C aring C aring December 5, 2002 H E A D L I N E S Working together to shape the future MGH Patient Care Services Inside: Medical Nursing at MGH ....... 1 Jeanette Ives Erickson. .......... 2 Emergency Preparedness Fielding the Issues. ................ 3 Staff Perceptions Survey Cultural Celebrations Education/Support. ................ 4 Managing Patients’ Complaints Nursing Grand Rounds. ......... 5 Individuals with Disabilities Psychiatric CNS Consultation Service ............. 6 Nurses and House Staff ......... 7 Exemplars .............................. 8 Maura Neville, RN Karen Ward, RN Surgical Technologists ........ 11 11 11 11 11 CNS. ..................................... 12 12 12 12 12 Ellen Robinson, RN Excellence in Action Award ... 13 13 13 13 13 Educational Offerings .......... 15 15 15 15 15 OB Family Education Program ........................... 16 Medical Nursing Wants You! Can you tell which one of these nurses is actually a recruitment poster? (Need help? Turn to page 10) Medical nurses staffing the Medical Nursing educational booth are (back row l-r): Nancy Holland, RN; Nancy Walsh, RN; Denise Ajewski, RN; Tracey Dimaggio, RN; Gayle Peterson, RN; Kathy DeGenova, RN; and Melissa Roddie, RN. (Front row): Maura Hines, RN; Keri Ross, RN; and Karen Murphy, RN.
Transcript
CaringCaringDecember 5, 2002
H E A D L I N E S
Working together to shape the futureMGH Patient Care Services
December 5, 2002December 5, 2002Jeanette Ives EricksonJeanette Ives Erickson
SMGH a leader in emergency
preparedness:
Jeanette Ives Erickson, RN, MSsenior vice president for Patient
Care and chief nurse
During disaster drill, November 8, 2002, team members (l-r): Erica Dee, RN,ED nurse practitioner; Chris Cabral, MD, emergency medicine resident;Pierre Borczuk, MD, ED attending physician; Michelle LaRue, ED PCA;
and Maureen Beaulieu, RN, ED staff nurse, triage patient at theentrance to the Emergency Department.
ince well beforethe events of
September 11, 2001,MGH has been a
leader in disaster plan-ning and emergencypreparedness, workingclosely with local, state,and federal agencies toensure a coordinatedand efficient response.Since September 11th,hospitals across thecountry, including MGH,are re-evaluating andmodifying their disas-ter-response plans to bemore accessible andmanageable in the eventof an actual emergency.
The MGH Emer-gency ManagementCommittee has takenseveral steps to ensurethe hospital’s readinessfor any type of internal
or external disaster. Oneof those steps was thehiring of full-time emer-gency-preparednessstaff person, Julia Gab-aldon, who has beenserving in this positionsince June. Gabaldonmeets with senior man-agement, departmentheads, and key commit-tees to maintain an on-going dialogue about,and make recommenda-tions on improvementsto, our disaster responsestrategies.
We have recentlyadopted a new emergen-cy command structure,called the Hospital Em-ergency Incident Com-mand System (HEICS).HEICS is an emergencymanagement systemoriginally developed in
California that has beenused successfully bymany hospitals acrossthe country. It is a flex-ible, reliable, efficientsystem that activatesonly those positionsrequired for a given cri-sis or disaster. The sys-tem is based on a clear-ly delineated chain ofcommand; a pre-priori-tized list of responsesappropriate for theevent; a common lang-uage to facilitate com-munication with inter-nal and external agen-cies; accountability ofparticipants; and a doc-umentation componentto be used for systemsimprovement and toassist in cost recovery.The HEICS emergencymanagement system
helps minimize the levelof chaos and confusionthat usually accompanya large-scale medicalemergency and optimizeour opportunity to re-spond in an efficient,coordinated manner. Todate, approximately 200MGH employees havebeen trained in theHEICS managementsystem.
MaryFran Hughes,RN, nurse manager inthe ED, has been veryinvolved in our disasterplanning efforts, bothwithin the hospital andas our representative onoutside committees.MaryFran chairs TheConference of BostonTeaching Hospitals Dis-aster Subcommittee,which is comprised ofrepresentatives fromthe Boston hospitals,The Boston EmergencyManagement Agency,The Boston Fire De-partment, and BostonEMS. The group meetsmonthly to discuss is-sues, plan drills, andevaluate our readinessto respond.
Obviously, many ofour preparations arecentered around bio-terrorism, chemical, andnuclear events. MGH isactively involved withThe Boston PublicHealth Council Bioter-rorism SurveillanceTask Force, which hasinstituted a monitoringsystem of hospital em-
continued on next page
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December 5, 2002December 5, 2002Fielding the IssuesFielding the IssuesStaff perceptions survey,
cultural celebrations,
ergency departments tohelp identify the onsetof a bioterrorist eventand alert infection-con-trol teams.
The Conference ofBoston Teaching Hos-pitals Disaster Subcom-mittee, working collab-
oratively, has identifiedminimum guidelines forpreparedness to chem-ical hazards, and is cur-rently designing trainingprograms for clinicaland non-clinical staff.
On November 8th,MGH participated in a
Jeanette Ives Ericksoncontinued from previous page
citywide drill to testour response to a crisisinvolving a ‘dirty bomb’(an explosive with radio-active material). Ourdisaster response teamdid an outstanding job,and independent evalu-ators gave us high gradeson our performance.
For more than 20years, MGH has been aleader in disaster plan-ning in this city. In that
time, we have learnedmany lessons and form-ed strong relationshipswith public-health andpublic-safety agencies.No one can predict oranticipate a medicaldisaster. But I agreewith MaryFran, a know-ledgeable and informednurse leader, who saidrecently, “The relation-ships we’ve formed andthe level of sophistica-
tion we’ve achievedaround disaster plan-ning will be our greateststrength in the event ofan emergency. I’m com-forted knowing that I’msurrounded by so manyindividuals who are com-mitted to the safety ofour hospital and ourcommunity.”
I think we can allfind comfort in thatknowledge.
Question: I notice a lotof different culturalcelebrations when Iwalk through the MainCorridor of the hospi-tal. Can you tell mehow decisions are madeabout which events arecelebrated?Jeanette: The PCSDiversity Steering Com-mittee coordinates anumber of events toacknowledge celebra-tions that are held na-tionally each year, suchas St. Patrick’s Day,Black History Month,Latino Heritage Week,etc. In 2003, with thehelp of many inter-ested employees, wewill be celebrating Dis-abilities AwarenessMonth (November),Asian American Aware-ness Month (April),and Women’s HistoryMonth (March) aswell. If you’re inter-ested in joining a taskforce to help plan orcoordinate special cul-tural events, or if youwould like to contri-bute an idea, pleasecontact Deborah Wash-ington, RN, director ofDiversity at 724-7469.
