May 2024
Kelly
Smith
,
BSN, RN, CMSRN
Palliative Care Unit
Virginia Commonwealth University Medical Center
Richmond
,
VA
United States
Kelly can navigate emergent scenarios with confidence and fortitude that places colleagues of all disciplines at ease and positively shapes patient outcomes.
Kelly Smith has been adjusting the sails of the palliative care unit with a steadfastness, earnestness, and dedication that is rare since 2020. She joined Virginia Commonwealth University Medical Center as a registered nurse in 2017, bringing with her a vast background in intensive care, oncology, and medical surgical nursing. She transferred to the palliative care unit in February 2020 and has been making a significant impression ever since. Prior to accepting the position as interim manager in 2023, Kelly was an informal leader, acting as a primary charge nurse, preceptor, mentor, EPIC super-user, unit scheduler, unit-based shared governance co-chair, and an esteemed colleague. On one occasion, she filled a divisional need and floated to the inpatient oncology unit as their charge nurse. Naturally, her “yes” has value and her presence is influential no matter the environment. Kelly can navigate emergent scenarios with confidence and fortitude that places colleagues of all disciplines at ease and positively shapes patient outcomes. There are many instances that affirm Kelly’s leadership merits and qualities as the DAISY Nurse Leader. I have chosen two specific examples to illustrate her impact.
Our unit has weathered winds, but what we experienced last year was unprecedented. Our unit provides specialized care in the setting of complex illnesses, symptom management, acute changes, and sacred transitions. Our acuity fluctuates, and it is not uncommon for a patient to become 1:1 depending on the symptoms. Some examples include acute bleeding, respiratory distress, breakthrough pain, delirium, anxiety, intractable nausea, or during final breaths. Families require continuous education and support throughout the care continuum as interventions evolve, values are honored, and, at times, existential crises emerge.
On one occasion, we had an experience where the patient and family required an interdisciplinary approach to manage multifaceted symptoms, psychosocial complexities, and unique relational dynamics. Beyond our typical interdisciplinary team, a strategic team was formed to include members from legal, patient relations, divisional and medical directors. The weight of care and advocacy placed the bedside nurses in a demanding position. Burnout and moral distress began developing within the team – Kelly remained accessible and acted. She advocated for our needs, and as a result, an intervention was implemented that ensured patient care was not compromised and the unit was equipped with additional resources. During this time, she often worked past regular hours to meet with the patient, family, team, and more specifically to be a hands-on guide for the unit. She went above and beyond to cover. It is a sacrifice that is not easily measured. Her attention to detail provided space for leaders across the healthcare system to have increased knowledge on the specialized care that we provide on our unit. Moreover, in crisis, Kelly provided a way forward that has become a blueprint for advocacy, action, and escalation.
On another and more somber occasion, our unit experienced a tragic event over a weekend. Immediately, Kelly left her family and came into the hospital to be with the team. She managed increased team members and assisted with flow of patient care as the unit still needed to run and was a real time resource to all team members. She did not delay in holding an emergent staff meeting to ensure that all team members, present and not present, had a chance to be updated and provided space to debrief. If you were unable to attend the emergency meeting, Kelly met with you one on one. The ripple effects of this experience were palpable and our Nurse Clinician raised awareness about Second Victim Syndrome. Kelly coordinated a specific training with the Employee Assistance Program on second victim syndrome and held space for us. The trainings accommodated schedules and learning needs both in person and virtual—it was powerful. It gave language for the work done on our unit both within the context of customary and unprecedented occurrences. Kelly’s compassion continues to create greater retention and well-being for our team.
Our unit has weathered winds, but what we experienced last year was unprecedented. Our unit provides specialized care in the setting of complex illnesses, symptom management, acute changes, and sacred transitions. Our acuity fluctuates, and it is not uncommon for a patient to become 1:1 depending on the symptoms. Some examples include acute bleeding, respiratory distress, breakthrough pain, delirium, anxiety, intractable nausea, or during final breaths. Families require continuous education and support throughout the care continuum as interventions evolve, values are honored, and, at times, existential crises emerge.
On one occasion, we had an experience where the patient and family required an interdisciplinary approach to manage multifaceted symptoms, psychosocial complexities, and unique relational dynamics. Beyond our typical interdisciplinary team, a strategic team was formed to include members from legal, patient relations, divisional and medical directors. The weight of care and advocacy placed the bedside nurses in a demanding position. Burnout and moral distress began developing within the team – Kelly remained accessible and acted. She advocated for our needs, and as a result, an intervention was implemented that ensured patient care was not compromised and the unit was equipped with additional resources. During this time, she often worked past regular hours to meet with the patient, family, team, and more specifically to be a hands-on guide for the unit. She went above and beyond to cover. It is a sacrifice that is not easily measured. Her attention to detail provided space for leaders across the healthcare system to have increased knowledge on the specialized care that we provide on our unit. Moreover, in crisis, Kelly provided a way forward that has become a blueprint for advocacy, action, and escalation.
On another and more somber occasion, our unit experienced a tragic event over a weekend. Immediately, Kelly left her family and came into the hospital to be with the team. She managed increased team members and assisted with flow of patient care as the unit still needed to run and was a real time resource to all team members. She did not delay in holding an emergent staff meeting to ensure that all team members, present and not present, had a chance to be updated and provided space to debrief. If you were unable to attend the emergency meeting, Kelly met with you one on one. The ripple effects of this experience were palpable and our Nurse Clinician raised awareness about Second Victim Syndrome. Kelly coordinated a specific training with the Employee Assistance Program on second victim syndrome and held space for us. The trainings accommodated schedules and learning needs both in person and virtual—it was powerful. It gave language for the work done on our unit both within the context of customary and unprecedented occurrences. Kelly’s compassion continues to create greater retention and well-being for our team.