Main 8 West Team
May 2020
Main 8 West
at VCU Health
Medical Surgical Care Unit
VCU Health
Richmond
,
VA
United States
William Kelly, Buildings & Grounds; Bee Chim, Buildings & Grounds; William Turner, Emergency Department EVS; Brittany Murphy, M8W EVS; Nina Carter, MSN RN CMSRN, Nurse Manager of M8W; Rhonda West RN, CNI, M8W; Erica Hobson MS RN CMSRN, M8W; Sue Ortmann BSN, RN, CEN, CNIV Clinical Coordinator of the Emergency Department; Donna Wright BSN, RN, CEN CNII Assistant Nurse Manager of the Emergency Department
Recently, I witnessed an amazing example of teamwork, leadership, compassion, and excellence in patient care by several nurses from Main 8 West, in particular Nina Carter, Nurse Manager; Rhonda West, Clinical Nurse I (a new graduate with three months of experience) and Erica Hobson, Clinical Coordinator. This exemplary story involved a patient who had been a patient on their floor for 49 days. He required extensive wound care and hadn't been able to bathe adequately the entire hospital stay. In addition, wound care was painful for the patient, and both time and labor-intensive for the team.
To summarize the day in a sentence: At approximately 8 am two Plant Operations team members appeared at the Clinical Coordinator office in the Emergency Department stating that Main 8 West needed to use the decontamination room. That seemed a bit odd so we asked for more information.
The request involved using a swimming pool to give a patient a bath and Plant Ops recommended using a room with a floor drain so they thought of our decontamination rooms. Donna Wright, Assistant Nurse Manager in the ED and I, called up to Nina Carter to get the whole story. Admittedly, this sounded rather peculiar.
We learned that the patient had an autoimmune disease resulting in huge skin lesions requiring extensive dressing changes over his entire body. These were painful because the dressing would often stick to the wounds. The team was looking for a place that could accommodate bathing this patient due to possible infection. They hoped that by putting him in water the dressings would loosen and be easier to remove. It would also give them the opportunity to rinse his skin and give some additional bathing they had been unable to perform. So, the team thought of a swimming pool. Nina had an answer for every one of our questions. The Main 8 West team would bring the patient and supplies, they planned to use their Safe Lift and already ensured it would lower the patient completely to the ground. During this time, the team would perform all the care, and they had already consulted with his provider, the Wound Care Team, and Epidemiology. All the teams agreed this was not only safe for the patient but a great idea. Most importantly, the patient also agreed to this plan.
We, in the ED, jumped on board. Nina talked about how depressed the patient was with his medical condition, chronic pain, and inability to see his family and hoped this would improve his emotional state.
Nina and Rhonda arrived with their cart of supplies and the swimming pool. Donna and I had already gone to ensure the room was clean, the water was warm and the drain was clear. The pool was set up and we started to fill it. We discussed what additional supplies they would need and made certain there were a couple of water pitchers to pour water with and enough towels, bath blankets, and 4X4s to care for him and keep him comfortable. We then set the team up with personal protective equipment to keep themselves dry and protected.
Nina called for the patient and Erica Hobson arrived with the patient and their Safe Lift. Erica had pain medication to administer to help him tolerate the wound care and prior to giving it, requested a scanner so she could scan his medication. (They thought of everything.) After that, he was lowered into the water and the process began.
To us, this is where the true magic happened.
The patient was cared for with such compassion, patience, and respect. They encouraged his participation and told him how proud they were of his efforts and cooperation. Then Nina said, "You should be proud of yourself as well, that's the most important thing." It was clear there was a strong bond of trust between the patient and the nurses or he would not have been so cooperative. He called them by name. When he said it hurt too much, they paused and inquired where the pain was. They provided positive reinforcement on his wound healing and participation. They focused on his ability to see his daughter when this was completed and a special trip to Chick Fil A on the way back upstairs.
His provider came down to get a good assessment of his wounds during the wound care and was pleased to see the plan had come to fruition. Once out of the pool they completed his wound care. This whole process took almost 3 hours. During this time, Donna and I alternated checking on them. We realized the ED was a foreign land to them.
Once the patient was back upstairs, Nina and Rhonda bagged all of the trash and linen while they debriefed on the entire event. We decided to let the swimming pool drain slowly to prevent the floor drains from becoming overwhelmed and backing up so we simply pulled the swimming pool plug. I said I would check on it, get EVS in to clean, and sent them back upstairs. They were truly exhausted.