Question:For the past 5years, the informationfrom The Staff Percep-tions of the Profession-al Practice EnvironmentSurvey has been an im-portant method of in-forming you about cli-nicians’ level of satis-faction with the profes-sional practice environ-ment. I heard that thesurvey won’t be con-ducted in 2003. Is thattrue?Jeanette: The Staff Per-ceptions of the Profes-sional Practice Environ-ment Survey will beconducted in 2003, butit will be postponed forapproximately six months.Let me tell you why.
Six years ago when Iwas appointed seniorvice president for Pa-tient Care, I workedwith the leadership ofPatient Care Services todevelop a vision state-ment and strategic planoutlining what we want-ed to achieve. Today, Ican honestly say that,together, we have madeconsiderable progress inimproveing the profes-
sional practice environ-ment for clinicians.
I’ve spent muchtime reflecting on whatwe have achieved andwhat we need to do toensure that MGH re-mains a supportive andprofessional environ-ment for clinicians.
Our vision is un-changed. But we haveachieved our six originalstrategic goals (see shad-ed box). It’s time to re-visit our strategic plan.
In October, I led astrategic planning re-treat with the PatientCare Services ExecutiveCommittee. Peter Slavin,MD, chairman and CEOof the MGPO and pre-sident-designate ofMGH, joined us forpart of the day. We re-viewed data from theStaff Perceptions of theProfessional PracticeEnvironment Surveyand patient-satisfactiondata. We had in-depthdiscussions about whatwe want our future tolook like.
By the end of thesecond day, we had iden-
tified our strategic dir-ection for the comingyear. How does thisrelate to the Staff Per-ceptions of the Profes-sional Practice Environ-ment Survey?
As you know, thesurvey measures eightorganizational charac-teristics important toclinicians (autonomy,control over practice,relationships with phy-sicians, teamwork, com-munication, conflict-management, internalwork motivation, cul-tural sensitivity) and it
gives me insight intohow we’re doing in meet-ing our strategic goals.
Since our strategicgoals are changing, it’simportant that we spendtime communicating andimplementing thesegoals before we ask foryour input on how wellwe’re doing.
Question:When will welearn more about thestrategic initiatives?Jeanette: We are in theprocess of synthesizingthe outcomes of ourretreat. I look forwardto sharing our new stra-tegic direction with youin the coming monthsand hearing your feed-back and suggestions.
Our 2002 Strategic GoalsGoal #1 Enhance communication to promote
employees’ understanding of organizationalimperatives and their involvement in clinicaldecisions affecting their practice.
Goal #2 Promote a professional practice modelthat is responsive to essential requirements ofpatients, staff, and the organization.
Goal #3 Assure appropriate allocation of re-sources and equitable, competitive salaries.
Goal #4 Position nurses, therapists, social work-ers and chaplains to have a strong voice inissues affecting patient care outcomes.
Goal #5 Provide quality patient care within acost-effective delivery system.
Goal #6 Foster diversity of staff and createculturally-competent care strategies supportingthe local and international patients we serve.
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December 5, 2002December 5, 2002Education/SupportEducation/SupportManaging Patients’ Complaints:a look at the work of the Office
of Patient Advocacyn Thursday,November 14,
2002, SallyMillar, RN, dir-
ector of the Office ofPatient Advocacy, pre-sented, “Managing Pa-tients’ Complaints,” ata meeting of the Associ-ation of MulticulturalMembers of Partners(AMMP). Millar setthe stage for her pre-sentation by giving anoverview of some keytrends that have emerg-ed over the past fewyears. Patient censusand acuity have risensignificantly; averageemployee workload isgreater; and the averagelength of stay has de-creased dramatically.“All of these factors,”said Millar, “have animpact on the work ofthe Office of PatientAdvocacy.”
Before sharing spe-cific (anonymous) casestudies, Millar explain-ed that the purpose ofthe Office of PatientAdvocacy (OPPA) is toserve as liaison betweenpatients and the organi-zation as patients sharetheir expressions ofcommendation or con-cern to ensure that mor-al, ethical, operational,and patient-care stand-ards are upheld.
The day-to-daywork and interactionsof the OPPA staff bringvalue to the hospital
O
Sally Millar, RN, director of the Office of Patient Advocacy,presents at recent meeting of the Association of
Multicultural Members of Partners (AMMP).
beyond the resolutionof individual complaintsand concerns. Said Mil-lar, the work of OPPAprovides added value inthe form of:
Providing objectiverepresentation in aneutral, non-threat-ening manner onissues brought to theoffice by patients,families, visitors, and/or staff.Providing guidance topatients, families,visitors, and/or staffon patient rights andresponsibilities, andorganizational ethics.Building versatilemechanisms foreffecting change whenit is needed based oninput from our cus-tomers.Establishing formalsupport strategiesthat empower staff tomanage commenda-tions and/or concernson the unit level.Some assumptions
that guide the work ofOPPA are that:
People want to beheardPeople want to knowthat we carePeople want us to dothe right thing (forthem)People want to makesure that if somethingnegative happened tothem, it doesn’thappen to someoneelse
People want to feelimportantOPPA offers some
guidelines for address-ing patient concerns.These guidelines can beuseful for staff in allsettings:
Acknowledge thepatient’s issueReply promptlyIf it is appropriate,apologize for theexperienceDeterminewhat resolu-tion the pa-tient is seekingConduct aninvestigation(report eventto the PatientCare Assess-ment Commit-tee and/or theService Qua-lity AssuranceCommittee, ifit is appro-priate)Follow upwith thepatient re-garding theresults of theinvestigation.Millar explain-
ed that issuesbrought to theOffice of PatientAdvocacy rangein severity fromserious to mun-
dane, but all issues needto be addressed withcare and respect. Millarsuggests:
Listening and empa-thizing with thepersonApologizing, whenappropriate. Evensaying something like,“I’m sorry you hadthis experience,” cango a long way towardreducing bad feelings.Finding a solution,and involving theperson in achievingthat solutionDoing somethingspecial to restore apositive relationship.Thanking the person
Following up when theresolution is achieved(if it is not immediate)“What is clear from
the feedback we receivein the Office of PatientAdvocacy,” said Millar,“is that our clinicians goto great lengths to pro-vide quality, problem-free care to all our pa-tients.”
For more informationon managing patient com-plaints, please call theOffice of Patient Advo-cacy at 726-3370.
For more informationabout AMMP or to in-quire about membership,please send e-mails to:phsammp@partners .org.
Page 5
December 5, 2002December 5, 2002
Changing our perceptions ofindividuals with disabilities
ccompaniedby their ser-vice dogs, Keelaand Homer,
speakers, BarbaraCeconi, president ofAccess Umbrella, andKurt Kuss, educationaltrainer, presented, “HowWe Perceive Individualswith Disabilities,” atNursing Grand Roundson Thursday, November14, 2002. Both blind,Ceconi and Kuss talkedabout the subtle preju-dices that exist towardpeople with disabilities,and how we need to beproactive in changingour perspective both
A out in the world and inthe workplace.
