Joan has been a nurse at Children's Mercy for nearly 16 years. During this time, she has cared for some of our most vulnerable patients in our Intensive Care Nursery, our infant home vent clinic, and our peds/trach clinic. Joan's commitment to patients with these medical complexities is unmatched. She is an expert in providing case management, care coordination, education, and comfort to patients and families across multiple states. The programs Joan manages are ones patients and families desperately need for survival. This population of patients travels from far and wide to receive this level of care.

This recent example from our inpatient team and Joan's peer in the clinic demonstrates further how Joan exemplifies curiosity and service excellence. They state, "Joan has been spearheading a recent admission for a very complex trach patient's transition to a specialized and rarely used tracheostomy tube that may improve the child's overall ventilation. Joan has persistently advocated for the admission/transition over a period of months and coordinated with multiple teams and services to make it occur as smoothly as possible. Due to associated complexities (tube ordering, DME coordination, manufacturer education, alignment of inpatient/outpatient education), it's quite possible that without Joan's leadership and advocacy, this family/child may still be waiting for this transition.

In Joan fashion, she has not only coordinated this care but has been an incredible support to mom who though supportive of this transition has been very nervous about the change it brings. Her work with this complex patient included coordinating the time and date with the family, PICU, Bed Control, ENT NPs, Trach Program Coordinators, Pulmonology and Children's Mercy Home Care. She worked to develop a timeline and plan and communicated that plan to the involved groups. She was at the bedside of the patient for both days of the admission, making sure that the supplies at the bedside and those being sent home were correct. She communicated with all teams involved to ensure that we were providing the correct information. She patiently answered Mom's questions and calmed her nerves prior to discharge.

Once the patient was discharged home, Mom called back with questions/concerns and Joan again rose to the occasion, providing answers and reassurance. Joan was the first to request a debriefing between all our teams so that we could continue to provide a consistent message to the family, as well as identify opportunities for improvement for the next time." This transition was crucial to this child’s survival and quality of life. Without Joan’s advocacy and care, it would not have gone as quickly or as smoothly. This family is so appreciative of Joan’s level of care, consideration, and attention.

Joan has been a member of the peds/trach team for just over 4 years. In that time, she assisted in growing and developing this program. She is the sole ENT nurse on the team and the go-to for all things tracheostomy-related. Joan works closely with our inpatient ENT team, the ENT surgeons, and the other members of the multidisciplinary team (including pulmonology) to ensure patients have timely access to care. She is the staple in the clinic and the liaison for so many parents of complex patients who need answers and assistance regularly. Her critical thinking skills and medical understanding allow her to ask parents the in-depth questions the APPs and doctors need to quickly make decisions. She truly appreciates the acuity of the trach patient population and provides quick responses back to the parents to not delay care.

Sometimes she will coordinate care and conversations on her day off just to make sure nothing falls through the cracks. Her experience has helped us all better navigate the DME world to get trach patients the equipment they need. She has recently become our liaison to one of our trach tube suppliers. She has done product research and led these communications so we can provide the most up-to-date care. She kept the whole trach team up to date when trach tubes were affected by supply chain backorders.

In addition to providing hands-on care, education, and coordination for patients in the clinic and via the phone when they are away from the hospital, Joan also regularly assists in community education. She travels to areas in the region to equip schools and other caregivers with the knowledge, equipment, and skills to provide hands-on care to patients when they are away from Children's Mercy. This aspect of her role is vital to the success of these patients in the community.

Our surgeons in ENT state, "Joan is the go-to person for all our outpatient tracheostomy patients at CM. Joan puts a warm, human face on the trach program. She gets to know these patients and their individual needs. The patients and families rely heavily on her for support and kindness. She makes me a better provider by remaining curious and organized." Other surgeons continued, "Joan always goes the extra mile for our trach patients/families. She makes such a huge impact on their care - often very complex medical patients with unique needs. Joan also works hard to make sure the Peds Trach clinic is organized and runs smoothly - functioning as a team. She provides updates to the care team and is quick to help get supplies/answer questions/follow up. Our clinic would not function in the same capacity without her."

While the COVID-19 pandemic disrupted all teams in the healthcare setting and outside of the healthcare setting, the peds/trach population was especially vulnerable to this highly contagious respiratory disease. Joan worked tirelessly to ensure the patients still had access to care by completing TH visits and triage support via the phone. Tracheostomy suctioning is considered an aerosol-generating procedure (AGP) which raised some concerns in our outpatient setting. If a patient were to be suctioned in an open area (waiting room) it would lead to needing to close the waiting room for an hour due to the exposure risk.

Patients who have a tracheostomy do not always know when they will need to be suctioned, and this situation can become emergent or urgent in a matter of seconds. There was one instance when a family needed to suction urgently in a waiting room, and the waiting room then had to be cleared out and closed for a period. This was uncomfortable for the patient and family involved, and the team did not want another family to have to feel this way after providing needed care to the patient. Joan worked with the IS team to create and run a daily report for all tracheostomy patients scheduled to attend an ambulatory visit. This report is shared with patient access and clinic leadership so patients with a tracheostomy can be watched for by all representatives and placed into an exam room immediately. This allows the patients/families to provide needed care without question or disruption.

Joan went out of her way remaining curious and inclusive to provide a resolution for everyone involved. This practice is still in place. This is just one small example of the impact Joan has on these patients daily. While Joan takes care of our peds/trach population, she doesn't shy away from any opportunity to assist with our ENT clinic as well. Even though Joan provides more specialized care, she is always willing to help with our general ENT needs. She is willing to step outside her comfort zone and cover clinics or phone calls on top of her regular duties exemplifying what an outstanding teammate she is to all.

Joan is a remarkable nurse, employee, teammate, and person. She is most deserving of this recognition as evidenced by the number of people in different roles who took the time to provide examples of how Joan exemplifies team, kindness, curiosity, inclusion, integrity, and overall excellence. We are fortunate to have Joan at CM and in the peds/trach clinic.