Daily Updates

Moments of Excellence

Visited Alicia and her new baby girl this morning, and they are doing great! Her baby is just beautiful!! Her name is Mireya Violet Hopkins!!!

Covid Updates
·         I am working on getting some of the reusable respirators for our team. We currently have 2 that I have borrowed from L&D for potential deliveries. Stay tuned for more info!
·         Please try not to discard PPE, I am more than happy to help exchange soiled/used for new supplies if you can’t get down to the Mezzanine.

Magnet
·         Sarah came by today for more Magnet prep using the questions in the treasure chest/box at the Nurses Station!
·         I have posted the Strengths from our Engagement Survey on the bathroom door for everyone to see, and they are included on this email (along with our Concerns).
·         Regarding concerns, one of the ways I try incorporate feedback into my practice as your Manager is my yearly Manager Survey. Please take a moment to provide input if you have not yet done so! https://www.surveymonkey.com/r/LTHKLZT
·         Try to think of our Unit Introduction (“We are a 26 bed, Level 3 NICU with single family rooms…”)!
·         I will do my best to continue pre-packaging speaking points and answers to questions!

Contracts
·         I submitted the updated count of shifts, contracts and staffing numbers to Kim yesterday. She asked that I wait until she can run the numbers and go through everything for now, before counting more of you into the contracts list.
·         I will let you know what the status is as soon as I hear back, and will post the new and updated needs list then!

Thank you everyone for your hard work!
Joe

Manager Update 07.27.20

Hi Team!

I can’t thank you enough for all the hard work you have been putting in over the last 2 weeks, and especially this past weekend. You may have also heard that Dr. Joseph Costa, chief of Critical Care passed away this weekend. Please keep his husband, his family and his/our ICU family all in your thoughts and prayers.

COVID Updates
· Covid+ mom couplets may now be taken care of by the same nurse, and this has already been in practice for a week on Mother/Baby.
· Some of you may have seen ICU, ED and/or even L&D nurses wearing Respirators. These are rated at the same efficacy as our N95’s but are more durable for multiple use. I am looking into acquiring some of these for our unit as well.
· Mercy continues to be very cautious in regards to social distancing and PPE, including eye shields at all times. Please let me know if you are in need of any PPE supply.

Magnet
· There is a Magnet treasure chest/box out at the Nurses Station. There are decorating materials inside, please feel free to decorate it for our unit. As we progress in our Magnet preparation, it will be periodically filled with treasures and rewards.
· Beth Kilmoyer will be coming around at 4pm tomorrow for our “Magnet Tour” where she will be going over practice questions like the ones Sarah has been coming around with!

Again, my apologies for the lapse in updates last week. It was fairly hectic and I often was preparing to come back and staff those evenings. If there is anything that you have any questions or thoughts about please let me know. I’m happy to include in future updates.

Thanks everyone,
Joe

Manager Update 05.11.20

Hi Team!

Happy Nurses Week!

I know that these updates have been sparse as of late, but with that being said there are not many major changes/updates!

I know this is in the news a little bit, and I had spoken with some of you about it but the warnings on a pediatric vasculitis (similar to but not Kawasaki Disease) has been gaining some traction in the news. I was not very familiar with this disease, so attached are 2 articles that might be useful in learning about it. Despite the media attention, there is very limited information about cases and the connection to Covid-19 is very unclear.

Mercy Updates

There are fewer Covid+ inpatients in house, and plans are to collapse the Covid space back to it’s original footprint. I will keep you updated with any changes (nothing has changed as of now).
L&D is still utilizing specific Covid rapid tests for their patients, currently this is focused use and not universal testing.
PPE is still available, but I have run out of KN95 masks. I will see if I can obtain more.
May 20^th NRP is currently STILL ON. Please stay tuned for updates.