“Most people aren’tcompletely comfortableinteracting with disabl-ed individuals,” saidKuss. “It doesn’t makeus bad people. It justmeans we need to beproactive in adopting adifferent way of think-ing about things.” Todemonstrate, Kuss en-gaged participants in aninteractive game of ‘Us-and-Them.’
Holding up little toyfigures, Kuss created amake-believe scenariofor each toy person andasked audience mem-
Kurt Kuss and Barbara Ceconi talk about the “Us-Them”syndrome during recent Nursing Grand Rounds that dealt
with, “How We Perceive Individuals with Disabilities.”
bers to label them ‘Us’or ‘Them.’ He describedpeople who were deaf,blind, mentally ill, orparaplegic. Each time,audience members said,‘Them.’ Then he am-ended the descriptions,making them familymembers, best friends,or temporarily disabledby an injury. Instantly,they became one of ‘Us.’
“Nothing about themchanged,” said Kuss,“except our perceptionof them.”
This is an importantlesson to learn as weembark on our own jour-neys to ‘change our per-
ceptions of individualswith disabilities.’
Some other salientpoints of Kuss andCeconi’s presentationincluded:
Remember that aperson with a disa-bility is a person first!Treat every individualwith courtesy andrespect.Use common sense inyour interactions withdisabled people; but ifyou don’t knowsomething... ask!If you ask a question,listen to the answerand take it to heart.Be aware of thelanguage you use.Such phrases as‘wheelchair bound’can seem prejudicial.Remember that there
are ranges of disabili-ty within everydisability (levels ofdeafness, degrees ofmobility, etc.)Know what accom-modations yourpatients with disabi-lities may need (helpgetting changed, helpgiving a urine sample,help reading andsigning forms).When caring for ablind person, describesights, procedures,activities, etc. Includecolors and sizes inyour descriptions incase the patient mayneed to relay thedescriptions to some-one at home.Know what resourcesare available in thehospital to assistindividuals withdisabilities.Give people options.Let the individualwho has the disabilitydecide what’s best forhim or her (elevatorvs. stairs; wheelchair;physical assistance;etc.)If a disability is stillnew, remember thatthere is a time of grief/mourning as theperson comes to gripswith his or her loss ofindependence.The December 5th
Nursing Grand Roundswill address “HiringIndividuals with Disabi-lities.” Rounds are heldon the first and thirdThursdays of the monthat 1:30pm in O’KeeffeAuditorium. For moreinformation, call TheCenter for Clinical &Professional Develop-ment at 6-3111.
Nursing Grand RoundsNursing Grand Rounds
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December 5, 2002December 5, 2002
n an effort toimprove ac-
cess to psychi-atric care for pa-
tients on medical units,to improve the experi-ence of clinicians caringfor patients with psych-iatric and behavioralissues, and to enhancemedical and psychiatricbed capacity, a newpilot program has beenintroduced on five unitsin the hospital. ThePsychiatric ClinicalNurse Specialist Consul-tation Service pilot pro-gram began in June of2002. Units participat-ing in the pilot are: Big-elow 11, and White 8,
9, 10, and 11.To meet the goals of
the program, four psych-iatric clinical nurse spe-cialists are working stag-gered hours, includingweekends, to respondto referrals from staff.Referrals can be madeto request a mental sta-tus assessment, a safetyassessment, to helpclinicians develop andimplement behavioralcontracts with patients,to help educate staffabout psychologicalcare to medically ill pa-tients, or to assist teamsin making decisions thatfacilitate patient transi-
tions. Any clinicianwho encounters a pa-tient whose reactions,responses, or behaviorschallenge their skillbeyond their level ofcomfort may call for apsychiatric nursing con-sult.
The CNSs partici-pating in the pilot areBarbara Guire, RN;Jenny Repper-Delisi,RN; Mary Lussier-Cushing, RN; and Mo-nique Mitchell, RN.Each CNS brings aunique perspective fromprevious positions atMGH and/or other in-stitutions. Each brings a
New ProgramsNew ProgramsPsychiatric CNS
Consultation Service—by Robin Lipkis-Orlando, RN,
nurse manager, Blake 11 Psychiatric Unit
wealth of psychiatricnursing experience tothis new role.
The success of thePsychiatric ClinicalNurse Specialist Consul-tation Service will de-pend on strong collab-orative practice withunit-based CNSs, nursemanagers, the multi-disciplinary teams oneach medical unit, andthe department ofPsychiatry consult ser-vice. Already, therehave been a number ofpatient-care conferencesto discuss managingpatients in restraints,patients in withdrawalfrom alcohol or othersubstances, patientswith end-of-life issues,and patients with be-havioral problems. Work-ing directly with staffnurses on each unit,
psychiatric CNSs havehelped develop treat-ment plans that incor-porate psychologicaland behavioral inter-ventions and supportthe complexity of carethat staff provide 24hours a day, 7 days aweek.
The psychiatricCNS’s involvement inassessing and treatingpatients with profoundmedical illness and con-comitant psychiatricillness allows patientsto remain on medica-tion with additionalpsychiatric support, orif medically stable,allows for discussionswith case managersand other members ofthe treatment teamabout options for trans-fer to a psychiatricsetting. This coordin-ated care model en-hances our ability toprovide patients withthe most appropriatecare in the most appro-priate place.
Feedback about ThePsychiatric ClinicalNurse Specialist Con-sultation Service pilotprogram has been verypositive, including com-ments such as, “Yourexpert assessment andassistance not onlysupported our patients,but supported those ofus striving to providequality nursing care,”and, “You are an ac-cepted group amongour staff. Staff alwaystakes the initiative tocall.”
This is how partner-ships in caring are cre-ated. For more infor-mation, call 4-9110.
I
Nurse manager, Robin Lipkis-Orlando, RN (second from right), with members of The Psychiatric Clinical Nurse SpecialistConsultation Service pilot program (l-r): Monique Mitchell, RN; Jenny Repper-Delisi, RN; Barbara Guire,RN;
and Mary Lussier-Cushing, RN.
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December 5, 2002December 5, 2002
lenge, teach, and sup-port one another fromthe moment new housestaff arrive, always driv-ing each other to be anddo better. But even con-sidering the amount oftime that nurses andresidents spend togeth-er, gaps can exist intheir understanding ofone another’s practice.
In an effort to closethat gap, Theresa Galli-van, RN, associate chiefnurse, and Hasan Bazari,MD, director of theResidency Training Pro-gram, came up with anidea to bring these twogroups closer together.
Based on the belief thatcommunication is thekey to understanding, amonthly lunch meetingwas established wherenurses and residentscome together to ad-dress issues that impactpatient care and collabo-rative practice.
