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FOCUS
VA SAN D I EG O HEA LT H CA R E S YS TE M
— NU RS I NG AN D P AT I EN T C A RE S ERV I C ES —
Professional Models
of Care
A message from Janet Jones, RN
ACOS/Nursing & Patient Care Services
Magnet
Hospitals are known for employing professional models of care that give nurses the responsibility and authority for the provision of patient care. In
these models, nurses coordinate the care of the patient and are accountable for their own practice. A variety of professional care models are found in hospitals
that have achieved Magnet status.
Whether the care models are termed Primary, Patient-centered, or Holistic, they all possess certain key
professional practice components. These characteristics include giving the nurse responsibility and the related authority for the care of a group of patients, and
holding nurses accountable for their own practice. In
all care models studied, nurses coordinate the care of
their patients, set standards, and function in a collegial
manner with other members of the treatment team to
meet the needs of the patient. The Hospital has the
responsibility to provide the professional practice environment that supports nurses practicing nursing.
Nurses working in professional care models realize an increased sense of respect and recognition
within the practice setting, have a sense of being valued, and are viewed as a productive member of the
health care team. Patients being cared for in these
practice environments are more satisfied with their
care. At VASDHS we continuously strive for excellence by supporting nursing and patient care practices
that demonstrate these characteristics. Thank you for
you contributions to this important work in caring for
veterans.
Volume 1, Issue 3
July 2004
VA San Diego Healthcare System
2004 Performance Improvement Fair
“Measuring Success”
by
Vilma Divinagracia RN, MSN, CNS
Out of a total of 24 PI storyboards submitted in the PI
Fair last April, 12 projects involved nurses. A total of
165 staff participated in the annual PI fair and out of
this 67 (41%) were nurses. Below are the awardwinning entries which all had Nursing participants.
First Place: Improving Blood Readiness in the Operating Arena
(2 nurses: Pam Stevens CSD, Julia Azurin CSD)
The problem addressed was the lack of blood readiness before surgical procedures. Timely delivery of
blood improved to 75%, then to 100%.
Second Place: Patients Complete Lab Orders for
Renal Clinic Appointments
(6 nurses: Heidi Gutierrez RN, Aniceta Banayo RN,
Lisa Garcenila RN, Bernadette Bauer RN, Jose Flores LVN, Raelene Paulus RN)
Before this PI project, only 50% of patients completed
their lab work before their scheduled Renal appointment. Changes resulted an improvement to 90%.
Third Place: Total Quality Improvement Project:
To Improve Patient Satisfaction in the DOU
(4 nurses: Bob Bledsoe RN, Susan Hamamlow RN,
Priscilla Cortez RN, David Newton RN)
Areas which DOU patients expressed dissatisfaction
through a patient satisfaction survey were addressed.
The areas were poor quality of patient education, not
being informed or updated about their treatment plan,
pain management regimen, and environmental cleanliness.
Honorable Mention:
Janet Jones, RN, ACOS/Nursing & PCS addresses staff
during the Nurses Week Celebration in May ‘04
1. Improved Cholesterol Profiles and Glycemic
Control in Patients with Diabetes
(2 nurses: Mitch Rice NP, Joan Fitzgerald, NP)
The improvement actions consisted of education of
healthcare providers of the Diabetes Clinic, standardized testing and institution of treatment, establishing a
dedicated Lipid Clinic for difficult cases, and the use of
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Clinical Reminders set if LDL-C was greater than 100
mg/dl. The follow up LDL-C after a minimum of six
months in the Diabetes Clinic decreased to a mean of
101 mg/dl with 85% of the patients below 130 mg/dl,
and 55 % of the patients below 100 mg/dl. The mean
HBA1c decreased to 7.2%.
