Clinical Practice in a Large Hospital
Omana Simon, DNP, RN, FNP-BC
Michael E. DeBakey Veterans Administration Medical Center

In 1865, in his second inaugural address, President Abraham Lincoln made a pledge to America’s Civil War veterans: “To care for him who shall have borne the battle and for his widow and his orphan.” Dr. Omana Simon works diligently to fulfill that promise by serving and honoring the men and women who are America’s veterans.

 

As an advanced practice nurse working as facility telehealth coordinator at Michael E. DeBakey VA Medical Center (MEDVAMC), Dr. Simon provides primary, secondary, and tertiary prevention strategies to the veteran population. Employed by MEDVAMC since July 1990, she worked as staff nurse, charge nurse, minimum data set coordinator, and nurse practitioner in primary care before her involvement in home telehealth (HT). Known for her calm attitude, professional values, and dedication to her profession, her unique management style sets her apart.

 

Dr. Simon received her BSN from Bombay University, her MSN from Houston Baptist University and her Doctor of Nursing at Case Western Reserve University. She has been a nurse for 34 years.

 

A compassionate nurse practitioner (NP) who leads by example and sets the bar high, Dr. Simon has instituted numerous nursing best practices in the home telehealth program. She developed templates for use during Hurricane Ike that were shared with Veterans Integrated Service Network (VISN) 16, which includes nine other facilities. During the VISN 16 leadership meeting in December 2008, she, along with two other nurse practitioners, presented an emergency preparedness plan that formed the basis of today’s VISN 16 emergency preparedness policy.

 

Dr. Simon and pulmonologist Amir Sharafkhaneh, M.D., led the development of the National Home Telehealth Chronic Obstructive Pulmonary Disease Management Protocol. She also implemented a process for home telehealth patients to bypass ER triage and be seen immediately by the provider, resulting in improved patient satisfaction.

 

During the VISN 16 Home Telehealth Leadership Forum in December 2009, she presented discharge criteria for home telehealth. The influenza immunization rate among HT veterans was above the national and primary care benchmark in 2007, 2008, 2009, and 2010.

 

As facility telehealth coordinator, Dr. Simon is responsible for home telehealth, teleretinal image, teledermatology, and clinical video telehealth. With a short timeframe, she implemented a number of clinical video telehealth programs including telepreop, telerehab, and tele-epilepsy. She is currently implementing 15 other clinical video telehealth programs at MEDVAMC. Under her leadership, the HT program received three hospital-wide recognitions and was named one of the best managed telehealth programs nationally by office of Telehealth.

 

Dr. Simon also led the “Standardize Blood Pressures Taken in Primary Care” project with other nursing staff members to improve processes. In the course of the project, the team updated the Ambulatory Care Protocol for management of patients with hypertension; distributed a pocket card on accurate monitoring of blood pressure measurement; and added a yearly review of accurate blood pressure measurement in the Skills Competency and Primary Orientation Packet.

 

Dr. Simon upholds the image of nursing locally, nationally, and internationally. She was deployed to Florida to help with the Hurricane Ivan recovery in 2005, which led to Primary Care program recognition with the TEAM Award of the quarter. In response to Hurricanes Katrina and Rita, she has taken assignments in the temporary New Orleans VA Clinic to serve evacuee veterans. In 2010, she served on the panel of experts that set standards for the Commission on Graduates of Foreign Nursing Schools for the minimum speaking score and minimum writing score necessary to perform job responsibilities.

 

She also has a long track record of community service. In 2008 and 2009, Dr. Simon served as chair of the career guidance seminar for high school students in her church, and as the advocate for nursing, attracted more than 200 youth in the community. She volunteers her time at Christmas to serve at the annual Star of Hope dinner. She chaired health fairs conducted for the indigent, noninsured and underinsured population in 2008 and 2009, sponsored by her church and the local Indian nursing organization. She works with student volunteers in various academic arenas and was appointed as the resource person for the Leadership Development Institute group for VISN 16 in 2012.