Since the fall of1999, a group of staffnurses and nurse mana-gers from the generalmedical units, and housestaff have met everymonth to discuss gen-eral and specific issuesaffecting their dailypractice. The group hasdiscussed and resolved
Collaborative PracticeCollaborative PracticeNurses and house staff
working together to improvepatient care
—by Mary Ellin Smith, RN,professional development coordinator
issues such as:nurses and physiciansrounding together toensure coordinateddevelopment of thepatient’s plan of careand to prevent nursesfrom having to pagephysicians out ofrounds latermethods of ensuringtimely and appropri-ate blood drawsthe development oforientation materialsfor house staff andnurseshaving photographsof nursing staff on theunits to help housestaff in identifyingunfamiliar faces.Says Jeremy Abram-
son, MD, “House staff-nursing relationships areof paramount impor-tance in being able toprovide the finest med-ical care to our patients.The ability of nurses
and residents to main-tain open communica-tion is also an impor-tant factor in nurseand house-staff satis-faction. These meet-ings allow us to raiseissues and resolvethem early.”
Amy Sozanski, RN,staff nurse on White 8,says, “The committeepromotes communi-cation and collabora-tion. Both groups gaina greater understandingof each other’s issuesand concerns.”
Meetings are heldon the fourth Thurs-day of every monthfrom 12–12:30 in theBigelow 10 ConferenceRoom. Meetings areopen to medical housestaff and general medi-cal nurses. For moreinformation, pleasecontact Mary EllinSmith, RN, at 4-5801.
very June anew group ofresidents comesto MGH to con-
tinue their education.This is when their edu-cation moves beyondbooks and labs to theday-to-day accountabi-lity of actually caringfor patients. Workingalongside these resi-dents and fellows aremembers of the inter-disciplinary healthcareteam. But perhaps nogroup works more close-ly with new house staffthan nurses.
Together, nurses andhouse staff work toensure the best possibleoutcomes for patientsand families. They chal-
At a recent lunch meeting, are (l-r): Michelle Ciaramaglia, RN; Andrea Kelley, RN;Keith Perlberg, RN; Jeremy Abramson, MD; Eran Zacks, MD; and Andrew Yee, MD.
E
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December 5, 2002December 5, 2002
Maura Neville, RN,staff nurse, White 11
ExemplarsExemplars
y name isMaura Neville,and I am a
staff nurseon the White 11 Medi-cal Unit. As a new grad-uate nurse, I was hiredby MGH to work on aUrology Unit, but short-ly after I started, theunit was changed toGeneral Medicine. Whenthe announcement camethat the unit would bechanging, many nurseshad to decide whetherto move to the newUrology service or re-main on White 11 andpractice in general med-icine. Many of thenurses I worked withhad been urology nursesthroughout their entirecareers. Some did decideto explore other special-ties within the hospital,and some chose to stay.I was one of the nurseswho stayed.
After the change togeneral medicine, I wasapprehensive about thepatients I would be en-countering on our unit.Would I be able to carefor this patient popu-lation? At times it wasoverwhelming to thinkabout managing patientswith multiple and var-ied medical problemsand complex psycho-social issues. But it wasa challenge I was up for.
About a month afterthe transition, I wasassigned to care for Mr.T, an elderly patientwith multi-system fail-ure who was expectedto die that day. As Ireceived report on Mr.T, I wasn’t able to ab-sorb any more informa-tion other than the factthat he was activelydying. I felt uncomfort-able and afraid of whatit would be like to care
for a patient in the lastmoments of his life.
When I went in toassess Mr. T, his breath-ing was shallow andlabored. When I put myhand on his chest, Icould feel fluid rumblein his lungs. His eyeswere closed and hedidn’t respond when Ispoke his name. How-ever, when I touchedhis wrist to take hispulse, he reached formy hand. Mr. T contin-ued to hold my hand asif to say, “Please don’tleave me alone.”
It being my firsttime caring for a dyingpatient, I asked the cli-nical nurse specialist(CNS) for guidance. Ifelt like I should be do-ing something more tochange the situation andhelp Mr. T. As a nurse,it was difficult for meto switch from workingtoward making a patientwell to not interveningwhen someone is soclose to death. The CNScame into Mr. T’s roomand assured me that Iwas, in fact, doing theright thing. Just beingwith the patient andletting him know thathe wasn’t alone was thebest thing I could do.Eventually, Mr. T’sbreathing became slowerand each breath seemedas though it would behis last. I stood next toMr. T, leaned over hisbed, and began talkingquietly to him. I also
New graduate nurse caresfor dying patient
M
began to cry. After Mr.T died, I stood in hisroom in awe of what Ihad just experienced. Ihad never witnessedsuch an incredible mo-ment before.
Performing post-mortem care is a humbl-ing task. It made merealize how important itis to care for someoneafter they’ve died thesame way you would ifthey were alive. It rein-forced for me that beinga nurse is not limited toperforming activitiesthat contribute to health,it’s also helping some-one to have a peacefuldeath.
It has been eightmonths since White 11became a medical unit,and my experience withMr. T has been one ofmany that have chal-lenged me. Caring forMr. T was demandingemotionally, but theexperience taught me alot. I am no longer waryof caring for dying pa-tients. I consider it anhonor.
In this narrative, Maurashares a paradigm mo-ment in her career. Whatshe is describing is thepower of presence.When Maura first metMr. T, she worried shehad nothing to offerhim—no interventionto heal him, no magicpill. With the guidanceof her CNS, Maura real-ized she did have some-thing to give: her pres-ence. She held Mr. T’shand, cried with him,comforted him, andstayed with him.
Maura’s descriptionof post-mortem care isimportant. The respectand dignity with whichwe care for a personafter he dies is part ofour contract to deliverthe highest quality, com-passionate care. I’msure Maura will reflecton this experience oftenthoughout her career.
Thank-you, Maura
Call for PortfoliosPCS Clinical Recognition
Program
The Patient Care Services ClinicalRecognition Program is now acceptingportfolios for advanced clinicians and
clinical scholars. Portfolios may be submit-ted at any time; determinations will be
made within three months of submission.
Refer to the http://pcs.mgh.harvard.edu/website for more details and application
materials, or speak with yourmanager or director.
Completed portfolios should be submittedto The Center for Clinical & Professional
Development on Founders 6.
For more information, call 6-3111.
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December 5, 2002December 5, 2002
Karen Ward, RN,staff nurse, Bigelow 12
y name isKaren Wardand I have been
an oncologynurse for four years. Ihave worked on theEllison 14 Oncology-Bone Marrow Trans-plant Unit, and for thepast 18 months on theBigelow 12 InfusionUnit. As an oncologynurse on Bigelow 12, Inot only manage pa-tients’ medical needs,but I strive to connectwith them on an emo-tional level as well. Itwas during my time onBigelow 12 that I hadthe pleasure of meetingMary and Tom.
Mary was my firstprimary patient in theoutpatient setting. I mether and Tom for thefirst time in January of2001. She was a 68-year-old woman withendometrial cancer. Shewas in clinic for her firstcycle of chemotherapywith carboplatin/taxol/adriamycin. I’ll neverforget walking into herroom and seeing her.She was wearing a vi-brantly colored sweaterand her hair and make-up were just so. She hadthe most beautiful eyesthat looked so serene.She smiled with hereyes. I couldn’t helpthinking: “How couldthis be my patient? Shedoesn’t even look sick.”