2. Reduction of Wait Times and Improved Patient
Satisfaction in the Anticoagulation Clinic
(4 nurses: Julienne Awtrey RN, Imelda Mina RN,
Sue Randolph LVN, Jerry Sabio LVN)
By expanding clinic times and increasing FTEE, patient-waiting time in the Anticoagulation Clinic was decreased by 58% despite a 67% increase in number of
patient visits.
People’s Choice Award:
Successful Outreach
Leads to Increased Access for Women Veterans
(2 nurses: Rita Osterman CNS, Robert Scinta CNS)
This PI project led to a 31% increase in the number of
women veterans seeking services at the WAVE Clinic.
KUDOS!!!
Several RNs from VA San Diego Healthcare System
where honored at the Commencement Ceremony at
the University of Phoenix on June 26, 2004.
The name of our staff receiving the following
degrees are listed below.
Master of Science in Nursing/MBA/Health Care
Management:
Julia Azurin
Dawn Berthiaume
Cindy Gerlan
Laureen Pada
Linda Shepherd
Master of Science in Nursing:
JoAnne Costanzo
Bachelor of Science in Nursing:
Perla Bambico
Jacquelyn Thomas
Editor’s note: If you have completed a degree and
would like to be recognized in a future edition of
FOCUS, please send an email announcement with
your name, school, degree, and date of graduation to
Carole Hair, ACNS/Education.
Pictured at the University of Phoenix
Commencement Ceremony are:
Linda Shepherd (1st on the left), Dawn Berthiaume
(3rd on the left), Laureen Pada (6th on the left) and
Cindy Gerlan (7th on the left).
Nursing Council and
Committees Reports
May—July 2004
compiled by Vilma C. Divinagracia, MSN, CNS
Report from Education Council:
1. Cultural Awareness Taskforce:
a. Completed template/ guide for cultural storytelling. Will be shared with staff through Education
Council facilitators.
b. Handout and short quiz on cultural awareness and
sensitivity completed for Nursing Orientation.
c. Diversity exam in Vista being revised. Has been
shared and approved through EEO/ Special Emphasis
Program. Will be presented to the VASDHS Employee
Education and Training Team (EETT) for approval.
2. Current Projects: Computer training and competency testing- will be designed and implemented by the
CNS members of Education Council
3. Current Issues: Age-specific care for patients in the
Early adulthood and Adulthood stages has been identified as a new learning need with the influx of younger,
war-wounded veterans from Iraq. VHA initiative teaching materials available through Intranet/ Internet on the
care of this special population.
Administrative Council:
Mary Ellen Dellefield presented the final role differentiations tables for ECC, Inpatient, and Ambulatory Care
areas to the Nursing Executive Team (NET) in June.
The tables will improve role clarity, and assist managers and employees in their roles,
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and scope of practice. Before implementation, a short
policy will be developed to accompany the tables. This
policy and the tables will be reviewed with all staff
when approved.
Clinical Practice Council:
A memorandum from Kathy Dunn and Chris Trelease
was circulated outlining the plans to update resources
for wound management and skin care. Material from
the Puget Sound VA wound care website will be used
to update our policies and procedures. Additional
classes will be given for staff, and a website for reference will be created. Patient education materials will
be incorporated into the new resources.
The CNS Committee is delineating what tests, treatments, and medications can be ordered by different
groups of nurses without a provider’s order. Routine,
common, necessary tests, procedures, and medications such as immunizations will be emphasized.
Brown Bag lunch presentations on the topic of
“Autonomy” were held June 8 and June 10. This came
about as a result of the RN Survey data last fall that
showed some of the autonomy scores were lower than
some other scores.
ECC, UCC, OR, ASU, 3N, 3E, and 5E had lower group
and individual autonomy scores. ICU, DOU,2S, and
specialty clinics had lower individual autonomy scores.
Hemodialysis had lower group autonomy scores. Our
thought is that if we can educate nurses as to what
nurse autonomy is, we hope to positively affect their
scores in this aspect when we repeat the RN survey
this fall. Staff nurses are highly encouraged to attend
the classes.
