Tammy Marquez de la Plata
April 2023
Tammy
Marquez de la Plata
,
MSN, RN, NE-BC
Out-Patient Mental Health
South Texas Veteran's Health Care System
San Antonio
,
TX
United States
Tammy is able to balance organizational/leadership priorities, front-line staff concerns, and patient needs in a way that is difficult to put into words. The only explanation I have is that Tammy truly operates from a place of an amazing heart, generous soul, and caring mind such that the barriers seem smaller to her than they do to most other people in the room.
It is with an unabashed appreciation for the countless ways Ms. Marquez De La Plata exemplifies what a DAISY Nurse Leader is that I submit this nomination. I have had the privilege of observing Tammy grow as a leader for the past six years, particularly when she transitioned from an assistant nurse manager to her current position of Nurse Manager of Outpatient Mental Health. During the last four years, she has developed her staff to meet the demands of expanding and building new programs to improve behavioral health care at the South Texas Veterans Healthcare System (STVHCS). As a nursing leader, she oversees all nursing practice for 42 Registered Nurses in six geographically separated clinics supporting seven different outpatient mental health programs. Those programs are designed to meet the needs of Veterans who have varying levels of behavioral health needs including Behavioral Health Intensive Program (BHIP), Intensive Community Mental Health Recovery (ICMHR), Housing and Urban Development-VA Supportive Housing (HUD-VASH), (Prime), Primary Care Mental Health Integration (PCMHI), Somatic Therapies (esketamine and Transcranial Magnetic Stimulation), and Substance Use Disorder (SUD) via the Intensive Outpatient Program (IOP). She transformed the outpatient mental health nursing culture into a highly functional team who propel the VA’s mission to serve each Veteran by developing trust, modeling compassionate care, demonstrating respect, inclusion, and a continuous drive to destigmatize mental health care. Ms. Marquez De La Plata makes it a point to recognize her staff through multiple venues both formal and informal, she sends out weekly “huddle emails” that keep her staff abreast of organization changes/priorities, professional development opportunities, safety concerns, and special “shout outs” to give praise to her team. It is difficult to communicate the unrivaled energy and infectious enthusiasm she brings to the organization, the Veterans, her Team, and anyone she encounters.
On multiple occasions, she has encountered Veterans in need whether it be someone needing a wheelchair, having a mental health crisis, a medical emergency, or someone who has fallen in the parking lot…she immediately jumps in to help. She also takes the opportunity to send gratitude messages to show appreciation for not only her staff but others throughout the organization. Despite her busy role as Nurse Manager and multiple committee responsibilities, she still found time to craft personalized holiday gifts for each of her staff as an expression of appreciation and reflection of her heart Ms. Marquez De La Plata exemplifies leadership and compassionate nursing care in so many ways by being accessible and responsive to the needs of her team.
When the ICMHR team was short-staffed, she set aside her administrative tasks to perform clinical duties. She made home visits all over San Antonio and Kerrville to ensure our most Seriously Mentally Ill (SMI) Veterans receive appropriate medication management and were assessed for decompensation to prevent readmissions. She advocated to maintain the appropriate scope of nursing practice for her team by communicating recommendations and creating an algorithm to appropriately manage patients who either had attempted suicide or demonstrated preparatory behavior for suicide. The algorithm delineates roles and ensures nurses provide appropriate communication and interventions while preserving their scope of practice. As the subject matter expert, she collaborated with nursing education to create a virtual training regarding the algorithm which was assigned to all relevant nurses throughout STVHCS. She encouraged her staff to use critical thinking by supporting them in the development of a process to transport suicidal Veterans from outlying clinics to higher levels of care. This process was presented at the Center of Nursing Excellence (a shared governance avenue) and adopted as the best practice throughout STVHCS. Additionally, she encouraged nurses to develop and begin nurse-led groups on coping skills for anxiety and depression. Through her consistent guidance and reassurance, the nurses successfully implement the groups with positive patient feedback and one of her nurses developed an Evidence-Based Practice Poster submission for submission to the EBP committee.
