Nursing as a Second Career

Fall/Winter 2009 Nursing as a Second Career L&D and NICU: Teamwork Makes for Healthy Mothers and Babies Residency Program Graduates First Class

Table of Contents Westchester Medical Center Westchester County Health Care Corporation Michael D. Israel, President and Chief Executive Officer Board of Directors 2 To Our Readers From the Desk of the CEO From the Desk of the Chief Nursing Officer Officers John Heimerdinger, Chair Mark Tulis, Vice Chair Joseph Tomaino, Vice Chair Emmeline Rocha-Sinha, Treasurer Susan Gevertz, Secretary Directors Richard Berman Gerard Bernacchia Claudia Edwards Renee Garrick, M.D. Herman Geist Jon Halpern Mitchell Hochberg Michael Israel (non-voting) Patrick McCoy Alfredo Quintero Steven Rogowsky John Spicer Michael Staib 3 Nursing News and Notes Alumni Reunion, Nurse Manager Class...and more 4 Switching Gears Second-Career Nurses Bring Unique Skills and Experience to WMC 7 Accelerated Nursing Program Meeting the Needs of Mid-Career Professionals Nursing at Westchester Medical Center Laura Caramanica, R.N., Ph.D., Senior Vice President and Chief Nursing Officer Editorial Board Laura Caramanica, R.N., Ph.D. Charlotte Cady, M.S.N., R.N. Mary Reiser, R.N. Mary McKiernan, R.N., M.S.N. Kara Bennorth Office of Marketing and Corporate Communications Kara Bennorth, Senior Vice President Isabel Dichiara, Director, Community Relations David Billig, Director, Media Relations Leslie Mills, Director, Editorial Information Andy LaGuardia, Director, Children s Hospital Communications Katherine Turiano, Marketing and Communications Specialist Ellen Lane, Staff Writer Benjamin Cotton, Digital Imaging Labor and Delivery nurses at Westchester Medical Center care for high-risk mothers during delivery and healthy babies in the nursery. (From L to R: Jessy Paul, R.N., Assistant Nurse Manager, Tina Kurtenbach, R.N., and Sheila Buglione, R.N.) Read more on page 9. Nursing is published by Westchester Medical Center s Department of Marketing and Corporate Communications two times a year. We welcome your story ideas and content suggestions. Please send correspondence to millsl@wcmc.com or turianok@wcmc.com. On the cover: Nursing Supervisor Ken Tuttle, R.N., B.S.N., was a U.S. Marine and then a corrections officer before becoming a nurse. Read more about him and other second-career nurses at Westchester Medical Center starting on page 4. Honor a Nurse with a Donation The holidays are a great time to make a donation to Westchester Medical Center or Maria Fareri Children s Hospital in honor of a nurse it could be a colleague, a friend, a family member or a group. The recipient of your donation will receive notice that a gift has been made in his/her honor, and you can choose to be named or give anonymously. Our Foundations are not-for-profit charitable organizations as described under section 501(c)(3) of the Internal Revenue code. For more information, contact Allison Egan at (914) 493-2722 or EganA@wcmc.com. 8 WMC Hosts First Collaborative Ed Conference A Meeting of the Minds for Area Nursing Schools and Health Care Facilities 9 Teamwork Makes for Healthy mothers and Babies Labor and Delivery and NICU Teams Collaborate to Provide the Best Care 12 Going Places WSN Alumnae Prove that Learning is a Life-Long Process Providing Many Opportunities 14 Nursing Residency Program Congratulations to Our First Class of Graduates 1

To Our Readers Nursing News & Notes From the Desk of the CEO This issue of Nursing is particularly intriguing because the various articles all relate to a common theme nursing as a career. From our first class of nursing residents, to our first- and second-career nurses on staff, to our Westchester School of Nursing alumni who show the many different directions nursing can take you it s obvious that nursing is a rewarding, challenging and fulfilling career. According to the Bureau of Labor Statistics, there are about 2.5 million registered nurses in the United States. Nursing is the largest health care profession, and just more than half of nurses in the U.S. practice in hospitals. While the shortage continues and is expected to intensify as baby boomers age and the need for health care grows, those who become nurses are increasing their levels of education with some significance each year, and the profession itself is expected to grow considerably in the coming years. At Westchester Medical Center, the wealth of knowledge, experience, education and expertise among our nursing staff is immeasurable. Nurses are essential to health care, to hospitals, to patients and I am pleased to able to work with the outstanding group we have here. Have a safe, healthy and enjoyable holiday season and a happy new year. Sincerely, Michael D. Israel President and CEO Westchester Medical Center From the Desk of the Chief Nursing Officer This issue of Westchester Medical Center Nursing spotlights Nursing as a career! People choose a career in Nursing because they possess specialized knowledge and skills and want to use these to make a difference. Unlike the still public portrayal of Nursing as a band of angels only, this issue is intended to further explore why and how nurses do what they do which is increasingly becoming more evident through research