DiversityNursing Blog

Article from www.discovernursing.com

With the many horrific disasters happening across the country, have you considered how you can help? Of course you have. You’re a Nurse and that’s what you do – care for others. This is a terrific interview of a Nurse who retired a year ago and is now volunteering for the Red Cross. Her skills are desperately needed. Perhaps her story will inspire you.

Mary Yoshino, FNP, wore an identification badge for years that told the world who she was and what she represented in the healthcare community. When she retired from being a nurse, Mary wasn’t sure what her next step would be, but she knew she wanted to continue to help people.

Currently, Mary is on the ground in Houston, Texas, volunteering in the aftermath of Hurricane Harvey, an extremely destructive Category 4 Atlantic hurricane that made landfall in southern Texas in August 2017. We recently had the opportunity to speak with her to learn more about her career and her current role as a volunteer disaster response nurse.

Nursing Notes (NN): Can you share a little bit about your nursing background?

Mary: All my life, I wanted to be a nurse. As a student nurse at Johnston-Willis Hospital School of Nursing in Richmond, Va., I became very active with the American Red Cross by taking and teaching classes. Since graduation, my nursing career has spanned 47 years in all areas of nursing and multiple states. I have worked in intensive care units and emergency rooms, college health services, and the Army Nurse Corps Reserve. I went back to school to become a nurse practitioner in 1990, and then worked as a family nurse practitioner for 26 years before retiring last year at the age of 69. I took this past year to reflect on what I wanted to do in my next phase of life.  

NN: What made you want to volunteer during Hurricane Harvey, and how did you get involved?

Mary: I received a text from my son in Friendswood, Texas, saying that his home was taking on water and that he and his family were evacuating. That morning, I signed up to volunteer with the Red Cross. I was so desperate to help people again and was deployed out of Albany, N.Y., to Houston with a team of four other nurses.

NN: What are your day-to-day responsibilities as a volunteer nurse?

Mary: Currently, I’m a supervisor for a 460-resident shelter facility. We’re responsible for going from cot to cot, making rounds and assessing residents’ health needs daily. We are doing dressing changes, distributing over-the-counter medications, and calling for prescription refills. Some of our patients are very sick; yesterday alone we called 911 four times. We talk to our patients, hear their stories, and hold back our tears as we wipe away theirs. Our day is busy. There’s no time to sit, and very little time to eat because our patients’ needs come first.  

NN: What is the most rewarding aspect of this volunteer role?

Mary: The most rewarding aspect is to see the gratefulness in the eyes of the people we help. They come in feeling dehumanized, as they have lost all that they hold dear. Some cry and some are quiet, but they see that we care and we talk to them about the realness of their situation and ask them quietly how we may help them. Today, I was with a woman who teared up and said, "You really care, don't you?" A kind smile, manners, and showing respect goes a long way.

NN: What did you take away from this experience?

Mary: This experience has inspired me to go back and work in our local Red Cross chapter, to be a spokesperson for the Red Cross and to encourage others to volunteer. Even on a local front, there are so many ways to help.

NN: What do you wish others knew about the impact that Hurricane Harvey has had on citizens and communities?

Mary: My team has seen firsthand the destruction around Houston and realized just how real this hurricane was and how it has changed the lives of so many. As other breaking news has developed, people here are still feeling the effects of Harvey and are coming together in the communities that were hit the hardest. In my son's community, all homes were destroyed, but they went door to door helping each other. It’s about people helping people.

NN: What advice do you have for other nurses who are interested in disaster response nursing?

Mary: Let's do it!!! Be there, hold a hand, wipe a tear, make people feel human and safe again. Think back to why you became a nurse, and let those reasons once again come to the front. Let's go make a difference.

NN: Is there anything else you’d like to share about this experience?

Mary: When I retired from nursing, I broke down emotionally. I did not know who I was besides a nurse practitioner. The Red Cross has given me my life back. I feel like I have found my niche. I came to Houston and realized that I can still make a difference. I will return home in mid-October after having been in Houston for a month. In November, I hope to be deployed somewhere again. This time, I will go in knowing I have the confidence to lead and make a difference for the victims of a disaster.

To learn more about volunteering as a nurse through the Red Cross, visit www.redcross.org.  

When Intensive Care Unit (ICU) nurses Kerrie Klepfer, BSN, RN, CNIII, and Jennifer LeBlanc, BSN, RN, CCRN, CNIV, were discussing ways to improve patient care, they had no idea that their efforts would save their hospital 2.9 million dollars and inspire similar initiatives across the globe. They just wanted to see their patients experience a safer, quicker recovery.

