In This Issue:

Nurses Making a Difference

Horizontal Hostility

Cancer Survivorship Survey Underway

What's New

Nurse Q & A

Nurse Volunteer Opportunities:

City of Seaside Health Fair
November 2
1:00-4:00 p.m.
Seaside City Hall

Monterey Chamber of
Commerce Showcase
November 6
4:00-7:00 p.m.

Hyatt Regency Hotel
Health Fair
November 12
10:00 a.m.-2:00 p.m.
Hyatt Regency Grand Ballroom

The Californian Showcase
November 23
4:30-7:00 p.m.
Sherwood Hall

For more information on
these volunteer opportunities, contact Health Promotion at

Nurses Making a Difference
Dana Rogers, RN III, ICU/CCU

Dana Rogers, RN III, ICU/CCU Dana Rogers, RN III, ICU/CCU saw an opportunity to improve patient care and crafted a proposal for a Pressure Ulcer Initiative in August 2007. “We had patients in the critical care areas that were prone to developing pressure ulcers and we needed a better system for identifying those at risk and strengthening our prevention efforts,” says Dana. Her proposal was approved and the initial phase was launched in May this year.

“It was a collaborative effort with the Wound Healing Center, critical care departments and administration,” she says. “I couldn't have done it without all of their support and participation.” They looked at the critical care areas specifically, compiling data including co-morbidity, nutrition deficits, mobility status and age of patients with and without pressure ulcers. “Prevention is the main goal of the initiative,” she continues. “We’re taking a multidisciplinary approach to increase staff awareness that involves nurses, doctors, physical therapists, nutritionists, CNAs and others.”

The initial information gathering stage was finished in September. “This data will help us make refinements to the program and then it will be implemented throughout the hospital,” she adds.

Dana joined the staff of Salinas Valley Memorial in 1993 and graduated from Hartnell’s Nursing School two years later. “Critical care nursing really suits my personality,” says Dana. “It’s very cognitive and focuses on the whole patient. And I specially enjoy the team effort that it takes.”

“If I can do something like this, anyone can,” Dana says. “Everyone should put their ideas for improvement out there. You gain so much from doing a project like this and it truly benefits patients. It’s been a great experience and makes me want to do more.”

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Has It Ever Happened To You?

Irene Neumeister mentioned it in her letter in the last issue of SVMHS Nurse. The final session of the Regional Nurse Network was devoted to it. The topic has its own section in our Precepting with Pride class and 60 percent of new nurses leave their first position within 6 months because of it.

“It” is horizontal hostility (also called lateral violence) or more specifically nurse to nurse hostility. It refers to the way nurses covertly or overtly direct their dissatisfaction toward each other, themselves and those less powerful.

New nursing school graduates are going through orientation now, so this might be a good time to take a look at ourselves and what goes on in our units. We all deserve to be treated well by our co-workers and have the responsibility, and obligation, to nurture and support one another.

Have you ever been on the receiving or the giving end of horizontal hostility? Here are just a few of the forms this unprofessional behavior can take:

  1. Non verbal innuendo (raised eyebrows, face making)
  2. Verbal affront (snide remarks, lack of openness, abrupt responses)
  3. Undermining activities (turning away, not available)
  4. Backstabbing (complaining to others about an individual and not speaking directly to that individual)
  5. Scape-goating (attributing all that goes wrong to one individual)
  6. Infighting (bickering with peers)
  7. Broken confidences
  8. Failure to respect privacy
  9. Sabotage (deliberately setting up a negative situation)
  10. Withholding information (practice or patient)

As nurses, our focus is on patient safety and quality care. Anything—behaviors, attitudes, actions and inactions—that impedes our ability to provide professional, compassionate nursing care to our patients, has no place in our nursing practice or our organization. If you encounter or witness this type of behavior, it is your responsibility to point it out. Together, we can continue to create an environment of nurturing and mutual respect that fosters excellence in patient care.