As I introduced my-self, I saw that peacefullook in her eyes turn to
fear. When I asked, “Howare you? Are you okay?”she understandably be-gan to cry. I spent sometime with her and Tomteaching her about herchemotherapy and po-tential side-effects; herantiemetic regimen; andwhat her typical visitswith me would be like.Mary showed suchstrength, but throughher tears, I also saw afragile woman.
For the next fourmonths, I saw Maryand Tom every threeweeks for Mary’s che-motherapy. It was dur-ing these four monthsthat I really got to knowher and the simple thingsthat meant so much toher. She spoke proudlyof her three children,Kathy, Steven, and Liz;her grandchildren; howshe and Tom met. Sheshared stories about thefour years they hadlived in Hong Kong, herlove of singing, and evenher taste for Thai food.These conversationsand a sharing of feelingshelped our relationshipdevelop. Our relation-ship became more thanillness and treatment.
After Mary’s firstfour cycles of chemo-therapy, she began week-ly carboplatin and ra-diation therapy. She didwell with this, but afteronly a few months, shebegan to have headachesand had a seizure at
home. Her cancer hadspread to her brain. Heroncologist confirmedthis with me. When hegave me the news, Icried. I knew this meantthat Mary’s prognosiswas poor. The relation-ship we had formed wasmuch more than patient/nurse, but it wasn’t untilthis moment that I fullyunderstood that. Ithought: “How could Ihave let this happen?What was I thinking?Or was I thinking?” Thesimple answer was yes,I knew what gettinginto this relationshipcould mean. As an on-cology nurse, I’m some-times afraid to get tooclose to my patients. Iknow I won’t have thiskind of emotional con-nection with all my pa-tients, but every once inwhile you meet some-one and can’t help butlet them into your life.That was Mary, and byextension, Tom andtheir family.
In addition to contin-uing Mary’s treatment,I knew we had to makethe time she had leftquality time. She beganwhole brain radiationtherapy and more che-motherapy. This wasvery taxing on her body,and she was beginningto have more symp-toms: intractable nauseaand vomiting, headaches,and some memory loss.Even with all of theseside-effects, Mary kept
a positive outlook. Shetried to keep life as ‘nor-mal’ as possible. After along day of radiationand chemotherapy, shestill found the energy tovisit with her daughter,Liz, and granddaughter,Katie, for what she re-ferred to as her, ‘Katiefix.’ As time moved on,Mary’s cancer contin-ued to progress to heradrenal glands, lungs,and bones. She contin-ued to fight with all shehad. Her doctor, socialworker, and I continuedto support her throughall her decisions, keep-ing her best interests inmind. We had two meet-ings with Mary andTom about the thingsthey wanted to do be-fore she died. We askedthe difficult questions,like: Were there thingsshe needed to say orshare with her childrenbefore she was unableto speak? Mary andTom were both veryreceptive to these dis-cussions, but still want-ed to pursue any treat-ment that held hope.
By December of2001, Mary’s symp-toms worsened. Shebecame increasinglydifficult to care for athome, and Tom becamemore concerned for hersafety. With their con-sent, we set them upwith a VNA bridge pro-gram. We chose a bridgeprogram because it wouldprovide care for Maryat home and when thetime came that she need-ed hospice, the sameagency would be able tocontinue her care. Aftermeeting with the VNAnurse at home, Marycame into clinic and toldme she didn’t want thebridge program. She feltit was too much, havingsomeone associatedwith her illness at homewith her all day. Be-tween physical therapyand the VNA nurse, byafternoon, she was ex-hausted and felt shehadn’t accomplishedanything. She also feltshe wasn’t ready forhospice. I spent a lot oftime with her and Tomexplaining that although
M
continued on page 14
‘Simple acts of nursing’ bringcomfort and support
Page 10
December 5, 2002December 5, 2002
‘Poster nurse,’ TraceyDimaggio, RN, also appearedon candy bars used as tasty give-aways
hen you’reproud of what
you do; whenyou’re good at
what you do; and whenyou want everybody toknow it, it’s time for acelebration! That wasthe motivation of theMedical Nurse Groupin planning a specialday to showcase theirwork and accomplish-ments.
The Medical NurseGroup is comprised ofstaff nurses from eachof the general medicalunits (Bigelow 11, Elli-son 16, Blake 7, Phil-lips 20, Phillips 21,White 8, White 9, White
10, and White 11) andthe Medical IntensiveCare Unit (MICU).
Members of theMedical Nurse Groupwanted to do somethingto promote the image ofmedical nursing, to edu-cate MGH employeesand the public about therole of medical nurses,and to more clearly de-fine medical nursing as anursing specialty. To-ward that end, the groupdecided to designate aspecial day to showcasethe many aspects ofmedical nursing at MGH.That day was Wednes-day, November 13,2002.
The Medical NurseGroup staffed an edu-cational table in theMain Corridor and dis-played posters reflec-tive of their work andthe complex field inwhich they practice.
Some of the postersfocused on:
Statistics on medicalnursing at MGHUnit-specific high-lights of past year’saccomplishments
Collaboration be-tween unitsMedical nurse devel-opment programs(including the NewGraduate-MentorProgram, etc.)A history of nursingat MGHPatient education(including handoutson common diagnosessuch as hypertensionand diabetes)Reflections of medical
work in general medicalunits and in the Medi-cal Intensive Care Unit.They care for some ofthe sickest patients inthe hospital, and oftenfor patients who sufferfrom multiple, complexmedical problems.
Says Kate Barba,RN, medical clinicalnurse specialist, “Medi-cal nursing is one ofthe most rewardingprofessions a personcan choose, and wejust wanted to get theword out. The eventwas a huge success;hundreds of employeesand visitors stoppedby. I think we reached alot of people.”
For more informa-tion about medicalnursing at MGH, callKate Barba, RN, clini-cal nurse specialist, at6-2754 or Adele Keel-ey, RN, nurse manager,at 6-2594.
Medical NursingMedical NursingCelebrating
medical nursingat MGH
W
A passer-by stops by the Medical Nursing educational boothand poster display in the Main Lobby on November 13, 2002.
Page 11
December 5, 2002December 5, 2002
The goal of the program
is to nurture versatile, productive,
satisfied practitioners who’ve had
broad-based exposure to the multi-
faceted aspects of an exceedingly
complex, high-tech environment.
n October 19,2002, the Mass-achusetts State
Assembly of theAssociation of SurgicalTechnologists (AST)held its annual meetingat Mercy Hospital inSpringfield. MGH sur-gical technologist, TedTodd, CST, interim ori-entation coordinator inthe Main OR, and JayneMacPherson, CST, cli-nical director of the Sur-gical Technologist Pro-gram at Bunker HillCommunity College,spoke about the impor-tance of precepting sur-gical technologists. Toddand MacPherson areboth active in the AST—MacPherson serves asvice-president and edi-tor of the AST news-letter, A Stitch in Time;Todd is AST secretary.
