As a single working mom and PhD candidate, Leticia Rios, RN, has balanced many 24/7 challenges, applying lessons learned as a caretaker, clinician, and educator to her mission, helping mothers and babies in underserved communities avoid adverse birth and neonatal outcomes.
Rios received the top honor for Clinical Nursing Excellence from the Nassau-Suffolk Hospital Council at this year’s Nurse of Excellence Award Ceremony. She was among 23 nominees selected by nurse leaders at hospitals and teaching institutions throughout Long Island.
And now Rios can add another accolade to her list of honors as Daily Nurse’sNurse of the Week.
We are proud to honor Rios for being an outstanding practitioner, leader, and advocate in the maternal and neonatal health equity field.
The Nassau-Suffolk Hospital Council cited her service as the nursing professional development specialist in the Neonatal Intensive Care Unit (NICU) at NYU Langone Hospital—Long Island and for being a certified neonatal nurse and an internationally board-certified lactation consultant. Rios has helped implement practice changes that lead to quality improvements in the NICU, including achieving more than 1,000 days without a central line bloodstream infection and zero hospital-acquired pressure injuries to date.
As a co-chair of the Black Mothers Matter Committee, “she passionately advocates for maternal health equity locally, regionally, and globally,” says Valerie T. Terzano, PhD, RN, NEA-BC, vice president for nursing and patient care services at NYU Langone Hospital—Long Island.
Rios, along with other members of the committee, was credited with developing a Holistic Black Birth Nurse Navigator program to improve outcomes and experience for Black birthing patients. The successful pilot has been awarded a research grant from the National Institutes of Health. Rios is also a core New York State Birth Equity Improvement Project member.
Rios struggled to get support to exclusively breastfeed her daughter after giving birth. Knowing that breastfeeding can reduce maternal and infant morbidity and mortality, the experience prompted her to start a business dedicated to educating and supporting other mothers to meet their breastfeeding goals. She also facilitated a grassroots initiative, Brownsville Baby Café, which provides breastfeeding support for underserved women and addresses food insecurity and other social issues.
As a young person and daughter of immigrants, Rios says navigating academia was challenging. Despite those barriers, the NYU Langone nurse is working on a dissertation for her PhD from Adelphi University. She summed up her passion for being a maternal health advocate with a quote from celebrated neuroscientist Abhijit Naskar: “Injustice on one life is injustice on all lives.”
Nominate a Nurse of the Week! Every Wednesday, DailyNurse.com features a nurse making a difference in the lives of their patients, students, and colleagues. We encourage you to nominate a nurse who has impacted your life as the next Nurse of the Week, and we’ll feature them online and in our weekly newsletter.
Buffalo, NY, nurse Trinetta Alston has made it her mission in life to help others, and in the past year, she has opened her heart to help as many Tops supermarket associates as possible.
Tops in Buffalo was the site of a mass shooting on May 14, 2022, and days later, Alston started talking with survivors to help them heal from this tragic event.
Daily Nurse honors Trinetta Alson as the Nurse of the Week for showing kindness, compassion, and empathy for the survivors of this tragic day by connecting with them and letting them know that they’re not forgotten, and people care.
“Nursing is the only field where you can genuinely show you care for somebody, and they don’t think you want anything in return, and I don’t,” says Alston.
Alston plays many roles at the Community Health Center of Buffalo, but her involvement with helping Tops associates heal began the Monday after the shooting.
“It started just listening to the Tops associates who came to speak to us. And, after that, I’m wondering, as a nurse, nobody’s hurt. I didn’t understand why I was there. And it just evolved from there. People are put in places for reasons, and mine was to connect with them to let them know that everybody didn’t forget about them, that they are important, and that we care,” says Alston.
Alston goes to Tops two to three times a week to check on everyone, give them hugs, and make sure they know she’s available 24/7 to talk. She’s now an honorary Tops employee.
“The things they saw, they can’t un-see, so this is where I’m supposed to be. I’m supposed to be here with them, walking them through whatever they need to be walked through,” says Alston.
“What does it mean to you to have somebody like Trinetta in your life?” asks Kelly Dudzik.
“It means a lot. She definitely was there for me when all this happened at Tops and for my kids, too,” says Larose Palmer, a Tops cashier.
“Just a lifesaver. Truly a lifesaver,” said Rachez McCullough-Moore, a Tops office manager.
