Cleaning your hands can prevent the spread of germs, including those that are resistant to antibiotics, and protect healthcare personnel and patients.

It takes just five moments to protect yourself and others! Using the five moments of hand hygiene, we should all clean our hands and change our gloves:

1.       Before touching a patient

2.       Before clean/aseptic procedures

3.       After body fluid exposures

4.       After touching a patient

5.       After touching the patient’s surroundings

Need help to remember these moments? Listen to this: link to the song/video

Our own Cheryl Petersen, RN, MBA, NEA-BC, made history as one of the inaugural members of the “Healthcare Workforce Task Force” for the state of Texas.

Cheryl is the Chief Nursing Officer and Senior Vice President for Patient Services.

According to the statement for the office of Texas Governor Greg Abbott, the healthcare workforce shortages in Texas to meet the demands of our growing state and provide students with the skills they need to succeed.”

“I feel very honored to selected to be a part of this task force, but more than anything I look forward to making real change for our state’s nurses and healthcare workers,” Cheryl said. “We know how the shortage of the healthcare workforce places a real strain on the people who are providing the best care available to our patients and their families. We understand the need to address this shortage and identify strategies to address this issue.”
 
Governor Abbott said, “Health professionals across Texas work tirelessly to meet the needs of our growing state and provide high-quality care to their fellow Texans. In April, I directed the Texas Higher Education Coordinating Board to address our state’s healthcare workforce shortage by maintaining sufficient clinical placement sites and retaining qualified clinical faculty so that students have the tools they need to succeed in this vital industry. Today, we’re announcing the inaugural members of the Healthcare Workforce Taskforce. This highly qualified group of experts, industry leaders, and individuals from Texas’ top-tier higher education institutions will ensure Texas can expand our healthcare workforce to meet the needs of all Texans for generations to come.”

The Healthcare Workforce Task Force and advisory members will meet monthly and gather insights from state agency experts and additional healthcare stakeholders throughout Texas. The task force will issue a final report on Oct. 1, 2024.

“When you look at the members of this task force, you are looking at some of the most knowledgeable and respected health care leaders in the state,” said Nancy Cychol, Executive Vice President, Hospital Services. “While it’s a tremendous honor to be selected, they chose Cheryl because she understands this issue firsthand. Her experience will be a valuable asset to the taskforce. We are so proud of Cheryl and this once again places Cook Children’s at the forefront of making impactful change in the health care industry.”

Cheryl brings a wealth of experience to the task force. Prior to her current role, she was Assistant Vice President of Nursing and Nursing Director with Cook Children’s for more than 20 years. She has led her nursing team to a fourth Magnet Designation in 2016, and a fifth Magnet application submitted this past February, achieving an academic preparation of nurses at 84% BSN, maintaining nursing turnover less than 11%, and an advanced certified nursing rate of 50%.

She is a current member of the American Association of Critical-Care Nurses, Texas Organization for Nursing Leadership (TONL), American Organization for Nursing Leadership, American Nurses Association, and Texas Nurses Association. Additionally, Cheryl is President Elect for the Texas Organization of Nursing Leadership, served on the Communication and Membership Committees with TONL and currently serves on the Board of Directors for Community Healthcare of Texas and the DFW Hospital Council Foundation. She received a master's in business administration from Benedictine University in Illinois and baccalaureate degree in nursing from the University of Iowa. She was honored as one of the Dallas-Fort Worth Great 100 Nurses in 2012.

These nurses represent excellence in the art and science of nursing and all the winners have shown themselves to be role models, leaders, community servants, compassionate caregivers, and significant contributors to the nursing profession. 

Recipients are: 

Great 10 Nurse Honorees

Amy Valenta, 4P/EMU; Chansey Pullen, Neuro Pain Services; Christina Richardson, 3 Main North; Danielle Ransonette, PICU; Kelsey Bassett, Research Operations; Kimberly Sheehan, Emergency Department; Lori Parrott, Quality Improvement; Melissa Lubahn, PICU; Shakyryn Napier, Heart Center, and Sheralyn Hartline, Prosper Nursing Administration. 