 

 “I started nursing in 1974 and it’s been my passion ever since,” she says. “I’m especially passionate about telehealth, which I think is the future of health care. Within three months after starting the program, we had enrolled more than 200 patients. I dedicate this award to my veteran patients who serve this country and who keep this planet safe and sound. Without them, I would not have received it.”

 

 

 

 

Clinical Practice in a Small Hospital
Pam Mengo, MSN, RN, ACNP-BC, CCRN
Methodist Sugar Land Hospital

Pam Mengo has an extraordinary gift of presence. The story that led to her nomination for an Excellence in Nursing Award begins with a 47-year-old female patient on the oncology floor at Methodist Sugar Land Hospital, with breast cancer and metastasis to the lung and brain. She failed aggressive chemotherapy at a hospital that specializes in cancer treatment and was sent home on hospice care. She began to decline, and the family, not yet ready to let go, became frightened and called EMS and asked that she be transported to Methodist Sugar Land Hospital.

 

The husband was devastated at the thought of losing his young wife. Their 22-year-old daughter had been planning her wedding for months. Knowing that her mother was terminally ill, and that her one wish was to see the wedding, she moved the wedding date up. But her mother was hospitalized on the oncology unit, nonresponsive and on noninvasive ventilation – a cumbersome mask tightly fitted over the nose and mouth.

 

Pam, a staff nurse practitioner with the gift of bringing a sense of peace and compassion to even the most difficult situations, saw this as a potential moment of joy in a terribly sad situation. She decided to do all she could to honor the patient’s wish to be present for her daughter’s wedding.

 

The woman’s oxygen saturation was 60 to 70 percent, well below the 90 percent needed to perfuse the brain. Unless an adjustment was made to increase the pressure on her ventilation mask, the patient would not survive for the wedding.

 

The distraught husband, wanting to ensure his wife’s comfort, agonized over the decision. “I asked the husband what he knew about BiPAP and took a moment to explain,” Pam says. “I suggested that we administer some pain medication to ensure her comfort and make minor adjustments in the mask so she could live to see the wedding.” The family agreed, the adjustments were made, and the wedding proceeded.

 

To everyone’s surprise, the patient became more responsive and acknowledged her daughter during the wedding. “This was such a nice gift to her,” Pam says. “Her husband was afraid that giving her more pain medication would hasten her death, but it allowed her to be more comfortable. After the wedding, the patient was interacting with her family. They were sending photos on Skype, and she was waving.”

 

With empathy and caring, Pam provided the family with the support they needed. Their greatest fear was that their loved one would be in pain in her last moments. They wanted to respect her wishes while allowing her to gracefully pass from this world. Pam’s calming demeanor put the family at ease, and her genuine caring gave them a day to remember. The husband was able to honor his wife’s last wishes, and the daughter was blessed to have her mother present for the wedding – all made possible by simple acts of kindness and the presence of nurses who care.

 

“It gives me goose bumps,” Pam says. “When I looked back at the record, I saw that her birthday is the same day as mine but she was four years younger. It’s these kind of experiences that make you love what you do because you’re making a difference in people’s lives.”

 

Pam taught school for 11 years before she went back to college and earned her BSN at Texas Woman’s University. She received her MSN from The University of Texas Health Science Center at Houston in 2007.

 

“I was a nurse for 12 years before I became a nurse practitioner,” she says. “What I love most about being an NP is having the ability to give orders that will allow our nurses to provide good care. I think the nurse practitioner role will grow, and we’ll be given even more responsibility. Every day I get thanked for what I do. It’s very gratifying.”

Clinical Practice in Hospice/Home Health Care/Clinic/Other Setting

Linda Brixey, RN

Kelsey-Seybold Clinic

 

Linda Brixey wanted to be a nurse for as long as she can remember. Her mother has pictures she drew in kindergarten with a stick figure in bed and another stick figure beside the bed with a red cross on her hat. It’s no surprise that Linda has turned that early desire to help into a 32-year career path that has taken her from direct patient care as a registered nurse to nurse educator.

