Not even a global pandemic, with all its difficult diversions and delays, could stop the nurses of Ellison 9 from staying on track with a project timeline they had set before the COVID-19 outbreak.
In May, two patients that typically would have recovered in the Cardiac Surgery Intensive Care Unit (ICU) on Blake 8 were instead cared for on the Cardiac ICU on Ellison 9, marking a major milestone for staff on both units. One was a heart transplant patient taken to the unit immediately after surgery, and the other was a patient on venous arterial extracorporeal membrane oxygenation (VA-ECMO)—a life support machine that pumps oxygen into the blood from outside the body.
“Many hours spent cross-training our nurses in recent years has afforded us the flexibility to receive patients across the cardiac care spectrum on both units,” says Rodilyn Glushchenko, RN, nurse director on Ellison 9.
The initiative was just a seed of an idea several years ago when nursing and physician leaders began envisioning how the two floors could serve as one Heart Center ICU, despite having physically separate locations. “We didn’t want to be working in silos, so we started looking at what it would take to make the 34 beds across both units available to all types of patients, including a rapidly growing number of heart failure patients,” says Vivian Donahue, RN, nurse director on Blake 8. “The evolution in the care of this patient population is really what drove the need for us to evolve.”
Nurses say the training also has represented a much-needed shift in streamlined care for patients and their families. “We no longer have to send to a patient off to the operating room and wonder how they are doing while recovering on another surgical floor,” says Lisa O’Neill, RN, of Ellison 9. “They can come right back to us where they know the faces of their nurses and we know their favorite radio station or sports team.”
Jamie Ronin, RN, Ellison 9 clinical nurse specialist, says while medications have historically been used to address heart failure, treatment options have since expanded to include heart pumps and other surgically implanted devices, offering patients a chance at living longer or a bridge to transplant.
“As the technology advances, there’s more overlap between the traditional medicine and surgery units,” says Nicole Bezreh, RN, clinical nurse specialist on Blake 8.
To provide more continuity of care, nursing staff have been involved in phased learning across the two floors since 2014. In the last two years, training was widened for Ellison 9 to include the experiential instruction in mechanical circulatory support services and ECMO. But just as the overall effort began to bear fruit, the training field was abruptly left fallow, due to the emergence of COVID-19.
“Once COVID died down, we shifted right back to caring for very sick cardiac patients and somehow found time to continue with our advanced education,” says Michelle Crocker, RN, of Ellison 9.
Despite the challenges, the group successfully completed all necessary training to meet their original “go live” plans.
“When you work collaboratively, it’s amazing what you can do for the quality of the patient experience,” says Glushchenko.