Todd and MacPher-son’s presentation ad-dressed the principlesof precepting surgical
technologists, includingstudents in their clinicalrotations, new graduates,and newly hired surgicaltechnologists. MacPher-
son described the exper-ience of students at theclinical site and the work-ing relationships thatexist between the cli-nical director of thecollege, and the coordi-nator, preceptors, andsupport staff at thehospital. Accurate, on-going, consistent com-munication is crucial.
Support is anotherkey factor in the suc-cess of the program.
Many students embark-ing on a new career inSurgical Technologycome from diverse back-grounds. The OR set-
ting is new and strangeto them; the tasks canseem overwhelming. Itis essential that precep-tors and support staffare not only knowledge-able, but patient, sen-sitive, supportive, andconsistent.
Todd followed with:“Up and Running: Pre-cepting with a Purpose.”Todd focused on thenew graduate-newlyhired surgical technolo-
Precepting surgicaltechnologists
—by Ted Todd, CST, surgical technologist andinterim orientation coordinator in the Main OR
Surgical TechsSurgical Techs
DomesticViolence Vigil
The MGH Chaplaincy, HAVEN, The EmployeeAssistance Program, and Police & Security
invite you to attend the AnnualDomestic Violence Vigil.
FridayFridayFridayFridayFriday, December 6, 2002, December 6, 2002, December 6, 2002, December 6, 2002, December 6, 200212:15pm12:15pm12:15pm12:15pm12:15pm
in the MGH Chapelin the MGH Chapelin the MGH Chapelin the MGH Chapelin the MGH Chapel
Please come to remember those who havedied as a result of domestic violence,and to commit ourselves to creating acommunity where all people are safe.
A light pick-up lunch willbe provided.
For more information, call theChaplaincy at 6-2220
Ogists, their training andorientation. He describ-ed the newly evolvingorientation programcurrently being imple-mented for new gradu-ate surgical technolo-gists and registerednurses in the OR. Theprogram, called the No-vice Block Program, isbased on the adult-learn-ing theory put forth byPatricia Benner, RN, inher book, Novice toExpert. Benner describesperformance at the no-vice, intermediate, andexpert levels.
The Novice BlockProgram in the OR isbuilt on this theory thattakes into considerationthe different stages oflearning and skill-acqui-sition of new graduates.The year-long programfocuses on novice capa-bilities and supportspractitioners as theydevelop their service-specific skills to theintermediate and expertlevels. The goal of theprogram is to nurtureversatile, productive,
satisfied practitionerswho’ve had broad-basedexposure to the multi-faceted aspects of anexceedingly complex,high-tech environment.
One of the advan-tages of the NoviceBlock Program is itspotential for recruitmentand retention. Whenstudents first hearabout the program, theylike the idea that theywill experience a highdegree of independencewhile enjoying the sup-port and guidance of theprecepting team.
The Novice BlockProgram is a work inprogress, constantlychanging to meet theneeds of new studentsand new hires. But Todd,his fellow coordinators,the clinical staff, clinicalnurse specialists, andnurse managers are con-fident the program isworking.
For more informa-tion about The NoviceBlock Program, e-mailTed Todd at [email protected].
No Home for the Holidays:Ethical Issues in the Care of Homeless Persons
Sponsored by the MGH Ethics Task Force
Moderator: Susan Warchal, RN, BS,chair of the MGH Emergency Department Ethics Committee
Panel Members:
Linda Kane, MSW, social worker, Emergency DepartmentCaroline Melia, RN, MS, advance practice nurse, St. Francis House
James O’Connell, MD, Boston Health Care for the Homeless
FridayFridayFridayFridayFriday, December 13, 2002, December 13, 2002, December 13, 2002, December 13, 2002, December 13, 200212:00–1:00pm12:00–1:00pm12:00–1:00pm12:00–1:00pm12:00–1:00pm
Bring a lunch. Beverages, chips and dessert will be provided
For more information, call 6-3111.
Page 12
December 5, 2002December 5, 2002
new role hasbeen createdin The Cen-ter for Clini-
cal and Profession-al Development: clinicalnurse specialist in ethics.The role promises toprovide great opportu-nities for clinicians inPatient Care Services toenhance their knowledge,comfort, and skill inidentifying and analyz-ing issues that troublethem as they go aboutthe business of provid-ing care to patients andfamilies. I assumed thisnew role in September,and hope to be able tobring a more program-matic approach to ourwork around ethicalissues, focus on newstrategies to supportpractice, and tap intothe resources of theCCPD to develop newprograms and integratethis work into existingprograms as appropri-ate.
Healthcare ethics canbe defined as a disciplinethat provides clinicianswith the theoreticalbackground and toolsnecessary to help ident-ify ethical issues in prac-tice, usually as theyrelate to specific patientcases. An understandingof theories and analyti-cal strategies gives us a‘language’ that lendsclarity to our discus-sions of ethical issues.Once this understanding
is achieved, clinicians,patients, and familiescan begin to explorealternatives to ensurethe patient’s well-being.In health care, this pro-cess is best accomplish-ed through inter-disci-plinary participation.Each discipline has aunique philosophicalperspective and know-ledge base essential to aholistic approach to thepatient’s medical condi-tion and the impact ofthat condition on his orher life.
In today’s world,ethical questions havebecome commonplace.Technological advancesin science and medicinehave produced a pleth-ora of treatment optionsfor individuals at everystage of life. For many,these options are bothlife-saving and life-giv-ing, and carry the addedgift of enhanced qualityof life. For others, thismay not be the case.
Decisions about howbest to use technologyto enhance the physical,psycho-social, and spi-ritual lives of patientsand families are complex.Often the answers arenot readily apparent.Healthcare ethics assistsclinicians, patients, fam-ilies, and researchers toachieve more rationalityin determining the ap-propriateness of vari-ous technologies for
each individual situa-tion. When applied inan inter-disciplinarymodel, each professioncontributes a philosoph-ical perspective, whichwhen shared, often re-sults in a synergy ofstrategies that are creat-ive, sound, and provideuntold benefit in theindividual patient-fam-ily situation.
As a clinical nursespecialist in ethics, mygoals are to developnew approaches to learn-ing, contribute to staff’sawareness regardingethics resources, andhelp staff feel comfort-able identifying andfacilitating alternativesspurred by ethical is-sues in their practice.Currently at MGH,opportunities exist forclinicians to enhancetheir knowledge of clin-ical ethics throughevents and seminarscoordinated by the Eth-ics Task Force, the Eth-ics in Clinical PracticeCommittee, or unit-based ethics rounds.Some clinicians havedeveloped expertise inethics as a result of theirinvolvement with thesegroups, or through par-ticipation in the MGHOptimum Care Commit-tee, the Pediatric Bio-ethics Committee andother groups.