 

To Linda, excellence in nursing is being a patient advocate and maintaining a competency base that allows you to provide the best care and education for each patient. As nurse educator and program manager of clinical education over Kelsey-Seybold’s nurse training operation, Linda helps other nurses achieve excellence by helping them to maintain their competence, feel empowered to be the patient advocate, and go the extra mile for clinic patients to improve their outcomes and quality of life.

 

Linda has worked for Kelsey-Seybold Clinic for the past 28 years. Hundreds of nurses at Kelsey-Seybold’s 20 ambulatory locations throughout the Greater Houston area look to her for her clinical expertise and passion for teaching. She supervises a staff of three educators, continually evaluating and researching the educational needs of the nursing staff to develop training criteria and conduct classes. She has helped develop or support numerous programs for clinical staff, including skills training and updates to promote and document staff competencies; Nurses Call the Shots, a program to improve immunization rates; audit tools for quality improvement and chart documentation; telephone messaging and emergency response documentation; policies and procedures for patient care; and an asthma training program with tools embedded in the electronic medical record (EMR) to improve patient care, among other projects.

 

Linda also has been on the frontline of preparing Kelsey-Seybold for accreditation with the Joint Commission and now the Accreditation Association for Ambulatory Health Care (AAAHC). She chairs or participates in numerous Kelsey-Seybold committees, including the Code Blue Committee, Medical Standards Committee, Cancer Committee, Asthma Committee, Diabetes Advisory Committee, Nurse Practice Committee, and Nursing Peer Review Committee.

 

Tahirih Baker, M.D., a family medicine physician at Kelsey-Seybold’s West Clinic, has known Linda for about 20 years. As past chair of the Medical Standards Committee on which Linda has served, Dr. Baker has observed firsthand Linda’s commitment to excellence, her compassionate patient care and her efforts to raise the bar for Kelsey-Seybold support staff. “When it comes to nursing, she knows her stuff and then some,” Dr. Baker says. “I am always impressed with her fund of knowledge and know-how. It’s no secret why she has excelled in her field and is relied on by many for education of the clinical staff and leadership. Linda has what I would consider to be the perfect combination in nurse leadership: she knows the job, is willing to get in and do the job, teach the job, and fix what is wrong with the job. She is a team player and has the ability to think outside the box. She’s committed to the right guiding principles of nursing and patient care. She is an exemplary nurse and leader.”

 

Linda’s peers look to her for rapid response on both finding and fixing problems, and Linda delivers. Mary Derden, R.N., a nurse educator who reports to Linda, describes her as knowledgeable, a very good resource, loyal, fair, and caring — qualities that serve as a role model for other nurses. “She is the epitome of a nurse,” Derden says. “She’s very involved and she’s a leader. Her contribution goes beyond Kelsey-Seybold – it’s to the nursing profession as a whole. Her impact on Kelsey-Seybold is unbelievable because of her involvement in many different aspects of the organization to help improve patient care and advocacy. Linda reaches every patient who comes in the door with her programs and her involvement with the nurses. She’s touching many more people as an educator than she could on the clinical side.”

 

Linda is also active in community outreach through her church, and she just completed a term as president of the AAACN. Many of the resources she has at her fingertips are books from this national organization, several of which she’s contributed to and one in which she’s listed as editor.

 

The enthusiasm Linda brings to her work is obvious — “I love what I do!” she’ll readily tell you — and it’s infectious. Nurses want to emulate her style and commitment to quality care. Linda is a grassroots, make-it-happen powerhouse – a real Kelsey-Seybold asset.

 

“I’ve always, always wanted to be a nurse,” says Linda, who graduated from Bethesda Hospital School of Nursing in Cincinnati in 1970. “Not a ballerina. Not a movie star. It’s such an honor to win this award, and I’m humbled by the experience. This isn’t an award that’s just for me. I’ve been successful because of the nurses I’ve worked with who have helped me to be a better nurse. It’s a recognition for all the nurses who have helped me be who I am.”

 

Nursing Education: Clinician

Marlene Walden, PhD, RN, NNP-BC, CCNS

Texas Children’s Hospital

 

 

 

Dr. Marlene Walden is a nationally known writer, presenter, and researcher in the assessment of pain and management of critically ill preterm and hospitalized neonates. As a successful clinical practitioner, educator, and researcher, she serves as a mentor and role model for other nursing professionals, sharing her passion for quality care and professional organizational involvement, and demonstrating how both can significantly impact the care of neonates and their families.