funded by Robert Wood Johnson Foundation (RWJ). RWJ s Interdisciplinary Nursing Research Initiative (INQRI.org) is generating, disseminating and translating research to understand how nurses contribute to quality patient care. Teams of researchers from throughout the nation have joined efforts to articulate this gap in knowledge. Check out this important website! And while you do so, look for newly released information on how RWJ has joined with the Institute of Medicine (IOM) to launch an unprecedented initiative on the Future of Nursing in America (futureofnursing.org). This important work will put forth a blueprint for expanded access to quality care through better use of nurses. The belief behind all of this is that the nation cannot adequately address the challenges facing our health care system without also addressing the challenges facing the nursing profession. Leaders on this committee believe that nurses are a linchpin for health care reform and will be vital to implementing systematic changes in the delivery of patient care. Become informed. Be proud of being a nurse. You make a difference. Sincerely, Laura Caramanica, R.N., Ph.D. Senior Vice President and Chief Nursing Officer Westchester Medical Center Alums Enjoy Reunion Gathering The Westchester School of Nursing held an alumni luncheon on October 3, 2009, at Westchester Medical Center. All who attended shared fond memories of their time on campus, where they lived, worked and learned while in nursing school. Thank you to our alumni for coming to spend the day with us to reminisce and be part of the continuing history of Westchester Medical Center! WSN Alumni Dutch Researchers Visit BHC Carmela Trepasso, WSN Class of 1936 Westchester Medical Center recently hosted Roland Van de Sande, MSc., Senior Lecturer and Master of the Advanced Nursing Practice Program at Hogeschool Utrecht, University of Applied Science, Faculty of Health Bolognalaan the Netherlands. Van de Sande was in the Roland Van de Sande United States along with his colleagues to present their research on nurse-led crises monitoring of aggressive patients at the International Law and Mental Health Conference. Van de Sande s study, Nurse-Led Structured Crises Monitoring Versus Clinical Judgment Effects on Aggressive Incidents and Coercive Interventions in Acute Psychiatric Practice, demonstrated that their use of a newly designed risk assessment enabled nurses to proactively identify patients who could become aggressive or violent while hospitalized. Professionals at WMC s Behavioral Health Center dialogued with the Dutch researchers as to how to apply their learning in this clinical setting. Nurse Managers Complete AONE Class Congratulations to Westchester Medical Center s Nurse Managers on completing an online class worth 40 Continuing Education Units developed by the American Organization for Nurse Executives. Through online attendance and monthly discussion groups, each manager will be prepared to receive their Nurse Manager and Leader Certification by the end of this year. Also, each manager will participate in a group Performance Improvement Project over the coming months using their knowledge from the course to address the needs of the organization. WMC Nurses Prompt Product Improvement Dale Medical has just released a new update on the product literature insert for all Stabilock Endotracheal Tube Holders. The update was added to alert nurses to pay particular attention to potential skin breakdown on the lip and area just above the lip. The changes to the Dale Stabilock ETT Holder were brought about by complaints registered by WMC nurses Kathy Longo, R.N., Kathy D Aquila, R.N. and Barbara Ward, R.N., to the Patient Safety Department. Patient Safety filed the complaint with MEDSUN and the Food and Drug Administration (FDA). As a result, changes were made to the Stabilock ETT Holder instructions. Congratulations to all three nurses for prompting a product improvement! 2 3

4 Cover Story Switching Gears Second-Career Nurses Bring Unique Skills and Experience to WMC Caring for a single patient in a quaternary care medical center today may require the services of a primary physician, specialty physician, dietitian, laboratory technician, pharmacist, respiratory therapist, physical or occupational therapist and social worker. And in the center of it all, the point person for these services, the one person who is knowledgeable about all of the patient s needs, and the person most likely to be remembered by the patient long after the care is complete, is the nurse. Forty years ago, nurses were primarily task oriented. Physicians gave orders for the care of the patient; nurses followed those orders. But times have changed. While physicians still diagnose and prescribe treatment, nurses today play a key role in managing patient care and ensuring patient safety. In today s health care environment, a nurse may recommend that a patient stay in the hospital a day longer, or call for psychiatric consult if a patient seems depressed, or be the first to detect a life-threatening change in a patient s condition. Yet, the essence of nursing the intimacy of being with patients at their most vulnerable moments remains unchanged. Given the challenges and