A Nurse-Led QI Project to Reduce ED to ICU Transition Time

Countless studies conclude that the longer an admitted patient boards in an emergency department (ED) the greater the risk for negative outcomes such as falls and hospital-acquired conditions. ED patients waiting for admission to the intensive care unit (ICU) may be at the greatest risk, as they are categorized as critical.

Transporting critical patients from the ED to the ICU requires coordination of multiple clinicians from both units, which can lead to delays. Leading and managing these coordination efforts is a challenge. However we are optimistic as small tests of change have led us to advancements in the timeliness of ICU admissions and improvements in quality and safety.

-Jonathan Nover, MBA RN, senior director of nursing, Mount Sinai Queens

The Project

Geneline Barayuga, MSN RN

The ED and ICU teams at Mount Sinai Queens, a 165-bed hospital with 70,000 annual ED visits in Queens, New York, performed a quality improvement (QI) project by developing a collaborative approach between the ICU and ED charge nurses to reduce the median […]

2023-12-11T10:17:23-05:00December 11th, 2023|Nursing, Quality improvement|0 Comments

The Nursing Work of Sojourner Truth and Harriet Tubman

Both Sojourner Truth and Harriet Tubman are known for their courageous struggles against slavery, their humanitarian work, and their support of suffrage. They are not known as much as they should be, however, for their role as nurses. (Editor’s note: this is the third in a series about important Black nurses of the past that we are publishing during Nurses Month 2023. Previous posts are here and here.)

Sojourner Truth

Sojourner Truth (1797-1883)

Isabella Baumfree was born into slavery in 1797 in New York State and grew up speaking Dutch. While still enslaved, she provided nursing care to the Dumont family. These nursing skills were used after she escaped slavery in 1826 with her infant daughter. In 1828, she became the first Black woman to sue a white man in a U.S. court and win, thereby recovering her son who had been sold into slavery in Alabama. In 1843, Baumfree’s religion convinced her that it was her mission to travel and testify. She changed her name to Sojourner Truth and throughout the rest of her long and complex life was to fight for the rights of African Americans and women.

During the Civil War, the U.S. War Department appointed Truth to Freedmen’s Hospital in Washington, DC, the first hospital that […]

2023-05-17T11:28:49-04:00May 17th, 2023|Nursing|0 Comments

How I Would Prepare My Child to Become a Nurse

‘Mommy, do you like your job?’

Photo by Tatiana Syrikova from Pexels

My five- and seven-year-old daughters are now old enough to understand that Mommy has a job as a nurse where she takes care of some pretty sick patients. From what I gather, their young minds really only seem to grasp that sometimes Mommy comforts her patients when they don’t feel well. As much as I would love to explain to them that my work as a pediatric ICU nurse is much more complicated and challenging than this, I also don’t mind them seeing me as someone who comforts others as a key part of my job.

But lately my five-year-old has started asking me more questions about my job: “What kind of patient did you take care of? How was your day at work? Do you like your job?” As one with a strong disdain for fluffy answers, even to a five-year-old, I’ve found myself considering how to answer her in a way that is both age-appropriate and honest.

When she asked if I liked my job, I thought about my patient writhing in agony yesterday—his loving parent present in the room—as we struggled to perform necessary interventions while also looking […]

2021-05-03T09:46:09-04:00May 3rd, 2021|Nursing|5 Comments

The Emergence of Sacred Space and Time in Hospice Care

I knew he was close. His breathing had changed, but I also knew it could be hours. It was 4:30 on a Friday afternoon and I was ready to be done with my week. The apartment was full of friends and family, full of an energy that was neither nervous nor productive. It felt like the buzz of being. The man’s wife and daughter were in the bedroom with him.

In the February issue Reflections essay, “The Car Ride Home,” author Paige Fletcher movingly evokes an episode from her experience as a hospice nurse. This one-page essay, which will be free until the end of February, is written with unusual clarity and restraint and is well worth the five or 10 minutes it takes to read it.

Fletcher writes convincingly of a sense of sacred space and time that can emerge as a life ends in a supportive home hospice setting. And she describes her […]

2021-02-16T15:30:52-05:00February 12th, 2021|Nursing|0 Comments

The Unsung Heroes of Hospice Are Family Caregivers

Nurses who find their vocation in hospice may be among the most understanding people on earth. As a nurse who has helped many, perhaps hundreds of patients transition into palliative care and hospice, I thought that I would be prepared to handle placing my father into home hospice after a stroke. At 90, my father had vascular dementia due to chronic infarctions. The call from his provider informing me that he had had an embolic stroke with a hemorrhagic component was not completely unexpected. After his anticoagulation was reversed, I knew that he was likely to have another stroke soon.

Walking the tightrope: daughter, nurse, caregiver.

I guess that’s the curse of the nurse. No false hope for me. As the nurse in the family, I walked the tightrope of caregiver, support person, and grieving daughter. The help from the hospice team was extraordinary, but the overall care and responsibility was placed on the family. It was a bit of a shock to me. I can’t imagine how families without members in health care manage.

My father did not pass his swallow test, and he had left-sided paralysis; however, he was initially able to communicate, with some effort. In fact, the priest who saw him on the first day was obviously curious as to […]

2021-01-14T11:15:10-05:00January 14th, 2021|family caregiving, family caregiving, Nursing|2 Comments
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