Mylene de Vera describes herself as a private person of few words. However, the conviction that her team, the Bone Marrow Transplant/Stem Cell Transplant unit at the University of Maryland Medical Center, Baltimore, is the best nursing team around led her to find her voice. (Click here to view a video of some members of the team.)
Her carefully chosen words drew the attention of the three judges in the 2010 ADVANCE for Nurses Best Nursing Team contest earning the unit at the University of Maryland Medical Center, Baltimore, first place.
And, it is their communication that made this team stand out - in the form of daily interdisciplinary rounding, in how they conduct research for the patient's benefit and the way they collaborate to make self-scheduling work.
De Vera, BSN, RN, OCN, who entered the team without telling them, highlights this collaborative communication at the beginning of her entry: "If I had to choose one thing that makes me proud to work in our unit, it's our daily, nurse-led interdisciplinary rounds, which keep nurses well-informed about their patients' intended care. To date, our unit is the only one in our hospital that conducts these rounds."
The Art of Working Together
For a nurse who could really only learn about transplantation through books during her nursing school years in the Philippines, "very few transplants were being done in the Philippines when I was in nursing school," de Vera waxed lyrical in her entry about what this 32-RN unit offers its patients at the Greenebaum Cancer Center, besides great communication.
Amanda Choflet, RN, OCN, new nurse manager on the 16-bed unit, agrees the team is exemplary. She began as manager the week of the February blizzards. "I knew I was coming into an awesome unit because I had worked with these nurses while a nurse on our outpatient bone marrow transplant unit," Choflet said. "I saw this was true when the team worked together to get the job done the week of those storms.
"I can't stress enough how much this group sees themselves as resident experts in their field," Choflet said proudly. "They take what they do seriously. They have created a culture of excellence on this unit that spills over into other units they work with."
Choflet pointed out stem cell transplant units sometimes have long-term patients with complications because of comorbidities and other issues. "I see these nurses go above and beyond to ensure their patients get the best care," she noted. "They take each patient and make them feel like a top priority."
The judges in the ADVANCE Best Nursing Team contest agreed with Choflet's assessment.
"These nurses have demanded professional respect and autonomy which resulted in them being involved in every aspect of patient care and patient medications that can't be altered or changed without the nurses first being informed," said Maj. Guy D. Lewis, MS, RN, CNOR, Army Nurse Corps, weekend operating room nurse at Temple University Hospital, Philadelphia, and a judge in the contest. "The profession will benefit tremendously from the actions of these nurses."
"This team is an example of the powerful impact nursing advocacy has on patient satisfaction and outcomes," noted judge Barbara J. Romig, MSN, RN, CPHQ, director of clinical practice, nursing administration, The Reading Hospital and Medical Center, West Reading, PA. "Rounds have resulted in decreased medication errors, increased patient satisfaction and increased RN satisfaction."
And the team accomplishes all this with self-scheduling.
"About 10 years ago, the team began setting their own schedules as part of a unit-based governance council," Choflet said. "A blank schedule is published 2 months ahead and people manually write in the shifts they'd like to work. They work out conflicts in scheduling among themselves as a team, which is a challenge because a lot of these nurses are in school and their academic schedules aren't flexible. By the end of the process they present me with a completed perfect schedule, which makes my job much easier."
The Art of Transplant Nursing
Besides the self-scheduling and research studies the team embraces, they must deal with the particular needs of working with transplant patients, needs which any transplant team encounters. Due to the immunodeficiency of some patients preparing to accept stem cells, certain precautions are necessary. For example, during the flu season everyone wears a mask when around a patient.
"Our entire unit is hepa-filtered and our rooms are positive pressured," Choflet explained. "All rooms and hallways in our unit are restricted as well."
The infection control restrictions of the unit don't impede it from collaborating among themselves and with other units. "The effort to have an interdisciplinary culture is evident," Choflet said with pride. "The nurses work well with staff and other services. Our housekeeper is part of our daily life. His birthday is on our birthday board. This feels like and is a united team."
Gail O. Guterl is editor at ADVANCE.
A special thanks to Dansko, the 2010 ADVANCE for Nurses Best Nursing Team sponsor.
Read the winning entry for this team on next page.