Clinical Policy and Procedure Subcommittee:
NET approved “Cleaning and High-Level Disinfecting
of Flexible Endoscopes in the Procedure Center” in
June.
Documentation Subcommittee:
The Psychiatry CNT Admission form has been started
with ITS. The RN Reassessment Note was demonstrated on June The PACU documentation note in
CPRS was approved with changes.
The group is still working on the Nursing Documentation Policy, and guidelines for Clinical Reminders.
Plans of Care Subcommittee:
The ICU pilot test of plans of care in CPRS was highly
successful. The DOU would also like to use the
computerized format, and both groups would like to
expand the list of diagnoses to the full 29 which are
available. Once this is done, the plans of care can be
expanded and reorganized according to patient
problems, but this will take considerable time and
effort. Plans of care in the Outpatient Areas are
usually integrated into the note rather than listed
separately due to time constraints
Research Council:
The Research Council coordinated efforts to display
research posters for Nurses’ Week. The Council also
sponsored a brown bag seminar, “Linking Research
Evidence to Your Practice,” presented by Ann Kelly
and Cathy Magruder during Nurses’ Week. This will
be repeated on December 8 (0800-0900) for the
Outpatient staff. The program will be presented via VTel.. The next brown bag presentation will be held on
September 9 in the ICU Conference (5095) from 121300. The topic will be “CALNOC – the data on nursesensitive indicators, and how we measure up”. Ann
Kelly will be the presenter. Extensive publicity will be
arranged, including the Nursing Education Calendar.
The program will be submitted for CEUs.
The 9th Joint Southern California Chapters of
Sigma Theta Tau International, Nursing Research
Conference will be held in San Diego on October 2122, 2004. Four nurses have submitted abstracts:
Candice Bowman, Jacquelyn Thomas, Marty Shively,
and Mary Ellen Dellefield.
The ICU staff will be submitting the work they did
on the NG/Feeding policies for the Greater LA
conference.
A newly designed web site is available for
providing instruments for use in health-related
research. The web site is www.measurementexperts.
org.
Jill Bormann, Ph.D., RN, and Ann Kelly, MN, RN,
attended the 37th Annual Communicating Nursing
Research Conference and 18th Annual WIN
Assembly, April 22-24, 2004, in Portland, OR.
Bormann presented a poster, “Mantram Repetition for
Managing Stress in Veterans,” in collaboration with coinvestigators Sheryl Becker, MN, RN, Madeline
Gershwin, MA, RN, and Ann Kelly, MN, RN.
The hospital-wide electronic Research Journal
Club is transitioning to Outlook from VISTA. Some
issues remain, such as enrolling the members. At
present there is no mechanism for new members to
self-enroll. Once this is done, the club will begin again.
The focus will be basics of research articles, how to
read a study, etc.
Barbara Rose, PhD(c), RN has become the new
Co-Chair of the Research Council as of April 2004.
Performance Improvement Council:
Presentation of unit-based Performance Improvement
projects continues. 5E presented their project on using
a revised Kardex communication tool. Service goal for
the year is to increase SHEP scores on emotional support, with emphasis on assessing fears or concerns for
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all patients at time of assessments/reassessments.
Unit Coordinators Committee:
The group has completed their charter, roster, and
mail group. They will also be working on a general job
description, then unit specific job descriptions.
Differentiating Nursing Practice
by
Mary Ellen Dellefield, RN, PhD, ECC Clinical Program
Manager
The Nursing Service at VA San Diego Healthcare System (VASDHS) is comprised of a variety of types of
nursing staff members. It includes health technicians,
nursing assistants, licensed vocational nurses, nursing
students (Valor program participants, student nurse
externs, and student nurse technicians), graduate
nurse technicians, and registered nurses, some of
whom are also nurse practitioners. Each of these nursing roles is associated with a specific educational requirement and, in some cases, a licensing and/or certification requirement. The staff members performing
each role contribute in unique ways to the achievement of desired clinical outcomes for our Veteran patients.