Through continuedefforts in education,
consultation and com-mittee work, the focusof my work will be toassist clinicians to inte-grate ethical sensitivityand decision-makinginto their daily practice.This will be manifestedthrough an increasedcomfort in representingtheir concerns aboutpatients’ cases at theinter-disciplinary table.Clinicians, particularlynurses, can become moreconfident in, and trust-ing of, their ethical sen-sitivity. Often, when aclinician experiences asense of moral distress,it is a signal for the needfor inter-disciplinaryreview. Sometimes, per-ceived ethical problemscan be resolved throughteam and family meet-ings. Others might re-quire more sophisti-cated consultation toidentify ethical issuesand alternatives. A co-ordinated approach toethics education fromthe CCPD will be a firststep in moving towardthis staff-oriented goal.
Today, ethics is partof everyday clinicalpractice. Knowledge oftheories and approachesto ethical analysis isaccessible and under-standable and should bepart of every healthcareprofessional’s clinicalpreparation.
Consider the workof the PCS Ethics inClinical Practice Com-mittee where cliniciansof all disciplines havehad the opportunity tolearn, discuss, and col-laborate on projectsthat have enlightenedthinking and integratedethics into practicethroughout the institu-tion. Contributions topolicy-development andeducation are but a fewof the achievements ofthis committee. In therole of clinical nursespecialist in ethics, Iwill strive to assist staffin building their clinicalskills in ethics, whichultimately will betterserve the patients andfamilies in our care. Ilook forward to thisjourney with all of you.
Ellen Robinson, RNclinical nurse specialist
New role: clinical nursespecialist in ethics
—by Ellen M. Robinson RN, PhDclinical nurse specialist, CCPDA
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 should be submittedin writing by fax: 617-726-8594or e-mail: [email protected]
For more information, call: 617-724-1746.
Please recycle
RecognitionRecognitionEllison 16 PCAs receive
Excellence in Action Award
Educational Offerings and EventCalendar now available on-line
The Center for Clinical &ProfessionalDevelopment lists educational offerings at:
http://pcs.mgh.harvard.edu
For more information or to register for any program,call the Center at 6-3111.
eter Slavin, MD, chair-man and CEO of theMGPO and presi-
dent-designate of MGH,paid a special visit to Ellison16 on Thursday, November 21,2002, to present an Excellencein Action Award to the unit’steam of patient care associates.
Co-nominated by NormaGerton, RN, nurse manager,and Alan Goostray, clinicalservice coordinator for Peri-operative Nursing, the teamwas recognized for their com-mitment to quality patientcare, their support and pre-
P ceptoring of new employees,and for the part they play increating an atmosphere of col-legiality on the unit. Said Sla-vin, “I want to recognize thepatient care associates of El-lison Sixteen for their abound-ing energy and for the impor-tant contributions they maketo patient care on a daily basis.You go that extra mile to en-sure that our patients’ experi-ence at MGH is a positiveone.”
The Excellence in ActionAward program began in Jan-uary, 2001, as a collaborative
project between the MGHService Improvement Programand Human Resources. Awardsare given monthly by Slavinand Britain Nicholson, MD,chief medical officer.
Says Mary Cunningham,coordinator of the program,“Employees in all roles andpositions who demonstrate thehighest caliber of care and ser-vice are eligible for the award.This recognition helps makethe contributions of staff at alllevels visible.”
For more information, call4-1004.
Chaplaincy offers Buddhistmeditation sittings
The MGH Chaplaincy offers monthlyBuddhist meditation sittings in the Chapel
on the third Thursday of every month,from 2:00–2:30pm.
For more information, call 6-2220
Peter Slavin, MD, chairman and CEO of the MGPO and president-designate of MGH with (l-r): Lillian Kahn; JenniferLunetta; Norma Gerton, RN, nurse manager; Emmanualla Valcimond; Foos Sheikahmed; Toni-Ann Pedi;
Theresa Gallivan, RN, associate chief nurse; and Carola Benjamen.PCAs not pictured: Blossom Beckford, Elsa Powell, Pedro Torres, and Viviane Wade.
Page 14
December 5, 2002December 5, 2002
this program had hos-pice attached to it, itdidn’t mean we weregiving up on her; shewould still come in toclinic to see me for che-motherapy. I spent therest of the afternoonreinstating her VNAbridge program. I madesure all her visits withPT and nursing werescheduled together inthe morning so she wasable to have some timeto do the things shewanted during the day.After having time tothink about what hadhappened, I realizedhow frightened she wasbecoming of dying.
All the hard work,team meetings, and ask-ing the difficult ques-tions paid off. Duringone of her next visits tothe clinic, Mary told mehow she had been talk-ing to her children andTom about things shemight not have, had wenot had our meeting.She shared that she hadgiven a piece of jewelryto one of her daughters,a piece she wanted herto have after she wasgone. Mary was takingslow steps toward final-izing important thingsin her life, but keepingin mind that she wasnot giving up. I had sucha great feeling of accom-plishment after hearingabout the things shewas doing. I thought tomyself: What would sheor Tom have done hadwe not discussed these
important issues? Wouldthey have been as pre-pared?
Mary was hospital-ized not long after this.It was during this lasthospitalization that Ibegan to see that fragilewoman again. We hadone last family meetingwhere we told Marythere was no chemo-therapy or radiationtherapy that would stopher cancer now. Sheunderstood what thismeant. Her main con-cern was her husband. Irecall her turning to Tomwith sad eyes and say-ing, “I’ll be okay, butwhat about you?” I wasamazed at the timing ofher comment. At a timewhen you’d think shewould only be concern-ed with her own painand suffering, she wasstill giving to others.Her concern for her hus-band was no surprise tome. They had a wonder-ful bond of love andfriendship, and theirunderstanding of eachother went beyondwords. As a newlywedmyself, I admired theenduring sense of loveand commitment theystill had so many yearsinto their relationship.
Because of the sup-port of her medicalteam and her family,Mary was coming toterms with her owndeath. We had allowedher the time to do this.By the end of the meet-
ing we had learned ofMary and Tom’s wishfor her to be at homewith their family. Onher last day in the hos-pital, I spent some qua-lity time alone withMary. We expressed ourfeelings for each other.It was a very difficultmoment for both of us.I think, in our minds weboth thought we prob-ably wouldn’t see eachother again. As I got upto leave, she said, “Thenext time I’m here, Ipromise I’ll come andvisit you.” And I be-lieve she has kept herpromise to me. It was awarm feeling I had leav-ing her that day. I knewthat because of the hardwork of her medicalteam, she was able tocomfortably go homeand spend her last fewdays with the peopleshe loved. Mary died afew days later at home,surrounded by her fam-ily.
I attended Mary’swake the following Sun-day. As I approachedthe family, I was over-whelmed with feelings.Other nurses may beable to relate to this ex-perience. I was introduc-ed to many people andmany others just ap-proached me. They wereall “so happy to finallymeet me” and “hadheard so much aboutme.” Though I onlyknew a small number ofthem, I felt as if they allknew me. I was receivedwith such warmth. Ithought attending thiswake was a simple, re-spectful act, but it wasobviously more than
that for Mary’s friendsand family.
