VA Nurse Executive Valerie Rodriguez-Yu serves on the executive leadership team at the 567-bed South Texas Veterans Health Care System.
For more than 10 years, Valerie Rodriguez-Yu, MSN, RN, NEA-BC, has served in nursing positions at the U.S. Department of Veterans Affairs (VA). She is now Associate Director for Patient Care Services/Nurse Executive (ADPCS/NE) at the South Texas Veterans Health Care System, after being in the deputy role for three years. Based in San Antonio, Rodriguez-Yu is a key member of the executive leadership team, serving as senior nurse adviser and consultant, responsible for areas such as Nursing, Social Work, Sterile Processing, Chaplain Services, Recreation Therapy and Nutrition/Food Services for the South Texas system.
In this installment of #ChooseVALeadership Careers and #FemaleLeaderFridays blog series and as VA prepares to attend the American Organization of Nurse Executives annual meeting in April (find us at booth 132), Rodriguez-Yu explains her role as nurse leader and why she chose a VA career.
What is your primary job at VA?
I serve on the executive leadership team and as a senior adviser and consultant for the South Texas Veterans Health Care System, which is an active ambulatory care program with multiple outpatient clinics. The system is comprised of the Audie L. Murphy Memorial VA Hospital, Kerrville VA Medical Center and the Satellite Clinic Division. We are a 567-bed facility providing primary, secondary and tertiary health care in medicine, surgery, psychiatry and rehabilitation medicine. We have a Community Living Center, Spinal Cord Injury Center, Bone Marrow Transplant Unit, Polytrauma Rehabilitation Center, and a Geriatric Research, Education and Clinical Center.
How long have you been in this particular job?
I started my VA career in 2003 as a Registered Nurse at the VA San Diego Healthcare System. In 2005, I relocated to Alexandria, Virginia, where I managed a Brain Injury Unit. I returned to VA in 2008 to serve as the Outcomes Coordinator for the Spinal Cord injury Center in San Antonio. In 2010, I was elected Associate Chief Nurse for Polytrauma/Spinal Cord, where I was responsible for nursing services within the Polytrauma System of Care and Spinal Cord Injury Center. In 2015, as Deputy ADPCS/Nurse Executive, I oversaw more than 1,300 full-time bargaining unit employees, guiding the overall management of the profession and practice of nursing. In 2018, I was promoted to ADPCS/NE.
What was appealing about a career at VA?
As the spouse of a retired Marine, I was driven to the mission of caring for our nation’s heroes. Additionally, as a nursing student, I had several clinical rotations at VA. I was so impressed with the teamwork and mutual respect among all disciplines. When I graduated from nursing school, working for the VA was an obvious choice. I wanted to be part of the elite VA team!
What is the most rewarding part of your job?
The most rewarding part of my job is hearing about the experiences of our Veterans and staff. The Veteran’s perspective reaffirms that VA is the best place for our Veterans to receive care. Also, when I observe how empowered and forward-thinking our frontline nurses are, it really makes me proud to work at the South Texas Veterans Health Care System.
How has VA helped you grow in your career?
VA has been instrumental in my career development. From mentorship programs to executive leadership development programs, VA has been influential in my professional success. I am supported through conference attendance, detail opportunities, Pathway to Excellence Program participation and succession planning. There are several dedicated programs that have facilitated my professional advancement. VA invests in its employees and encourages nurses to build a lifetime of experiences so that we can provide the best care to our Veterans. (Learn more about leadership opportunities for VA nurses in the Office of Nursing Services.)
What are a few key benefits of working at VA?
Some key benefits include an impressive amount of paid time off, the Federal Employees Retirement System, Thrift Savings Plan and, one of my personal favorites, the benefit of making a difference in the lives of our Veterans.
What do you find most surprising about working at VA?
The most surprising thing for me was how well-respected nursing is among our physician peers. I have worked in organizations outside of VA, where the dynamics were very different and where nurses did not necessarily have a voice. VA is very collaborative!
What story do you most often tell people about your work?