Alston has made it her life’s work to serve her community. Years ago, she experienced homelessness and faced addiction until others helped her through her struggles.
“I firmly believe that God walked with me through my addiction, put people in places for me so that now I can be that person in place for them,” says Alston. “I just want to be able to say job well done when I close my eyes at the end of the day. That’s all I want. And I get to do that here.”
Nominate a Nurse of the Week! Every Wednesday, DailyNurse.com features a nurse making a difference in the lives of their patients, students, and colleagues. We encourage you to nominate a nurse who has impacted your life as the next Nurse of the Week, and we’ll feature them online and in our weekly newsletter.
“She poured her heart into helping patients and keeping her fellow nurses safe.”
—President Joseph Biden, as he draped a Presidential Medal of Freedom around the neck of Sandra Lindsay, DHSc, MS, MBA, RN, CCRN-K, NE-BC.
“Thank you for inspiring us.”
The impact her example had on vaccine-hesitant Americans can’t be measured, but Sandra Lindsay herself has heard directly from people who say that watching the Jamaican-born nurse persuaded them to get their shots. Last year, while on a visit to the Jamaican Embassy, a woman recognized her and thanked her profusely. She and her family had not intended to be vaccinated—until they saw Lindsay getting that first jab on TV. After seeing the nurse’s confident mien, she said, “We all went and made an appointment. So I want to thank you so much for inspiring us.”
That sort of recognition can be a force for good, and Lindsay is surely one of the best-known living nurses in the United States (and in Jamaica, of course!). It’s become a milestone in the history of the pandemic and a powerful symbol of what it means to be a nurse: the image of her serene face wrapped in a pale blue surgical mask, her expressive brown eyes gazing into the distance as she extends her arm to receive the first Covid-19 jab in the US.
Like most people who become symbols, she is not unique. The profession is filled with nurses like Lindsay—nurses who lost family to the pandemic and had no time to grieve; who continued pursuing their education through all of the upheavals; who coped with almost unbearable stress, and scrambled for data when the mRNA vaccines really did emerge at “warp speed” and forced us to rethink everything we thought we knew about vaccine development. But Lindsay’s exceptional poise and sense of responsibility during her frank “I trust the science” spotlight moment have made her representative of the skills, empathy, common sense, and honesty we associate with nursing.
A quiet icon of nurse leadership
While everyone yearned for certainty, Dr. Lindsay never claimed that science is a source of 100% correct, oracular knowledge; she merely said that this is the way that science works—and in effect acted as America’s test pilot for the vaccine.
As she sat down to receive her jab on December 14, 2020, what Lindsay displayed was a nurse’s dedication to evidence-based practice. When she backed this up by not collapsing on the spot or exploding in the weeks following her vaccination, she faded from national headlines and proceeded with her duties at Long Island Jewish Medical Center and worked toward yet another degree. But Lindsay’s persistent lack of rare side effects, her utter failure to cash in on her time in the spotlight, and apparent inability to catch even a mild case of breakthrough Covid made her a quiet icon of nurse leadership during the pandemic.
Millions of mistrustful, frightened people at all levels of society heard her speak with the sane, confident, honest voice of a nurse who has no agenda other than a desire to see her patients well and healthy. Amid rumor-driven panics, false claims based on specious data, and adult mobs throwing tantrums that would be the envy of any 3-year-old, Lindsay’s voice – imbued with a science-based assurance similar to Dr. Fauci’s but without any confrontational edge – resonated. Meanwhile, she has navigated her unasked-for celebrity and public honors with a cool-headed grace and continues to keep her head above water in an era when staffing shortages and burnout are the norm, women’s health care decisions are predicated not on science but on a peculiar blend of metaphysics and politics, and public health officials are driven from office… for doing their jobs.
How about featuring American Nurses on some postage stamps?
Today, after a year and a half of combining full-time work with study, waving from cars during ticker-tape parades, holding a little girl’s hand for her Covid jab, and adding tchotchkes to her diploma and awards wall, Dr. Lindsay is making space for the Presidential Medal of Freedom she received today from President Biden. (He obviously likes standing next to her and handing her things. This is their second rendezvous). As the White House defines the honor, the medal is bestowed on people who have made exemplary contributions to the prosperity, values, or security of the United States.