rewards of nursing, it is little wonder that more and more mid-career professionals are turning to nursing as a second career. The ranks of second-career registered nurses at Westchester Medical Center include a former flight attendant, forester, corrections officer and horse trainer, just to name a few. Trauma Program Manager Kathy Aronow, R.N., traveled the world as a flight attendant before becoming a nurse 14 years ago. Like their colleagues, these four were drawn to the field of nursing by strong market demand, diverse opportunities and the chance to do meaningful work. As second-career nurses, they brought skills from life experiences and their former professions to the work they do today at Westchester Medical Center. As a flight attendant for United Airlines, Kathy Aronow, now Trauma Program Manager, says she often saw a look of sheer terror in the eyes of passengers as a plane prepared for takeoff. It was her job to know emergency procedures inside and out and to project an air of calm. As a nurse, Aronow says, she also sees fear in the eyes of patients and their loved ones when serious Former transportation supervisor at the U.S. Post Office in Manhattan, Eddy Pageot, R.N., B.S.N., is now a critical care nurse. illnesses or severe injuries strike. In nursing, the vulnerability of the population is greater. But in both situations you have to have ways to de-escalate emotions, and you have to be wellversed in procedures to protect those you serve. Having travelled all over the world for 16 years, Aronow says she was ready for a change after the birth of her second child. At the time, she says, the New York Times Want Ads were filled with positions for nurses, something that hasn t changed since she made the switch 14 years ago. In fact, the Bureau of Labor Statistics predicts the need for more than one million nurses to meet growing demand by 2016, while other industries are downsizing. The nursing profession also offers lifestyle benefits like flexible working hours, tuition reimbursement and the ability to find positions all across the country that many second-career professionals find attractive. I feel fortunate to have had two very rewarding and enriching careers, says Aronow. I worked as a flight attendant during the heyday of air travel and came to nursing at a time of tremendous advancement in medicine. As Trauma Program Manager, Aronow maintains the trauma registry, using statistical analysis to drive performance improvement programs. She also monitors care of in-hospital patients, serves as a resource for clinical practice and engages in community outreach aimed at reducing the incidence of serious injury. One of the most rewarding aspects of nursing, Aronow says, is that today s nurses are true members of the multi-disciplinary team with clinical expertise and technical skills that are valued. The bar has been raised for the profession as a whole. As professional members of the health care team, nurses relieve pain, coordinate care, share in decision making and management of a patient s treatment and advocate for disease prevention and healthy lifestyles. To ensure the safety and quality of care provided, nurses employ evidence-based practices, use information technology to its fullest, prevent adverse medical events and prepare the next generation of nurses for the future. Jeremy Arnett, R.N., says his experience as a forester has served him well as a nurse in the Cardiothoracic ICU. As a forester in California, Jeremy Arnett was often on his own in the wilderness for a week or more at a time. It was his job to identify tree species, core trees to determine their ages and assess fuels on the ground in order to determine which areas needed to be thinned to prevent forest fires and which areas were best for logging. With many tasks to complete on a tight deadline, Arnett had to be a self-starter, capable of making decisions on his own, setting priorities and responding to emergencies. These days, as a nurse in the Cardiothoracic Intensive Care Unit, Arnett says his independence, decisiveness and ability to respond to emergencies serve him well. Nurses have a great deal of autonomy in the Cardiothoracic ICU, says Arnett, who has worked in the unit for two of his three-and-a-half years as a nurse. When patients come from surgery, we work with the physician s assistant to recover the patient, per protocol. We can wean them off the ventilator and Ken Tuttle, R.N., M.S.N., made the move from Westchester Department of Corrections to Nursing at Westchester Medical Center in 1995. extubate patients, per protocol. It is one of the most challenging units in the hospital. Arnett says he also enjoys the challenge of mastering all the technology connected with cardiothoracic patients, including those who must be maintained on Ventricular Assist Devices. When you are caring for a patient who is being kept alive by a VAD, your awareness heightens and all your skills are being used. We ve had patients like that who have turned the corner and come out of it fine that s rewarding. As Aronow and Arnett illustrate, nurses defy description. There is no neat, one-size-fits-all definition of a nurse because the field of nursing is so diverse, offering opportunities in every