Because there is such a diversity of roles within the
Nursing Service, it can be challenging to remember
what nursing activity a staff member is able to perform,
given each person’s specific educational and licensing
background. It is also difficult to hold people accountable for individual practice if the specific clinical activities that are associated with a specific nursing role are
not clearly identified. For both these reasons, members of the Nursing Leadership Council decided to develop some guidelines that would assist staff members
and managers in easily identifying the nurse practice
roles of specific members of the nursing staff. These
guidelines are entirely based on existing and approved
policies and procedures of the Nursing Service. The
guidelines simply provide a new format for more easily
identifying practice roles and scopes that have already
been established.
After significant efforts by members of the Nursing
Leadership Council, three tables were developed, with
a fourth still under development. The tables are useful
for new orientees, for charge nurses developing shiftspecific assignments, and for any staff member wanting to recall a specific clinical activity attached to a
specific nursing role. The tables will be periodically updated, as existing policies and procedures are revised,
and role-specific clinical activities change.
Because the nature of each staff member’s nursing
practice is affected by the clinical setting and accreditation standards that provide the context of practice,
the tables have been developed for three settings.
These include acute care services, ambulatory services, and extended care services. The fourth setting,
intensive care services, will be addressed in a table
that is still under development. All tables have the
same format, consisting of several rows and columns.
The clinical activity for the nursing staff member is
identified in the left-hand column. The remaining rows
and columns identify which nursing staff member (i.e.
RN, LVN, SNT, etc) is able to perform the activity. If
there are any special educational requirements for an
activity, these are identified in the final column. It is important to note that the tables were not constructed to
delineate specific clinical activities of the nurse practitioners and advanced practice nurses in various settings.
These tables will ultimately be available in Docushare. For ease of access, they may be included in
the schedule book on each unit as a resource to staff
members. As our Nursing Service prepares for the
Magnet Accreditation visit, the tables on differentiated
nursing practice may also be seen as tools to enable
nurse managers to monitor and evaluate the delivery
of nursing care. The hope is that these tables will be
routinely updated to serve as practical clinical and
management tools for all nursing staff members.
VASDHS NURSING VALOR
PROGRAM
by: Jane Edens, BSN, RN
The VA Valor Program is designed to give student
nurses who have achieved academic excellence
through the junior year an opportunity to expand
knowledge and skills through an intensive 10-week
summer clinical internship. The VALOR intern
provides professional nursing care to patients under
the direct supervision of a BSN prepared RN
preceptor. Through this, the student achieves the
overall goals of the internship, expansion of
theoretical knowledge base, improved psychomotor
skills and experience in the application of the nursing
process to patients in a specific unit of interest. All
Valor students at VASDHS chose to continue this
program on a part time basis while completing their
senior year of school. Valor students (and externs
completing similar hours of clinical experience on a
specific unit) receive an additional step to their
starting salary upon conversion to a RN in recognition
of their success in the program and their continued
commitment and performance to their “Valor” unit.
Recent Valor students and their areas include:
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2002—2003
2003—2004
2004—2005
Allison Gove –ER/UCC
Laura Kobulnicky- SCI
Anne Leonard- SCI
LeAnn Shipp – ICU
Tanya Noland- DOU
Rebecca Villamil- DOU
Amber Costello- SCI
Theresa Liu- SCI
Melinda Christian- DOU
Autumn Messerli- DOU
Joan Oliveros- ICU
Jeremy Cabrera- ICU
Jennifer Heintz- 2South
Stanley Szary- ER/UCC
Elizabeth Bushouer- 3N/Hemodialysis
Mark Sarigan- 5East
We congratulate all of you and wish you continued
success in your nursing career at the VASDHS.
We will highlight the Extern and SNT programs in
our next Focus issue.
