AACN excellence in clinical practice award.

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Judith M. Rojo, RN, BSN, CCRN 

The Valley Hospital, Ridgewood, NJ

When a young woman undergoing surgery developed a major cardiac decompensation, a STAT call was made to the CCU for a nurse to assist the OR staff. There was no question about who should go--Judy Rojo, RN.

Judy ran downstairs, not knowing what challenge she would face. Upon arrival, Judy took charge after comforting the patient. She assisted in hanging multiple vasopressors and cardioverting the patient. Judy assisted in placing an intraaortic balloon pump (IABP), a procedure never previously performed in the OR. Judy then transported the patient to the cardiac catheter lab and helped prep the patient. Subsequently, Judy brought the patient to the CCU.

On arrival at the CCU, the staff learned that this critically ill patient was one of their own. Barbara was a beloved hospital employee. In the ensuing hours, Judy was a source of calm, providing care and comfort. She never left the patient's bedside. Judy was the clinician, expertly managing multiple drips, a ventilator and an IABP. She was the compassionate professional, comforting the patient and family. Judy's shoulders were damp from many tears. As it became clear that Barbara would not survive, Judy supported her in her final moments. Barbara died with dignity, with her family, her doctors and her nurse at her side.

Many traits characterize an excellent critical care nurse. They have excellent clinical skills and are able to apply them in stressful circumstances. They are leaders, willing to take charge of difficult situations. They welcome new challenges. They are compassionate and caring, supporting patients and families through the most dire of circumstances. They are often the patient and family's greatest advocate. Judy Rojo is the epitome of a critical care nurse: clinician, leader, patient advocate and humanitarian.

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Carol Hafer, RN, BSN, CCRN

Mission Hospital Regional Medical Center, Mission Viejo, CA

As a nurse in the CICU, I think my greatest contribution to the unit has been my role in changing the unit to an environment of patient/family-centered care. As we were preparing to move into a new, stateof-the-art unit, my director asked me to look at our visitation policy and determine if changes were needed. I found overwhelming research-based evidence supporting open visitation policies where families are encouraged to play a central role in the care and healing of their loved ones.

My project consisted of gathering the research; identifying the barriers; establishing rapport with doctors, nurses, staff and other stakeholders; developing an educational program; and implementing the changes, which also incorporated the core values of the organization. We found the patients and families embraced the change. Staff, however, experienced mixed feelings and emotions that required ongoing support and education to help them cope with the changes.

I knew from the beginning that this was the right thing to do. But when I began to experience the emotions of my patients and their family members to this close involvement with sickness and healing, and sometimes death, I knew we had crossed an important threshold in patient care. A young husband, whose pregnant wife had been transported to our unit emergently after suffering a cardiac arrest, was grateful to witness the efforts and teamwork of the doctors and nurses as they worked toward a positive outcome. Families now develop trust in the caregivers, and I think trust is the greatest gift you can give your patients and their families.

As I experience the benefits and rewards of a patient/family-centered care environment on a daily basis, I wonder how we could ever have managed our care any other way.

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Kelly Walton, RN, BSN, CCRN

Carolinas Medical Center, Charlotte, NC

The headline read, "A beautiful life taken too early." A 17-year-old made a decision that ended a life full of hope and promise. S.K.'s pupils were fixed and dilated on arrival, and the CT scan revealed a massive closed-head injury. A mother prayed for peace.

Because she was showing no improvement, S.K.'s parents asked questions, exploring the possibility of donation. Was organ donation the right thing to do? What would S.K. have wanted? That night, we cried while the emptiness inside her parents grew ever so large. We knew what S.K.'s sacrifice would mean to the recipients. Her parents were convinced donation was the right thing to do and what S.K. would want.

Showing great love in their decision, her father's only request was to hug his daughter one last time. Her parents gathered extended family and friends around her bedside to say their final goodbyes. LifeShare bracelets and pins were worn proudly by her classmates and friends as an outward symbol of S.K.'s ultimate sacrifice.

That day S.K.'s mother helped with her last bath. She shared stories, and I felt I had known S.K. all my life. As we started to wash S.K.'s long hair, her mother decided to donate her hair too. Surrounded by her personal things, S.K.'s parents requested to be alone with their daughter. As her ICPs reached 100, both Mom and Dad were at her bedside holding her, praying and singing her favorite songs.

As I hugged her dad goodbye, I remembered his last request and the promise I had made. With help from another nurse we lifted his daughter off the bed so he could give her one last hug. This experience has given me a different perspective on life and the difference I make as a critical care nurse.

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Jacqueline Gurnick, MSN, RN, CCRN

Clinical One, Ravenna, OH

It has been said that every journey begins with a small step, but last year I decided to take a giant leap! Having attained my MSN degree years ago, I have functioned in the clinical nurse specialist role and as a clinical educator. I had also served as adjunct faculty for nursing students at a local university. After serious consideration, I decided to become a travel nurse and head back to the bedside on a full-time basis.

My first assignment was in a neuroscience unit at a major teaching facility out of state. I got to experience many new opportunities, learn new skills and meet new people I never would have encountered if I hadn't ventured along this career path. One of my last patients was a 52-year-old Hispanic woman who had suffered a large subarachnoid hemorrhage. Due to her prolonged recovery, she had a tracheostomy and feeding tube. Although I never got to personally know "Edith," I got to know her through her family. I arranged meetings with physicians so family members could get answers to their questions. I collaborated with other disciplines to include family members in Edith's care, based on the long-term needs that were essential to her recovery. I made a difference because I included the family in Edith's plan of care. Her daughter wrote a thank you note that said: Though my mother could not talk, you could tell how she felt when she gave you a smile. That alone validates why I went back to the bedside. What a great memory of my first road trip!

I find that my past experiences and my CCRN credential provide me with credibility and staying power no matter where my professional nursing career might take me! To me, nursing is a journey, not a destination.