Editor’s note: For a photo gallery of the winners, see www.Nurse.com/Gallery/HLMW-GEM-Awards.
Each year, a national search is held to find the most exceptional nurses in the U.S. Nurses from across the country are nominated by colleagues. This year, Nurse.com continues its tradition of recognizing and celebrating the achievements of these dedicated nurses throughout the United States, the culmination of which results in the naming of six special nurses as 2013 Nursing Excellence GEM awardees. In each region, five remarkable nurses in six specialized categories were chosen from the hundreds of nominations received.
“Our program has a sparkly new look and a shiny new name,” said Cheryl Portner, RN, MSN, Nurse.com vice president of staff development and training and nurse executive, Greater Chicago region. “The GEM Awards are our way of publicly recognizing excellence in nursing by awarding nurses who were nominated, selected and celebrated by other nurses, and who represent the best of the best in our profession. It is our privilege to honor them.”
Advancing and Leading the Profession
Barbara A. Brunt, RN-BC, MN, MA, NE-BC, director, nursing research and professional development, Summa Health System, Akron, Ohio
Research and sharing her findings are passions for Barbara A. Brunt.
One area in which Brunt has great interest: nursing competencies. She focused on the topic after serving on a joint National Nursing Staff Development Organization/American Nurses Association task force, looking at advanced competencies in continuing education and staff development.
The information from that research study identified competencies for advanced practice continuing education and staff development educators, Brunt said. However, it did not include information to identify if someone was meeting those competencies. It also did not include basic competencies.
The nurse leader turned to the literature to identify basic competencies and ended up with 107 competency statements.
Brunt developed a proposal for a pilot study to identify performance criteria for 10 of the identified competencies. After determining the viability of the method, she conducted nine additional studies to identify performance criteria for each basic and advanced competency statement. She submitted grant proposals to continue the research and was awarded the needed funds.
She shared what she learned, not only presenting a session on grant-writing basics at a national conference but also writing a book documenting the results of her research to help guide staff educators on how to use the information in practice.
After the revised Standards for Nursing Professional Development came out in 2010, Brunt realized there were competencies she didnt include in her original research.
I was interested in identifying performance criteria for the new competencies and also classifying the competencies according to [Patricia] Benners novice-to-expert theory, she said.
Brunt sent out a survey asking nursing professional development educators to rank each of the competencies according to Benners framework.
There were a few surprises in that study, so, my next project will be to do a validation study with a group of staff development experts, she said.
Research starts with passion about a topic or question, Brunt said.
Doing a small study or replicating a previous study [is a good way]of getting started, she said. It is always helpful to have it relate to [a nurses]practice. We need educational research to give credibility to what we do. In order to advance the profession, we also need to share the results of research.
Clinical Nursing, Inpatient
Jenna Dziedzic, RN, BSN, nurse educator, cardiac ICU, University of Michigan Health System, Ann Arbor
To Jenna Dziedzic, being a nurse means being a patient advocate.
Dziedzic served three years, including two as chair, on the University of Michigan Health Systems Clinical Practice Committee to improve practice.
Sometimes, I am my patients only support, she said. Im blessed to have worked my entire nursing career at a leading teaching institution which respects that I have a voice. It is, however, up to me to use it and make sure Im heard.
True advocacy requires not only finding solutions to problems, but also teaching those best practices, said Dziedzic, who mentors senior-level nursing students.
In one project, Dziedzic focused on why pressure ulcer rates continued to be high in the ICU despite use of padded dressings that were shown to decrease pressure ulcers.
I noticed, during my patient care, that I was seeing many of the padded dressings in use but not always optimally placed over bony prominence, Dziedzic said. So the [clinical practice committee]team, with the help of our skin liaison, audited and re-educated. Then, we began to see a drop in our pressure ulcer rates.