Klepfer and LeBlanc are two of four ICU nurses from Duke Raleigh Hospital in Raleigh, N.C., who participated in the American Association of Critical-Care Nurses (AACN) Clinical Scene Investigator (CSI) Academy. Their team developed “Walk This Way: Early Progressive Mobility in the ICU,” a 2013 patient care intervention that encourages mobility in ICU patients.

Nationwide, more than 229 nurses at 68 hospitals have completed or are now participating in the CSI Academy. AACN created the 16-month nursing leadership and innovation training program to empower hospital-based staff nurses as clinical leaders and change agents whose initiatives measurably improve patient outcomes and hospital bottom lines. Participating nurses identify a patient care problem and solution, then work to implement the project to fit the culture of their unit.

“Nurses know what the problems are and they often have ideas for solutions,” said Devin Bowers, RN, MSN, CSI program manager. “Giving them the time to think through their ideas and encouraging their creativity are key aspects of the CSI curriculum.”

At Duke Raleigh Hospital, Klepfer and LeBlanc’s team decided to focus on early progressive mobility.

“In our team’s experience as ICU nurses, the primary practice and standard of care was to keep patients sedated and on bed rest while in the ICU, especially when the patient was intubated,” said Klepfer. “Unfortunately, this extended period of immobility was leading to more extensive rehabilitation and longer hospitalization lengths of stay for patients – and, ultimately, higher costs for hospitals.”

The group produced evidence that increasing mobilization earlier – starting in the ICU – could reduce a wealth of complications, such as muscle atrophy, longer inpatient and outpatient rehab, ventilator associated pneumonia, pressure ulcers, falls, lengthy hospital stays, and cost for patients and hospitals.

The “Walk This Way” project had a tremendous impact within the ICU unit and hospital system. Early progressive mobility is now the standard of care in the Duke Raleigh ICU and is ordered routinely by the team for patients. To date, LeBlanc noted that the program has saved the hospital $2,935,488. Klepfer also noted that at Duke Raleigh Hospital, the protocol was met with excitement from patients and families and even contributed to a significant increase in the ICU’s Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Scores, a national survey that publicly reports patients' perspectives of care. Additionally, “Walk This Way” received national attention. The team and ICU unit were profiled in the media, including by Forbes magazine, and highlighted at the 2014 AACN National Teaching Institute & Critical Care Exposition (NTI) conference.

According to Bowers, the impact of the AACN CSI Academy extends far beyond the nurses who have participated in the program. Projects have spread within hospitals, cities and across states. Klepfer and LeBlanc’s program even had an impact internationally, when Jai Prakash Narayan Apex Trauma Center, a New Delhi, India hospital, patterned its early mobility project on the “Walk This Way” program.

“Creating sustainable change isn’t just about coming up with the idea. In order for the idea to ‘stick,’ it must become part of the cultural norm in a given unit or hospital,” said Bowers. “Frontline nurses are experts when it comes to knowing what will work and what won’t work within the culture of their unit or their organization. This is one of the key reasons that we believe the CSI Academy has been so successful.”

Nurses and other clinical leaders are encouraged to browse the CSI “Innovation Database,” a catalog of past projects completed through the CSI program. With more than 25,000 unique downloads of project materials, including toolkits, presentations and research, the database is a resource for nurses seeking practice-based solutions to improve patient outcomes and reduce costs.

Bowers believes that the long-term impacts of the AACN CSI Academy are positive outcomes for patients, a network of empowered nurses who are active change agents, and organizations that understand the value of frontline nurse-led initiatives by giving them the dedicated time and resources needed to focus on the work.

“The AACN CSI Academy inspires and empowers nurses by demonstrating the connection between their nurse-driven patient care improvements and corresponding financial impact of the professional practice of nursing,” said Bowers. “In the end, this initiative supports nurses in developing a business case for pursuing better quality outcomes for patients.”

For Klepfer and LeBlanc, participation in the program had additional benefits.

“After completing the project, we noticed a significantly stronger bond within our ICU team and were better able to recognize each other’s unique qualities, capabilities and limitations,” said Klepfer. “This bond has become even stronger over time. Even though the specific project has ended and we are now implementing it, our sense of teamwork and motivation remains.” 

“For me,” explained LeBlanc, “involvement in the CSI program meant being a part of leading positive change – and feeling empowered to solve problems in our unit to change standards of care for the better.”

To learn more about the CSI program, visit www.aacn.org.