 

Dr. Walden has been actively involved in neonatal nursing for more than 35 years in a variety of positions. A certified neonatal nurse practitioner (NNP) for 30 years, she currently works in the Level IV Neonatal Intensive Care Unit at Texas Children’s Hospital (TCH) and serves as the lead NNP at Methodist Willowbrook Hospital under contract with TCH. She has been instrumental in assisting the unit’s leadership team in the development and implementation of an education program to prepare staff nurses to care for higher-acuity neonatal patients.

 

Dr. Walden received her BSN from Texas Woman’s University, her MSN from The University of Texas Health Science Center at Houston , and her doctorate in parent-child nursing at The University of Texas at Austin. She remained clinically active while advancing her knowledge through formal education.

 

A fervent advocate for evidence-based practice and the use of the research process to systematically examine questions that arise daily in her clinical practice, Dr. Walden serves as chair of the TCH Research Council, whose focus is mentorship and education for nurses interested in conducting a research or evidence-based project. She serves as course coordinator and lead faculty member for the hospital’s 12-month Research Scholars Program, which provides formal education on research and evidence-based practice, mentoring nurses through the research process from project inception to results dissemination. She currently coordinates an innovative research education project entitled The Great American Cookie Experiment, an initiative that engages nurses in research in a supportive, nonthreatening way.

 

Working to advance the profession of nursing is one of the noblest endeavors a nurse can pursue. Dr. Walden serves as a role model to both staff nurses and advanced practice nurses, encouraging them to advance their education and become actively involved in professional organizations where their voice and clinical expertise can make a difference. Her passion to improve the health of neonates and the experience of their families is evident in her extensive list of publications and presentations.

 

Dr. Walden served on the Board of Directors of the National Association of Neonatal Nurses (NANN) from 1997 to 2000. Prior to her service on the board, she chaired NANN’s Practice Committee, assisting in the creation of practice guidelines and technical bulletins issued by NANN. Most recently, Dr. Walden served on a National Association of Neonatal Nurse Practitioners’ task force to revise the Education Standards for Neonatal Nurse Practitioner Programs.

 

In addition to her clinical role, Dr. Walden is a professor of clinical nursing at The University of Texas at Austin, where she has served as the director of the Neonatal Nurse Practitioner and Acute Care Pediatric Nurse Practitioner programs since 2008. She was instrumental in developing the graduate curricula for these programs and in obtaining approvals from the university, as well as from accreditation and specialty certification organizations. She is passionate about teaching and providing each of her students with a quality nursing education.

 

She is a frequently invited keynote speaker at national and regional symposiums, and has authored numerous peer-reviewed manuscripts. Dr. Walden has also authored several book chapters in her area of clinical and research expertise. One of her publications has made a significant impact on neonatal nursing – the Core Curriculum for Neonatal Intensive Care, published by Elsevier, of which she is a co-editor. The National Guideline for Practice on Pain Assessment and Management, an evidence-based publication coauthored by Dr. Walden and published by NANN, has also made a significant impact in her field.

 

“My biggest love and passion is helping other people, and my biggest joy in nursing comes with working with babies and families,” Dr. Walden says. “I love helping to promote them on the road to recovery. I’ve been fortunate as a nurse to serve in a lot of roles over the course of my career, and one of them is to teach nurses at the bedside and in the classroom how to provide family-centered care. Teaching in the academia has also been rewarding. I’ve enjoyed having the opportunity to inspire new nurse practitioners to make a difference in their own lives so that they can make a difference in the lives of babies and their families.”

 

Nursing Education: Faculty

Jessica L. Peck, RN, MSN, CPNP, CNE

The University of Texas Medical Branch at Galveston

A dynamic course coordinator with unique problem-solving capabilities and a vision for improving nursing education in the state of Texas, Jessica Peck is an assistant professor of nursing at The University of Texas Medical Branch at Galveston (UTMB). In the words of her nominator, Natalie Bachynsky, MSN, RN, CNE, “Jessica has demonstrated true characteristics of excellence since her graduation as a BSN, MSN (PNP) and nurse educator from the UTMB School of Nursing.”