Daisy Leader Award

Ashley Chreene, Neurosciences Unit, Nurse Manager 

Daisy Team Award

5 North Tower – Hematology/Oncology, Central Venous Line (CVL) Team: Josephine Camus, Karen Gartner, Kelci Henegar, and Lacy Bayles. 

DFW Great 100

Shakyryn Napier, Director, Heart Center

Thank you to all Cook Children's nurses, for all that you do for our patient families.

By Kaley Johnson

In her five years as a Diabetes Coordinator at Cook Children’s, Tammi Morrison, RN, has developed close relationships with many patients and their families. In 2022, Tammi started working with Addyson Ray, a 15-year-old who had just been diagnosed with type 1 diabetes. For two days, Tammi taught Addyson and her family everything they needed to know about diabetes and how to manage it; perhaps just as importantly, she made sure Addyson knew that diabetes was not something that needed to hold the teenager back.

Tammi’s compassion and care inspired Addyson to write a school essay about her. Addyson wrote that Tammi made her feel like “anything was possible” with her energy and confidence.

“She also helped me realize that I was strong in my weakest moment. Having diabetes was not a setback, but something that made me unique, managing it was an accomplishment.

Tammi has not only helped educate Addyson’s family about managing diabetes, but over two years, she has provided a continuation of care and emotional support. The diabetes program at Cook Children's is one of the best, Tammi said, and the providers work diligently to continuously give the family the knowledge and support.

“I feel like it's always an honor when I go to meet with a new family,” Tammi said. “And I want them to leave with confidence that they can take care of their child when they go home.”

In her essay, Addyson mentioned Tammi’s dedication even after their initial visits. She wrote that Tammi gave them her phone number and the family was able to call Tammi several times when they needed a second opinion or advice.

Tammi also shared her personal experience with diabetes with Addyson. Tammi’s son was diagnosed with type 1 diabetes when he was seven years old. When she was in her 40s, Tammi decided to change careers entirely and go to nursing school in order to bring understanding, empathy and hope to other parents. The joy she feels every day when she comes to work is proof that she chose the right path, especially when she sees a patient like Addyson flourishing.

“You pray that you're making a difference and then when you educate that family and then you see them flourishing, you just, it just brings inner joy,” she said. “That's why I love my job. I absolutely adore my job.”

As for Addyson, who is now a patient ambassador at Cook Children’s, Tammi’s genuine care made a huge impact on her health and her life.

“She was a pivotal part of my diabetes journey and helped get me set off on the right foot. Everything we needed to manage through a critical/stressful period became that much easier with a loving nurse!” Addyson wrote in her essay. “We LOVE nurse Tammi and hope all patients have a nurse as kind and understanding as her!”

Tiffany Skrodzki, R.N., CCRC, has worked with the same family for four and a half years in her role as a Research Nurse Coordinator. As a baby, her patient Rushton was diagnosed with congenital hyperinsulinism. He was transferred to the NICU at Cook Children’s, which is one of two hospitals in the country that are considered Centers of Excellence by the Congenital Hyperinsulinism Institution for treating the condition. Rushton’s family lives in Utah, but they have traveled to the Cook Children's Hyperinsulinism Center several times a year since his birth for treatment.

During that time, Tiffany has gotten to know the family well and has watched the now-4-year-old’s freedom expand due to treatment. She’s watched Rushton’s progress and growth while providing the family with both medical and emotional support. 

Sometimes, in addition to medical expertise, a family needs to hear they’re doing a good job, and everything is going to be okay, she says. Tiffany is able to provide that support, especially since she has known the family for so long.

“They have my cell phone number, they always know I’m only a call away,” Tiffany said. “They know if they call me, I can help them, or if I can’t, I get them the help they need.”

