This week, the DailyNurse Nurse of the Week is one of the heroes of The Rebel Nurse Handbook (a 2020 AJN Book of the Year, awarded third place in Professional Issues). Nurse of the Week Richard Moore (PhD, MBA, BSc, RN, RNT, DMS, for entire panoply see his astonishing LinkedIn) is one of the passionately committed “rebel” nurses in the book whose journey shows that your nursing career can be just as unique, adventurous, and varied as you want it to be.
Setbacks such as ulcerative colitis, ADHD, and autism spectrum disorder failed to impede the nursing education or career of Richard Moore. The globe-trekking RN and MBA has treated everyone from cardiac patients in Leeds to a beloved dog in a desert village. A dedicated nurse, educator, and entrepreneur, Moore seems to be at home anywhere in the world, whether he is resolving toilet emergencies in the Australian Outback or teaching nursing students in England, North Korea, and New Zealand.
Starting at the age of seven, Richard Moore accompanied his mother on her nursing house calls in Ghana. She brought him along on visits both to the “very poor and the very rich,” and the boy’s keen eyes did not miss the Dickensian health disparities between the one and the other. His mother and sister were both nurses, and after they moved to the UK, 16-year-old Richard decided to follow in their path. He had struggled throughout high school: “my grades were so poor, I became the only student to finish in last place every year that I attended,” and was plagued by uncertainty as to whether nursing was the career for him, but it was all he knew.
Richard just managed to gain acceptance at the renowned St James University Hospital in Leeds, England. Before long, his uncertainty about nursing vanished, and he became passionate about working as a nurse. Even as he was stricken with ulcerative colitis from the start of his second year in school and underwent treatment, the erstwhile poor student threw himself into his work, and excelled.
After graduating, Richard became a Cardiac Care Unit nurse—which he loved—but also felt driven to further pursue his education and career. Richard went on to attain an MBA and before long, he started to pursue his “other passion” and became a nurse educator.
After teaching in major nursing schools in England, his felt a calling to move on. Richard ventured far from home and emigrated to New Zealand, where at first he directed nursing degree and post-graduate programs. Before long, though, Richard relocated to the Tanami Desert in Australia. There, he embarked on another dramatic life change as an Indigenous Learning Nurse Administrator. Working as a remote area nurse among the Warlpiri people, he provided “every conceivable healthcare from acute trauma to primary health for children to adults,” and when necessary, treated sick dogs as well, as the area had no veterinary care. Before long he was asked to direct outback hospitals. In love with the land, the desert, and the people, he happily accepted.
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Eventually departing from the desert, Richard’s life changed again. His six-year-old son was diagnosed with Asperger’s Syndrome, and not long afterward, so was Richard himself. In addition to Asperger’s, Richard was also found to be suffering from ADHD and sensory processing disorder and endured two years of clinical depression. With treatment, he started to recover and continued his global travels. His latest stop has been a North Korean university, where he has been simultaneously been teaching students at both the school of medicine and the school of international finance and management.
Reflecting on his varied and adventurous path, Richard says, “Nursing is a brilliant role. We make a difference for many people, often those who we don’t know. If I—with my ulcerative colitis, autistic spectrum disorder, ADHD, sensory processing disorder, depression, coming last in high school, living in several countries, deserts, and rainforests—can nurse well, so can you. You can make a difference to patients, families, and staff. Every person is unique and has their own story. Find it and walk with them.”
We need innovators in a crisis, and during the pandemic, the nursing community has been bursting with new ideas and creative solutions to improve patient care and public health. One of the biggest boosters of nurses’ role in healthcare innovation is the American Nurses Association (ANA), which has just announced the winners of its 2021 fourth annual Innovation Awards.
Individual Innovation Winner
Rebecca Cherney, RN
Awards are nothing new for RN Rebecca Cherney. The Michigan Medicine Intermediate Care Nurse won the hospital’s Nurse Hero award last year for an above-and-beyond 3D printing project she organized to counter the state’s PPE shortage last spring.
