CSICU Team
May 2021
Cardiac
Unit
Sentara Norfolk General Hospital
NORFOLK
,
VA
United States
ABDULLAEV, DAMIR RN, BSN, CCRN
AUCLAIR, KATIE RN, BSN, CCRN
AUSTIN, LEAH, NCP
AUSTIN, SHELBY RN, BSN
BROCKWELL, JAMIE (flexi) RN, BSN
BROOKSHIRE, CHRISTINE RN, BSN, CCRN
BRENNAN, CARRIE NCP
CLOVIS, KIM RN, BSN
COCCHI, CHLOE RN, BSN
CUMMINGS, CAITLIN RN, BSN
DOBSON, JACKIE RN
DZIAMA, RACHEL RN
FLYNN, JULIA NCP
GIVIDEN, EMILY NCP
GANTER,MARINA (manager) RN, BSN
GREGORIO, MARIO RN, BSN, CCRN
HORNSBY, MORGAN RN, BSN
HARVEY, KIMBERLEE RN, BSN, CCRN
HASTY, CHRISTINE RN, BSN, CCRN
HALL, EMILY RN, BSN
IRIZARRY, KASSANDRA RN, BSN
JOHNSON, JULIE RN, BSN
KOLODZIEJ, MELISSA RN, BSN
KAIYARE, MARY RN, BSN
LOVE, JESSICA RN, BSN
LEWIS, BRIDGET RN
MONGOLD, STACIE RN, BSN
MILCAREK, MARK RN, BSN
MITZEL, AMANDA RN, BSN
MERKEL-BRYANT, JACKIE RN, BSN
MORALES, JIMMY NCP
MORI, SARAH RN
NAJERA, AL RN, BSN, CCRN
NOBLE, JENNA RN, BSN, CCRN
OLD, DAVID RN, BSN
PATTERSON, DARIK RN, BSN, CCRN
PASKEWIC, BARBI RN, BSN, CCRN
PIERCE, ANASTASIA RN, BSN, CCRN
PETALCORIN, MAY RN, BSN
PINEDA, RINA RN, BSN, CCRN
POSCH, KAREN RN, BSN
POZO, LAURA RN, BSN
RIVERA, LINDA NCP
ROBERTS, BRITTANY RN, BSN, CCRN
RUFFIN, REBECCA RN, BSN, CCRN
ROMBAOA, PATRICIA RN, BSN, CCRN
ROWE, CARLY RN, BSN, MSN
ROBERTSON, BRITNEY NCP
SIMONS, TONIA RN, BSN, CCRN
SNYDER, TORI RN, BSN, CCRN
SDAO, EMILY RN, BSN, CCRN
SCHAFER, LEE RN, BSN, CCRN
SPICER, BILL RN
STEWART, KRISTY RN, BSN, MSN, AGACNP-BP
SURMAN, STEFANIE RN, BSN, CCRN
TEEGARDEN, JULIE RN, BSN
VAUGHN, SHELBIE RN, BSN
VELAYUDHUM, KEERTHANA RN, BSN, CCRN
WILLIAMS,OLIVIA RN, BSN
WILLIS, NATASHA RN
AUCLAIR, KATIE RN, BSN, CCRN
AUSTIN, LEAH, NCP
AUSTIN, SHELBY RN, BSN
BROCKWELL, JAMIE (flexi) RN, BSN
BROOKSHIRE, CHRISTINE RN, BSN, CCRN
BRENNAN, CARRIE NCP
CLOVIS, KIM RN, BSN
COCCHI, CHLOE RN, BSN
CUMMINGS, CAITLIN RN, BSN
DOBSON, JACKIE RN
DZIAMA, RACHEL RN
FLYNN, JULIA NCP
GIVIDEN, EMILY NCP
GANTER,MARINA (manager) RN, BSN
GREGORIO, MARIO RN, BSN, CCRN
HORNSBY, MORGAN RN, BSN
HARVEY, KIMBERLEE RN, BSN, CCRN
HASTY, CHRISTINE RN, BSN, CCRN
HALL, EMILY RN, BSN
IRIZARRY, KASSANDRA RN, BSN
JOHNSON, JULIE RN, BSN
KOLODZIEJ, MELISSA RN, BSN
KAIYARE, MARY RN, BSN
LOVE, JESSICA RN, BSN
LEWIS, BRIDGET RN
MONGOLD, STACIE RN, BSN
MILCAREK, MARK RN, BSN
MITZEL, AMANDA RN, BSN
MERKEL-BRYANT, JACKIE RN, BSN
MORALES, JIMMY NCP
MORI, SARAH RN
NAJERA, AL RN, BSN, CCRN
NOBLE, JENNA RN, BSN, CCRN
OLD, DAVID RN, BSN
PATTERSON, DARIK RN, BSN, CCRN
PASKEWIC, BARBI RN, BSN, CCRN
PIERCE, ANASTASIA RN, BSN, CCRN
PETALCORIN, MAY RN, BSN
PINEDA, RINA RN, BSN, CCRN
POSCH, KAREN RN, BSN
POZO, LAURA RN, BSN
RIVERA, LINDA NCP
ROBERTS, BRITTANY RN, BSN, CCRN
RUFFIN, REBECCA RN, BSN, CCRN
ROMBAOA, PATRICIA RN, BSN, CCRN
ROWE, CARLY RN, BSN, MSN
ROBERTSON, BRITNEY NCP
SIMONS, TONIA RN, BSN, CCRN
SNYDER, TORI RN, BSN, CCRN
SDAO, EMILY RN, BSN, CCRN
SCHAFER, LEE RN, BSN, CCRN
SPICER, BILL RN
STEWART, KRISTY RN, BSN, MSN, AGACNP-BP
SURMAN, STEFANIE RN, BSN, CCRN
TEEGARDEN, JULIE RN, BSN
VAUGHN, SHELBIE RN, BSN
VELAYUDHUM, KEERTHANA RN, BSN, CCRN
WILLIAMS,OLIVIA RN, BSN
WILLIS, NATASHA RN
Even though these patients require minute-to-minute observation and intervention, the staff has consistently arranged for “face time” with the families and the patient.