area of health care. At Westchester Medical Center, for example, nurses provide advanced care for 640 patients a day; conduct clinical research; create new and improved protocols to reduce morbidity and mortality; and serve as top administrators. You can do anything with this career, says Harriet Feldman, R.N., Ph.D., F.A.A.N., Dean of Nursing at the Lienhard School of Nursing at Pace University. If you love people and want to stay at the bedside, you can spend your entire career working directly with patients. You can specialize in one area of medicine or become a nurse practitioner. Or, you can go into administration or nursing education. When he was studying to become a nurse, Ken Tuttle, a former corrections officer, says, I took a lot of ridicule from my colleagues in corrections who didn t see nursing as a man s job. But things have changed since then, and I ve recommended nursing to a number of men at the Corrections Department. They can see now that it is a great profession because it has so many applications and offers many opportunities for advancement. Tuttle is himself a case in point. A former U.S. Marine, Tuttle came to nursing as a result of a personal experience. continued on page 6 5

Cover Story continued from page 5 He was working as a corrections officer in 1981 when he was diagnosed with chronic myelogenous leukemia (CML). He underwent a successful allogenic bone marrow transplant then a new and experimental procedure at Westchester Medical Center. When I was having the transplant, I wasn t sure if I was going to live, Tuttle says. I saw how great the nurses were and thought they were doing something really special. So, I prayed to God and promised that if I survived I would give nursing my best shot, even though I never had been a very good student. Tuttle had five years of follow-up treatment with radiation and chemotherapy but eventually made good on his vow and went back to school for nursing. In 1995, he made the move from Westchester s Department of Corrections to Westchester Medical Center. By 1999, Tuttle had his bachelor s degree in nursing from SUNY New Paltz, and in May 2004, he graduated with a master s in science degree in Family Nursing. Erica Dretzin, R.N., B.S.N, who made the switch from veterinary technician to pediatric nurse, was recently honored with a DAISY Award. Ive Francis, R.N., taught school for several years before studying nursing and becoming a member of the overnight team in our Cardiothoracic ICU. For the past four years, Tuttle has served as a Nursing Supervisor, a position that requires oversight of more than 40 clinical staff as well as a great deal of collaboration with physicians, patients and families. In addition to collecting data and problem-solving, Tuttle serves as resource for nurses in the areas he oversees. Like Tuttle, many nurses serve in leadership positions today. Nurses are also more involved in elected and non-elected positions charged with making and shaping health care policy. Most recently, Mary Wakefield, R.N., Ph.D., F.A.A.N., a nurse from North Dakota, was designated by President Obama to be the new head of the federal agency charged with improving health care, the Health Services and Resources Administration. Of course, when all is said and done, it isn t the lifestyle benefits or the leadership opportunities that keep nurses in the profession. It is the art of nursing that Lisa Palmieri, R.N., B.S.N., became a nurse five years ago after two decades as a hair stylist/cosmetician. unique combination of medical expertise and compassion that enables nurses to make a difference in people s lives every day. Erica Dretzin s first love was horses. After owning a small horse farm in Michigan, Dretzin moved back to New York and went to work as a veterinary technician, a position that allowed her to continue working with horses and care for small animals. But, she says, there was little room for professional growth in that field. I decided to go to nursing school because I had always been interested in medicine, says Dretzin, who received her BSN from Pace University. The nursing field is so highly in demand. You can make a difference in people s lives and have a stable financial path. Dretzin, a pediatric nurse at WMC for eight years, is obviously good at what she does, having been honored as a DAISY Award Winner for exceptional nursing. Like other secondcareer nurses, Dretzin has no trouble finding parallels between her previous work and her life as a nurse. As a pediatric nurse, you have to be a keen observer of signs and symptoms because small children, like animals, can t tell you what is wrong, she says. But what I find most rewarding is the unspoken communication between patient and nurse, when a child takes you into his world. You have to have tenderness to forge a relationship with a sick child. Accelerated Nursing Programs Meet Unique Needs With the Bureau of Labor Statistics predicting the need for one million nurses to meet growing demand by 2016, and the economy forcing cutbacks in many other industries, more and more people are considering a career change to nursing. For many mid-career professionals who do so, the most efficient path to their career goals can be an accelerated degree