I most often tell people that I love working for VA because when a Veteran needs something, VA does everything in its power to make it happen. When the Veteran is at the center of all that we do, you can never go wrong.
What would you tell other nurse leaders interested in choosing a career at VA?
Drown out the “noise” and hearsay about VA. Come work with us, and I promise you will find that we are innovative, that we embrace evidence-based practice and that we provide outstanding care. All those things make VA a great place to work.
What else would you like us to know about your work?
My career at VA is fulfilling, and I have felt supported in every role. I am respected and valued as a member of the executive team. VA values align with my own, and it is rewarding to be among the best places to work, where everyone is willing to give a little extra to get the job done.
This story was originally posted on VAntage Point.
One of the most intense, yet most rewarding experiences in the field of nursing can be found in a place you may not expect: the neonatal intensive care unit (NICU). A day in the life of a neonatal nurse is never the same day twice, with patients ranging from babies who are born mostly healthy to those born with complications. It’s a profession with struggles, but the little victories that make them worthwhile.
In this article, we’ll take a look into the lives of neonatal nurses to find out what exactly their job entails, what it takes to get there, and how you can get started on the path to working in the NICU should you decide it’s the right career path for you. If you’ve ever wondered, “What is a neonatal nurse, and what do they actually do,” then read on.
THE DAY TO DAY JOB OF A NEONATAL NURSE
There are four different levels of care in a hospital’s neonatal unit, and a neonatal nurse could be assigned to any one of them, or work multiple levels. The first is the nursery, where healthy, full-term babies go until their parents can take them home from the hospital. Levels two through four are organized in escalating order of severity, with level four housing the most serious cases.
Level two is for babies who were full term but have fallen ill, infants born on the latter end of preterm but still early, and those with more minor health issues. Three is where infants born very prematurely, with major respiratory issues, or with defects. Level four is where babies born with major chronic issues requiring sustained care are placed. Some smaller hospitals will only have levels one and two, and then transfer more serious cases to larger and better-equipped facilities, while some can house all levels of care. In all cases, the duty of the NICU nurse encompasses both care for their infant patients and assisting the parents emotionally coping with the situation.
Kathleen Colduvell, a NICU nurse with a decade of experience under her belt, described the highs and lows of the job — the emotional toll it takes and the reward of seeing a patient make it through — on a blog entry for a nursing website:
“Even though there has been more heartache than I care to remember, the success stories make every single minute of my shifts worthwhile. We fight to help our patients breathe on their own, take bottles independently, and achieve their developmental milestones, and that is such a reward.”
A neonatal nurse’s shifts are often 12 hours long, and at variable times, as their tiny patients often need round the clock care. The babies are fed every three hours, and the nurse will often conduct any testing or procedures like blood draws during feedings to make sure the infant can spend the majority of their time on rest and recovery. The amount each baby can eat needs to be monitored and adjusted according to their condition, vitals need to be checked, and a plethora of other variables need attending to for each patient. In addition to these duties, a NICU nurse will often end up helping the babies’ families, explaining care and procedures to them to keep them informed.
A common saying in the nursing world, and to which the NICU is no exception, is that “there is no typical day.” Neonatal nurses have to be close by their patients to lend them the best possible care, especially since babies can’t articulate what may be happening with them. Anyone who describes the job will tell you it can be challenging, but also that they love it and wouldn’t want to be doing anything else. One nurse described helping parents care for their child for the first time as especially rewarding:
“…there are a thousand amazing great things about being a NICU nurse. You can be the first person to help a mom see, touch, or even hold her fragile little preemie. You get to help people become parents for the first time and do ‘normal’ parent things like change diapers for the 1st [sic] time while working alongside an oscillator and IV pumps. We facilitate all those early and important bonding tasks, regardless of the baby’s acuity, there’s always something the parents can do and we get to show them that.”