The staff of CSICU has experienced unprecedented challenges over the past year. CSICU was identified as a COVID -19 unit at the onset of the pandemic. This unit is the referral ICU for the community for patients in our surrounding hospitals that require ECMO support for oxygenation for severe cases of COVID -19. These patients present with extreme acuity and require relentless hours of nursing care. Along with the stress from the required clinical care comes the requirement of maximum PPE, personal anxiety of the staff from caring for patients that have a disease that has ravished our country.
This staff needed to put their personal fears aside and provide the expected high level of care that these patients needed to receive. Due to the COVID -19 visitation restrictions, staff has had to communicate by phone only with the families to support their needs as well. Even though these patients require minute to minute observation and intervention, the staff has consistently arranged for “face time” with the families and the patient. These patients are severely hemodynamically unstable requiring high doses of inotropes and vasopressor support. To achieve hemodynamic stability these patients are normally heavily sedated and paralyzed to enable better oxygenation. These “face time” visits are purely for the family as the patient is not able to communicate. The staff feels that it is important for the family to see their loved ones, as well as, for the patient to hear familiar voices.
I have witnessed a nurse hold the hand of a dying patient. The husband could not emotionally stay with the patient after comfort care interventions were made. The nurse went into her patient’s room, closed the door and held her hand, talking to her as she passed. This nurse would not let her patient die alone.
Another act of compassion was with a potential transplant patient. He was on maximum support – ECMO for cardiogenic shock, multiple vasoactive IV drips, but he for a short period of time was not ventilated. He had two young boys who the wife felt should not visit due to the tubes and machinery in his room. Time was arranged for him to “face time” with his children. Not too long after this “visit”, the patient became unstable and required intubation and placed on a ventilator. The patient did not survive, but the staff gave the wife two heart pillows, and the EKG strip jars, one for each boy to have. Feedback has been received from the wife stating how much the children cherished these items.
Staff routinely sit by scared/confused patients – freely interacting with them, playing comforting music, holding their hand while completing the necessary required clinical documentation. These interventions allow us to use less restraints, less medication and help the patients.
Another example is when the unit had a young woman who was going to die from cancer. The family and patient had been placed in hospice care. One thing that this patient wanted was to see the new “Wonder Woman 1984” movie. Without hesitation, the CSICU nurse ordered and paid for this movie to be streamed for this patient to view with her family. It was just hours later that she died peacefully with her family by her side.
Negative clinical outcomes inspired CSICU to evaluate their practice. The unit experienced 28 HAPIs in 2019. Constant education, auditing, rounding, and support from clinical experts was requested and completed. Staff has trialed new products and worked together to maintain nursing care standards for the patients in CSICU. The unit experienced a 40% drop in HAPIs in 2020. The motivation by the staff was to achieve clinical excellence.
