NICU gets the Magnet word out to staff
Communication, with patients and between staff members, is the cornerstone of Magnet Recognition efforts in the NICU. Here, Bonnie Parker, R.N., right, visits with 8-month-old Tanner Roberson and his family, parents Jimmy and Patty and brother Jay, when they returned to the unit for a social visit.
Photo by Kats Barry
Across Vanderbilt University Medical Center, units are preparing for the Magnet Recognition site visit in September.
The American Nurses' Credentialing Center (ANCC) appraisers will be looking for departments that are energized, team-oriented and dedicated to top-quality patient care — exactly the traits they will find at the Monroe Carell Jr. Children's Hospital at Vanderbilt Neonatal Intensive Care Unit (NICU).
“We have some of the most wonderful nurses in the Medical Center on our unit, and we're looking forward to showing the appraisers what we do,” said Marlee Crankshaw, M.S.N., R.N., NICU manager.
The NICU is one of the largest units in the Medical Center. It comprises the entire fourth floor of Children's Hospital, with a total of 71 beds divided among eight pods.
This is the place where premature babies (less than 37 weeks gestation) receive treatment for respiratory, cardiac and surgical issues. The 200-plus nursing staff serves multiple roles as health care practitioners, social workers, and, in some cases, surrogate care givers to the most critically ill. The unit sees nearly 1,300 babies a year, and its patient survival rate is consistently in the 94 percent to 96 percent range.
Managing such a large unit is full of challenges, and communication is the key to success. During the past year, NICU managers have focused on how to improve communication to nurses and even to patients' families. They have found some success in using several vehicles to reach staff and receive input.
In January, the NICU hosted its first all-day retreat. The management staff booked a conference room from 5 a.m. through 8 p.m., provided meals and encouraged staff to share thoughts about strengths, improvements and the unit's vision. More than half the staff participated. The managers received valuable feedback ranging from suggestions for improving the employee lounge to increased supplies needed in the 10-bed NICU in Vanderbilt University Hospital's Stahlman unit, which accepts NICU admissions from the delivery rooms.
Since NICU nurses typically work three-day shifts, keeping current can be difficult. Crankshaw compiles a weekly update that is e-mailed to all staff on Fridays. It contains letters from patients, procedural information and general news. Instead of getting barraged with e-mails throughout the week, all the pertinent information goes into this one weekly communication. The comprehensive approach has been so successful that collaborating areas such as respiratory, pharmacology and other health practitioners have asked to join the list.
“There are so many different levels of experience and work schedules here, but we all have to be on the same page,” said Katie Carter, R.N., NICU staff nurse and member of the Magnet escort team. “It brings us together and reminds us that we are really the NICU family.”
Inspired by elevate, NICU staff have recently starting rounding with patients' parents and family members. The five-person management team's goal is to introduce themselves to each patient's family within the first few days of a baby's admission to the unit. Crankshaw said the results have been amazing.
“We want to start a relationship with every new admission,” said Crankshaw. “By making the extra effort to meet each new family, we can really make a difference.”
The NICU managers are constantly looking for ways to further motivate their staff and increase the level of communication. The unit uses a jam-packed “Kudos” board where anyone can post compliments, hosts “Meet the New Hire” lunches and also distributes a separate newsletter written by staff.
“We think communication is the key to success,” said Crankshaw. “We want people to bring their babies to Vanderbilt, because our nurses are the cream of the crop.”
“I am in love with the NICU and am excited about showing the unit to the appraisers,” said Carter. “I've been here two years and get to learn from nurses who have been on this unit for more than 30 years. It's true the babies are cute and sweet, but they're also very sick. Every day at the NICU, there are miracles.”