 

The two nurses have known each other since 2008, when Jessica volunteered as a preceptor for UTMB’s nurse educator program. “Jessica mentored me as I became accustomed to the role of clinical facilitator by allowing me to accompany her to clinical rotations with senior nursing students,” Bachynsky writes. “She demonstrated excellent teaching characteristics while modeling caring behaviors with clients and families at the bedside. She also has the unique ability to challenge her students to strive to be better in a non-intimidating manner. She is adept at facilitating learning in the clinical setting, using current practice modalities and learning scenarios that are drawn from her own practice.”

 

In addition to teaching at the bedside, Jessica provides role modeling by remaining current in her practice as a pediatric nurse practitioner (PNP) with a local pediatrician. She demonstrated her desire for lifelong learning by recently completing the post-master’s nurse educator program at UTMB and receiving certification through the National League for Nursing (NLN) as a certified nurse educator. In August 2012, she received the Doctor of Nursing Practice (DNP) degree from The University of Alabama.

 

To maximize clinical learning opportunities, Jessica has incorporated the use of alternate clinical placements for the pediatric clinical, using daycare centers, ambulatory clinics, and summer camps for special needs children. She has recruited nurses from practice who are willing to accompany students during nontraditional hours, including evenings, nights, and weekends. Her ability to “think outside the box” has doubled clinical capacity with same number of clinical faculty through creative placements.

 

Jessica has also incorporated service learning by initiating a community partnership in which students go to area schools to complete hearing and vision screenings on children ages 4 to 18. By becoming a certified vision and hearing screener through the State of Texas, she has trained students and facilitated these free screenings for 3,000 to 4,000 children each year.

 

She has demonstrated excellent clinical coordination with Capstone clinical placements, during which she places more than 200 students with preceptors for their final clinical rotation according to the student’s chosen area of interest. To incorporate the baccalaureate essentials while preparing students for their diverse clinical roles, she implemented a Disaster-Based Simulation Project, in which students participate in a simulated disaster in the UTMB “Smart Hospital.” She also includes problem-based assessment simulations and interdisciplinary code simulation to promote synergistic learning experiences between nursing and neonatal nurse practitioner students.

 

As a faculty advisor for UTMB students working on “The Butterfly Project, Jessica helped nursing students breathe new life into the project after it was abandoned following Hurricane Ike. The results have been outstanding. The project has benefitted UTMB clients and families by offering a place to spend time with terminally ill infants and children while providing comfort items and support as well as bereavement training for interdisciplinary professionals.

 

Jessica grew up as the eldest of five children and is a first-generation college student. When she received her associate’s degree in nursing, she considered it a significant accomplishment. “I’ve gone on to continue my education and am proud to say that both of my sisters have gotten degrees. My youngest sister is now a pediatric NP and is working with me as adjunct faculty, which is a lot of fun.”

 

She was voted "Outstanding Faculty" this year by the students in the School of Nursing’s accelerated program, a testimony to her achievements.

 

“One of the greatest things in my life is having four children age 3, 5, 7 and 9,” says Jessica, who has been a nurse for 15 years. “It’s fun to have my own pediatric clinical at home. And my children inspire me to bring excellence to pediatric nursing. Many times I bring them to class with me to help my students learn how to interact with children. A lot of my students don’t have experience with children, and this provides a comforting and safe environment to teach them communication and other skills.”

 

Nursing Administration and Leadership

P. Ann Coleman, RN, EdD, MPA, MSN, NI-BC

The University of St. Thomas School of Nursing

“What I love most is how my career has taken on a direction I never would have thought about when I graduated from nursing school in 1978,” says Dr. Ann Coleman, who is assistant professor of nursing and U.S. Department of Education Title V Grant Nursing Activity director at the University of St. Thomas School of Nursing. “The introduction of technology into our practice has pushed me into a field I never thought I would enter – informatics. I’m excited about where we’ll be five years from now. What we’re teaching our students will make them better practitioners immediately and equip them to incorporate timesaving technology into their practice so that we can all get back to doing what we do best – caring.”