Since the family lives in Utah, they might have to take Rushton to a local Emergency Department or health care provider who does not know his rare disorder as well as his Cook Children’s team does. Because of this, they sometimes contact Tiffany or Paul Thornton, M.D., one the most recognized and respected hyperinsulinism specialists here and around the world. They make sure the treatment Ruston is receiving at any other facilities is the best course of action for him.

Every time she sees Rushton, Tiffany is able to see how much he’s grown and changed.

“It’s worth it when you start looking at making a difference,” she said.

By Heather Duge

Nurses now have a place dedicated to supporting their professional journey.

The new Center for Nursing Excellence offers a range of exciting opportunities to help nurses excel in their careers and promote overall well-being. The team will help nurses stay at the forefront of the field with ongoing learning opportunities, gain valuable guidance and support from experienced nurses on projects, and offer programs and resources tailored to nurses' well-being, helping them manage stress and maintain a healthy work-life balance. This team is dedicated to helping nurses elevate patient care and creating a first-class work environment for everyone, all while celebrating nurses every step of the way. 

The Center for Nursing Excellence is not a location; it is a comprehensive initiative that aims to empower our pediatric nurses, at every stage of their career and across Cook Children’s, to achieve outstanding results for themselves, our patients and the entire System.

“I am very excited for the ability to solidify the foundation for nursing research, evidence-based practice, and innovation,” said Cheryl Petersen, MBA, BSN, RN, NE-BC, Senior Vice President, Nursing and Chief Nursing Officer. “We have the right individuals at the helm of our team, and I am looking forward to seeing where they take this program.”

Supporting Nurses in Many Ways

The Center is dedicated to tenured nurses and those just entering the profession, such as those in our Nurse Residency Program. The team guides nurse residents through evidence-based practice and quality improvement projects – from planning, implementation and analysis to abstract writing and presentation.

This Nurses’ Week, the Center for Nursing Excellence has established an opportunity for nurses to build their professional portfolios. There will be a photographer available to capture headshots from 6-10 a.m. and 4-8 p.m.  on Thursday, May 9 in the meditation room near Goodies to Go on the first floor of the South Tower in Medical Center-Fort Worth

“We are looking forward to focusing on our nurses who are the most numerous providers in the hospital and touch every patient,” said Kaylan Branson, DNP, RN, CPN, CNL, Director of Nursing Quality and Magnet Program. “We are here to set the foundation for structural empowerment to help them perform the best they can.”

The Center for Nursing Excellence also assists in engaging our nurses in the Texas Christian University (TCU) Evidence-Based Practice (EBP) Fellowship. Nurses who participate in the TCU EBP Fellowship receive formal training in evidence-based practice and protected time every pay period to work on their chosen project.

The team at the Center for Nursing Excellence is excited to support nurses who are working toward completing an advanced degree or considering implementing practice changes in their work areas. They encourage nurses who are completing quality improvement projects, evidence-based practice projects, or research studies to reach out directly in order to utilize their expert guidance and resources.

The Center for Nursing Excellence offers a variety of continuing education opportunities. They facilitate courses covering topics such as evidence-based practice, development of measurement tools, statistics, submitting abstracts, and writing for publication. 

The Center is delighted to be able to provide nursing scholarships with professional and educational opportunities for nurses. Recently, the Center awarded two bedside nurses a trip to the National Evidence-Based Practice Conference. These nurses were grateful for this opportunity and excited to return to Cook Children's with new insight and ideas. 

“Nurses are innovators – always fixing things and finding ways to work through problems,” said Julie Van Orne, MSN, RN, CPN, CNL, Director of Nursing Research and Innovation. “Our goal is to help them continue to innovate.”

Nursing Wellness

Ora Asheton, BSN, RN, CPN, CCRC, LSSYB, Nursing Excellence and Wellbeing Manager, said that she was drawn to her new role because it will promote nursing excellence by fostering nurse wellness and a culture of belonging and engagement. 

