Ms. Rachel Coffey is a deserving recipient of the DAISY Nurse Leader Award, and I am pleased to nominate her. Ms. Coffey has served in a variety of roles during her time as a VA nurse. She began as a PACT nurse at the “then” Rutherfordton VA Clinic, and while there, she also served as a wound care nurse. Later, she transitioned to the assistant nurse manager position at that clinic and later served as the nurse manager for primary care at the main facility. She transferred back to the Rutherfordton VA Clinic as nurse manager for a short period before being selected as the Chief of the Community Based Outpatient Clinics. Ms. Coffey’s leadership skills have fostered environments of caring behaviors, health promotion (for veterans and staff), nursing excellence, and performance improvement. She exemplifies the highest level of commitment, clinical practice, accountability, and leadership in the delivery of veteran care.

First and foremost, Ms. Coffey is always focused on doing the right thing for veterans. As the CBOC Chief, she is held accountable for many aspects of veteran care. One of the most significant areas is veteran access to care. When wait times for access to care in the CBOCs exceeded the VA target goal, she engaged leadership in discussions about how to impact this measure. After input and interdisciplinary coordination, she arranged for veterans seeking access to CBOC services to be offered an appointment with a PharmD to establish care, review and order needed medications, and to begin planning for any chronic disease management that may be needed as a part of the veteran’s treatment plan. Ms. Coffey demonstrated innovative thinking and a willingness to try new approaches to resolve complex issues. This process ensures the veteran’s immediate needs are met and streamlines the initial visit with the designated primary care provider.

Ms. Coffey promotes well-being, positive mental health, and resiliency for all her employees. Examples include the following:
•    Ms. Coffey denied comp time at the end of the day to one employee, stating all the work would be there the next day and to go home and do something fun. The employee went to a yoga class that evening and returned the next morning to thank Ms. Coffey for not allowing her to stay late, stating she had needed that time for her own well-being.
•    Ms. Coffey purchased stress relief coloring sheets for each department in all three CBOC locations. Recognizing that coloring is a healthy way to relieve stress and anxiety, this was one evidence-based strategy she used to enhance mental well-being during work hours. (see attached for a peek at her employees’ artistry)
•    Ms. Coffey approves leave liberally when the operational needs of the clinic are met. She encourages employees to plan for rest and relaxation. She models this behavior as well, encouraging other supervisors to do the same and by taking time herself. She has supported and offered the Employee Assistance Program on numerous occasions when life was just too challenging for employees. She has supported each CBOC in building compressed tours for interested employees and balanced that with no loss in productivity but demonstrating improved work attendance and work/life balance.
 
Ms. Coffey has served as a preceptor and mentor for many nurse managers and leads by example. Personally, she served as this writer’s preceptor three years ago and continues to be a mentor and guide. She displays patience when explaining policy, procedure, and process within the supervisory roles. She has been invaluable by providing guidance on how to approach and handle situations with human resources, employee and labor relations, and difficult employees. She has supported several CBOC initiatives for Shared Governance. One example is the establishment of an outpatient nursing practice council. It was identified that the outpatient setting was not as well represented in Shared Governance as it could be, so she actively listened to concerns and proposals, ultimately supporting the development of a practice council devoted to outpatient needs. She has a unique ability to make difficult tasks appear easy, is open to feedback, and is always willing to admit when there is something she doesn’t know. She has a practical way of drilling down to the simplest piece of information and is incredibly decisive in decision-making. This writer is always learning the lessons from her like “done is better than perfect” and “write it down to memorialize the moments.” She always makes time to listen and offer advice and supports staff in the most meaningful of ways. Quarterly, the CBOCs have a check- in meeting with ELT to present highlights, challenges, and hot topics. This writer frequently provides her with input on each of these so that she can work with ELT to achieve goals. One example is the CBOCs were often not offered a voice in the planning of organizational events and celebrations. She served as an advocate to have a champion at each CBOC location ensuring CBOC involvement. She advocates for technology and equipment needed to do the jobs required in CBOCs. Over the last fiscal year, she has supported and implemented three new lab refrigerators, a new EKG machine, complete replacement of two clinic’s eye lane equipment, clinic scales, and supported the clean-up/pick-up of old equipment. Ms. Coffey is professional and respectful in all her interactions with colleagues consistently role modeling the VA’s ICARE values and partnering with colleagues to achieve goals as a team. Because she models these behaviors so well, it encourages her employees to do their best and be their best.

Ms. Coffey often uses friendly competition as a means to motivate her staff. She offers kudos during staff meetings for those with the highest trust scores and promoted a competition for the first clinic to get to 80% participation on the All-Employee Survey this year (pizza and ice cream were this year’s rewards to the winning teams). She regularly recognizes those for high performance and achievement, often through ICARE award nominations and/or special performance/achievement awards. This writer was recognized with a special award due to a nomination she submitted. These behaviors encourage engagement and teamwork ensuring success for the entire CBOC service.