An infection control audit bought up another opportunity for improvement: to eliminate bloodstream infections in the CICU. Dziedzic and committee colleagues studied the issue and found dressings that held patients pulmonary artery catheters were consistently loose. Using products readily available on stock carts, they developed a specialized method of applying dressings for patients with the catheters. Bloodstream infection rates went to zero, and the CCU enjoyed 378 consecutive days without a BSI. The CCU has since adopted the dressing approach as the standard of care for pulmonary artery catheter patients. And Dziedzic and her team have presented a poster on the topic at multidisciplinary and nursing meetings.
Its like the little project that could [it]just keeps going, Dziedzic said. Start with a small, manageable thing. Little things often have greater impact than you first realize. Also, when it comes to attempting any change, we will meet resistance. But barriers are rarely as solid as they seem.
In my committee work, weve joked about the 80/20 rule: 20% of people will be resistant to doing something new; the other 80% will be receptive. I choose to be a part of and keep my focus on the 80%. The 20% will eventually follow.
Education and Mentorship
Nancyruth Leibold, RN, EdD, MSN, PHN, LSN, assistant professor of nursing, Minnesota State University, Mankato
Being a nurse educator involves lifelong learning of nursing and nursing education topics to fuel inspiration and creativity, said Nancyruth Leibold.
Leibold immerses herself in not only teaching but also learning by constantly developing her teaching skills and using a variety of tools to help students learn. Leibold wrote and produced 21 instructional videos for her students in 2012 and developed more than 20 educational games during 2011 and 12. She stays up to date on how to keep nursing students engaged, having in the last two academic years completed Faculty Teaching and Excellence in Teaching/Learning Online certificate programs.
I incorporate a variety of teaching strategies in [courses]to keep students engaged and promote interaction, Leibold said. By changing the learning activity often, it promotes interaction and keeps learners interested.
I use a lot of technology, such as gaming, making my own videos. Learning is fun, and it should be, since in nursing lifelong learning is necessary to keep current [with]new advances.
Leibold takes a special interest in helping her students prepare for the NCLEX-RN. She coaches students in their test preparations and has made five NCLEX prep videos.
She also shares information with her colleagues. After attending conferences about concept-based curriculum for schools of nursing, Leibold made a video for colleagues about the topic, including ideas of how concept learning can be implemented in courses.
Continuing education is important to learn new things, but it also can inspire nurse educators, she said. There is always a new gold-nugget discovery for use in educating tomorrows nurses.
Leibold said one of her tasks as a nurse educator is to create environments in which students can be engaged in interacting and learning. And providing caring, compassionate interactions and competence to patients, families, communities and populations is an essential aspect of her nursing practice.
The blending of this passion into nursing education is a critical point of my teaching practice, Leibold said. One thing I tell students is that knowledge and application, evidence-based practice and technical skills, are not enough in nursing, because therapeutic communication and interaction are also necessary for nurses.
Home, Community and Ambulatory Care
Kimberly Kousaie, RN, BSN, CHPA, director, Summa Palliative Care and Hospice
Summa Health System, Akron, Ohio
For Kimberly Kousaie, a trip to treat patients in Kenya turned out to be as much a teaching as a learning experience. She not only came back a better nurse, but she was able to help her U.S. staff return to the essence of hospice nursing.
Kousaie visited Summa Health Systems global partnership with a Kenyan hospice and palliative care center two years ago. She and her team brought supplies and educated staff about Western medicine. They also learned about Kenyas cultural and healthcare beliefs. Kousaie went on home visits to learn more about patient care in the country.
We did not have access to medications, she said. We didnt have access to hospitalizations, any of the interventions we do here. It really took you down to the absolute grassroots of what is nursing assessment? What is nursing care? How do you provide that comfort without all the technology and access to things that we have here in the U.S.?
Kousaie retained what she learned and observed, sharing it with her staff and, ultimately, helping them to refocus on the essence of what they do.
When we initially returned, it was quite a culture shock to be back, Kousaie said. In a very odd way, it made me frustrated when I would hear things here from our staff, complaining about having to drive an extra 10 miles to a patients home. I had just come from patients who would walk three miles barefoot on a dirt road to get to an outpatient clinic.
Kousaie said issues such as electronic medical record implementation and the many administrative tasks involved in modern care had distracted her and her staff from their true work: focusing on the patient, the family and how to provide them comfort.