Lindsay has been a very atypical American celebrity, and there has not been a peep about reality TV deals, an as-told-to book, or even a barrage of media appearances. However, this writer still thinks she belongs on a stamp. While we still have a postal service, we deserve a “nurse” postage stamp of a more recent vintage than 1961—and in fact, it would not be amiss to issue a full series of stamps honoring American Nurses and Nursing.
When New York Gov. Kathy Hochul signed the state budget into law, it secured improved health care access for residents in the state. New York joins 24 other states, the District of Columbia and two U.S. territories in adopting Full Practice Authority (FPA) legislation. The legislative action enables nurse practitioners (NPs) to provide the full scope of services they are educated and clinically trained to provide. The American Association of Nurse Practitioners® (AANP) commends Gov. Hochul and the New York Legislature for modernizing nursing licensure law and positioning New York for a healthier future.
“New York has taken a critical step forward in our country, increasing access to vital health care services. New Yorkers will now have full and direct access to the comprehensive care NPs provide,” said April N. Kapu, DNP, APRN, ACNP- BC, FAANP, FCCM, FAAN, president of AANP. “Over the past two years, New York has waived unnecessary and outdated laws limiting access to health care. AANP applauds the state legislature and Gov. Hochul for recognizing that these provisions need to continue. These changes will help New York attract and retain nurse practitioners and provide New Yorkers better access to quality care,” said Kapu.
FPA is the authorization of NPs to evaluate patients; diagnose, order and interpret diagnostic tests; initiate and manage treatments; and prescribe medications, all under the exclusive licensure authority of the state board of nursing. This framework eliminates unnecessary, outdated regulatory barriers that prevent patients from accessing these vital care services directly from NPs. Leading health policy experts like the National Academy of Medicine have long recommended that states adopt such legislation to improve health care access and outcomes.
“As the 25th state with Full Practice Authority, New York joins an expanding list of states acting to retire outdated laws that have needlessly constrained their health care workforce and limited patient access to care,” said Jon Fanning, MS, CAE, CNED, chief executive officer of AANP. “This is a no-cost, no-delay solution to strengthening health care for the nation. Decades of research show that states with Full Practice Authority are better positioned to improve access to care, grow their workforce and address health care disparities, while delivering quality health outcomes for patients. We look forward to more states following suit.”
NPs deliver high-quality health care in more than 1 billion patient visits each year. As of April 2022, there are more than 355,000 licensed NPs in the U.S. providing care in communities of all sizes across the nation. Recently, U.S. News and World Report ranked the NP role first on its 2022 Best Health Care Jobs list.
Nurses care for patients with asthma exacerbated by poor air quality and heat exhaustion during heat waves. They respond during natural disasters like hurricanes and flooding. Now, a growing number of nursing schools are incorporating an underlying driver of these health issues into their courses: climate change and the environment. Their goal is to prepare nurses to better care for patients and communities in a world with a changing climate.
At NYU Rory Meyers College of Nursing, faculty have developed content focused on climate change and the environment for several courses. In 2020, the college added a module on the clinical relevance of climate change in health care decision-making to the applied epidemiology course for Doctor of Nursing Practice (DNP) students, and the following year added modules on the environment for the health policy-focused course for PhD and DNP students.
Beginning this fall (2022), NYU Meyers will devote a brand-new course to climate and environmental health: The Environment and Health of Populations. The course is designed for graduate nursing students, but undergraduate students can enroll with permission from professors.
Historically, nurses may have learned about air quality and its effects on respiratory health, but haven’t necessarily been taught to care about dirt and water sources, which can become contaminated or carry pathogens, putting communities at risk. New coursework focused on climate might cover issues such as disaster preparedness, severe weather and health (for instance, protecting older adults during storm-related flooding or rising temperatures and infectious diseases) and sustainability in healthcare.
Robin Klar, DNSc, RN, a clinical associate professor at NYU Meyers who focuses on the environmental context for nurses in the U.S. and around the world, said that this growing interest in climate change demonstrates nursing education’s eye on the future—as healthcare evolves, so does how we train nurses. “Nursing is not static; it’s a dynamic profession,” said Klar.
NYU Meyers is one of 53 schools currently taking part in the Nurses Climate Challenge, a national campaign to mobilize nurses to educate 50,000 health professionals on the impacts of climate change on human health. Thus far, the movement has reached nearly 36,000 health professionals, including more than 15,000 nursing students.