Patient Education:
TEACH for Success
Who Should Attend
Clinical staff who are involved in educating patients,
including but not limited to:
Nurses
Advanced practice nurses
Physicians
Physician assistants
Dietitians
Pharmacists
Psychologists
Social workers
Therapists—physical, occupational, speech, hearing
Continuing Education Credit
The VA Employee Education System designates the
complete course for 22.5 contact hours. CEUs have
been approved for physicians, nurses, pharmacists,
and social workers. Read your email for upcoming
classes to register for Patient Education: TEACH for
Success. Register for the Preview Session to find out
more about the course program.
Please contact Laureen Pada, Patient Health
Education Coordinator for questions about the course
content at x3988.
Photos from Nurses Week—May ‘04
by
Laureen Pada, RN, BSN, Patient Education
Coordinator
Frustrated with your current efforts?
Want to get more out of your teaching?
Want patients to be more successful?
Want to feel more satisfied—and have satisfied
patients, too?
Then this course is for you.
Features of the Course
It’s a blended learning experience:
O You learn about state-of-the-art, evidence-based
strategies through self-study using an interactive
CD-ROM
O You practice the techniques in the classroom with
your colleagues using simulated patients and case
scenarios
Based on a self-assessment you complete during the
Preview Session, you attend as many units as you
need
Each unit stands alone and carries its own continuing
education credit, so you can take only one or all five—
it’s up to you
You can take the units in any order, although the
TEACH sequence is recommended
The course meets JCAHO requirements for patient
education skill development
Staff from the night shift of the Extended
Care Center in their Thursday orange
scrubs looked awake and radiant during
the Nurses Week breakfast. From left to
right: Sylvia Chanchico RN (charge
nurse), Rachel Ann Edrosolo RN, Edil
Belisario RN, and Ronald de la Cruz, LVN
The ocean theme adopted for the celebration
was evident in many gift baskets displayed at
the Nurses Week reception.
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FOCUS
VA San Diego Nurses
The Honey Bees Goal Sharing Team
Needs You!!
by
Kathleen O’Hanlon, RN, MSN, Certified Diabetes
Educator
Goal of Team: To create a core group of nurses with
comprehensive training to become Diabetes Resource
Nurses who can foster knowledge of diabetes in their
respective areas.
Format: A total of 8 hours course work that includes
diabetes management goals, pharmacology, diet, patient self-care issues, exciting innovations and research findings. Attendees will also share what is
learned with their fellow workers through an activity of
their choice. Course will be offered three times this
summer, with CEUs. Request AA!
First Step: So that we may tailor our course to meet
your needs, please complete the “Honey Bee” survey
distributed to your area, and return it to the designated
collection envelope.
Second Step: Let your supervisor know that you’re
interested in attending our program!
Third Step: Be on the lookout for details about dates/
time of classes.
Contact Kathleen O’Hanlon RN, MSN, CDE for questions (x7245).
VA Nursing Education for
Employees Program (VANEEP)
by
Carole Hair, RN, PhD, ACNS/Education
Earlier this year the VA Health Care Staff Development
and Retention Office (HCSDRO) announced the implementation of a new program called the VA Nursing
Education for Employees Program or VANEEP in order to address workforce needs for the Veterans
Health Administration. This new program is specifically
focused on supporting current VA employees who are
seeking to become Licensed Practical Nurses or Registered Nurses. The VANEEP program provides funding for VA medical centers to hire replacement personnel for a VANEEP participant, which enables the employee to attend the nursing program full-time and not
have to maintain a full or part-time work schedule.
This program was authorized under the authority of the
existing Employee Incentive Scholarship Program
(EISP). Employees who are approved to receive EISP
funds for tuition, books and fees are also eligible to apply for VANEEP. The employee MUST be applying for
EISP funding in order to apply for VANEEP. If you are
thinking of returning to school to continue your education, this program may be for you. Contact Carole Hair,
ACNS/Education at extension 3455 or Gary Cornaglia
in Education Service at extension 3626 for more information about this program.