Its not all about the medications, electronic charting or other patients on the schedule, Kousaie said.
Its reminding [staff]that hospice care is about that patient and that family at that moment, she said. We just had to bring that core piece back to our team. I think sharing some of the stories from Kenya really helped them realize what we do have here, and the exceptional care we are able to provide.
Patient and Staff Management
Joan McNeice, RN, MA, nurse manager, CICU, University of Michigan Health System, Ann Arbor
Joan McNeice is committed to empowering nurses to provide patient- and family-centered care.
McNeice helped design her facilitys cardiovascular ICU when it was being built. Among the accommodations she implemented: a couch bed in every room and windows built low enough to allow patients to look outside from their beds.
Individualizing care starts with the patients story and continues to develop throughout the continuum of care, McNeice said. When a healthcare provider actively listens, documents and communicates a patients story across the continuum of their care, patient advocacy is strengthened.
Throughout the years, McNeice has advocated for open visiting hours, better patient education materials, patient and family involvement in policy decisions and patient involvement in care. She has been known to emphasize quality measures that affect patients and families, such as medication reconciliation, fall prevention, patient and family pathways of care for the vascular surgery population and pressure ulcer prevention.
McNeice strives to promote information sharing, through which healthcare providers, patients and families share complete and unbiased information with one another; participation, through which patients and families build strength via experiences that enhance control and independence; collaboration, which includes policy and program development along with the delivery of care; and dignity and respect.
McNeice makes a point of attending the annual Patient & Family Centered Care Conference and has presented at the conference. She initiated an insulin management project and is working on an early mobility program. She overcame barriers and initiated bedside reporting.
But McNeice does not use a top-down approach. Rather, she believes in the shared governance model.
Shared governance is my approach to leading staff for successful outcomes, McNeice said. Ive always partnered with staff, supporting them with tools, time and knowledge to make decisions and solve problems.
Her advice to nurse managers? Start with patient- and family-centered care and empower staff to stop doing for patients and families and [instead]partner with the patient and family.
Celebrate what your team already does that is [patient- and family-centered]; document your journey; continue to celebrate; and share with others. In a shared governance unit, the staff feels responsible and acts accountable for patient outcomes.
Volunteerism and Service
Sarah Elizabeth DeFlon, RN, MS, ACNS-BC, registered nurse/cardiology, University of Michigan Health System, Ann Arbor
Chances are good that when she isnt working on the University of Michigans cardiac step-down unit, Elizabeth DeFlon is volunteering as a nurse at Neighborhood Service Organization in Detroit.
The nurses at the organization not only provide care but help manage crises. It can get crazy, DeFlon said.
The clients at the Neighborhood Service Organization have one thing in common: They are in dire need of healthcare. Detroit is really lacking in [healthcare]services. [Many of these people] have gone decades without getting any care or good treatment, DeFlon said.
If she could swing it financially, DeFlon said she would work full time for the uninsured.
When I graduated from school with my masters, I wanted to start a nonprofit for people with no insurance, she said. But when I really looked into that getting a board of directors and getting funding it was a huge undertaking, and I was not able to quit my job at that time to put all my energy into that.
Working at the University of Michigan allows DeFlon flexibility not only to work at the Detroit nonprofit, but also to do more to help others.
DeFlon, who travels abroad extensively, is developing a website she hopes to launch soon aimed at helping to tackle human atrocities she has witnessed, including sex trafficking and slavery. She also is a volunteer nurse with Project Medishare in Port-au-Prince, Haiti.
Her focus on helping others, including patients, is evident regardless of the healthcare setting. DeFlon is a member of the University of Michigan Health Systems Patient- and Family-Centered Care committee. She also precepts for unit staff, mentors nursing students and participates in medical student orientation to clinical care.
A quote that resonates with DeFlon is one by Portuguese photographer Jose Ferreira, who documented the harsh reality of life in Mozambiques trash city, where some make a living from other peoples waste: The life we waste every day because we want a better one or because we are never satisfied with it is the life that many wish and yearn to have and would give anything to have.