of hand-off communication. "The staff share all the information they can so that the next week can pick up and take the very best care of our patients," Hepner said.

As a team.

Jennifer L.W. Fink is a freelance contributor to ADVANCE.


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