She came to this mixed medical/surgical ICU as a new graduate nurse, and has worked nonstop to improve the care of our patients. She is an outstanding clinical nurse. She can care for the sickest of our patients, she is a preceptor, and a charge nurse.  She is honest in all of her communications and does not shy away from difficult conversations. I have personally witnessed her having conversations with the families of her patients regarding the wishes of their loved ones. She is amazing at forming a relationship with the families so that they trust her. She never hesitates to bring forth safety concerns for our Zero Harm initiative, and she then actively assists with the A3. There have been many improvements in our unit because this nurse does not hesitate to speak out.

Perhaps the most amazing example of excellence in my nominee is in her work on comfort care. During the rollout of the Value Packets, this nurse spent a lot of time with her peers as they interacted with patients and families. She quickly realized there was an even bigger discomfort when nurses were faced with what to say to families regarding end-of life-decisions, as well as a gap in the knowledge of care withdrawal and comfort care. My nominee worked with ICU leadership to have nurse orientation include a four-hour shadow session at Hock Family Pavilion inpatient hospice. This has increased the comfort level with the death and dying process for nurses. Her incredible work on comfort care has improved the care of these patients across the health system.

This nurse successfully collaborated with a multidisciplinary team to create and implement a standardized comfort care order set in Maestro Care. By standardizing an order set for end-of-life care, this nurse was able to promote improved communication between nurses and providers, and encourage the health care team to follow best practice when considering comfort measures, discontinuing unnecessary tests and monitoring, and ensuring that the correct medications were available to patients transitioning to end of life. The interdisciplinary team included nursing, the ICU provider team, and the palliative care team, and the resulting order set was implemented across the health system. Following the order set’s implementation, feedback from our nursing team demonstrated a higher level of satisfaction and comfort when caring for patients at the end of life.

In her comfort care work alone, she collaborated with the Palliative Care team, DUHS Informatics, DRH ICU Intensivist group. She collaborated with Hock Hospice to coordinate ICU nurse shadowing and the Hospice nurse teaching at ICU staff meetings. She collaborated with ICU leadership to make a four-hour shadowing at inpatient Hospice a part of each ICU nurse orientation. She collaborated with DRH executive leadership and volunteer services to obtain funding for the patient blankets, and collaborated with pastoral services to arrange for volunteers from local churches to make blankets. The amount of coloration required would overwhelm a very experienced nurse, but it did not stop my nominee. If she met a roadblock, she reached out for assistance and advice and approached from a different angle.

We had a patient whose death was imminent and was an organ donor. My nominee cared for this patient  and formed a bond with the family. When plans were finalized for withdrawal of care, she promised the family she would come back to support them. The nurse who was assigned to the patient that day was rather new to the ICU and came to me to let me know how much he appreciated my nominee’s help: “She came in on her day off to be there for the family, totally fulfilling our hospital’s values of taking care of our patients and their families. She also supported me through our patient’s final day on Earth by constantly reminding me she was here for me, and reassuring me I was doing right by the patient.”

This nurse’s compassion and empathy are extraordinary, and have led to improvements in the care of patients and their families during the most difficult periods of life and even death. Her interventions have meaningfully impacted patients’ and their loved ones’ experience with end of life – and has empowered our health care team to confidently provide evidence-based, compassionate care at end of life.