“This position was conceptualized by nurses for nurses and I’m excited about shifting to look at nurses as my patients,” Ora said.

Leaders in the Center for Nursing Excellence are collaborating with members of the Evidence-Based Practice and Research Council, which has been working on a project to develop an intervention designed to improve nursing wellness and investigate the impact of implementing a practical method of supporting our frontline nurses.

Ora will also be working directly with Kaylan to sustain Magnet designation standards.  

“We will apply for our fifth Magnet designation next year, and all components of the Center meet the model of Magnet, so we continue to work toward excellence in all we do,” Kaylan said.

A Bright Future for Nursing 

The team at the Center for Nursing Excellence looks forward to the future of nursing at Cook Children’s. 

“The development of the Center for Nursing Excellence is an acknowledgment of the impact nurses have on patient care and the work environment,” said Malorie Brooks, DNP, RN, CPN, CHSE, EBP-C, Director of Evidence-Based Practice and Implementation Science.

Kaylan added: “Since we moved from the bedside to a leadership position, it feels impactful to take care of those who are caring for patients 24/7. It is very fulfilling to see the outcomes from the perspective of the patients and nurses.”

Stan Davis, President of Cook Children’s, looks forward to seeing the Center for Nursing Excellence fulfill the organization’s mission for the countless patients who walk through the doors of the hospital each day.

“Our Promise should not just be a phrase on our walls, but also what we witness in our halls,” Stan said.

GREAT 10 NURSES

Congratulations to nurses from across the System who were named Great 10 Nurses at a special ceremony on May 9. The event was live streamed so that employees from across the system could join the celebration.

These nurses represent excellence in the art and science of nursing and all the winners have shown themselves to be role models, leaders, community servants, compassionate caregivers, and significant contributors to the nursing profession. 

Recipients are: 

Great 10 Nurse Honorees

Amy Valenta, 4P/EMU; Chansey Pullen, Neuro Pain Services; Christina Richardson, 3 Main North; Danielle Ransonette, PICU; Kelsey Bassett, Research Operations; Kimberly Sheehan, Emergency Department; Lori Parrott, Quality Improvement; Melissa Lubahn, PICU; Shakyryn Napier, Heart Center, and Sheralyn Hartline, Prosper Nursing Administration. 

Daisy Leader Award

Ashley Chreene, Neurosciences Unit, Nurse Manager 

Daisy Team Award

5 North Tower – Hematology/Oncology, Central Venous Line (CVL) Team: Josephine Camus, Karen Gartner, Kelci Henegar, and Lacy Bayles. 

DFW Great 100

Shakyryn Napier, Director, Heart Center

Thank you to all Cook Children's nurses, for all that you do for our patient families.

For nearly nine years, Angela Velasquez, RN, served as a middleman between Clayton Coker's family and insurance companies, doctors’ offices and other medical services. 

She was “basically Clayton’s problem solver.” 

As a Cook Children's Health Plan Case Manager, Angela works in the Medically Dependent Children Program with medically complex kids and their families. She worked with Clayton and his family until he aged out of the program last month at 21 years old. 

“If the pharmacy won’t fill a script, I would call and get that taken care of,” she said. “If (his mom) had questions about what doctors she needed to call, or equipment she needed delivered, I was basically available to her Monday through Friday.” 

Clayton’s mom, Cindi Coker, said working with Angela meant “everything in the world.” 

When the Coker family first met with Angela, they had been on a traditional Medicaid plan before and enrolling in the Cook Children’s Health Care Plan. 

“We got assigned a case manager and when things are happening at such a state level and you have a medically complex child, it can be unnerving,” Cindi said. “And she just kind of scooped us up and said, ‘I got you.’” 

The medical care can be multifaceted and confusing, and for families of a medically complex child, navigating it can feel impossible. Angela helps take some of that load off the shoulders of family members. 

