Katie Thom, RN

Katie Thom, 8 South charge nurse, consistently encourages nurses to view complex patient situations through an ethical lens. She keeps ethics top of mind when considering patient care, professional development, and interdisciplinary practice across the hospital. Her leadership reflects the ANA Code of Ethics by empowering nurses to act as ethical agents.

Ethical Care in Complex Patient Situations: Katie reframes complex cases as ethical questions, making ethical reflection a routine expectation on 8 South. She reminds us that moral distress often underlies discomfort with a patient’s situation and approaches these questions with curiosity and openness.

For example, a confused patient with a poor prognosis was signaling distress during care such as turns and urinary catheterization. Her daughter, acting as healthcare representative, requested continued painful and invasive interventions. Caregivers experienced significant moral distress providing care over the patient’s repeated cries of “STOP.” Given the prognosis and the patient’s expressed wishes, continuing this care felt ethically troubling. Katie engaged the Ethics team and facilitated essential interdisciplinary discussion, asking, “Given the prognosis, is there a point at which we would stop providing care?” Her calm leadership helped the team honor the patient’s dignity while navigating surrogate authority. That same week, she guided the team through concerns involving a spouse not honoring an advance directive, a sickle‑cell patient refusing care except narcotics, and a patient with dementia on a surrogate‑decision‑maker hold.

Encouraging the Ethical Development of Our Team: Katie promotes a culture in which nurses feel supported in raising ethical concerns rather than carrying them alone. She helps me think through the ethics of a situation without judgment. She educates staff about the ethics consult process and reminds us that any caregiver may request one. She promotes the Providence Center for Health Care Ethics Clinical Ethics curriculum. This learning has deeply enriched my practice, for example, by strengthening my understanding of patients’ rights, including the right to refuse psychiatric medications. Katie helps ensure that ethical decision‑making on our unit is grounded in evidence‑based frameworks.

Promoting Systemic Improvement of Ethical Interdisciplinary Practice: Through Katie’s advocacy, PPMC has provided more consistent and ethical care for patients with questionable decision‑making capacity. Providers sometimes document, “Place hold if tries to leave AMA,” without assessing capacity or placing a substitute decision‑maker hold. This ambiguity left charge nurses and security unsure how to respond when patients attempted to leave, including questions about restraints and reassessing capacity. As neurology nurses, we know capacity often changes during hospitalization.

Katie escalated this issue through Practice Council and, despite delays, continued to pursue resolution. When the concern resurfaced at Charge Nurse Council, she coordinated efforts and identified that social work, hospitalists, and supervisors were addressing related issues independently. Through her insistence on collaboration, she convened an interdisciplinary working group that standardized practice, developed procedures, and created education and tools for nurses. Katie persisted through complexity and delay, recognizing that inaction itself constitutes ethical harm.

Protecting Human Welfare and Reducing Disparities: Katie Thom is the ethics angel on our shoulder, consistently lifting up the dignity of every patient. Whether advocating for accurate capacity assessments, ensuring patients’ voices are heard when surrogates disagree, or supporting nurses experiencing moral distress, she protects patient welfare and promotes equitable, humane care. By addressing moral distress directly, Katie preserves both patient dignity and the nursing staff's moral integrity.