JOB OUTLOOK AND REQUIREMENTS FOR NEONATAL NURSES
In order to specialize in neonatal nursing, you need to already have completed a Bachelor of Science in Nursing (BSN) degree. After that, two or more years of experience working with neonatal patients and a passing score on the certification exam for neonatal nursing must be completed. Areas of care recommended for gaining those years of clinical experience include:
- Labor and delivery nursing
- Maternal-child nursing
- Pediatric nursing
- Well baby nursing
There are two main routes candidates for a neonatal nursing job usually take to become certified: a critical care neonatal nursing certification (CCRN) via the American Association of Critical Care Nursing, or an RNC Certification for Neonatal Intensive Care Nursing (RNC-NIC) via the National Certification Corporation. If you wish to further certify to gain a leg up on the competition and increase your job prospects, you can choose to get one of the following certifications:
- Advanced Cardiovascular Life Support (ACLS) certification
- Basic Life Support (BLS) certification
- Neonatal Resuscitation Program (NRP) certification
Nurses can pursue some or all of the above to reinforce their professional tool kit. Continuing education programs through accredited providers like the National Association of Neonatal Nurses (NANN) are also necessary to remain at the top of your game as you progress along a career path in the NICU.
The Bureau of Labor Statistics (BLS) predicts a rise in demand and a healthy job outlook for the nursing field as a whole over the next decade, and that demand will be even higher for nursing professionals in specialized fields. As a large portion of the nursing workforce nears retirement, more will need to be recruited to replace them. The median salary for a registered nurse is around $73,500 according to the BLS, but respondents on Payscale report an average salary of $97,306.
HOW YOU CAN TAKE THE NEXT STEP
At D’Youville Online, we’ve designed our online RN to BSN program with working nurses in mind, to let you gain the knowledge and skills necessary for the next level of your career on your time. Our courses run the gambit from evidence-based practice to enhancing patient outcomes, and you can complete the clinical component of the program where you already work.
Our program is CCNE accredited and taught by passionate, highly-educated professionals actively working in the field of nursing. A rolling admissions policy means you can sign up when you want, and the program can be completed in as little as two years. If you’re ready to advance yourself and your career visit our website for a detailed breakdown of courses and credit hours required.
This Sponsored Post is brought to you by D’Youville College.
Arizona State University is helping more students pursuing health-related degrees to marry their knowledge and curriculum with entrepreneurship, in order to help them forge stronger paths in their healthcare careers. The ASU Health Entrepreneur Accelerator Lab (HEALab) program helps teach students to think up new solutions, design a business model, and apply to the ASU Venture Devils Program for further mentorship and funding.
While their Tempe campus has hosted their business,
engineering, and design schools for a long time, the health-centered colleges are
based in the downtown Phoenix and West campuses. Combining the resources and
strengths from these schools and ASU’s office of Entrepreneurship and
Innovation creates opportunities for nursing and health students pursuing their
bachelors and masters degrees, both in the classroom and in the workplace.
From Classroom to Competition to Career
Students are already showing major successes from the program, as shared by the Phoenix Business Journal. Ramona Ramadas, who has been pursuing her Masters in Healthcare Innovation through ASU’s online courses, recently competed in the Nurse-Pitch competition at the 2019 Healthcare and Management Systems Society conference and placed third. Her startup, New Trails Navigators, is an AI-driven platform designed to train newly incarcerated inmates to begin a career in healthcare. The mentoring and networking Ms. Ramada has been able to gain through the HEALab has helped her win three additional competitions and awards, including the Pakis Social Entrepreneurship Challenge and the Alliance for the American Dream.
In addition to being a resource for Arizona State students, the HEALab has been used by students at other schools. Back in February, students from Mayo Clinic Alix School of Medicine visited the lab and other school campuses and centers, through a week long Entrepreneurship and Innovation selective with Dr. Rick Hall, CONHI’s Senior Director of Health Innovation. These students used applied human-centered design techniques and lean startup business tools to develop application ideas.
The HEALab offers monthly guest speakers and one-on-one mentoring to all ASU community members, faculty, and students, including those from different campuses, and those taking online coursework. For more information about the HEALab, click here.
Katelyn McKibben, R.N., has always been passionate about taking care of others. At age 16, she became an emergency medical technician (EMT), where she developed her skills and discovered a lifelong passion that led her to nursing school. During that time, she fell in love with Eric Kline, a 1st Lieutenant in the Army National Guard. Eric was deployed to Afghanistan shortly thereafter, but when he returned in 2010, his disposition had changed considerably. A few weeks later, he took his own life.