For Clayton and his family, she was even able to coordinate home modifications to help him get from his bathroom to the bedroom more easily. Angela, through her years of dedication and tackling roadblocks head-on, provided an integral continuity of care, Cindi said. 

“It makes all the difference in the world,” Cindi said about having Angela by their side. “Because without them (case managers), things can't really get done or they can get done, but they're just not done as easily.” 

It’s easy to see that Angela is passionate about helping the families she works with and making sure their care is as smooth as possible. 

“I enjoy everything about my role,” she said. “I enjoy being able to provide these families with a little bit of relief.” 

Even though Clayton aged out of the Medically Dependent Children program, the tools Angela gave his family will continue to help them with his care, his mother said. 

“Her skillset as the case manager was preparing me for the unknown and the unseen and how she attacked that taught me how to manage and handle what was coming,” Cindi said. 

Throughout her years in the Medically Dependent Children program, Angela has helped patients and families with everything from getting infant formula to making sure Medicaid pays for medications properly. She also is there as a listening ear to reassure families to make sure they know they’re doing a great job. 

Being able to watch “her kiddos” overcome the odds and grow up is its own reward, Angela said. 

“It's really fulfilling,” she said. “The great part about this program is that we're helping these kiddos not be institutionalized, and they're able to be at home with their families.” 
 

By Ashley Antle, APR

Advocate is not her middle name, but it might as well be. Shakyryn Napier, DHSc, RN, CPN, NEA-BC, Director of the Heart Center at Cook Children’s, is known for championing those who need support and shining a light on issues that deserve the spotlight.

This leadership won her a spot on the 2024 Dallas/Fort Worth Great 100 Nurses list. Napier will be honored for the recognition on May 3 at the annual Great 100 Nurses dinner and celebration. The event honors 100 Dallas/Fort Worth-based nurses nominated by their peers for being role models, leaders, community servants, compassionate caregivers and significant contributors to the nursing profession, according to the DFW Great 100 Nurses organization.

“I am so humbled and honored to even be nominated and so grateful to be named a DFW Great 100 nurse,” Shakyryn said. “I feel very blessed and so appreciative.”

Shakyryn’s nomination form described her as “a commendable example for aspiring health care professionals” demonstrated by her completion of a doctoral degree. She’s also said to be a “risk taker” as evidenced by her bravery in sharing her personal tragedy so others may learn from what she endured. Her peers praise her “leadership prowess,” saying she has a unique ability to motivate and support her team even in the face of unprecedented challenges like the COVID-19 pandemic.

Ardent Advocate

Shakyryn’s staff can always count on her to go to bat for them and get results. When a member of her nursing team met resistance from the Texas Board of Nursing for disclosing a treated mental health condition while renewing her license, Napier worked with the Texas Nurses’ Association to successfully advocate for policy change concerning a question about mental health treatment on the license renewal form. She and many of her fellow nurses believed the question could penalize and stigmatize nurses who had or are seeking treatment for a mental health condition.

Shakyryn advocated that nurses should not encounter punitive measures for being honest about their mental health and treatment. In response, the Texas Board of Nursing revised its license renewal process, and removed the question from the renewal application.

The change, Shakyryn says, is one of the proudest moments of her career so far, primarily because the cause of destigmatizing mental illness is a personal one. Three years ago, tragedy struck her family with the accidental fentanyl-related death of her young adult son who had a mental health condition. Shakyryn bravely put her own heartache on display to raise awareness for mental illness and its associated challenges.

“We have huge gaps in this society when it comes to mental health, and the weight of not having adequate mental health coverage for both children and adults is not sustainable,” she said. “Even as a nurse with the contacts I had, it was difficult to know where to turn when my son needed help for his mental health. I can't imagine someone who does not have the resources that I do having to navigate the system. We need policy that directs more funds to mental health providers and services.”

Climbing the Ladder

A native of Pennsylvania, Shakyryn completed her nursing diploma right out of high school. By the time she was 20 years old, she was at the bedside doing the work she loves.