Cherney really stepped up her innovation game, though, when she developed her breakthrough TrachTrail ™ program, the ANA’s 2021 Individual Innovation Award winner. Michigan Medicine describes it as “the first comprehensive, standardized adult tracheostomy care education program of its kind, focusing on combined nurse, patient and caregiver training.” The ANA Innovation team noted that Covid-19 has increased the need for adult tracheostomies by 15-20%. Cherney’s bright idea fills an important gap at a vital time, the ANA explained: “There were few standardized training programs available for adults in the self-care of tracheostomies before discharge, leaving nurses unable to effectively instruct patients and caregivers in the skills needed to care for their tracheostomy at-home.”
Cherney’s accessible multimedia guide has already been road-tested, and the data suggest that it can help to improve new tracheostomy patients’ quality of life. While testing TrachTrail™ on a progressive care unit in 2017, the length of hospital stays on the unit dropped from an average of 64.8 days to an average of 16.6 days, and a wider hospital implementation is planned for 2021-2022. (For a detailed study on the TrachTrail™, see this May 2020 study co-authored by Cherney).
Nurse-Led Team Innovation Winners
Left: Dr. Brighid A. Gannon. Right: Dr. Pritma Dhillon-Chattha.
This year’s nurse-led team award is being presented to a pair of entrepreneurial DNPs. Dr. Pritma Dhillon-Chattha, DNP, MHA, RN and Dr. Brighid A. Gannon DNP, PMHNP-BC met at Yale when they both enrolled in the Doctor of Nursing Practice (DNP) program. After receiving their DNPs in 2018, Dhillon-Chattha returned to Canada to open a cosmetics injectables company, while Gannon founded a nursing home consulting group in New York with 14 psychiatric nurse practitioners. The pair had talked about possible joint business ventures before, but when the pandemic arrived, they engaged in serious brainstorming. The result? Lavender, an online psychotherapy service.
Both DNPs agreed that they had to work fast, and they had to work smart. Gannon, a New Yorker, told the Yale School of Nursing News, “We recognized that there was a time-sensitive need. New York was literally in crisis. Part of our mission was that we wanted to help people as soon as possible. We wanted to launch quickly, even if things weren’t perfect.” As Gannon started recruiting psychiatric NPs, Dhillon-Chattha employed her clinical informatics expertise and focused on the technology. They opened Lavender in May 2020.
Unlike brick-and-mortar psychotherapy offices—many of which had to hastily adjust their systems to accommodate virtual appointments, Gannon and Dhillon-Chattha designed their practice to specifically address the needs of online therapy. This helped them to avoid the common pitfalls encountered by office-based practices. Gannon recounted some of the key pain points: “So many of my colleagues are fully booked and have no more referrals. [And as] many providers don’t offer email as a method of contact, getting a hold of them by phone is near impossible. There’s no pricing transparency, and no one will tell you how much these services actually cost. What a shame that when you’re already feeling down and struggling that the process of accessing mental health services is re-traumatizing.”
Dillon-Chattha told the Yale School of Nursing, “Telehealth has been a viable option for many years, and now the system is being forced to embrace it. COVID-19 has accelerated the adoption of telehealth by at least five years. This will help seniors, rural patients, and those with different abilities safely access the care they need.”
The individual nurse and nurse-led team winners will be awarded $25,000 and $50,000, respectively, to support the development and implementation of their products over the next year. Award winners have a year to further develop their projects and will share their outcomes and findings in 2022.
This series takes a deeper look into the stories appearing in The Rebel Nurse Handbook, which features inspiring nurses who push the boundaries of healthcare and the nursing profession. This installment focuses on Nicole Lincoln’s work as an innovator and her mission to inspire others to become innovators as well.
“Nursing has bestowed gifts upon me which I can never pay back: independence, joy, pride, self-esteem, and purpose.”