The pool drained faster than anticipated and the room filled with water. I was so happy and relieved that we had allowed them to use our decontamination room rather than attempting this in a patient room. We were able to direct the water to the drains and then wash the floor without damaging any equipment or other rooms because that is how it was designed. (Thank you Plant Ops for the suggestion.) William from EVS worked for an hour to clean up the remainder of the room to make it ready for the next need. As we stated in the beginning this was an amazing demonstration of teamwork and organization. Nina, Rhonda (who came in on her day off at the patient's request), and Erica coordinated multiple departments and activities to get this approved and make this happen without a hitch. Nina even bought the pool herself-on closeout. The best part for all of us was seeing the transformation of the patient.
To summarize the day in a sentence: At approximately 8 am two Plant Operations team members appeared at the Clinical Coordinator office in the Emergency Department stating that Main 8 West needed to use the decontamination room. That seemed a bit odd so we asked for more information.
The request involved using a swimming pool to give a patient a bath and Plant Ops recommended using a room with a floor drain so they thought of our decontamination rooms. Donna Wright, Assistant Nurse Manager in the ED and I, called up to Nina Carter to get the whole story. Admittedly, this sounded rather peculiar.
We learned that the patient had an autoimmune disease resulting in huge skin lesions requiring extensive dressing changes over his entire body. These were painful because the dressing would often stick to the wounds. The team was looking for a place that could accommodate bathing this patient due to possible infection. They hoped that by putting him in water the dressings would loosen and be easier to remove. It would also give them the opportunity to rinse his skin and give some additional bathing they had been unable to perform. So, the team thought of a swimming pool. Nina had an answer for every one of our questions. The Main 8 West team would bring the patient and supplies, they planned to use their Safe Lift and already ensured it would lower the patient completely to the ground. During this time, the team would perform all the care, and they had already consulted with his provider, the Wound Care Team, and Epidemiology. All the teams agreed this was not only safe for the patient but a great idea. Most importantly, the patient also agreed to this plan.
We, in the ED, jumped on board. Nina talked about how depressed the patient was with his medical condition, chronic pain, and inability to see his family and hoped this would improve his emotional state.
Nina and Rhonda arrived with their cart of supplies and the swimming pool. Donna and I had already gone to ensure the room was clean, the water was warm and the drain was clear. The pool was set up and we started to fill it. We discussed what additional supplies they would need and made certain there were a couple of water pitchers to pour water with and enough towels, bath blankets, and 4X4s to care for him and keep him comfortable. We then set the team up with personal protective equipment to keep themselves dry and protected.
Nina called for the patient and Erica Hobson arrived with the patient and their Safe Lift. Erica had pain medication to administer to help him tolerate the wound care and prior to giving it, requested a scanner so she could scan his medication. (They thought of everything.) After that, he was lowered into the water and the process began.
To us, this is where the true magic happened.
The patient was cared for with such compassion, patience, and respect. They encouraged his participation and told him how proud they were of his efforts and cooperation. Then Nina said, "You should be proud of yourself as well, that's the most important thing." It was clear there was a strong bond of trust between the patient and the nurses or he would not have been so cooperative. He called them by name. When he said it hurt too much, they paused and inquired where the pain was. They provided positive reinforcement on his wound healing and participation. They focused on his ability to see his daughter when this was completed and a special trip to Chick Fil A on the way back upstairs.
His provider came down to get a good assessment of his wounds during the wound care and was pleased to see the plan had come to fruition. Once out of the pool they completed his wound care. This whole process took almost 3 hours. During this time, Donna and I alternated checking on them. We realized the ED was a foreign land to them.
Once the patient was back upstairs, Nina and Rhonda bagged all of the trash and linen while they debriefed on the entire event. We decided to let the swimming pool drain slowly to prevent the floor drains from becoming overwhelmed and backing up so we simply pulled the swimming pool plug. I said I would check on it, get EVS in to clean, and sent them back upstairs. They were truly exhausted.
The pool drained faster than anticipated and the room filled with water. I was so happy and relieved that we had allowed them to use our decontamination room rather than attempting this in a patient room. We were able to direct the water to the drains and then wash the floor without damaging any equipment or other rooms because that is how it was designed. (Thank you Plant Ops for the suggestion.) William from EVS worked for an hour to clean up the remainder of the room to make it ready for the next need. As we stated in the beginning this was an amazing demonstration of teamwork and organization. Nina, Rhonda (who came in on her day off at the patient's request), and Erica coordinated multiple departments and activities to get this approved and make this happen without a hitch. Nina even bought the pool herself-on closeout. The best part for all of us was seeing the transformation of the patient.