Methicillin-Resistant Staphylococcus
Aureus (MRSA)
by
Grace Kirkland, RN, Infection Control Nurse
Staphylococcus aureus is often referred to as "staph."
The MR part stands for methicillin-resistant.
When
identified in the microbiology lab, this resistance pattern
sends a red flag and is investigated to determine
whether or not it is hospital-acquired. A patient with a
positive culture, whether colonized or infected, is a possible source of spread. Staph aureus may be spread
on inanimate objects but people are more likely, hence
the term 'Staff-spread staph." It is not airborne.
Once we know it's present and we know how it gets
from one patient to another, we can utilize procedures
to keep from spreading it. MRSA is tracked as one
marker to indicate when a breakdown in our system,
i.e. lack of hand hygiene or failure to use gloves appropriately, may have occurred. We have shown a decrease in hospital-acquired MRSA since Isagel® was
introduced. Research has shown that serious MRSA
infections such as bloodstream and surgical site infections have a higher mortality rate than antibiotic susceptible Staph aureus infections. MRSA infections also
result in increased costs and lengths of stay for patients. Preventing these infections will decrease patient
suffering and save the hospital much expense.
Contact Precautions, as recommended by the
CDC, are used to prevent spread of MRSA. Take this
opportunity to role model and teach other staff:
Gloves for all contact.
Excellent hand hygiene when gloves removed.
Gowns to prevent contact with clothes.
Private room if possible.
Disinfect all equipment.
Contact Grace Kirkland RN, Infection Control Nurse, for
questions or ideas to help prevent infections.
-Interesting Fact About NursingAccording to a 2001 World Health Organization report,
the number of psychiatric nurses in poor countries is
about 0.1 per 100,000 persons.
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FOCUS
Keeping our Patients
Safe
by
Vilma Divinagracia, RN, MSN, CNS
Safety has always been a responsibility and concern
for nurses. As the public is increasingly consumer
conscious of the cost and quality of services they
receive, there is an increased awareness of the
important role of nursing personnel in maintaining a
safe environment.
What are some of the risks to you, your patients,
or family members when you are hospitalized?
Falls, infections, skin breakdown, and injury from
improper or inappropriate use of restraints are some of
the major issues, and not coincidentally, viewed as
Nursing Sensitive Indicators by the American Nurses
Credentialing Center.
As defined by the Scope and Standards for Nurse
Administrators (ANA, 1996), Nursing Sensitive
Indicators are “Measures and indicators that reflect the
impact of nursing actions on outcomes”.
Hear are some safety facts about these measures and
outcomes here at VASDHS:
Restraints
• Total hours of restraint in ICU have
consistently increased over the last three
quarters, presumably an effect of higher acuity
patients with longer lengths of stay.
• Episodes of restraints as a percentage of bed
days of care are somewhat higher than
CalNOC averages.
• High utilizer patients (>72 hours) in ICU
account for the vast majority of restraint use.
For example, 20% of the patients in ICU
account for almost 80% of the total hours of
use.
• DOU, 3N, 5E are all below the levels expected
from CalNoc data comparison.
• DOU has shown a slight increase in the use,
but not at statistically significant levels.
• 2 South (Psychiatry) has shown continued
dramatic improvements in the use of seclusion
and restraint. In 2003, a total of 6.5 hours
were used for seclusion and less than 15
hours for restraints. This is compared to 2002,
when 21 hours were used for seclusion and 77
for restraint.
Pressure Ulcers
Although official reports from CalNOC on our March
2004 pressure ulcer survey have not yet been
received, we were able to determine the following
about pressure ulcers:
⇒ SCI completed risk assessment for pressure
ulcers on 100% of patients assessed the day
of the study.
⇒ Patients are admitted to the hospital with
pressure ulcers in all 4 stages.