When Nicole Lincoln decided to embark upon a nursing career, she had to power through a variety of hurdles to reach her goal. While pursuing her baccalaureate degree in Boston, she balanced pregnancy and childbirth with school, but a more serious challenge arose when her home life was afflicted by domestic violence. Forced to take refuge at a homeless shelter for women and children, Nicole managed to find subsidized housing in an apartment closer to her classes in Boston. In this new place, she found a true mentor through Catholic Charities, on which she leaned until she graduated with her BSN.
Nicole’s first nursing position was at a state hospital in 1995, during the height of the AIDS crisis. Three years later, she began work at Boston Medical Center in an intensive care unit, where she is still employed. In 2011 she felt a calling to further her education: “I wanted to be a part of innovating the evolution of the nursing profession. The recent wave of technology and advancements were monumental. Change was the only thing you could count on in medical care.”
Having attained her higher degrees as a Critical Care Nurse Specialist and Family Nurse Practitioner, Nicole became a nurse educator at Boston Medical Center and embarked on her innovation journey.
She began by investigating safety events that were occurring in the units. She worked with the front-line nurses, quality improvement specialists, and healthcare engineering students to evaluate their problems and devise solutions. One of Nicole’s most successful projects was the implementation of SAFETY (Stand at the Bedside – Assess your patient – Falls or other safety risk? – Explain the plan of care – Try to involve the patient in the plan of care – Y time for questions/clarifications), which she describes as “a standardized bedside nursing handoff with my cardiac interventional floor who had experienced serious medication errors on their unit.” As a result of their early projects, her nursing team reduced the fall rate by 76% and achieved a 25% reduction in medication error during the pilot periods.
In response to these successes, the hospital actively encouraged innovation among nurses and worked to further foster interdisciplinary cooperation between doctors and nurses. Nurses became key members of quality improvement committees, and a spin-off from “Shark Tank,” known as “Nursing Tank,” was formed to encourage nurses to create and share innovative ideas. By the end of “Nursing tank,” Nicole notes, “we had 70 ideas of which 10 were funded to move forward by the board of trustees.”
As the mission to innovate progressed, residents formed workgroups with nurses to improve communication, and physicians collaborated with nurses on Boston Medical Center’s patient safety publication, OK to Proceed. Nicole notes, “There have been major strides in the reduction of the preventable harm index and mortality observed to expected ratio. This can only be done when all members of a team feel they have a significant voice.”
Mindful of her own early experiences, Nicole is also deeply committed to helping women who are struggling to move ahead amid social, economic, and other obstacles. In addition to mentoring nursing students and graduate students from local universities, she participates in a number of initiatives, including Boston Medical Center’s hiring program for RNs with Associate degrees and Certified Nursing Assistants (CNAs). Described by Nicole as an opportunity for “nurses who come from diverse backgrounds, are single parents or economically challenged to get started making an income faster,” RN hires at BMC are given five years to complete their BSN and receive tuition reimbursement, and CNAs are also eligible for tuition reimbursement.
Among her many activities to help nurses move forward in their careers and as innovators, Nicole also serves as a faculty member with distinction at the Boston University and BMC Leadership Academy, is a founding member of SONSIEL (Society of Nurse Scientists, Innovators, Entrepreneurs, and Leaders), and speaks professionally to “hopefully inspire nurses to believe in their ability to be leaders of change and innovation. “
Nicole’s tips on how to bring innovation to your unit:
Form a Unit Based Council to support Local Improvement
Share ideas with peers for improvement
Identify workarounds that are broken elements of the system that can be fixed
Identify waste
Identify solutions to problems
Engage peers in innovation ideas
Improve workplace teamwork
Embrace change
Work with others on the multi-disciplinary team (join committees or improvement projects)
Take a course on innovation or creativity (That’s what got me hooked!!)
