The value of teamwork

Without the backing of a great team, it would be almost impossible to perform his long list of daily nursing duties, said Brent Thomas, a registered nurse in the unit. “Helping burn patients recover takes a team that is willing to do whatever needs to be done.”

Thomas didn’t plan to be a burn nurse. He was hired and trained as a patient technician after losing his computer job in 2001.

“I enjoyed being able to help someone as soon as they came through the door. I loved it so much, I went back to school to become a registered nurse,” Thomas said.

Founded in 1963, the Grady Burn Center, one of only two such facilities in Georgia and 125 in the United States, is the nation’s fourth largest.

Patients often arrive by helicopter from the scene of a fire or an explosion.

“We’re a front-line unit. A physician, two nurses and a [technician] meet the copter, and the work is fast and furious,” Thomas said. “Burns affect every organ in the body, so you have to stabilize the patient.

“You start them on life support. Swelling can cause breathing and circulation problems and they’ve lost a lot of fluids, but everyone has a chance. There’s always hope.”

Patients are admitted to the center’s intensive care unit, where the average stay is three months. Afterward, patients move to a step-down unit, where they begin the slow process of rehabilitation. Burn center nurses are cross-trained to work in both areas.

“Seeing a patient finally walk out the door and knowing that you did everything you needed to do is my greatest satisfaction,” nurse Calandra Thomas said. “Burns are my niche. I love working with a team of specialists to make sure the patient gets what he or she needs. Everyone goes beyond what’s expected.”

Elaina Hall, burn center director, has seen nurses come to work on their day off to say goodbye to a patient or bring a Happy Meal to coax a child to eat.

“People have to love what they do to work in a burn unit, because there are too many wounds, smells and tears — too much pain-management and nursing care not to give 100 percent,” Hall said. “People don’t have the luxury of saying, ‘That’s not my patient.’ In a center of continuous care, every nurse touches a patient at some time.”

Nurses help each other change two-hour dressings, debride wounds, start medication drips, solve problems and educate families.

“In a burn unit you have to be flexible and move from critical care to rehab, depending on where you are needed. You’re given more opportunities to use your talent and skills,” nurse Jacinta Okolie said.

Hall sees herself as a coach of sorts.

“My job is to help my staff develop and evolve as a team,” she said. “I want to give them the tools to be cohesive and work through their differences.”

Hall focuses on education, sending staff members to conferences and team-building classes. A Wall of Recognition, which displays patient thank-you notes, Burn Foundation commendations and performance goals met, affirms the value of a dedicated team.

Teamwork helped the 4A/5A cardiovascular-thoracic critical care unit at Emory University Hospital become the first cardiovascular unit in Georgia to earn the Beacon Designation. The American Association of Critical Care Nurses awards the Beacon to outstanding critical care units across the nation.

“Teamwork is part of a healthy work environment,” said Therese Baker, unit director. “To give excellent patient care, which is our ultimate goal, we need to feel comfortable talking to each other, asking questions and learning from our mistakes.”

“In a stressful situation, when your patient is crashing and burning, you know that you’re not alone. You know someone has your back,” said Phyllis Lowery, a nurse who has worked on the unit for 25 years.

Pitching in is part of the unit’s culture.

“But even in a nonemergency situation, people help each other. We all know who has the heavier assignment, and we’ll juggle to assist that person. I’ve been here two years, and it’s awesome to watch these nurses in action,” nurse Toni Barrett added.

Critical care is high-stress, heavy-workload nursing and Emory’s cardiovascular-thoracic unit sees some of the highest patient-acuity levels in the Southeast, if not the country, Baker said. Caring for patients recovering from heart and lung transplants or serious heart attacks with complications are the norm.

“Our unit is the last chance for some patients, and they come from all over with their families. We take care of them, too,” Lowery said.

Nurses include families in their daily rounds and bedside shift reports, knowing that when loved ones are part of the continuum of care, everyone benefits.

The Beacon Designation process, which took months to complete, allowed the nurses to look closely at the unit’s strengths and weaknesses.

“We were already doing a lot of the things necessary to achieve outstanding patient outcomes. We just hadn’t recorded them in black and white,” nurse Debbie Malone said.

More than 40 percent of the nurses had sharpened their individual skills by earning the critical care nursing certification — the highest percentage of any unit in the hospital. Mary Zellinger, a clinical nurse specialist, helped improve the success rate by leading a review class for the exam.

Increasing staff knowledge has always been a top priority within the unit.

“A unique feature of our team is that besides their bedside duties, our nurses have specialties, like infection control or skin care,” Zellinger said. “Their job is to gather resources, learn about new products and share that information with the rest of us so that we can all work together to address problems.”

It takes everyone’s dedication to follow strict infection-control measures and the evidence-based standard practices that help decrease bloodstream infections, ventilator-associated pneumonia, catheter-related infections and pressure ulcers.

“When everyone is analyzing and monitoring care, the outcomes are always better,” Malone said.

Being part of an outstanding team means, “I’m 100 percent sure that when I leave, I’m leaving my patients in good hands,” Zellinger said. “It’s not just me. We all support each other.”

Celebrating Nurses: Honoring Georgia's angels in scrubs

When you or your loved ones are in the hospital, nurses provide the healing hands and hearts that touch us all. Besides taking vital signs, dispensing medication and answering questions, nurses deliver tender loving care when it’s needed most.

Many of these unsung heroes describe their career choice as more than a job; for them it’s a calling.

For the fifth consecutive year, The Atlanta Journal-Constitution and ajcjobs honored 10 of Georgia’s top nurses with the 2010 Nursing Excellence Awards. The 2010 winners were honoroed at a May 5 luncheon at Cobb Energy Performing Arts Centre.

Year in and year out, nurses are voted into the top spot in the Gallup Organization’s Most Trusted Professionals poll. That’s no accident; it’s a reflection of what we celebrate during National Nurses Week (May 6-12).

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Read the profiles of our top honorees by choosing from the list above. You can also download a full list of the 2010 Nursing Excellence Awards nominees.

Nominate a nurse for the Celebrating Nurses ajcjobs Nursing Excellence Awards