Nurses Week

Yes we are getting gifts, it is my understanding they will be distributed at the end of the week. They are not in my office.
Though a little different this year, there are still activities planned to help celebrate Nurses Week. Today there is candy bars and blessing of hands!

I think that is it for today! Please let me know if there is anything you need!

Thanks,

Joe

Manager Update 04.23.20

Hi Team,

It’s been a little while since I posted these, but here are some interesting links to data, numbers and mathematical models for Maryland and our Baltimore City area:

https://coronavirus.maryland.gov/

https://covid19.healthdata.org/united-states-of-america/maryland

Delivery Plans

Currently the plan is for PUI or Covid positive moms to deliver on B9, with 932 and 933 ready for vaginal deliveries and 927 still set up for C/S’s.
Babies needing transport to 1028 (Covid nursery) can use the NRP transporter currently in 1028, in the event a baby would need to come to NICU we can use our transporter here.

Infant Care

Babies should be bathed as soon as possible (tolerating temperature), before tested or given Vit K or Hep B.
To allow for sufficient viral shedding from mom, infants of positive or PUI moms would be tested (swabbed) at 24hrs and 48hrs, and would be discharged even if results are not yet back.

PPE

ALL patient care and patient care areas now require N95 with simple mask overtop, and choice of eye protection (currently goggles, eye shields or face shields are OK).
Full PPE in deliveries would require ALL of the above (face mask mandatory), cap and shoe covers required for C/S and I would recommend the same for all deliveries.
NON-Covid related isolation (MRSA for example, but also including Covid related isolation) should discard PPE including OUTER simple mask upon leaving the room, we have ample simple masks.

Parent Teaching

Please encourage our moms/visitors to still take precautions even when they are at home. While they do a good job here, and you all do a great job teaching it is always helpful to remind them that they can be thoughtful about what they do outside of here, that will protect their babies still here.

Thanks everyone!

Joe

Manager Update 04.14.20

Updates for today!

Susan Finlayson, VP of Operations and Kim Schwenk, CNO will be holding a Webex call tomorrow (Wednesday 4/15) at 12:30! Please try and call in if you can!

1-650-429-3300

Meeting number (access code): 795 459 290

And!

Patsy is having food delivered for us on Thursday!
More eye shields (over the glasses type) came in, please let me know if you need one!

Also, our 3pm Webex calls with MCH Leadership has changed to M-W-F! My apologies if you called in today!

Thank you always for everything you do,

Joe

Manager Update 04.13.20

Hi Team,

Happy Monday!

Here are the websites I referenced today!

Maryland Department of Health numbers able to be viewed by county and zip code!

https://coronavirus.maryland.gov/

COVID-19 Mathematical Models, able to be viewed by State!

https://covid19.healthdata.org/united-states-of-america/maryland

A few quick nuggets for today’s update!

Mercy continues to receive shipments of PPE! Thanks to Supply Chain for their hard work!

B11 is now open!

Krispy Kreme does in fact give free dozens of donuts for healthcare workers, you just need to show your badge.

And lastly, our VP of Operations, Susan Finlayson and our CNO, Kim Schwenk are hosting a Webex call on Wednesday for our areas! Please try and call in if you can.

1-650-429-3300

Meeting number (access code): 795 459 290

That’s it for today! Thank you as always,

Joe

Manager Update 04.09.20

Hi Team!

Here are our main updates for today, all related to PPE!

Plain surgical masks should be worn at all times, including in public spaces here in Mercy.
All patient care should include a plain mask as well as eye protection (face shields or goggles are fine).
All deliveries should also have a plain mask OVER N95 and eye protection,
But C-Sections should have full PPE (including face shields).
ALL masks are to be worn/used until damaged or visibly soiled, no longer just for 1 week.
Babies of PUI or positive moms require full PPE, and you may dispose of the surgical mask over the N95, for as long as we can support the supply. Mercy has said that you should wear the surgical mask indefinitely since the face shield protects it. Here in NICU, I would like us to try and not do that until we absolutely have to.
C-Sections and other procedures (LP for example) should still discard the surgical mask.