During #NURSEHACK4HEALTH, nurses will come together on Microsoft Teams to apply their resourcefulness and innovative thinking to COVID-19 related healthcare problems. There’s still time to register for the virtual hackathon, which is set to begin on Friday, May 15 at 7.00PM, EST.
Presented by the Society of Nurse Scientists, Innovators, Entrepreneurs & Leaders (SONSIEL), Johnson & Johnson, Microsoft, and dev up, NURSEHACK4HEALTH is an opportunity for you to collaborate with colleagues to create a technological solution for a COVID-19 pain point. Each team will work within one of five different challenge areas (see the hackathon Home Page for details):
TECHNOLOGY / REMOTE PATIENT MONITORING – ACUTE CARE
TECHNOLOGY / REMOTE PATIENT MONITORING – HOME SETTING
PATIENT TRANSFER, HAND-OFF, & HUDDLE
DATA & REPORTING
RESILIENCY AND SELF-CARE
If you have never taken part in a hackathon, this is a great time to get started. Whether you’re a first-timer or a hackathon veteran, you should read the FAQ on the NURSEHACK4HEALTH website.
This series takes a look at the stories appearing in The Rebel Nurse Handbook, which features inspiring nurses who push the boundaries of healthcare and the nursing profession. This installment focuses on nurse, writer, public speaker, and acting director of Show Me Your Stethoscope, Dr. Jalil Johnson, Ph.D., MS, ANP-BC.
Jalil Johnson found his career in nursing at what might have been the lowest point of a hard life. After graduating from high school, the impoverished Tennessean was struggling. Living from paycheck to paycheck, he ultimately found himself working as a $7.00-an-hour dishwasher. Then came the night—at a time when he had no more than $10 to his name—that Johnson found himself laid off.
During the relentless job hunt that followed, a newspaper ad for free Certified Nursing Assistant (CNA) classes caught his eye. Johnson was intrigued, but in his impoverished state, the cost of the course textbooks was beyond his means. As he sat in front of the school planning his next move, he happened to encounter the Dean of the program. The Dean was touched by Johnson’s situation and his astounding resolve. With his encouragement and assistance, Johnson applied for financial aid, enrolled in the CNA classes, and embarked upon a career in nursing.
The CNA training, and later the job itself, changed his life. After getting his CNA, Johnson decided to continue his nursing education. What inspired this decision? Johnson says, “there were many pivotal moments that encouraged me to pursue higher education. An important moment was the sense of absolute fulfillment I felt after working with my first patient as a CNA. Until that point in my life, I’d never actually helped a person with their care, health, or with the simple aim to make their life a little better. When my patient sincerely said ‘thank you so much’ to me that day, I knew I wanted to learn as much as I could about how to do this work. I wanted to expand my ability to have positive impact on people.”
Johnson spent the next two decades climbing the professional ladder: he became an LPN, an RN, was awarded a BSN, went on to take his master’s degree and training as a Nurse Practitioner, and later received his PhD as a nurse scientist. “Each time I completed another degree or level of licensure, my scope of practice and experience changed. The impact I had on patients wasn’t better with more education, but it was different. I enjoyed being challenged in this way. I continued this way of thinking through my studies, including my journey to become a nurse practitioner and nurse scientist (PhD).” Along the way, he worked in positions ranging from traveling nurse, to ICUs and EDs, to substance use treatment programs and behavioral health, and teaching CNA, LPN, RN, and DNP students. “I’ve never forgotten how amazing it feels to empower someone else,” he says.
Empowerment is a keyword for Johnson, who vividly recalls “the powerlessness I often felt throughout my career. Regardless of my level of practice, I always felt that the work and the care could be better, but I never felt I had any power to really change anything. My assumption was that more education would lead to having more say in my practice, and subsequently less feelings of powerlessness. Well, I was wrong about that. The powerless feeling followed me throughout many practice settings and scopes of practice.”