Katelyn continued her nursing education and found much needed comfort in the Tragedy Assistance Program for Survivors (TAPS)—an organization that provides care and grief support programs for military survivors. Katelyn became a peer counselor at TAPS to help others in similar situations find healing and hope. Today, Katelyn is a nurse at the Erie Veterans Affairs Medical Center in Pennsylvania. “Caring for Veterans has given me a purpose. This career allows me to honor 1st lieutenant Eric Kline every single day. What my patients don’t know is that while I am helping them heal, they have done so much more to help me heal,” she says.
Ready for a rewarding career with purpose? Join VA and you, too, will experience the unique satisfaction and joy that comes with serving our nation’s heroes. To get started, search for opportunities near you and apply today.
This story was originally posted on VAntage Point.
It’s probably safe to say that nurse leaders’ favorite subject is not finance. But in today’s healthcare industry, financial incentives and reimbursement have become so entwined with patient care and outcomes, that you cannot have one without considering the other.
Below are recent HealthLeaders Media articles to help nurse leaders make sense out of the dollars and cents attached to patient care.
Last year the Centers for Medicare & Medicaid Services (CMS) reined in its mandatory bundled payment models, leaving many healthcare providers concerned that investments they made to prepare for these models might for naught.
But those investments in value-based care models may not go wasted after all under CMS’ new voluntary Bundled Payments for Care Improvement (BPCI) Advanced model.
Participants in the new model will be expected to keep Medicare expenditures within a defined budget, while maintaining or improving performance on these seven specific quality measures:
- All-cause hospital re-admissions
- Advanced care plan
- Perioperative care: Selection of prophylactic antibiotic (first or second generation cephalosporin)
- Hospital-level risk-standardized complication rate following elective primary total hip arthroplasty and/or total knee arthroplasty
- Hospital 30-day, all-cause, risk-standardized mortality rate following coronary artery bypass graft surgery
- Excess days in acute care after hospitalization for acute myocardial infarction
- Agency for Healthcare Research and Quality patient safety indicators
CMS is changing its formula for calculating and allocating funds for uncompensated care for hospitals that qualify under its Disproportionate Share Hospital program. This new method presents both opportunities and challenges for organizations.
Thanks to the changes, hospitals may be able to identify care currently written off without a determination of financial need. Additionally, the new methodology for calculation of Factor 3 — a hospital-specific factor representing its share of the total uncompensated care provided — may allow hospitals to capture a larger portion of uncompensated care funds.
However, leaders should be aware that CMS is phasing in the use of cost report Worksheet S-10 data, including charity care and unreimbursed bad debt. This year, one-third of Factor 3 will be based on this data, but by fiscal year 2020, use of this data will be fully implemented.
To ensure compliance with reporting data on Worksheet S-10, leaders need to review new guidance from CMS as well as their own organizational policies for charity care determinations, uninsured patient discounts, and bad debt collections. Training for staff involved with submission of the cost report and handling charity care write-off is imperative.
One concern consistently raised about the implementation of pay-for-performance models is that healthcare providers and organizations serving more complex patients would not reap the same rewards as hospitals caring for less sick patients.
New research suggests that those fears may be warranted. A November 2017 study found that Medicare’s Value-based Payment Modifier program inadvertently shifted money away from physicians who treated sicker, poorer patients to pay for bonuses that rewarded practices treating richer, healthier populations.
The study’s lead author Eric Roberts, PhD, of the University of Pittsburgh Graduate School of Public Health, said that if changes aren’t made, value-based payment models will continue to foster this inequity.
“Risk adjustment is usually inadequate in these programs, in part, because it is difficult to measure the differences in complexity of patients across providers. We need to take a careful look at how incentives in these programs are structured and how performance is assessed in order to create the right incentives to improve value and outcomes for the most vulnerable patients,” Roberts said.
This story was originally posted on MedPage Today.