The staff of CSICU has had incredible staffing challenges this past year. The unit has experienced sustained and extremely high acuity with the number of ECMO patients, COVID isolation and the overall admissions from the cardiac service line. The staff have consistently given CSICU extra hours. These hours have afforded the unit to provide the care the patients required clinically. The staffing challenges has required the CSICU staff to work closer as a team and anticipate the operational needs of their peers. Prior to the COVID -19 patients, the staff had taken for granted how freely they could move in and out of their patient’s rooms. The staff readily support their peers who are in the isolation rooms by retrieving pertinent patient care supplies, manage their IV pumps that are arranged on the outside of the room. This support allows the nurse to stay in the isolation room and avoid interruptions to her care delivery.
This past year has required the CSCIU staff to adapt to a different clinical environment. CSICU team members are highly specialized nurse clinicians who can care for any cardiac surgical or medical patient. Even though the nurses are highly trained cardiac experts, it is the compassion and caring that patents, their families and loved ones remember. It is an honor to be part of this highly trained, compassionate group of professionals who are fully worthy and deserving of this pestiferous award.
This staff needed to put their personal fears aside and provide the expected high level of care that these patients needed to receive. Due to the COVID -19 visitation restrictions, staff has had to communicate by phone only with the families to support their needs as well. Even though these patients require minute to minute observation and intervention, the staff has consistently arranged for “face time” with the families and the patient. These patients are severely hemodynamically unstable requiring high doses of inotropes and vasopressor support. To achieve hemodynamic stability these patients are normally heavily sedated and paralyzed to enable better oxygenation. These “face time” visits are purely for the family as the patient is not able to communicate. The staff feels that it is important for the family to see their loved ones, as well as, for the patient to hear familiar voices.
I have witnessed a nurse hold the hand of a dying patient. The husband could not emotionally stay with the patient after comfort care interventions were made. The nurse went into her patient’s room, closed the door and held her hand, talking to her as she passed. This nurse would not let her patient die alone.
Another act of compassion was with a potential transplant patient. He was on maximum support – ECMO for cardiogenic shock, multiple vasoactive IV drips, but he for a short period of time was not ventilated. He had two young boys who the wife felt should not visit due to the tubes and machinery in his room. Time was arranged for him to “face time” with his children. Not too long after this “visit”, the patient became unstable and required intubation and placed on a ventilator. The patient did not survive, but the staff gave the wife two heart pillows, and the EKG strip jars, one for each boy to have. Feedback has been received from the wife stating how much the children cherished these items.
Staff routinely sit by scared/confused patients – freely interacting with them, playing comforting music, holding their hand while completing the necessary required clinical documentation. These interventions allow us to use less restraints, less medication and help the patients.
Another example is when the unit had a young woman who was going to die from cancer. The family and patient had been placed in hospice care. One thing that this patient wanted was to see the new “Wonder Woman 1984” movie. Without hesitation, the CSICU nurse ordered and paid for this movie to be streamed for this patient to view with her family. It was just hours later that she died peacefully with her family by her side.
Negative clinical outcomes inspired CSICU to evaluate their practice. The unit experienced 28 HAPIs in 2019. Constant education, auditing, rounding, and support from clinical experts was requested and completed. Staff has trialed new products and worked together to maintain nursing care standards for the patients in CSICU. The unit experienced a 40% drop in HAPIs in 2020. The motivation by the staff was to achieve clinical excellence.
The staff of CSICU has had incredible staffing challenges this past year. The unit has experienced sustained and extremely high acuity with the number of ECMO patients, COVID isolation and the overall admissions from the cardiac service line. The staff have consistently given CSICU extra hours. These hours have afforded the unit to provide the care the patients required clinically. The staffing challenges has required the CSICU staff to work closer as a team and anticipate the operational needs of their peers. Prior to the COVID -19 patients, the staff had taken for granted how freely they could move in and out of their patient’s rooms. The staff readily support their peers who are in the isolation rooms by retrieving pertinent patient care supplies, manage their IV pumps that are arranged on the outside of the room. This support allows the nurse to stay in the isolation room and avoid interruptions to her care delivery.
This past year has required the CSCIU staff to adapt to a different clinical environment. CSICU team members are highly specialized nurse clinicians who can care for any cardiac surgical or medical patient. Even though the nurses are highly trained cardiac experts, it is the compassion and caring that patents, their families and loved ones remember. It is an honor to be part of this highly trained, compassionate group of professionals who are fully worthy and deserving of this pestiferous award.