Our practice is consistent with most of our area peers, with us probably being on a little more protected side. Thank you to all of our staff or former staff who continue to provide me references from Hopkins, Maryland, St. Joe’s, Baltimore Washington, Georgetown and Carroll.

Lastly, yesterday at risk to her own wellbeing, a colleague acquired a very small amount of the eye shields that fit over glasses. I have ordered more, and I anticipate their delivery any day so as soon as I get them in I will let my fellow glasses wearers know!

That’s it for today, as always thank you for everything!

Joe

Manager Update 04.01.20

Hi Team! Nothing changed today! April Fools! Of course things changed! Here we are:

Attached is the Mercy Essential Personnel Letter. This was discussed briefly in leadership meetings today, that at least anecdotally there have not been incidents of anyone being pulled over and needing to produce it, however I would advise you to keep a copy in your car. At least, this would offer you electronic access as well if you would need to provide it on your phone.

Mercy News

Mercy continues to build and develop strategies anticipating an increase in COVID-19 related patients, currently there are 3 whole units in various stages of completion!
To support staff, Mercy has started food carts to round on the floors to help minimize flow of traffic downstairs, as well as provide convenience for our staff.
Many of our colleagues in other areas have been working very hard to train and crosstrain nurses to expand and augment their skill sets. In addition, many of our nursing friends have been testing patients, screening at entrances and manning the call center and Command Center to support us.
Mercy will be trialing “drive through” testing, and is working on expanding availability of testing not only to patients but also to staff.

NICU Visitation

Moms are to now wear a plain surgical mask when here. Due to supply, please have them save and reuse each time they come in.
Only 1 visitor per family is allowed, including twins even if both are admitted.
Our Parent Hospitality Room is now closed to families/visitors. Please feel free to access the water/ice, microwave or refrigerator for them.
Mercy is developing means for communications using tablets, including Skype and Zoom and webcams. Stay tuned for more information.
Effective last week, all cardiology (echo) and radiology (X-ray and ultrasound) staff MUST wear gowns and gloves with our infants.

MCH Plans

Effective IMMEDIATELY, anytime a mother needs to be intubated for general anesthesia in the OR, all personnel must don N95 mask and face shield. I will be putting up hooks on the wall immediately outside the OR doors (in the NICU) for anyone to place their bags of PPE for easy access. Please make sure you have your PPE with you on the unit, as trying to retrieve from a locker (or car!) would be too slow.
Back hallway rooms 817, 818, 819, 820 and 827 are now negative flow (negative pressure), 826 to be held as an anteroom should we need to utilize that entire hall.
IF NEEDED, 817 and 818 can be used for admissions. After that would be 827. Please hold 826, 819 and 820 for as long as possible.
PUI or COVID positive mothers plans for delivery remain the same for right now (837 for vaginals, 927 for C/S), however this will be changing in the near future. The current plan for an infant requiring NICU admission is still to admit to 819 (820 being the ANTE room). If we need to transport, we will utilize the L&D hallway and admit to those rooms through the back of the NICU.
Dr. Kapoor shared a Hopkins collaborative set of algorithms for COVID positive and PUI mothers, I’ve attached to this email.

PPE

All MCH staff will be issued individual PPE including N95 masks, surgical masks and face shields. Quality is now making pickup available on Bunting 4 Mezzanine 24 hours a day. Please limit the amount of staff that are down there at the same time.
All MCH staff should wear plain surgical masks every shift, for the duration of that SHIFT. Please call Command Center if we are running low.
I have created additional GO BAGs for NICU which contain N95 masks, surgical masks with shields, eye protection, gowns and bouffant caps. These are stored at the Charge Desk, and are to be used ONLY for deliveries including Code 88. Please do not use for any other personal or routine use.

