The nursing staff on 7C exemplified the ICARE values when we received a direct admission from the Tomah VA. The staff knew very little about the veteran aside from needing Continuous Protective Observation and requiring a medical work-up. This veteran required specialized care and the 7C nursing staff went above and beyond and at times used creative interventions to meet this veteran’s needs.

Mr. B was admitted to 7C on the PM shift which usually sees the majority of our admissions, but off-tours do not always have the same resources available as the day shift. The 7C Team came together to ensure Mr. B was comfortable and safe while staffing was challenging and the unit was turbulent. Mr. B arrived very confused, aggressive, agitated, and non-cooperative. He arrived in an acute psychiatric crisis that not many med-surg units are equipped or familiar with handling. With assistance from the Milwaukee VA Police, Mental Health Consult Team, and the Acute Inpatient Medicine Team, a plan of care was developed to ensure we were addressing his needs while respecting his wishes.

Due to Mr. B’s cognitive and Mental Health history, it was difficult to get the full medical work-up completed as he didn’t fully understand the need for the ordered tests. The 7C staff adopted a Behavioral Journal to log a history of what worked and what didn’t work for Mr. B. They got to know what music he liked, gave him a structured routine, and even implemented a walking routine that helped keep him mobile. The staff received compliments from the VA Police, Psychiatric Team, and Medicine Team for their dedication and commitment to providing the best care.

Integrity: Even though this veteran had a category flag and required two staff members to care for him at times, the staff treated him with integrity and respect.

Commitment and Respect: The 7C staff met Mr. B with patience, kindness, compassion, and commitment when recognizing his behaviors and aggression were related to his illness. Even though some 7C staff members were injured by Mr. B, they continued to care for Mr. B and provide him with a comfortable, safe environment.

Advocacy: Personalizing Mr. B’s plan of care was something the staff excelled at, based on his amazing progress from admission to discharge. Staff members would often realign assignments based on Mr. B’s needs. The staff advocated for Mr. B’s safety related to medication adjustments and minimizing the impacts an acute inpatient setting had on his well-being.