Managing any nursing team carries its challenges, and the pandemic has added even more complexity to that formidable task. With such a daunting landscape, how do nurse leaders enable a nursing organization to perform at a high level, and what steps are needed to get there?
In developing a high-performing nursing culture, nurse leaders need to focus on two things, notes Courtney Vose, DNP, MBA, RN, APRN, NEA-BC, FAAN, senior vice president and chief nursing officer at Robert Wood Johnson University Hospital. The first is “truly driving employee engagement.” The second is to “really drive for RN satisfaction.”
Vose started her role in late January. Previously, Vose served as vice president and chief nursing officer in the New York-Presbyterian Hospital system.
Courtney Vose, senior VP and chief nursing officer.
“From a nursing leadership perspective,” says Vose, “I feel that if we take better care of our staff, they can take better care of patients and their families. The benefit of creating an engaged culture is that outcomes should improve in every domain, from quality to satisfaction to flow to affordability. When you have a high-performing team, they want to perform well in all domains.”
When it comes to employee engagement, “it’s really helping to create a shared vision and developing the strategy with the voice of the team from all levels and disciplines so that there’s a shared sense of purpose and direction on where we want to go,” says Vose
At New York-Presbyterian/Columbia University Irving Medical Center, employee engagement scores rose so quickly that Gallup, who measured these scores, wanted to know what they were doing. “At the end of the day, it was really very simple,” Vose says. “We listened to the collective voice of all team members. We created a shared vision that everyone got aligned to, and then we developed our strategy and then tactics on how we were going to get there.”
“If I were to boil it down, I would say create a shared vision that gives people a sense of purpose. And then really dig into that to figure out how you’re going to get there and then take action to make it happen.”
RN satisfaction, notes Vose, is tied to employee engagement since it is a key component of engagement. Satisfaction measures how much employees enjoy their work. Components of this for nurses include autonomy in their practice and access to professional development opportunities.
Vose notes that the American Nurses Credentialing Center (ANCC) Magnet Recognition Program is related to high-performing nursing organizations. “Magnet organizations invest more in nursing. The evidence strongly suggests Magnet organizations have higher engagement and RN satisfaction, which leads to better results for patients and families.”
Learning from the pandemic
The pandemic holds lessons for creating a high-performing nursing organization, notes Vose. One involves resilience. “How we provide respite and keep a workforce resilient is an incredibly important learning,” she notes.
A second lesson involves creating new models of care that allow nursing to become more “elastic,” says Vose. “That’s my word for how can we expand our workforce quickly when we have an event that requires more resources.”
At Robert Wood Johnson University Hospital, nursing students from Rutgers University School of Nursing assisted staff nurses during the Omicron wave. This allowed RNs to delegate to the nursing students and take better care of patients and families.
“So how could we utilize students all the time?” asks Vose. “Why do we have to wait for a pandemic to do that? How could we utilize licensed practical nurses who could be delegated to and allow us to take care of more patients, especially when the time comes when we really need additional resources? Those are the things that the nursing community at large is really engaged in trying to figure out.”
No need to “complexify”
In developing a high-performing nursing organization, nurse leaders should avoid the tendency to “complexify” leadership, says Vose. “I think leadership is actually fairly easy, but the work is hard with long hours,” she says.
Many nurse leaders, says Vose, make the mistake of wanting to jump into higher-functioning activities before they’ve established trust with their team. “Establishing trust with your workforce is probably the most important thing that you can do as a leadership team,” says Vose. “Until you have that, it’s hard to get to the next levels where you would engage and empower them to really take ownership of their practice and make decisions about their practice environment.” If it takes a year to develop that trust “then take the year to do that because it will be a year well spent.”
Leadership, Vose notes, will set standards. “But for me, it’s always trust and respect first, however long that takes to establish, moving quickly into engaging and empowering leaders and staff. Once you have those two solid foundations in place, you can achieve anything that you want to.”
Historically, nurses may have learned about air quality and its effects on respiratory health, but haven’t necessarily been taught to care about dirt and water sources, which can become contaminated or carry pathogens, putting communities at risk. New coursework focused on climate might cover issues such as disaster preparedness, severe weather and health (for instance, protecting older adults during storm-related flooding or rising temperatures and infectious diseases) and sustainability in healthcare.