 

Dr. Coleman received her BSN at Texas Woman’s University; her Master of Public Administration at California State University, Fresno; her doctorate in educational leadership in a joint program at the University of California, Davis and California State University, Fresno; and her MSN in nursing administration at The University of Texas Health Science Center at Houston. She exemplifies excellence in the field of nursing informatics and the integration of information and educational technology in nursing education. She has expertly facilitated the creation of infrastructure – facilities and technology – for the new University of St. Thomas (UST) School of Nursing BSN curriculum. The university officially began the process of opening a School of Nursing with the appointment of a director for nursing program development in July 2009. The BSN program was approved by the Texas Board of Nursing on July 21, 2011, and 28 nursing students began clinical nursing coursework on May 29, 2012.

 

The university received the U.S. Department of Education Title V grant to support School of Nursing development in October 2010. Dr. Coleman began her position as nursing activity director for the grant in February 2011. In less than 15 months she led a remarkable effort to develop a Nursing Success Center for specialized nursing student academic support, developed a Nursing Simulation Center, established a framework for instructional support and technology integration in nursing courses, and developed strategic plans for technology integration in nursing curriculum and faculty development. When she began her work at UST, there was no location or space for a Nursing Success Center or a Nursing Simulation Lab on campus, and she and the program director were the only nurse faculty members. The School of Nursing had no staff and limited operational funding outside the grant. Through her expertise in clinical simulation lab and faculty development, her project management expertise, and intense commitment to the mission, she has accomplished these goals.

 

The Nursing Success Center opened for pre-nursing students in September 2011. Through Dr. Coleman’s skills in forging relationships with UST’s Facilities and Information Technology teams, she led the successful renovation of a battered townhouse that is now a beautifully designed and welcoming center for students. She worked tirelessly with support departments to identify solutions for needed space for a Nursing Simulation Lab. With her guidance, a modular building was specially designed for the small open space available on the crowded urban campus. She oversaw planning, design, delivery, outfitting, and equipping the 2,000-square-foot-facility, keeping the quality of the student experience and learning needs in mind. The Nursing Simulation Lab was fully outfitted and staffed for the first cohort of nursing students to begin nursing studies on May 29, 2012.

 

In addition, she helped create a strategic plan for development and integration of educational and information technology, including clinical simulation, for the School of Nursing, which guides the school’s continuing evolution. Her strategic planning incorporates a plan for addressing American Association of Critical-Care Nurses (AACN) [do this mean ANCC here instead of AACN?] and Texas Board of Nursing-required competencies in nursing informatics for our BSN curriculum.

 

Her achievements are strongly connected to her ability to bridge the worlds of nursing and information technology. She demonstrates excellent leadership skills in creating effective interdepartmental and interdisciplinary teams. As the University of St. Thomas moves toward expanding the use of educational technology and distance education, she is setting standards and providing a model for the School of Nursing and for the university as a whole.

 

A nurse for 36 years, Dr. Coleman is recognized at the national level for her expertise. She has been invited to serve as an item writer for the American Nurses Credentialing Center (ANCC) Informatics Certification Exam and as a member of the ANCC Standard Setting Committee for the Informatics Exam. She has presented nationally and internationally. She has outstanding expertise in the integration of technology in nursing education, and is highly committed to the UST School of Nursing holistic nursing philosophy and healing framework. She recognizes that technology serves the greater purpose of nursing, which is to create the conditions and relationships that support healing. With her expert guidance, the University of St. Thomas School of Nursing is preparing 21st-century nurses to shape the future of health care and nursing while building on historic traditions of care in Catholic nursing education.

 

“What motivates me is my faith in God and knowing that what we’re doing here is truly God’s work,” she says. “We’re not given an opportunity very often in our lives to really change the future. By coming to the University of St. Thomas from Texas Woman’s University, where I first experienced the field of informatics and simulation, by bringing that knowledge here and building a program from the ground up, we’re doing something that will impact people for the rest of their lives.”