EP - Exemplary Professional Practice

EP26: Diversity and Workplace Advocacy-Describe and demonstrate how nurses use resources to meet the unique and individual needs of patients and families.

A key resource at the MedicalCenter which is used by nurses is the core tenets of the Professional Practice Model. This model is utilized to meet our patients unique and individual needs. Performing our shift-to-shift hand-offs at the patients bedside allows us to include the patients and their family members in the establishment of goals and lends itself to discussions regarding the plan of care. The use of the whiteboards in the patients room is an excellent communication tool for patients and highlights individual care needs. Hourly rounding by our staff nurses provides multiple checkpoints throughout the day when the nurse and the patient can connect. Safety huddles drill-down even further to bring specific patient needs to all caregivers.

Resources for Nurses

One resource available to nurses is the Patient Representative Department. Our Patient Advocate, Raul Pamplona, is available to nurses at all times of the day or night. Nurses on the patient care units will call him directly to inform him of a patient complaint. He is on the units on a daily basis making patient rounds and assuring that the patients needs are met. Mr. Pamplona is also a Chaplain and will attend to the Spiritual needs of the patients and families if requested.

Our nurses can also access as a resource our Interfaith Chaplains. Chaplains are available on a 24 hour-per-day basis to consult with patients and their families on their religious needs. For example, nurses call the Chaplains for support regarding Perinatal loss, a devastating diagnosis and death of a patient.

Special assistance for patients with limited English proficiency or sensory impairment

Special assistance for patients with limited English proficiency or sensory impairment

Resources are provided to patients who have little or no English speaking abilities. A telephone language line is provided whereby a dual receiver is used. One receiver is utilized for the English version and the other receiver, which the patient holds, is used for the translation. These lines are located in every nurses station. There is also a Language Bank of hospital-wide personnel who have received specialty certification for a specific language. These employees are available throughout the day, evening and night to translate if needed. Languages covered include Spanish, Polish, French, Arabic, Portuguese and Filipino.

When caring for the hearing impaired, an Audio/Video Language Line is utilized. There are nine (9) of these units hospital-wide and therefore are readily available. The hospital also contracts with qualified sign-language professionals who are available to perform face-to-face interpretations primarily during the daytime and evening hours.

The MedicalCenter provides written documents in the most frequently encountered foreign languages (ReferenceEP26-A and Reference EP26-B1, Reference EP26-B2, Reference EP26-B3, Reference EP26-B4, Reference EP26-B5, Reference EP26-B6, Reference EP26-B7). For example, EBSCO, the NurseReferenceCenter, is frequently used for patient discharge instructions and can be written in both Spanish and English. See below for discharge instructions for diabetes in Spanish.

Discharge instructions for diabetes in Spanish

Culturally Sensitive Care

In order to support our nurses and other caregivers in providing culturally sensitive care, the MedicalCenter makes available the EBSCO NurseReferenceCenter where evidence-based Care Sheets are provided. These Care Sheets reference: cultural values, religious beliefs, prominent health conditions, attitudes towards illness and health, death and dietary needs. These Care Sheets are an awareness tool for encouraging culturally congruent care.

Care Sheets

Examples of nurses using resources to meet patients unique needs

Example 1

Karen Caldas MSN-BC, RN, Clinical Risk Manager recently handled a complaint from a family member. The complainants mother was the patient who had an underlying medical condition and had recently undergone surgery. The daughter was the primary care giver and was always with her mother. The hospital was preparing to transfer the patient to a RehabilitationCenter for extended care. It was imperative that the daughter be out-of-town for the next few days. She expressed concern about moving her mother without her being available to assist her with the adjustment. Ms. Caldas telephoned Leigh Bailie MS, LSCW, Director of Case Management and requested for the patient to remain in the hospital for one more day until the daughter returned. Ms. Bailie made the necessary arrangements and the patient stayed in the hospital until the daughters return. Needless to say, the daughter was very appreciative of this gesture.

Example 2

A young mother was recently admitted to the Intensive Care Unit (ICU) with a head injury. She and her infant had fallen from a second-story window and, tragically, the infant did not survive. She slowly regained consciousness and was told about the death of her infant through family members and clergy. As she began to improve, two nurses, Cristina Simeone BSN, RN, Nurse Manager of Critical Care and Jaymie Cavero BSN, RN Staff Nurse in the ICU engaged Mary Beth Smith RN, Case Manager of Critical Care, to assist with this patient. Ms. Smith, through her many contacts with various rehabilitation centers, was able to obtain a place for this patient at one of the best centers. Ms. Smith also arranged for crisis intervention to speak with the mother and assist her with her loss. Ms. Smith continued on to collect clothes for the mother to take with her to the rehabilitation center. She also performed a follow-up visit to the center to visit this patient to insure that her recovery was progressing.

Example 3

Anna Rivera BSN, RN, Discharge Nurse on 7 East and West utilizes the expertise of Sandra Liu Pharm D. Ms. Rivera, in her role as discharge nurse, prepares the patients educationally to return home following discharge. She had recently collaborated with Ms. Liu with one of her patients who was a newly diagnosed diabetic. Ms. Liu has assembled kits for the units with a simulation practice pad for instructions on how to give injections. Ms. Rivera works with the patients on how to prepare the site and actually give the injection, and Ms. Liu discusses the different types of insulin and their long and short term effects. This collaboration is extremely effective for the patients.