As a primary family member of a critical patient at JMC, the months I have spent in the JMC ICU Unit, observing the professional services, care and process that occur here on a 24/7 basis, it is very exciting to realize that this group is special and should be recognized with the highest honor possible for their ongoing commitment to learning, growing, and serving; their dedication to what they do for others; their compassion for all; and finally, their level of individual and team performance. Individually, they are almost all models of excellence, superior in their performance, and selfless in their concern for their patients and families. As a Unit, they are more than this, for as we all know, “the sum of the parts is far greater than the whole.” This is certainly true of JMC’s ICU. They are notably and observably meritorious in their daily efforts to save lives and help families cope with often overwhelming situations and circumstances. In total, they are special individually, as a team, as a Unit, and as a collective group of outstandingly dedicated and exceptional professionals.
And so the story begins in the ICU at JMC. For over 2 months she (the patient) has been professionally and compassionately cared for by the ICU nurses. To date, 43 different nurses, many repeatedly, have been observed by the patient’s Aunt during their care for 12+ hours each day. Although there was never any intention or intellectual decision, for the Aunt to observe the nurses, upon spending so much time in a small unit, and given the proclivity of any professor, it just happened. Knowing she was going to be there a while, the Aunt immediately began to keep a list of the nurses, and notes on each, for the purpose of later preparing thank you notes. She began to make some notes so that she could let the nurses know the ways in which they provided excellent care. That became a rubric. Once again, as a researcher/professor who has used extensive rubrics in her university engineering/technology classes, this was just a second-nature way of thinking about things, so a simple rubric emerged.
Once the Aunt realized the quality and consistency of care that her niece was receiving, it seemed important that it be recognized; however, to do that, it made sense to organize some notes/data she had been collecting during her lengthy daily (and sometimes around-the-clock) visits. Although qualitative in nature, the notes/data repeated itself across individual nurses enough to extend beyond individuals, to become more a Unit pattern/trend, and then it was realized that the knowledge, skills, process, and ongoing teamwork and leadership exhibited in the JMC ICU is simply the way they work individually, together, as a team and unit. The Aunt noted that their experience at JMC ICU was not just a random “good” day/week/month; rather, their experience went beyond that to being a clearly evident and notable realization that this is quite simply just how this dedicated group of individuals work together in the interest of their patients each and every day.
Worthy of mention, and common in most hospitals today, is that the Travel, Seasonal, Per Diem Nurses who come into the picture, then are gone, do not interrupt the quality of care experienced. Then, there are also nurses who take time off to go back to school, so they come and go on various schedules. In such situations, one would expect to see some disruption, or at least a minor drop in quality of care, organization, process, etc. However, that does not seem to occur at JMC ICU. Also, after observing some “rounds” of orientation, then having those new nurses care for her niece, the Aunt realized that the individuals chosen to provide orientation are great at what they do. She actually observed several orientations, leading her to believe that the quality of the orientations, along with thoughtful hiring (as the new nurses she has seen join the Unit seem to be of high professional capability) has noticeably resulted in a seamless transition from orientation to practice. In addition to observing orientations, on more than one occasion, she observed “teaching moments” where one nurse taught another a new procedure; there seem to be excellent ongoing teaching practices taking place in the JMC ICU. As an observer, this is not something the Aunt can explain, nor does she attempt to do so; she is simply commenting on her direct observations or insights from direct experience. She comments that the varied background and experiences the “travelers” bring to the Unit is important, and she feels can be viewed as a benefit to the Unit; but also that the permanent contracts are valuable in the stability and ongoing development, leadership, and execution of the Unit.
From a personal, first-hand perspective as the patient’s Aunt, this unit is phenomenal. The professional teamwork, quality of care, work, and individual work ethic, efficiency, productivity, and equal concern for patient and family members was beyond exemplary. “I’ve rarely seen such professional comradery; these nurses actually offer to assist each other without a cue. Of course, they ask each other when necessary, but I’ve often observed nurses sticking their head in a room, unsolicited, and asking the attending nurse, ‘Do you need help?’ When there is a minute (or several seconds to spare), they look for someone to help. Many of them set up for each other at the end of the shift, when not required. Also, their shift change-over seems to take place with accurate, precise, and effective communication most of the time. The transition is usually seamless, from the viewpoint of an engaged family member.”
As mentioned above, in an effort to organize the observations into notes/data to thank individuals upon leaving the ICU, it was realized that the notes were quite extensive and easily organized into categories of performance, actions, behaviors, and results. It was easy to organize a simple, but extensive rubric to be able to inform individual nurses where their excellence was observed. The Unit as a whole and the far greater majority of Nurses employed in the JMC ICU are a model of excellence and exhibited superior performance on an ongoing basis of observation.
The ICU Team exhibited commitment, dedication, concern, compassion, and professional attitude and ethics each and every day they come to work.
Important to me, is that each of these individuals is showing great leadership, e.g., group leadership, servant leadership, and self-leadership. Clearly, they are individuals whom others respect and count on to lead, although, individually, they may not realize this. Each person is very different from each of his/her colleagues. These individuals are quiet about what they do and how they lead, some more visible than others; they seek no acknowledgment. Transforming leadership at its most grass-roots level is happening here. These individuals give intensely of themselves, daily; it just seems to be who they are. They “shine” in all aspects of their work, as individual beings, and as a team-based Unit; they show courage when they are willing to speak up respectfully to help other colleagues see or consider something in a different light; and the quality of what they at JMC ICU offer patients and family members is exceptional.
They are all true DAISY Nurses!