Sarah Merkle
May 2024
Sarah
Merkle
,
MSN, RN, CNS-BC, NE-BC
PIH Health
Whittier
,
CA
United States
Sarah is courageous when making decisions and promotes initiatives that advance ethical behavior within nursing and healthcare overall.
Upon hearing that the DAISY Foundation introduced a Nursing Ethics Award, I immediately thought of Sarah Merkle and the way she has embedded herself in nursing ethics throughout her career, and demonstrated the ethical standard for the profession daily. The Code of Ethics for Nurses provides a guide for nurses to use in ethical analysis and decision making and is non-negotiable in any setting. Sarah embodies this code daily.
This award is meant to recognize those nurses who demonstrate the importance of human values and ethics in nursing. On behalf of patients and families, Sarah has exemplified ethics in action and role-modeled the importance of human values and human connection in healthcare practice.
Throughout her nursing career Sarah has always advocated for patients rights, dignity and respect. Sarah is always mentoring someone and collaborating with them to improve their skills. With every individual she encounters, Sarah ensures she is communicating at his or her level, hearing their perspective and assisting with decision-making as needed.
She is the epitome of a true facilitator for a healthy practice environment. She does this through her positive interactions and compassionate leadership with physicians, staff, leaders, patients, and families. One example of this was during the peak of COVID-19 surge. As the patient census continued to surge beyond anything we had ever experienced, we had to strategize regarding the management of patients. Sarah led numerous teams during this time to ensure patients received appropriate care with limited resources. She supported physicians and staff who were mentally, emotionally, and physically exhausted while preserving respect, dignity, and compassion for patients and families. Sarah worked tirelessly when developing the Crisis Standards of Care policy for PIH Health and led discussions on Goals of Care with the medical staff and administrative leaders, demonstrating true partnership with the entire healthcare team.
Sarah met one-on-one with many physicians, supporting them through the challenges of providing futile resuscitation efforts versus assisting patients with natural death. One specific example was with a young man in his early 30s who was at the end of his battle with COVID-19. The family was still requesting all efforts to save the patient even though the patient had arrested multiple times and there was no chance of survival. The physician was struggling to assist the family in understanding the outcome. Sarah went to the ICU, and after collaborating with the physician, they were able to guide the family to an end-of-life decision, ultimately allowing the patient to die without inflicting further suffering.
The COVID-19 pandemic challenged everyone to think outside the box and to push themselves to limits they never believed they could. Sarah worked constantly in supporting the frontline registered nurses in providing the care the patients required. She assisted with development of a Dyspnea Physician Order set and trained a small team of nurses in the administration of specialty medications to ease patients’ distress and support bedside nurses.
Sarah was also focused on supporting staff and ensuring they had what they needed. She constantly rounded on staff to identify their needs and assisted with developing educational support, supplies, and alternate workflow processes. Sarah worked closely with the frontline staff in supporting them with information and empathy and was an objective leader supporting them when they struggled with the decision of obtaining the COVID-19 vaccine or not. She worked closely with Employee Health in developing processes to FIT test staff for safety with N95 masks. Our hospital was not unlike other hospitals with nursing shortages, and Sarah worked closely with a team to develop Team Nursing to ensure patients received the care they needed with the resources available. Throughout the pandemic, Sarah maintained a positive can-do-attitude and adjusted workflows as needed but always included the end-users input to ensure staff perspectives were considered. She facilitated the opening and closing of units over ninety-three times during the pandemic to ensure we had beds available for patients as needed. On one occurrence, she managed to facilitate the entire movement of the Outpatient Infusion Center (chairs, medication carts, eye wash station, etc.) from a nursing unit to the auditorium in an effort to open up an additional 34 beds for patients requiring hospitalization. This was accomplished in under 8 hours.
Beyond the pandemic, Sarah leads numerous committees and is an active member in several national organizations. She is courageous when making decisions and promotes initiatives that advance ethical behavior within nursing and healthcare overall. She has worked to implement a process at PHWH that would support nurses obtaining national certifications. She encourages staff and highlights achievements. Sarah works closely with the Cancer Program and Clinical Research team to ensure patients receive ethical, compassionate care at all times. She has been an active member of the Ethics Committee for years and shares her knowledge of evidence-based practices with the team to incorporate into every decision, policy and process at PHWH. She has worked with the committee to bring speakers to assist physicians and staff with understanding and maneuvering through bioethical dilemmas with patients and families. In addition, she has worked closely with physicians to assist with addressing behavioral health needs of our patients, ensuring respect and dignity are provided at all times while keeping the staff safe during the care process.