⇒ Items common to many of our patients, such
as a nasogastric tube or an oxygen cannula,
can be the cause of a hospital acquired
pressure ulcer.
Falls
⇒ In 2003, Falls represented 32% of all
incidents reported.
⇒ Between 1999 and 2003, the fall rate at
VASHDS was lower than other hospitals in our
VISN and lower than the CalNOC average.
⇒ The fall aggregate review team is a
multidisciplinary team that reviews all patient
fall incidents and develops recommendations
to decrease occurrences.
MRSA infections
⇒ Result in increased cost and length of stay.
⇒ May be spread on inanimate objects, but
spread from person to person contact is
much more common.
⇒ The Center for Disease Control recommends
that Contact Precautions be used to prevent
the spread of MRSA.
⇒ VASDHS has shown a decrease in hospitalacquired MRSA infections since Isagel was
introduced.
FROM THE
MAGNET CORNER
Magnet Champions
Esau L. Evans III
Was born and raised in Wilmington,
Delaware. He was named after his
grandfather who had a twin brother
named Jacob, both of whom were
named after the biblical sons of Isaac.
After spending five years in the
United States Navy honing both his
active and passive listening skills a Sonar Technician,
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Esau decided to pursue a career in nursing. He
worked his way through nursing school in the allied
health field as a lab assistant and as a ward clerk/
CNA. He graduated from San Diego State University in
1998 with his Bachelor of Science in Nursing and
obtained his Master of Science in Nursing from the
University of Phoenix in 2002.
He especially enjoys working at the San Diego
VAMC, due to his military background; Esau feels a
special bond with his patients. He practices holistic
nursing care with gentle yet firm approach. As a new
graduate RN he began his career in the Spinal Cord
Injury Unit. Later, he matriculated to the DOU and he
currently has aspirations toward nursing management.
Esau still maintains a passion for electronic
gadgets and gardening. His other hobbies include
collecting antique books and assorted memorabilia
Photothe
Not early 1920’- 1950s. When he has time, he
from
Available
also
enjoys drawing and painting with reckless
abandon, everything from flowers to figure studies. A
loving husband, he also dutifully nurtures two dogs and
four cats at his home in Spring Valley.
The Focus Group report from the Patient Care Services staff and non-licensed staff in Nursing Service is
being compiled. Look for an article on the results of
the Focus Group discussion in the next issue of
FOCUS.
Michele W. Sommers
Michele served on active duty in the Navy as an
electrician on the USS Acadia during Desert Storm,
and has owned and operated a home daycare for
children. She now absolutely LOVES being a nurse in
the DOU, and has been at the VA 4 years. She also
owns and operates “Sommers Scents,” an
aromatherapy business.
Michele believes in the holistic approach to
nursing for both staff and patients. She has sought
training in Aromatherapy and Reiki and Healing Touch,
and is currently in training for CranioSacral therapy.
She recently purchased a house with a huge back
yard and lives with her daughter, dog, 2 cats, hamster,
fish, leopard gecko lizard and dust bunnies.
She loves “putzing” around in the garden and plans on
bringing in all the zucchini and tomatoes her fellow coworkers can ever hope to eat!
Michele thought she was a pretty smart woman
until her daughter turned 11 and showed her
otherwise. She prays they both make it through her
adolescence with only minor bumps & bruises..!
We’d love to hear from you!
Please send us your items of interest, critiques, or
comments by e-mail or drop us a note in our Nursing
Office (4EA) boxes.
Editorial Board: Vilma Divinagracia, MSN, RN; Lauraine Dwyer MS,
RN; Jane Edens RN, BSN; Francine Fomon MSN, RN, FNP; Carole
Hair, PhD, RN, GNP; Cathy Verkaaik MS, RN
To access the Focus Newsletter on-line please visit:
http://vhasdcweb4/nursing/Magnet/magnet_main_page.
htm