Nicole began at Monmouth Medical Center as a Patient Care Associate in June 2012 while working her way through nursing school. What makes it all so grand, is that in such a short amount of time, she has risen through the ranks. Through due diligence and hard work, she has accomplished the title of Assistant Clinical Director. It has affected her own nursing practice for the better, as she has developed stellar leadership skills. She takes the initiative in every situation presented. In all these aforementioned accomplishments and accolades, she continues to lead by example. Nicole has experienced all aspects of patient care due to her resume, from the beginning as a patient care associate, to delegating as a Registered Nurse to a PCA, to becoming the quarterback of the unit.
Nicole began in her current position as coordinator of in March of 2015. Since her conception in the role, she has markedly improved the unit's standings. The Todd 6 East Orthopedic and Neurosurgical Unit is the best in the system by the numbers, due to Nicole's efforts and success. The following information is gathered from the first quarter of 2015 to the most recent quarter of 2016. For example, when Nicole began in her current job title, the unit was scoring 86.5 in the 91st percentile with regards to "Communication with Nurses". The latest scoring in this category is 87.2 in the 93rd percentile. This jump is due to Nicole's implementation with multidisciplinary rounding and huddles every shift. By taking on the responsibility of discharge teaching, Nicole has allowed the staff to focus more time and effort at the bedside, providing a greater push to open the door in the communication between patients and the nursing staff. "Discharge Information" has gone from 93.5 in the 95th percentile to 96.3 in the 98th percentile. This leap is solely due to Nicole's bedside discharge teaching. By making herself available at the bedside, she is reiterating the teaching that she has done in the pre-operative course. She takes her time at the bedside, going over each and every line in the custom discharge packet that she creates for each patient, tailored to their procedure and progress throughout their hospital stay. She takes the time to answer every question posed by the patient and their caregiver. Something as simple as waiting for the caregiver to arrive at the bedside prior to discharge teaching has made a significant difference, as this removes any misconception and doubt for the caregiver when the patient arrives home. Perhaps most impressive is the triumphant increase in the category of "Communication about Medicines". When Nicole began, the score was 66.4 in the 65th percentile. Currently, the score in this category has catapulted to 72.7 in the 92nd percentile. This increase can be directly linked once again to the pre-operative course, where new medications are introduced, as well as the medication sheets that she created and implemented for every single patient with the multidisciplinary contribution of the doctors, Pharmacist and Pain Management Nurse Practitioner. Nicole will be working on a new hospital-wide initiative called "M in a box", where each shift the nurses will teach about a medication and it's side effects that are new to the patient at the bedside. This will only serve to further increase the scores in this category.
Nicole has created a highly successful discharge program. She recognized that there is a high patient turnover on the unit. With the highest number of admissions and discharges in the hospital, the nurses can often feel like they are pulled in many directions. Nicole has taken on the responsibility of personally discharging each post-operative patient. These patients have taken the pre-operative course that she offers, and for her to assist in their discharge, everything comes full circle. She believes that discharge teaching actually begins before the patient steps foot in the hospital, and by reiterating important aspects of the discharge instructions and follow-ups prior to the patient leaving the hospital, she is further instilling confidence for success. When a patient is up for discharge, Nicole will assemble a custom discharge packet tailored specifically for that patient and their procedure. She will then enter the patient's room and sit next to him or her for an in-depth discussion about the discharge while utilizing therapeutic communication. She will also wait for the caregiver to be at the bedside with the patient, to ensure that the highest level of understanding is accomplished. As this process has become standard on the unit, the nurses are now free to focus on bedside nursing because they are not being pulled away to initiate discharges. Prior to Nicole's revolutionary discharge program, nurses were unable to participate in effective bedside nursing and were rushing through discharges due to other pressing responsibilities. She holds the patients' hands, literally and figuratively, as their stay literally begins and ends with her. In addition, she is responsible for patient call-backs. After the patient has been discharged for a period of time, Nicole will call the patient at home to follow-up with their discharge teaching and ensure that they are comfortable and obtaining their individualized goals. This process has since been adopted house wide on med surg units and it has become a best practice.