Ms. Marquez De La Plata has exceptional communication and relationship skills, including boundary-setting and establishing and maintaining trust. She has an amazing ability to engage Veterans at every level of their behavioral health recovery with empathy, compassion, and kindness. She also has incredible de-escalation skills and models techniques for others by teaching Preventative Management of Disruptive Behavior (PMDB) classes for STVHCS employees. She will stop whatever she is doing to help someone else but still manages to meet all her deadlines, be present for her staff, colleagues, and leadership as well as excel in her collateral duties as Co-Chair for the Disruptive
Behavior Committee (DBC)/Employee Threat Assessment Committee, and PMDB trainer. She has been the Co-Chair of DBC since 2016 because of her ability to lead a team with kindness and empowerment, and her dedication to safeguarding the safety of staff, patients, and visitors alike. On many occasions she has fielded calls in the middle of the night from local law enforcement partners in the community, partnerships she has helped to foster and maintain. These calls often involve assistance in managing acute crisis scenarios such as standoffs with law enforcement or hostage negotiations – all of which have ended in non-violent outcomes. Her response to veterans perceived as threatening or dangerous through her phone calls or face-to-face conversations with such individuals has helped provide context to frustrating and helpless situations in a large healthcare system often challenging to navigate. With this, she has helped reframe the perception of dangerousness with contextual insight, preserving the dignity of the stigmatized “threat,” and ultimately ensuring receipt and continuity of vital medical and psychiatric treatment that serves as a key to risk management and reduction.
Although not her area of responsibility, Ms. Marquez De La Plata launched a campaign to provide nursing support for recently discharged Veterans from inpatient psychiatry and residential SUD treatment. She provided guidance and training to her team to identify, engage, and track these Veterans to maximize their recovery. This Evidence-Based initiative provides continuity of care in the post-discharge period improving patient engagement during transitions of care from higher acuity treatment to outpatient care when health risks are high for readmission, relapse, and self-harming behavior. Through this initiative, the overall outcome measures improved by 41 points, which is the third lowest of the seven facilities in our Veterans Integrated Services Networks (VISN). Additionally, Ms. Marquez De La Plata was an evaluator for the VISN’s Vulnerable Veterans Outreach Project drill in January of this year. The aim of the project is to engage Cohorts of vulnerable Veterans who are homeless, ventilated/using home oxygen, on chemotherapy/infusions/dialysis, those enrolled in Telehealth/Homebased Primary Care, and those receiving home visits for spinal cord injury and serious mental illnesses. Ms. Marquez de la Plata collaborated with social work services in the homeless program to vaccinate over 50 Veterans for flu and Covid.
Tammy’s leadership does not reside solely within her team, she is widely respected amongst her interdisciplinary colleagues. The following are narratives from a few of her colleagues who were eager to share their perspectives of her leadership.
***
There are few other people I consider to be as altruistic and truly patient-centered as Tammy – and therefore, no one I can think of that is more deserving of a DAISY Nurse Leader Award. She works diligently to advance the scope of her outpatient psychiatric nurses which is a win for everyone involved – she has a team of nurses who strive to be the best versions of themselves, interdisciplinary team members whose time is leveraged due to the nurses operating at advanced levels, and patients who are connected to care through the meaningful relationships built with the nurses. A perfect example of this is when Tammy worked hand-in-hand with stakeholders to transition mental health treatment coordinators to outpatient nurses, truly allowing the nurses to shine in the triage, case management, and coordination of care roles that they are so skilled at. She took ownership of the esketamine outpatient policy and worked tirelessly through several rounds of barriers to execute the clinic, and now has offered to help with the inpatient roll out– an expansion that is much needed, and with her help, is doable. She is able to balance organizational/leadership priorities, front-line staff concerns, and patient needs in a way that is difficult to put into words. The only explanation I have is that Tammy truly operates from a place of an amazing heart, generous soul, and caring mind such that the barriers seem smaller to her than they do to most other people in the room. She usually has a smile on her face and a solution to offer, which makes collaboration with her so easy, and are priceless characteristics for a leader to have. It’s a great honor to work alongside Tammy, where we are constantly achieving new and exciting things, learning from one another, and advancing what it means to give amazing care to Veterans who deserve it most.
***
If ever I was in a personal crisis and needed someone to talk to who would likely be able to establish a connection and make me feel heard, appreciated, and loved, it would be Tammy. It is baffling how someone always puts others first and can find
goodness in even the most unlikable of characters without faltering. She not only embodies what it takes to effectively lead teams and prevent violence in the workplace, but she also exemplifies that which we all need to do more of every day to connect to one another as human beings - to be kind, for where there is kindness there is goodness.
***
As part of our Pathway to Excellence (PTE) journey for redesignation, direct care nurses have to opportunity to provide feedback on the performance of their nursing leader. The nurses consistently provide heartfelt accolades of the impact Ms. Marquez De La Plata has as a leader and wanted to provide input into this submission. The following are just some of the multiple recent comments that Ms. Marquez De La Plata’s staff provided.
• “I have the utmost respect for her. She is so dedicated. She makes her team want to do better.”
• “In the entirety of my nursing career, I cannot say I have experienced the type of leadership I have since coming to the VA and Outpatient Mental Health. Tammy worries about every single employee, making sure we are getting a good work-life balance, feel heard, and respected. I fully intend to remain with the VA and retire from here due to the positivity shown by Tammy and other leadership. Tammy is so supportive of all our aspirations as employees to grow ourselves personally and professionally, she is an absolute cheerleader for every one of her staff and we appreciate her for it!”