program. The most successful accelerated students are bright, inquisitive and sophisticated consumers of higher education who actively pursue learning opportunities, says Harriet Feldman, R.N., Ph.D., F.A.A.N., Dean of the Lienhard School of Nursing at Pace University, which has offered a Combined Degree Program since 1984. As adults, these students tend to know what they need and aggressively pursue programs that best meet their needs: fast-tracked, competitive, and well respected. Nationwide, accelerated degree nursing programs have seen an increase in enrollment. According to the most recent numbers from the American Association of Colleges of Nursing (AACN), 10,000 students enrolled in accelerated baccalaureate programs in 2007, a 21 percent increase over 2005 enrollments. Accelerated programs are also proliferating across the country. In 2008, there were 205 such programs, compared with 31 in 1990, according to AACN. Pace s Combined Degree Program offers students who already have a bachelor s degree the opportunity to complete a Bachelor of Science in Nursing (B.S.N.) coupled with an optional Master of Science or Master of the Arts in their chosen specialty in as little as two-and-half-years. For students who already have completed the science prerequisites, the bachelor s degree can be completed in one year. Of course, accelerated programs aren t the only route to a career in nursing. Some students may choose to obtain an associate degree in nursing (A.D.N.) at a community college, which will prepare them for the licensing exam as a registered nurse. From there, many nurses pursue bachelor s and master s degrees while working. As a result of its success, Pace s Combined Degree Program has been awarded grants from the Robert Wood Johnson Foundation for the past two years to support scholarships for deserving students. Each year, 12 students are awarded $10,000 scholarships to defray the cost of tuition and related expenses. Martha Greenberg, R.N., Ph.D., who chairs the Combined Degree Program at Pace, says students come to nursing as a second career for many different reasons. Some are seeking greater job satisfaction. Some want the stability of working in a field in which demand exceeds available applicants. Still others come to nursing with a lifelong passion that was deferred earlier in their careers for personal reasons. We have professionals from marketing, theater, art, history, social work, graphic design and education, says Greenberg. They are now finally finding their passion. One student was in medical school, but what she really wanted was to be a nurse. Students pursuing a second degree tend to be highly motivated and focused, says Greenberg. They come prepared for classes and expect their professors to be experts. As a group, second-degree nursing students are also more likely to pursue advanced degrees. Greenberg says she is not surprised that so many people turn to nursing as a second career because it is such a diverse field. Everyone in nursing can find their niche whether it is at the bedside, in administration or in research, she says. There are many different areas of nursing and a variety of great opportunities. 6 7

Education WMC Hosts First Collaborative Education Conference (Above) Nearly 30 health care professionals attended the Collaborative Education Conference. (Left) Mary McKiernan, R.N., M.S.N., played a key role in organizing the conference. that goes on now, which creates more work for people who are already trying to accomplish this task under pressure. Teamwork Makes for Healthy Mothers and Babies From Door to Delivery to Nursery or NICU, Our Nurses Ensure a Complete Continuum of State-of-the-Art Care for this Special Group It took more than a single doctor or nurse to bring Michael into the world. In fact, it took the skill and expertise of two teams of nurse and physician specialists from the Labor and Delivery unit at Westchester Medical Center and the Regional Neonatal Intensive Care Unit (NICU) at Maria Fareri Children s Hospital. Together, these two units work seamlessly to ensure the best possible outcomes for high-risk pregnant women and their often fragile newborns. Nurses in both units possess a depth and breadth of knowledge not found in ordinary Labor and Delivery units or community hospital nurseries. Feature Story Newborn Nursery. Our nurses care for women with diabetes, hypertension, premature labor, toxemia, cardiac and renal problems and other pre-existing medical conditions, as well as women whose babies have been diagnosed with anomalies in utero. The key to providing the best care for this diverse patient group is collaboration. Instead of functioning as two separate units, we function as two very large, cohesive services that work together as a team, says Sue Malfa, R.N., Nurse Manager of the NICU. This fall, Westchester Medical Center hosted the first of what organizers hope will be a regular series of meetings between the region s nursing schools and health care institutions. The Collaborative Education and Service Conference brought together representatives from Westchester Medical Center s affiliated nursing schools, hospitals and long-term care facilities, as well as the clinical partners of those affiliates. The