Social Distancing

Please be mindful of social distancing. Pay particular attention to CHANGE OF SHIFT and SHIFT REPORT, proximity to one another and amount of staff at the Nurses Station.

For Us

If anyone would be interested in a virtual support group please let me know.

I’m working with friends from Holistic Life Foundation (https://hlfinc.org/) and the Center for Anxiety and Behavioral Change (https://changeanxiety.com/) to see what they can do to help support us specifically!

Lastly, there are many ways to try and stay informed!

Daily Webex meetings with Director and Managers at 2:15pm. https://mdmercy.webex.com/mdmercy/j.php?MTID=m7300dd81e99f07b00d6b124b02bd6a62 Meeting number (access code): 799 959 896 Meeting password: Nurs1ng Or call 1-650-429-3300

Manager Update 03.31.20

Hi Team! Very minor updates for today. Most recent changes are the top bullet in each section. Attachments referenced from this email are available on the Files page.

Here are the resources I referenced! Holistic Life Foundation and Center for Anxiety & Behavioral Change will be working with me to help support you all!

These are wonderful friends that I am excited to collaborate with!

Governor Hogan issued a Stay-At-Home order effective 8pm last night. Please make sure you have your Essential Personnel Letter from Mercy accessible! It is attached to this email.

NICU Visitation

Moms are to now wear a plain surgical mask when here. Due to supply, please have them save and reuse each time they come in.
Only 1 visitor per family is allowed, including twins even if both are admitted.
Our Parent Hospitality Room is now closed to families/visitors. Please feel free to access the water/ice, microwave or refrigerator for them.
Mercy is developing means for communications using tablets, including Skype and Zoom and webcams. Stay tuned for more information.
Effective last week, all cardiology (echo) and radiology (X-ray and ultrasound) staff MUST wear gowns and gloves with our infants.

MCH Plans

Back hallway rooms 817, 818, 819, 820 and 827 are now negative flow (negative pressure), 826 to be held as an anteroom should we need to utilize that entire hall.
PUI or COVID positive mothers plans for delivery remain the same for right now (837 for vaginals, 927 for C/S), however this will be changing in the near future. The current plan for an infant requiring NICU admission is still to admit to 819 (820 being the ANTE room). If we need to transport, we will utilize the L&D hallway and admit to those rooms through the back of the NICU.
Dr. Kapoor shared a Hopkins collaborative set of algorithms for COVID positive and PUI mothers, I’ve attached to this email.

PPE

All MCH staff will be issued individual PPE including N95 masks, surgical masks and face shields. There are for our staff in MCH only, this is not a house wide endeavor.
All MCH staff should wear plain surgical masks every shift, for the duration of that SHIFT. Please call Command Center if we are running low.
I have created additional GO BAGs for NICU which contain N95 masks, surgical masks with shields, eye protection, gowns and bouffant caps. These are stored at the Charge Desk, and are to be used ONLY for deliveries including Code 88. Please do not use for any other personal or routine use.

Social Distancing

Please be mindful of social distancing. Pay particular attention to CHANGE OF SHIFT and SHIFT REPORT, proximity to one another and amount of staff at the Nurses Station.
Social Distancing is the primary strategy with regards to this coronavirus’ kinetics, especially in terms of containment.
CPR, NRP and STABLE have all been canceled for the immediate future. Licensure will be extended and you have, or will soon receive communications with more specific information.

For Us

If anyone would be interested in a virtual support group please let me know.
I’m working with friends from Holistic Life Foundation and the Center for Anxiety and Behavioral Change to see what they can do to help support us specifically!

Lastly, there are many ways to try and stay informed!

Daily Webex meetings with Director and Managers at 2:15pm.

https://mdmercy.webex.com/mdmercy/j.php?MTID=m7300dd81e99f07b00d6b124b02bd6a62

Meeting number (access code): 799 959 896 Meeting password: Nurs1ng Or call 1-650-429-3300