• “The best supervisor that I have had in 12 years at the VA. I wish more leadership could "intern" with her to learn how to be a positive role model and mentor.”
• “Tammy treats the staff like extended family, she cares about us and our work-life balance, as well as supporting our goals and roles within the team. Tammy exemplifies what a true leader is!”
• “I am truly blessed to have a manager that is 100% committed to the mission and her TEAM.”
• “Tammy is a great nurse manager who is consistently upbeat and positive. She engages with the team and integrates HRO and PTE principles daily.”
• “I'd be willing to do just about anything for my supervisor because she bends over backward to do just about everything to make my job easier, streamlined, and smooth. Therefore, I always go above and beyond to make her job as flawless as I can.”
It is my sincere hope that this submission depicts Ms. Marquez De La Plata’s amazing leadership and does justice in representing the tremendous impact she has as a servant leader…a DAISY Nurse Leader!
On multiple occasions, she has encountered Veterans in need whether it be someone needing a wheelchair, having a mental health crisis, a medical emergency, or someone who has fallen in the parking lot…she immediately jumps in to help. She also takes the opportunity to send gratitude messages to show appreciation for not only her staff but others throughout the organization. Despite her busy role as Nurse Manager and multiple committee responsibilities, she still found time to craft personalized holiday gifts for each of her staff as an expression of appreciation and reflection of her heart Ms. Marquez De La Plata exemplifies leadership and compassionate nursing care in so many ways by being accessible and responsive to the needs of her team.
When the ICMHR team was short-staffed, she set aside her administrative tasks to perform clinical duties. She made home visits all over San Antonio and Kerrville to ensure our most Seriously Mentally Ill (SMI) Veterans receive appropriate medication management and were assessed for decompensation to prevent readmissions. She advocated to maintain the appropriate scope of nursing practice for her team by communicating recommendations and creating an algorithm to appropriately manage patients who either had attempted suicide or demonstrated preparatory behavior for suicide. The algorithm delineates roles and ensures nurses provide appropriate communication and interventions while preserving their scope of practice. As the subject matter expert, she collaborated with nursing education to create a virtual training regarding the algorithm which was assigned to all relevant nurses throughout STVHCS. She encouraged her staff to use critical thinking by supporting them in the development of a process to transport suicidal Veterans from outlying clinics to higher levels of care. This process was presented at the Center of Nursing Excellence (a shared governance avenue) and adopted as the best practice throughout STVHCS. Additionally, she encouraged nurses to develop and begin nurse-led groups on coping skills for anxiety and depression. Through her consistent guidance and reassurance, the nurses successfully implement the groups with positive patient feedback and one of her nurses developed an Evidence-Based Practice Poster submission for submission to the EBP committee.
Ms. Marquez De La Plata has exceptional communication and relationship skills, including boundary-setting and establishing and maintaining trust. She has an amazing ability to engage Veterans at every level of their behavioral health recovery with empathy, compassion, and kindness. She also has incredible de-escalation skills and models techniques for others by teaching Preventative Management of Disruptive Behavior (PMDB) classes for STVHCS employees. She will stop whatever she is doing to help someone else but still manages to meet all her deadlines, be present for her staff, colleagues, and leadership as well as excel in her collateral duties as Co-Chair for the Disruptive
Behavior Committee (DBC)/Employee Threat Assessment Committee, and PMDB trainer. She has been the Co-Chair of DBC since 2016 because of her ability to lead a team with kindness and empowerment, and her dedication to safeguarding the safety of staff, patients, and visitors alike. On many occasions she has fielded calls in the middle of the night from local law enforcement partners in the community, partnerships she has helped to foster and maintain. These calls often involve assistance in managing acute crisis scenarios such as standoffs with law enforcement or hostage negotiations – all of which have ended in non-violent outcomes. Her response to veterans perceived as threatening or dangerous through her phone calls or face-to-face conversations with such individuals has helped provide context to frustrating and helpless situations in a large healthcare system often challenging to navigate. With this, she has helped reframe the perception of dangerousness with contextual insight, preserving the dignity of the stigmatized “threat,” and ultimately ensuring receipt and continuity of vital medical and psychiatric treatment that serves as a key to risk management and reduction.