agenda included a presentation on a centralized clinical placement project used in Massachusetts and an open discussion of developing a universal medical clearance form for nursing students. If we can standardize both the process and the forms, it certainly would make placements easier, says Laura Caramanica, R.N., Ph.D., Senior Vice President and Chief Nursing Officer at Westchester Medical Center. I have seen the sheer amount of paperwork and telephone tag The centralized system in Massachusetts, as described by project leader Marie Tobin from the state s Department of Higher Education, is a Web-based program that matches nursing students with clinical placements. Nursing school faculty can post details on students looking for placement, and health care institutions then can respond based on their needs (see www.mcnplacement.org). At the end of the day, what all of us want is to provide nursing students with the best experience possible, says Mary McKiernan, R.N., M.S.N., Vice President of Nursing Quality and Education at Westchester Medical Center. So the overall goal of this conference was to assist facilities with clinical placement for their students and to foster a greater sense of collaboration among the groups involved. Westchester Medical Center leaders would like to see the gathering become an annual or semi-annual event, noting that deans and directors in Massachusetts and Connecticut have such a formal meeting schedule. It s a good way to bring up major issues and form development teams to address them together, Caramanica says. Once you re having the conversations, there are many directions you can take. Like Michael s mother, 80 percent of the women who deliver at WMC are considered high risk for complications. They are referred to WMC s obstetrics service so their pregnancies can be managed by high-risk specialists, and their babies can be cared for in the NICU if needed. The remaining 20 percent of women who deliver at WMC are underserved, working poor, some of whom have received little or no pre-natal care. The obstetrics service cares for a group of highly complex, diversified patients, says Kerry Terminello, R.N., B.S.N., M.S., Nurse Manager of Labor and Delivery, Inpatient Maternity and Examples of teamwork abound: in the morning conference, in the delivery room and in the constant flow of communication among all members of both units. The morning conference, for example, brings together attending physicians, residents, nurses and nurse practitioners from Labor and Delivery and a neonatologist from the NICU to develop management plans for each patient in Maternity and Labor and Delivery. During morning conference, says Howard Blanchette, M.D., Director of Obstetrics and Gynecology, the charge nurse informs the physicians about any additional patient information 8 NICU nurse Lydia Delau, R.N. (left), discusses patient care with Sue Malfa, R.N., Nurse Manger of the NICU. (L to R) Donna DiLeo, F.N.P., and medical students Jayne Bird and Monique Gardner round with Howard Blanchette, M.D., Director of Obstetrics and Gynecology at WMC. 9

Feature Story for those who come in on an emergent basis, also reporting on subtle but important changes in patient condition. Maternity and Labor and Delivery nurses are very astute at monitoring fetal heart rate in relation to the mother s uterine activity, says Terminello. They are able to interpret those readings and can mobilize the entire OB team very quickly for the benefit of the mother and baby when necessary. For his part, Dr. Blanchette says, It is not uncommon for the physician to be called by a nurse, who not only recognizes that a mom or baby is in trouble, but diagnoses the problem and knows what must be done in response to it. Of course the greatest excitement, and most obvious collaboration, is in the delivery room. The delivery room is where everything is happening, says Malfa. A newly renovated private room in L&D. If a mother delivers by cesarean section, the Labor and Delivery team includes the circulating nurse who oversees everything in the room, an obstetrician, a labor nurse, an anesthesiologist and a scrub technician. The NICU team includes the neonatologist, a neonatal nurse and a respiratory therapist. Our NICU team cares for the sickest and tiniest babies in the region. In addition to all the technology in the room, NICU nurses and physicians are using their eyes, ears, nose and fingers to feel and assess what s going on. We are completely focused on the baby that is about to be born and what that baby needs, says Malfa. Everyone has a job to do. WMC recently cut the ribbon on a newly renovated Labor and Delivery suite. Shown L to R: Phyllis Lynch, surgical technician; Kerry Terminello, R.N., Nurse Manager; Theresa Clymer, unit clerk; and Adeline Maglione, R.N. If a baby needs to be resuscitated, for example, a nurse and respiratory therapist would warm the baby and establish an airway to prevent metabolic and respiratory acidosis, while the physician or nurse practitioner intubates the baby. If the baby needs further resuscitation, the nurse would provide chest compressions and medications to stimulate the heart. In the midst of all of this activity, both teams are very conscious of preserving