“Nursing was something I always knew I wanted to do,” she said. “I had a younger brother who passed away who had really severe asthma, so we were always in the hospital with him. That is where I got that first interaction with nurses and with the health care system, and seeing how people were so helpful just always stuck with me.”

In 2000, Shakyryn and her husband moved their family to Texas seeking job opportunities and a retreat from the harsh winters. She joined the Cook Children’s family in 2008. Since then, Shakyryn has risen through the ranks from night nurse manager to director of Med-Surg and Wound Care and now director of the Heart Center where she leads a team of approximately 200.

An active member of the Texas Nurses’ Association, Shakyryn served on the Board of Directors, chaired the Policy Council, chaired the CEO search committee, and has been a member of the Government Affairs and Finance committees. She also served as president of her local Texas Nurses’ Association district, and received the prestigious District President’s Award for her outstanding contributions. She currently serves as the chair of the Texas Nurses’ Association  Diversity, Equity, Inclusion and Belonging taskforce.

A Mind for Policy

Shakyryn's expertise in public health and nursing policy not only positions her as a prominent figure at Cook Children’s but also distinguishes her as a leader within the industry. She says the lack of health insurance options, especially for children, tops her list of policy concerns today.

She has good reason to be alarmed. Just recently, the Texas Health and Human Services Commission (HHSC) denied Cook Children’s Health Plan (CCHP) a new STAR and CHIP Managed Care Services contract, putting 125,000 CCHP members in jeopardy of losing health care coverage and, in turn, access to vital health services and providers beginning Oct. 1, 2025.

In any given year, roughly 50% of CCHP members will have an encounter with a Cook Children’s provider across the system. That figure is even higher among CCHP’s STAR Kids population.

“It is scary to think that children will be without the great care that we give here because they lose insurance coverage based on the decision of the state,” Shakyryn said. “Finding affordable insurance in the marketplace is hard and expensive, and this decision leaves our kids and families with limited options. It’s just so unfair and sad to see. There definitely needs to be some policy changes with this.”

Cook Children’s is appealing HHSC’s decision, citing that the state's scoring process lacked transparency and unfairly disadvantaged regional, non-profit community plans like CCHP. As a locally operated organization with deep roots in the community and first-hand knowledge of its unique needs, CCHP is able to tailor its many programs and services to address community and member-specific health barriers such as food insecurity, lack of transportation, access to behavioral health care and preventative health programs and much more. The state’s scoring process does not adequately capture and measure this benefit.

Model Mentor

These days, much of Shakyryn’s work is spent planning for the current and future growth of Cook Children’s cardiac program and making rounds to check on staff in the units she oversees. These include the Cardiac ICU, Cardiac Step-Down Unit, Echocardiography Lab and Cardiovascular Operating Room. Along the way, she never misses an opportunity to share the wisdom she’s acquired in nursing over the past 20 years.

Her advice to new nurses? Never compare yourself, your progress or your journey to others.

“When new nurses start orientation, they see the other nurses who can document quickly or do an assessment from across the room and they compare themselves to those nurses and feel inadequate. Absolutely not,” she said. “I tell them that they’ll be that skilled one day, too. And I tell our seasoned nurses to be kind to the new nurses because we have all been there.”

Congratulations, Shakyryn! Thank you for modeling, teaching and living the Cook Children’s Promise of “Everything for the Child,” and for advancing the practice of nursing with excellence.

By Heather Duge

When did you realize you wanted to pursue nursing? 
I remember my grandmother saying I would be a nurse, and I followed her lead. I like helping people and quickly found my true calling in pediatrics after my first opportunity in nursing school to rotate through that unit. 