Johnson sought ways to overcome this sense of powerlessness, and found that his views were shared by “hundreds of thousands of nurses out there, who love their work as I do, but also feel like the healthcare system doesn’t work for them or their patients.” Seeking empowerment for himself and his fellow nurses, he began to work in self-advocacy with communities like Show Me Your Stethoscope and Nurses Take DC, and became a writer and public speaker.
When asked what he feels most passionate about in his career, Johnson replies, “I’m passionate about many things. I enjoy caring for my patients and love teaching. However, I’m most passionate about inspiring other bedside nurses to unify behind causes they believe in. As the largest profession within healthcare, I believe nurses have the opportunity to be truly revolutionary if we band together and support each other. This is one of the ideas that motivated me to start writing my forthcoming book, Nation of Nurses, where I discuss specific ways nurses can mobilize and revolutionize healthcare.”
He is also passionate regarding his advocacy groups: “these online communities are filled with bedside nurses who are passionate about improving the nursing and the healthcare system. Honestly, through this work, for the first time in nearly 20 years, I feel like nurses are taking back their power; and this gives me so much hope.”
This series takes a look at the stories appearing in The Rebel Nurse Handbook, which features inspiring nurses who push the boundaries of healthcare and the nursing profession. This installment focuses on Brittany Molkenthin and the pivotal moment of her innovative nursing career.
In her junior year of nursing school, Brittany Molkenthin envisioned a new premise for a major maternal healthcare innovation. While shadowing a Lactation Consultant in the maternity ward, she encountered a mother attempting to breastfeed for the first time. What should have been a beautiful and life-affirming experience quickly went south. After months of planning to breastfeed her first-born child, multiple classes, and a volume of research, she had continuous trouble with positioning the baby, each time unable to get the right latch. The few times it worked, neither the mother nor the attending staff had any way of gauging how much milk the baby was receiving. After the numerous attempts that afternoon, an overall exasperation filled the room, accompanied by tears running down both the baby’s and the mother’s face. Desperate for her baby to eat, she asked for formula and a bottle.
Brittany replayed the incident over and over, throughout the
day and later that night. As a student, she was directly exposed to the concept
of innovation and the pain point/solution mindset through her school’s
Healthcare Innovations Program. Musing upon the dilemma, she identified the
pain point as the inability to register how much milk a baby was receiving from
its mother. A solution, she surmised, would be to develop “a device that
accurately calculated the amount of breast milk that infants receive during
breastfeeding.”
After working with a team of biomedical engineers to develop
a working prototype, Brittany was ready to enter in her university’s “Shark
Tank” event. Although she did not win the competition, she was undeterred.
Brittany reached out to one of the event’s judges to discuss plans for her
device further and, thereafter, push forward with her startup. The year after
graduation, she filed a provisional patent and launched into a flurry of
networking, pitch decks, and attendance at innovation events.
While applying for startup business grants and working to
keep her nascent company alive, Brittany had her hands full: employed as a
bedside RN in pediatric intensive care and simultaneously studying to become a
pediatric primary care NP. Her breastmilk gauging device, Manoula, is designed to inform
“mothers and providers how much breastmilk a baby has consumed” and share the
data via wireless technology. The product is moving toward its alpha prototype
and is expected to enter the market in 2021.
DailyNurse asked Brittany: What was the hardest part
of starting your LLC and creating a new medical device? And what was the most
rewarding?
She responded, “the hardest part about starting an LLC and
creating a medical device was the mere fact of starting with no previous
medical device development, business, or entrepreneurial background. I thought
I was going to be a nurse, that was it… I never imagined it would get this
far. The most rewarding aspect is seeing how far the company and the device has
come since that drawing of my “vision” started as a Crayola picture
and a school project. It is amazing to think this device will be in the hands
of breastfeeding mothers someday.”
Brittany also has some advice for any nurse who has an innovative idea and is interested in turning it into a new product: “Find a team. Team is essential to the success of any startup or any innovative idea. A team that shares your passion, drive, and vision can help bring an innovative idea to fruition.”