as much of the beauty of childbirth as possible for the mother. It is a very emotional time and part of our mission is to find something positive to give the parents in that delivery room, says Malfa. Even if the baby needs to be resuscitated, we ll say, You have a beautiful baby girl or boy or we ll talk to the baby because these are things that parents remember. Lize Mirditaj, R.N., who has been a maternity nurse for 10 years, says, It s an exciting place to work. I have the opportunity to use my medical-surgical knowledge and skills as well as my obstetrical skills because many of our mothers have complex medical conditions. When it comes to detecting problems, I rely on that knowledge and the gut instinct that comes from experience. From the moment a pregnant woman is referred to the obstetrics service, communication between Labor and Delivery and the NICU is constant. Labor and Delivery nurses call for a NICU consult if they have any concerns about fetal issues or the health of a baby in the well-baby nursery. They also brief NICU staff on all mothers whose babies are likely to need special care after birth. As a result, a neonatology fellow does an in-depth consult upon admission and the NICU team has an opportunity to meet with the mother and family before the birth. We ll provide them with a guided tour of the NICU, talk about the delivery process and try to ease any fears or concerns they may have, says Malfa. All of this helps us plan for the delivery and makes it less stressful for the mom. Lize Mirditaj, R.N. (left), pictured with Tina Kurtenbach, R.N., says she has the opportunity to use a wide range of nursing skills as a maternity nurse. Jean Horvath, R.N., a Labor and Delivery nurse, says one of the benefits of WMC s high-risk obstetrics service is the continuity of care patients receive. It s a comprehensive program, so the same nurse is with the mother during pre-operative, intraoperative and post-operative periods, says Horvath. We get to help them through an experience that some might feel they otherwise couldn t handle. Medical student Jayne Bird (left) assists Labor and Delivery nurse Jenny Tronchin, R.N. 10 11

WSN Alumnae Profile Going Places Two WSN Alumnae Prove that Learning is a Life-Long Process and You Never Know Where It Might Take You Patricia Haynor, R.N., Ph.D., 2009 Patricia Manzi Haynor, 1965 The Westchester School of Nursing was known for training skilled, compassionate nurses who were comfortable working with the most high-tech medical equipment. But the program also has been a leaping off point for graduates to pursue advanced degrees, research opportunities and certification in a variety of specialties and subjects. Just ask Patricia Haynor and Margaret Peggy Bruno, who graduated from the school in 1965 and 1976, respectively. Haynor now holds a doctorate in nursing education and works as an Associate Professor at Villanova University outside Philadelphia. Bruno is a certified nurse-midwife at a busy obstetrics and gynecology practice in Florida and has delivered about 1,300 babies over the course of her career. I ve always believed that education as a nurse opens up a lot of doors, Haynor says. It s wide open a career only limited by your own imagination and your willingness to take a risk. There s always something new you can do, and looking back I can see that my time at Westchester really prepared me for further studies. Haynor recognized the benefits of a career in nursing even at a young age. The oldest of six siblings, she would play the role of nurse when her siblings pretended to be soldiers. There s so much variety, flexibility and challenge, and it is a well-respected profession, she says. You re always learning. But even Haynor had no idea where her studies would take her. After two years as a staff nurse and nurse manager, she decided that to make changes she and other nurses wanted at the bedside, she would have more power as an administrator. That meant she needed more education, which has included a master s degree in nursing administration and medical-surgical nursing and MBA courses. She has held a variety of administrative positions in nursing departments. Still, Haynor s career had another unexpected twist. After finishing her doctorate while a chief nursing officer, she had what turned out to be a life-changing talk with a colleague, a dean at the University of Delaware. At the time, Haynor was a mother of two and about to marry a man who also had two children adding up to four teenagers under one roof. My colleague pointed out that teaching would give me more flexibility and time with my family, she remembers. She was very encouraging. She actually brought me to meet faculty and administrators at Delaware. It got me thinking about how I could have an impact on future nurses. Eventually, I accepted a faculty position at Delaware and began their nursing administration program. At Villanova, Haynor teaches both undergraduates and graduate students in nursing administration and leadership programs. She has drawn constantly on her training as a nurse. It helps with time management, focus and being open to continuously learning, she says. Her faculty position also has given her the opportunity to teach in