We have had the pleasure of Alyssa Guzman being the nurse to our son, M, over the last five and a half months that he has been in the PICU. In our view, Alyssa exhibits the characteristics of an excellent nurse - she is technically competent, has exceptional communication skills and solid problem-solving abilities, is empathetic and compassionate, can multi-task, is a diligent worker and has good judgment.
Strong Communication Skills. Alyssa is a good communicator, being both a good listening and a clear and effective speaker. She is an effective communicator with patients and their families as well as with the medical team and other hospital staff. For example, in managing our son's sodium levels with vasopressin, Alyssa keeps a close eye on what M's urine output is. When she senses his output is too high or too low (and confirms with calculations what his output is based on his weight per hour as well as his Is/Os), she discusses with us when it might make sense to consider changing his vasopressin dosing. At times, we raise it with her, and she listens openly. Regardless of who initiates, Alyssa effectively communicates ours or her concern to the fellow or resident on the team and makes her case as to why it should be changed at that point in time (including rather than waiting until the next sodium level blood draw) based on her prior experience knowing how M's body reacts and also backing it up with her calculations.
As another example, more recently, when there was blood in M's NG tube, she raised it with us immediately and called the overnight team to have them come to discuss with us. She stopped his feed and reviewed which upcoming meds should in fact still be given enterally and which should be held in order to give his stomach/GI tract a break.
She is never afraid of or hesitant about raising an issue and can very clearly articulate her reasoning for things. As well, Alyssa is always polite and respectful to those around her - whether that be other nurses who help sign out meds and assist with tasks, environmental services staff who come to take the trash and linens away, or SNAs who help with miscellaneous tasks.
Strong Technical Skills. Alyssa is technically competent. As nursing administration knows all too well, unfortunately, we have had several issues with very straightforward, policy-driven tasks such as cap changes (including nurses not scrubbing at all (!), scrubbing/waiting for less than the prescribed 15 seconds, dropping non-sterile items into a sterile field). Alyssa always does things by the book and she is familiar with hospital policies and protocols. Additionally, she knows how to get things done efficiently without ever cutting corners. She is always conscious of putting the health, safety, and comfort of our child first.
Personable and Compassionate. As an oncology family who has spent most of our younger son's life for the past two years (starting since he was eight months old) in the hospital, it is often icing on the cake to be assigned a nurse who is not only technically competent but is also personable and genuinely compassionate. Alyssa has an inherently warm personality, and it is obvious from her behavior that she deeply cares for patients and their families. She has been with us for so many nights that she has come to know us as individuals. As a nurse coming to work a shift, we know that is not a necessary part of the job. However, Alyssa has always made a conscious effort to actively engage with our entire family - not just talking to M to let him know what she is doing to him (even when he was essentially comatose and paralyzed at the start of our admission), but also asking M's older brother how his day was and conversing with him about whatever he might be playing with at the time. She sometimes shares with us what is going on in her own personal life (with our encouragement, of course), and we often have discussions about basic life things and what is going on in the "outside" world. For us as a family trapped in the PICU for so long, we find it so refreshing that she is genuine and "real" and, moreover, that she sees us and interacts and converses with us as real people too (and not solely about what is going on medically with M).
Effective Multi-Tasker and Time Management Skills. Alyssa is always on time with hanging meds, feeds, and coming in for M's every two-hour diaper and position changes. She also has good response time when our son's vent or monitor alarms. Moreover, she juggles her assignments with ease and always seems calm and collected no matter how busy she is. Knowing that we like to assist with the diaper and position changes throughout the night, Alyssa always informs us when she will be stepping away to attend to her other patient or otherwise and for how long she expects to be gone should we need her prior to her return to our room. Additionally, Alyssa always has the side table set up in the way we prefer so that diaper changes throughout the night can be efficient in order for our son to get as much uninterrupted sleep as possible.
Solid Stamina; Physical and Mental Endurance. Alyssa tends to work several days in a row - three to even four days at a time. As a family who has been in the PICU for almost six months and still continually seeing a new rotation of new faces and often for just one twelve-hour shift at a time, it is such a welcome sight to see Alyssa at shift change knowing that she will be caring for us for several days in a row. The continuity of care that she provides is invaluable for us and our son. She is able to observe, appreciate and react to sometimes subtle changes over time. And never has she shown any evidence of fatigue or exhaustion - neither physical or mental. Her level of energy and sharpness is just as fresh on day four as it is on day one.