Tell me about your journey to become a nurse.
I earned my bachelor's and nursing degrees at the University of Iowa and worked there in the pediatric unit. I moved to Chicago and worked in the Pediatric Intensive Care Unit at Loyola University Medical Center while studying for my MBA at Benedictine University in Illinois. In 1994, I was recruited for director of PICU and Dialysis and Transplant Programs at Cook Children’s, and I served in that role for over 20 years. Starting in 2014, I transitioned to AVP of Nursing and in 2015 was promoted to VP of Nursing. In November, I celebrated my eight-year anniversary in this role.

What are some of your proudest moments at Cook Children’s?
Our third and fourth Magnet designations were special for different reasons. For the third designation, I was an AVP and supporting Teresa (Clark), our CNO who was undergoing medical treatments. When she passed away, we were in the process of submitting the Magnet documents. Orlando Chapa (VP, Nursing and Patient Care Services) and I dug in and brought the documents up to the level for redesignation. Teresa would have been so proud to see it through. This accomplishment added another level of pride for all Cook Children’s Nursing. 

For the fourth designation, we were in the midst of the pandemic, and I saw all of the work firsthand as Chief Nursing Officer. It gave me a new appreciation for the effort and excellence to achieve designation. It was a true pleasure to work with the Magnet program director. We could not have done it without all our amazing team members.

What were some of the most challenging times you’ve been through at Cook Children’s?
The care we deliver doesn’t end when we walk out the doors. Our nurses have full lives, and my goal is to take care of them end to end and support them through the tough times. COVID was one of the most difficult periods anyone could have endured physically, mentally and emotionally. I remember at the beginning when there was a fear about going to the unit caring for COVID patients, and so the nurses felt like they were on an island. I saw them collaborate on how to care for these patients in the safest way. Their spirits were so strong, and they paved the path of how to do this at Cook Children’s. 

We are still recovering, and all people are triggered differently. The path to recovery is going to take time as we fully understand the impact. Our staff are doing amazingly well as some still carry the burden. Finding ways to support them is very important. We have brought all the concerns about burnout and overexertion to the forefront.

When hiring new nurses, what do you focus on?
I want us to focus on how special Cook Children’s is, the culture of care and the importance of looking at everything through a child’s eyes. Not everyone can fill the shoes of a Cook Children’s nurse. We look for experienced nurses with talents they can bring and those who fit into our culture.

Tell me about the nursing team at Cook Children’s.
We have a truly remarkable nursing team. They bring energy, enthusiasm, excitement and a willingness to undergo training to try new specialties. They adapt to changing environments and learn the latest about technology to make it easier for patients and families to use and understand. Collaboration is so important to nursing – it’s all about how we help align other team members to provide their services. I see them collaborate in an organized manner, communicate effectively and embrace togetherness. 

Tell me more about nurses collaborating with other staff in the hospital.
I love the opportunity to identify best solutions and one example of that is safety rounds in the PICU. Every Tuesday morning and night, physicians, quality nurses, quality team and nursing leadership collaborate at the bedside. It’s a wonderful time to see through others’ eyes the work they do and discover how to overcome hurdles that pop up. It’s amazing to see the nurses’ truly remarkable ingenuity as we find new ways to reimagine care.

What are some of your goals for the nursing team?
My goals are to enhance employee and patient engagement. Nurses look at us as a family and we need to have a joyful environment. I desire for the nurses to practice at the top of their nurse license and be the best they can be. Nursing wellness is also very important to me. Life isn’t always easy, and I want to support my nurses through the hard times. I want to learn more about what causes burnout and imbalance and improve on those things. We have a lot of work ahead of us as we continue developments on all fronts – new programs, safer work environments and innovation.

What have you learned from being a nurse?
It is very rewarding for us to have the opportunity to take care of patients and families and to be allowed into their lives if even for a moment to make a difference. Nursing has taught me so much about myself, others and what we can endure. I have seen a lot of traumas through the years and I’ve seen firsthand how prevention saves lives – buckling kids in car seats, watching the water to prevent drowning, and taking measures to prevent child abuse.