I continue to keep intouch with Tom andLiz. When I spend timewith them, I think ofhow it was because ofMary that I was able tomeet this amazing fam-ily, and I wish she couldbe here. I know howmuch she would love tobe with us, and in someways, I think she is.Tom and Liz frequentlythank me for all I do forthem, but I often haveto stop and thank themfor what they’ve givenme. Their friendship isvery special. Patientsand families don’t real-ize that although wegive something to them,they give so much inreturn. I feel privilegedto have cared for Maryand her family, and tohave shared this experi-ence with them. It’s noteasy for me to describehow my relationshipwith Mary and her fam-ily impacted me both asan individual and as anurse. I try to bringsome of the lessons Ilearned from her intomy daily practice. Itwas Mary and her fam-ily that brought me toappreciate what a pivo-tal role we play in thecare of our patients. Amonth before our finalgood-bye, Mary andTom gave me a beauti-ful pin for Christmas.It’s from one of Mary’sfavorite places. I wearthe pin every day atwork. When I look at it,I think of them. I thinkthat what we may per-ceive as simple acts of
Exemplar (Karen Ward)continued from page 9
nursing are much morethan that to our patients.Thank you, Mary.
Every day at MGHclinicians are intimatelyinvolved in the lives oftheir patients and fam-ilies. Many cliniciansworry that they mightbecome too involvedand lose their profes-sional objectivity. As Iread this narrative, Ithought about an articlewritten by Patricia Ben-ner recently on, “Cre-ating CompassionateInstitutions that FosterAgency and Respect”(American Journal ofCritical Care, March,2002). In it, Bennertalks about the role ofthe “compassionatestranger.” The compas-sionate stranger is one“who responds to thetragedy of others out ofcompassion and soli-darity with the traged-ies inherent in the hu-man condition.”
Karen worked withMary and her family tohelp them come to gripswith Mary’s impendingdeath and maximize thetime they had left to-gether. She asked the‘tough questions’ andaccompanied them onthis journey despite herown very real pain atthe loss of this remark-able woman.
This is a wonderfulnarrative. Thank-you,Karen.
Page 15
2002
2002
Educational OfferingsEducational Offerings December 5, 2002December 5, 2002
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/WhereCPR—American Heart Association BLS CertificationVBK 601
- - -December 168:00am–2:00pm
CPR—American Heart Association BLS Re-Certificationfor Healthcare ProvidersVBK 401
- - -December 177:30–11:30am,12:00–4:00pm
Social Services Grand Rounds“Examples of Short-Term Dynamic Psychotherapy: Treating AffectPhobias,” O’Keeffe Auditorium. For more information, call 724-9115.
CEUsfor social workers only
December 1910:00–11:30am
Intermediate ArrhythmiasHaber Conference Room
3.9December 198:00–11:15am
Pacing : Advanced ConceptsHaber Conference Room
5.1December 1912:15–4:30pm
Nursing Grand RoundsO’Keeffe Auditorium
1.2December 191:30–2:30pm
CPR—American Heart Association BLS Re-Certificationfor Healthcare ProvidersVBK 401
- - -January 27:30–11:00am,12:00–3:30pm
Nursing Grand RoundsO’Keeffe Auditorium
1.2January 21:30–2:30pm
ICU Consortium Critical Care in the New Millennium:Core ProgramTBA
45.1for completing all six days
January 6, 7, 13, 14, 21, 227:30am–4:00pm
16.8for completing both days
Advanced Cardiac Life Support (ACLS)—Provider CourseDay 1: O’Keeffe Auditorium. Day 2: Wellman Conference Room
January 6 and 238:00am–5:00pm
CPR—American Heart Association BLS Re-Certificationfor Healthcare ProvidersVBK 401
- - -January 147:30–11:00am,12:00–3:30pm
New Graduate Nurse Development Seminar ITraining Department, Charles River Plaza
6.0(for mentors only)
January 88:00am–2:30pm
OA/PCA/USA ConnectionsBigelow 4 Amphitheater
- - -January 81:30–2:30pm
Introduction to Culturally Competent Care: Understanding OurPatients, Ourselves and Each OtherTraining Department, Charles River Plaza
7.2January 98:00am–4:30pm
Nursing Grand RoundsO’Keeffe Auditorium
1.2January 161:30–2:30pm
New Graduate Nurse Development Seminar IITraining Department, Charles River Plaza
5.4 (contact hoursfor mentors only)
January 228:00am–2:30pm
Social Services Grand Rounds“The Treatment of ADHD in Adults.” For more information, call724-9115.
CEUsfor social workers only
January 1610:00–11:30am
Psychological Type & Personal Style: Maximizing YourEffectivenessTraining Department, Charles River Plaza
8.1January 248:00am–4:00pm
Psychological Complications of Pregnancy and PostpartumShriners Auditorium
TBAJanuary 248:00am–4:30pm
Page 16
December 5, 2002December 5, 2002
CaringCaringH E A D L I N E S
GRB015MGH
55 Fruit StreetBoston, MA 02114-2696
First ClassUS Postage Paid
Permit #57416Boston MA
n Tuesdaymornings at
10:00am thehallway begins
to fill with strollers andthe sound of babies coo-ing. The Mommy andMe Group is about tobegin. This post-partum
support group, part ofthe OB Family Educa-tion Program, started inMarch, 2002, and hasbeen a wonderful addi-tion to the OB services
provided at MGH. Oncea week, a group of newand veteran mothersmeets to share the joysand challenges of caringfor infants, toddlers,
and even older children.The forum offers first-time mothers an oppor-tunity to ask questions,seek support, sharestories, and see thatthey’re not alone instruggling to meet thechallenges of caring fora new baby.
Mothers bring theirbabies to group meet-ings, some as young asa week old. Mothers areoften surprised at howdemanding caring for anew baby can be. Hear-ing other mothers talkabout their frustrations,sleepless nights, newdiscoveries, advice, andparenting strategies is acomfort during this timeof great adjustment.Mothers are able towatch each other’s child-ren grow and changefrom week to weekwhile they themselveslearn and become moreconfident in their ownparenting skills. Saysone mother, “I look for-ward to Mommy and
Me meetings everyweek.”
To celebrate the suc-cess of the program, thegroup had a special pic-nic by the Charles on abeautiful day in Sept-ember. Eleven mothersand babies participatedin the celebration. Forone mother it was thefirst time out of thehouse since giving birth.For others it was achance to celebrate theirfirst summer as a par-ent.
The journey intomotherhood is chal-lenging. The nurturingand encouragement pro-vided by the Mommyand Me support grouphelps mothers feel con-fident along the way.Many mothers havedeveloped friendshipsand support networksoutside the group.
For more informa-tion about the OB Fam-ily Education Program,call 726-4312.
SupportSupportOB Family Education
Program—by Lori Pugsley, RN,
OB Family Education coordinatorO
Members of the Mommy and Me supportgroup enjoy a picnic on the Charles.