Barcelona, Spain, and the Sultanate of Oman, an Arab country in southwest Asia. It has been an amazing journey, she says. The most important message for nursing students to receive, Haynor says, is that they re all leaders. When I hear people say, I m just a nurse, I want to shake them, she says. I wish they saw how important they are in the health care hierarchy, no matter what their position. They influence other people to attain a goal that is important to them. Think about teaching the diabetic how to lead a better life and care for himself. Teaching is part of what a nurse does every day. Margaret Bruno, R.N., C.N.M., A.R.N.P., Peggy Bruno agrees. Her education at Westchester and years as a nurse in several specialty areas also taught her the immeasurable value of connecting with patients touching them, asking questions, listening to them and looking beyond the data from high-tech equipment they may be using. Nursing taught me everything, says Bruno, who was known as Peggy Kellerman in nursing school. You never lose what you have learned as a nurse. After graduating from the Westchester School of Nursing, Bruno worked in medical-surgical and intensive and critical care units. In 1993, she began in obstetrics for the first time at a hospital in New Jersey. She fell in love with the specialty but was frustrated that she couldn t deliver babies herself. I absolutely knew that I wanted to be a midwife, she says, and I knew I could do it. Part of Bruno s passion for midwifery was fueled by her experiences in childbirth. She used a midwife when delivering her third child and liked the approach. For a midwife, pregnancy and labor are natural processes, not an illness, she says. It is a positive experience. Bruno completed a 15-month national certification program at the University of Medicine and Dentistry of New Jersey. She worked for a family practice and an OB-GYN practice in New Jersey before joining the Florida office about two years ago. That practice, with four doctors and four midwives, is in an underserved area and regularly treats very young mothers. Pregnancy at 14 isn t uncommon, and Bruno once delivered a 10-year-old s child. It can be a challenge, but I love my work, she says. You have to love it, with the crazy hours and how messy it can be. I have a chance to give women personal care and confidence in their bodies. I help them believe they can do it. Like Haynor, Bruno is certain that she wouldn t be as successful in her field without her nursing education and experience. I m a very good midwife, she says, without ego but with pride. Without a question, I would tell others to go into nursing and see where it takes them. It is an awesome background to have. 12 13

Department of Marketing and Corporate Communications 110 Executive Offices Valhalla, NY 10595 www.worldclassmedicine.com Non-Profit Org. U.S. Postage PAID Permit No. 9523 White Plains, NY Nursing Residency Program Graduates First Class It helped me prioritize my responsibilities It was comforting knowing my fellow nurses were experiencing similar situations It gave me the confidence to be a better nurse Co-Coordinator of the program. That s significantly higher than the 50 percent retention rate for new nurses in hospitals that do not have a nursing residency program. What s more, Jordano-Smith says she expects the retention rate to improve even further over the next two years as the residency program becomes firmly established. The success of the program can be measured in other ways as well. You can see the level of confidence and clinical judgment skills being developed earlier in residency nurses as compared to nurses who didn t have the opportunity to do this, says Mary McKiernan, R.N., M.S.N., Vice President of Nursing Quality and Education. Those were just a few of the things recent graduates had to say about Westchester Medical Center s new yearlong nursing residency program. Launched in September 2008, the program is designed to support recent nursing school graduates as they transition from entry level to competent professional nurse. Spurred by concerns of a nationwide nursing shortage, the program was created by the University Health System Consortium in collaboration with the American Association of Colleges of Nursing (UHC/AACN). WMC is one of about 50 academic medical centers nationwide to offer the UHC/AACN program. Having graduated 49 of the 56 nurses this fall who began the residency program last year, Westchester Medical Center had a retention rate of 87.5 percent, says Peggy Jordano-Smith, R.N., Nursing Staff Development Specialist and The goal of the program is to help new nurses develop critical thinking, communication and leadership skills while incorporating evidence-based practice and improving patient safety. Compared to the previous education model, nursing residents participate in a longer preceptorship and meet regularly for seminars on such topics as nurse-sensitive patient outcomes, pain management, conflict resolution, ethical decision making and time management. To put some of their new knowledge in practice, nurse residents prepare evidence-based projects during the second half of the residency program. Seventeen projects were presented by the first cohort of residents.