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Cancer Survivorship Survey Underway

Cancer Survivor ArtOur Cancer Survivorship Program was initiated in September 2007 after Bree Nakashima, Oncology Social Worker and Carol Maynard, RN, OCN, Breast Health and Clinical Trials Specialist attended a survivorship conference presented by City of Hope Comprehensive Cancer Center. “A survivorship program is important, especially now as more patients survive cancer," says Carol. "They’ve changed; their outlook on life has changed. It’s unrealistic to expect them to return to life as they knew it.” During the initial needs assessment phase, we formed a committee of cancer survivors that has met monthly for the past year. “Many people said that what they needed most was a continuing support system to help them through the transition from active treatment to normalizing their life,” says Bree. In response, the Treatment Summary and Plan of Care is being developed and will be in use before year-end. The document summarizes diagnose, treatments, tests, medication side effects and suggested timing for follow-up appointments with the oncologist, surgeon, and primary care physician. So that we can continue to identify needs and refine our Survivorship Program, a survey of cancer patients and survivors, family members and caregivers is currently underway. If you would like a copy of the needs survey for a patient, friend, family member or yourself, please contact the Cancer Resource Center at (831) 755-0791

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What’s New

Bereavement packets

Chaplain Lillian Capehart and Chaplain Ken NolenThe Spiritual Care Services Department offers a bereavement packet that you can use with your patients and their families. “We selected a national program and worked with our Chaplains to modify it for use at SVMHS,” says Lynn Brooks, Director of Volunteer, Health Careers and Spiritual Care Services. Available in English and Spanish, the packets include a list of key hospital and community resources such as who to contact regarding veterans and social security benefits, funeral directors and bereavement specialists, as well as national resources and materials, a poem and a card people can use to provide feedback. A small tag with a simple leaf and teardrop design, can be placed on patient’s door to make caregivers aware that the patient is at the end of life stage. “It gives us an opportunity to be even more sensitive during this difficult time,” Lynn adds.

For additional bereavement packets and more information, contact Chaplain Ken Nolen or Chaplain Lillian Capehart at extension 3259.

Simulation Lab coming to SVMHS

Rachel Failano, RN, MSN, Clinical Nurse Educator, Clinical Simulation/Skills LabA state-of-the-art clinical simulation lab, located the new education facility at 611 Abbott Street, is scheduled to open in early 2009. “Simulation has been used for many years in aviation, the military and in medicine,” says Rachel Failano, RN, MSN, Clinical Nurse Educator, Clinical Simulation/Skills Lab Coordinator, “but is new territory for nursing, and in a non-teaching hospital setting in particular. It adds an entirely new dimension to learning. We can create specific patient care environments and scenarios using high-fidelity, human simulators, rather than patients, to learn the most effective and safest ways to respond in that situation.” The simulation lab is comprised of a control room, two simulation areas and de-briefing rooms. “We can run clinical simulations that include pre-programmed patient responses in addition to those in real time where we make changes based on the specific interventions of the learner,” explains Rachel. “From the control room, we have access to a speaker in the simulator allowing someone to be the voice of the patient.” Cameras capture and record audio and video from multiple views. Once the simulation is over, participants review the recordings, discuss how things went and identify areas for improvement. “The bottom line is patient safety,” Rachel says. “Clinical simulation supports this by providing an environment where learners can practice and gain experience.” Anyone interested in seeing high-fidelity human simulators in action is invited to attend an upcoming demonstration (date and times TBA). For more information, contact Rachel Failano at 759-3202, ext. 3202 or

Also, stay tuned for more information via MEMNET and SVMHS Nurse.


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Nurse Q & A

Q: What was the most important message you took from the Maria O’Rourke classes and how do you see what you learned affecting your practice?

Mario Zermeno, RN, PACUA: The Maria O'Rourke (MOR) program has inspired me as well as reminded me of the responsibilities and power of nurses. Even though we have busy schedules, we need to stay focused on patient safety and quality of care in order to achieve the best possible outcomes. In developing a Role Base Practice, we can use our keen attention to detail to gather historical and current information. This empowers us to provide the highest level of care within our scope of practice in collaboration with the medical team. It has helped me develop a decision-making process and utilize any necessary resources to provide the best nursing care within my abilities and scope of practice.
—Mario Zermeno, RN, PACU

Maryanne Conklin, RN III, Level IIA: The Maria O’Rourke program has inspired me in my nursing practice and has really brought out the fact that we are professionals. Through the classes, Maria has given us new tools to become a cohesive professional group of nurses with the power to provide excellent patient care and improve outcomes, and positively impact the hospital as a whole. It’s an opportunity for everyone in the nursing environment at SVMHS to be on the same page and is raising the bar of professionalism in our nursing culture.
—Maryanne Conklin, RN III, Level II

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View a Video clip of a portion of one of Maria's classes and hear her interviews

Question for the next SVMHS Nurse e-newsletter:
"What have you learned about horizontal hostility and how are you prepared to identify and address it if it happens to you personally or if you see it happening to someone else?” Send us an email.

Have a question or comment about SVMHS Nurse?
Send us an email.

Today's Smile from our own Peggy Clancy, RN

Illustration © Peggy Clancy, RN
Illustration © Peggy Clancy, RN

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