Although not her area of responsibility, Ms. Marquez De La Plata launched a campaign to provide nursing support for recently discharged Veterans from inpatient psychiatry and residential SUD treatment. She provided guidance and training to her team to identify, engage, and track these Veterans to maximize their recovery. This Evidence-Based initiative provides continuity of care in the post-discharge period improving patient engagement during transitions of care from higher acuity treatment to outpatient care when health risks are high for readmission, relapse, and self-harming behavior. Through this initiative, the overall outcome measures improved by 41 points, which is the third lowest of the seven facilities in our Veterans Integrated Services Networks (VISN). Additionally, Ms. Marquez De La Plata was an evaluator for the VISN’s Vulnerable Veterans Outreach Project drill in January of this year. The aim of the project is to engage Cohorts of vulnerable Veterans who are homeless, ventilated/using home oxygen, on chemotherapy/infusions/dialysis, those enrolled in Telehealth/Homebased Primary Care, and those receiving home visits for spinal cord injury and serious mental illnesses. Ms. Marquez de la Plata collaborated with social work services in the homeless program to vaccinate over 50 Veterans for flu and Covid.
Tammy’s leadership does not reside solely within her team, she is widely respected amongst her interdisciplinary colleagues. The following are narratives from a few of her colleagues who were eager to share their perspectives of her leadership.
***
There are few other people I consider to be as altruistic and truly patient-centered as Tammy – and therefore, no one I can think of that is more deserving of a DAISY Nurse Leader Award. She works diligently to advance the scope of her outpatient psychiatric nurses which is a win for everyone involved – she has a team of nurses who strive to be the best versions of themselves, interdisciplinary team members whose time is leveraged due to the nurses operating at advanced levels, and patients who are connected to care through the meaningful relationships built with the nurses. A perfect example of this is when Tammy worked hand-in-hand with stakeholders to transition mental health treatment coordinators to outpatient nurses, truly allowing the nurses to shine in the triage, case management, and coordination of care roles that they are so skilled at. She took ownership of the esketamine outpatient policy and worked tirelessly through several rounds of barriers to execute the clinic, and now has offered to help with the inpatient roll out– an expansion that is much needed, and with her help, is doable. She is able to balance organizational/leadership priorities, front-line staff concerns, and patient needs in a way that is difficult to put into words. The only explanation I have is that Tammy truly operates from a place of an amazing heart, generous soul, and caring mind such that the barriers seem smaller to her than they do to most other people in the room. She usually has a smile on her face and a solution to offer, which makes collaboration with her so easy, and are priceless characteristics for a leader to have. It’s a great honor to work alongside Tammy, where we are constantly achieving new and exciting things, learning from one another, and advancing what it means to give amazing care to Veterans who deserve it most.
***
If ever I was in a personal crisis and needed someone to talk to who would likely be able to establish a connection and make me feel heard, appreciated, and loved, it would be Tammy. It is baffling how someone always puts others first and can find
goodness in even the most unlikable of characters without faltering. She not only embodies what it takes to effectively lead teams and prevent violence in the workplace, but she also exemplifies that which we all need to do more of every day to connect to one another as human beings - to be kind, for where there is kindness there is goodness.
***
As part of our Pathway to Excellence (PTE) journey for redesignation, direct care nurses have to opportunity to provide feedback on the performance of their nursing leader. The nurses consistently provide heartfelt accolades of the impact Ms. Marquez De La Plata has as a leader and wanted to provide input into this submission. The following are just some of the multiple recent comments that Ms. Marquez De La Plata’s staff provided.
• “I have the utmost respect for her. She is so dedicated. She makes her team want to do better.”
• “In the entirety of my nursing career, I cannot say I have experienced the type of leadership I have since coming to the VA and Outpatient Mental Health. Tammy worries about every single employee, making sure we are getting a good work-life balance, feel heard, and respected. I fully intend to remain with the VA and retire from here due to the positivity shown by Tammy and other leadership. Tammy is so supportive of all our aspirations as employees to grow ourselves personally and professionally, she is an absolute cheerleader for every one of her staff and we appreciate her for it!”
• “The best supervisor that I have had in 12 years at the VA. I wish more leadership could "intern" with her to learn how to be a positive role model and mentor.”
• “Tammy treats the staff like extended family, she cares about us and our work-life balance, as well as supporting our goals and roles within the team. Tammy exemplifies what a true leader is!”
• “I am truly blessed to have a manager that is 100% committed to the mission and her TEAM.”
• “Tammy is a great nurse manager who is consistently upbeat and positive. She engages with the team and integrates HRO and PTE principles daily.”
• “I'd be willing to do just about anything for my supervisor because she bends over backward to do just about everything to make my job easier, streamlined, and smooth. Therefore, I always go above and beyond to make her job as flawless as I can.”
It is my sincere hope that this submission depicts Ms. Marquez De La Plata’s amazing leadership and does justice in representing the tremendous impact she has as a servant leader…a DAISY Nurse Leader!