May 9, 2008

Nursing’s success hinges on its people: Dubree

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Marilyn Dubree, M.S.N., R.N., delivers this week’s State of Nursing address. (photo by Dana Johnson)

Nursing’s success hinges on its people: Dubree

Making a difference, investing in nurse leadership, seeking out practice innovations and ongoing financial stewardship were key themes in this week’s State of Nursing Address, delivered by Marilyn Dubree, M.S.N., R.N., Vanderbilt Medical Center's executive chief nursing officer.

“This is a time to look back at all that we have accomplished together this past year as we look toward a bright future full of opportunities in nursing and patient care,” said Dubree.

The 45-minute speech was structured according to the five elevate pillars, but Dubree spent much of her time focusing on people — the more than 4,000 Vanderbilt nurses and health care professionals who have made nursing care a priority throughout the Medical Center and its clinics.

Dubree shared the specific story of a new mother who came to Vanderbilt to deliver her first child in the early 1990s. Although the baby did not survive, the bond between patient and nurse thrived and continued through the delivery of a healthy baby just one year later.

Dubree told the story to remind the audience to “never forget that every minute of every day one of our nurses is delivering wonderful news or devastating news, and that interaction will be remembered for the rest of our patients' lives.”

In addition to personal perspectives, the story of Vanderbilt nursing is also told in a variety of quantitative measurements. Dubree highlighted nursing satisfaction indicators showing that in national survey results (NDNQI), Vanderbilt nurses scored higher in the six major practice environment benchmarks than the expected norm for Magnet organizations. Additionally, Vanderbilt nurse turnover, at 16.8 percent, remains well below the national average of 21.5 percent and is an important driver in consistency and quality patient care.

Investment in nursing leadership was illustrated by the success of the Center for Frontline Nursing Leadership, a program for new nurse managers and leaders to cultivate their leadership abilities, and by the restructuring of shared governance into four staff nursing councils that increase participation levels and perspectives from Vanderbilt University Hospital, the Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt Psychiatric Hospital and The Vanderbilt Clinic/Vanderbilt Medical Group.

Vanderbilt's national inroads in nurse wellness were showcased with statistics of progress in the Smooth Moves patient handling system, which by latest count has saved at least 200 potential on-the-job injuries this year, and most importantly, according to Dubree, avoided what could have been career-ending injuries to nurses and other caregivers.

Vanderbilt's commitment to growth was evidenced by the graduate nurse residency program that attracted more than 500 applications from nurses in 33 states, with 215 of those candidates set to begin their residency programs in June. Dubree also emphasized her support of Vanderbilt University School of Nursing's new Doctor in Nursing Practice (DNP) degree, focusing on clinical management and practice innovation, which starts this fall.

The audience received progress reports on a variety of initiatives that address patient care, such as successful new rapid response protocols, enhancements to, and feedback opportunities for, the HED system, 90-percent scan rates in the AdminRX system and increased VERITAS II reports.

“Despite all of our collective success, we cannot do what we are doing unless we manage our finances well,” said Dubree. “We need to continue that responsibility going forward.”

A commitment to financial stewardship was demonstrated by patient care expenditures in the adult and children's hospitals that came in slightly under budget, despite growth of patient beds and observational areas in both facilities.

Looking toward the future, Dubree said, “We have everything in the world to look forward to — our roles are about inspiring patients, their families and each other to solve problems and continually provide quality results.”

Dubree said nurses are well-positioned to make the Medical Center's Vision 2020 a reality by working in new ways, getting results that matter and transferring that knowledge to society.

“I'm very proud to be a Vanderbilt nurse,” said Dubree. “Thanks to every nurse in our clinics, units and satellite locations throughout Middle Tennessee who work every day to advance patient care.”