The examples of Sarah’s advocacy for providing compassionate, respectful care, and treating all with dignity and respect are endless. It is without hesitation that I nominate Sarah Merkle for The DAISY Award for Nursing Ethics.
This award is meant to recognize those nurses who demonstrate the importance of human values and ethics in nursing. On behalf of patients and families, Sarah has exemplified ethics in action and role-modeled the importance of human values and human connection in healthcare practice.
Throughout her nursing career Sarah has always advocated for patients rights, dignity and respect. Sarah is always mentoring someone and collaborating with them to improve their skills. With every individual she encounters, Sarah ensures she is communicating at his or her level, hearing their perspective and assisting with decision-making as needed.
She is the epitome of a true facilitator for a healthy practice environment. She does this through her positive interactions and compassionate leadership with physicians, staff, leaders, patients, and families. One example of this was during the peak of COVID-19 surge. As the patient census continued to surge beyond anything we had ever experienced, we had to strategize regarding the management of patients. Sarah led numerous teams during this time to ensure patients received appropriate care with limited resources. She supported physicians and staff who were mentally, emotionally, and physically exhausted while preserving respect, dignity, and compassion for patients and families. Sarah worked tirelessly when developing the Crisis Standards of Care policy for PIH Health and led discussions on Goals of Care with the medical staff and administrative leaders, demonstrating true partnership with the entire healthcare team.
Sarah met one-on-one with many physicians, supporting them through the challenges of providing futile resuscitation efforts versus assisting patients with natural death. One specific example was with a young man in his early 30s who was at the end of his battle with COVID-19. The family was still requesting all efforts to save the patient even though the patient had arrested multiple times and there was no chance of survival. The physician was struggling to assist the family in understanding the outcome. Sarah went to the ICU, and after collaborating with the physician, they were able to guide the family to an end-of-life decision, ultimately allowing the patient to die without inflicting further suffering.
The COVID-19 pandemic challenged everyone to think outside the box and to push themselves to limits they never believed they could. Sarah worked constantly in supporting the frontline registered nurses in providing the care the patients required. She assisted with development of a Dyspnea Physician Order set and trained a small team of nurses in the administration of specialty medications to ease patients’ distress and support bedside nurses.
Sarah was also focused on supporting staff and ensuring they had what they needed. She constantly rounded on staff to identify their needs and assisted with developing educational support, supplies, and alternate workflow processes. Sarah worked closely with the frontline staff in supporting them with information and empathy and was an objective leader supporting them when they struggled with the decision of obtaining the COVID-19 vaccine or not. She worked closely with Employee Health in developing processes to FIT test staff for safety with N95 masks. Our hospital was not unlike other hospitals with nursing shortages, and Sarah worked closely with a team to develop Team Nursing to ensure patients received the care they needed with the resources available. Throughout the pandemic, Sarah maintained a positive can-do-attitude and adjusted workflows as needed but always included the end-users input to ensure staff perspectives were considered. She facilitated the opening and closing of units over ninety-three times during the pandemic to ensure we had beds available for patients as needed. On one occurrence, she managed to facilitate the entire movement of the Outpatient Infusion Center (chairs, medication carts, eye wash station, etc.) from a nursing unit to the auditorium in an effort to open up an additional 34 beds for patients requiring hospitalization. This was accomplished in under 8 hours.
Beyond the pandemic, Sarah leads numerous committees and is an active member in several national organizations. She is courageous when making decisions and promotes initiatives that advance ethical behavior within nursing and healthcare overall. She has worked to implement a process at PHWH that would support nurses obtaining national certifications. She encourages staff and highlights achievements. Sarah works closely with the Cancer Program and Clinical Research team to ensure patients receive ethical, compassionate care at all times. She has been an active member of the Ethics Committee for years and shares her knowledge of evidence-based practices with the team to incorporate into every decision, policy and process at PHWH. She has worked with the committee to bring speakers to assist physicians and staff with understanding and maneuvering through bioethical dilemmas with patients and families. In addition, she has worked closely with physicians to assist with addressing behavioral health needs of our patients, ensuring respect and dignity are provided at all times while keeping the staff safe during the care process.
The examples of Sarah’s advocacy for providing compassionate, respectful care, and treating all with dignity and respect are endless. It is without hesitation that I nominate Sarah Merkle for The DAISY Award for Nursing Ethics.