How does the hospital’s culture platform fit into nursing?
Embracing our culture platform is so important. With pediatric nursing, it’s a package deal. You really must love families, not just children. When we open doors to the family, they help us plan their child’s care and interpret what their child needs. Who knows a child better than their family? They know their favorite color and the way they like to eat food. We can brighten a patients’ day by knowing them better and it adds a small sparkle to their experience. Bringing smiles to the kids’ faces is truly the reason to hope and look forward to the next thing.

Every year we celebrate 10 of our nurses who demonstrate excellence in the art and science of nursing.

Nomination letters should address the nominee’s attributes in the following categories: 
 

• Role model 
• Leadership qualities 
• Compassionate caregiver 
• Significant contributions 
• Service to the community 
   

Click here to nominate a nurse. Nomination letters will be judged on all five categories, so please make sure to address each one. Each category should be a maximum of 100 words. Do not include the nurse's name in the letter. You have up to one week to complete the nomination once you start. 

The nomination deadline is Sunday, April 7 at midnight. 

For questions, please email Great10NursesNominations@cookchildrens.org.

By Kaley Johnson

When Chrystal Bryant, RN, first became a labor and delivery nurse, she often wondered what happened to the parents and babies after they left the hospital. She wondered if the mothers were getting the support they needed, if the babies were healthy and if the family had access to needed resources.

Chrystal, who has been at Cook Children’s since 2017, knows from experience the importance of proper support before and after delivering a baby. She had her daughter at age 21, and as an ovarian cancer survivor, Chrystal had a high risk pregnancy. In her current role as Maternal Health Case Manager for Cook Children’s Health Plan, she is able to assess patients and their needs and get them the care and resources they need for a healthy pregnancy.

But she still wanted to do more.

Tarrant County has one of the highest maternal mortality rates in Texas, according to Tarrant County Public Health data, and the second highest maternal mortality rate among Black women. In 2022, United Way of Tarrant County announced the launch of the Maternal Health Initiative, a community-based doula program to reduce maternal mortality rates, especially among women of color and low-income women. Cook Children’s partnered with United Way to create the doula certification program. Chrystal signed up for the program and, in November, she received her doula certification.

Doulas work with pregnant women one-on-one before, during and after delivery. They provide education, create a birthing plan and plan a recovery period. One of the most important aspects of doula care is following up with parents after the birth. Postpartum health issues can be fatal, but education around those risks is not always available.

“My primary goal is just to do what I can to assist families throughout the perinatal period and in the postpartum period, just to make sure that babies have a good start to life and the pregnant woman has the resources that she needs to have a safe and healthy pregnancy,” Chrystal said.

As a doula and a case manager at Cook Children’s, Chrystal serves as a liaison for parents and connects them with resources they might not know about. This assistance can be crucial during a pregnancy, especially for underserved communities and low-income parents. For some, Chrystal said, sometimes simply finding a ride to appointments can be a barrier to proper maternal care.

Through her role at Cook Children’s, and now as a certified doula, Chrystal is able to truly change lives. 

Chrystal said by far the best part of her job at Cook Children’s is when Health Plan members come back and tell her how much having her as a case manager helped them through their pregnancy journey. She hopes families continue to receive more community support in the future, especially in areas that have limited access to health care, education, and even reliable food sources. More early childhood education, outdoor spaces and reliable transportation are needed in places like 76104, a Tarrant County zip code that a 2019 study by UT Southwestern Medical Center found has the lowest life expectancy in Texas.

“That's part of why I did the doula certification,” she said, “because I could do my part in this space as far as rallying around the women who need my support during that period of time.”  

Kathy Schwab, Director of STAR/CHIP Service Coordination and Population Health, since 2021, said she is proud of Chrystal’s certification, especially since Chrystal pursued the program on her own. She said the doula program aligns with Cook Children’s new initiative to “have an eye for community health, not just children’s health.”

“And although child's health is part of what they do, we're looking at maternal health and parents’ health. And so this focus really gives us an added layer,” Kathy said.

We’re delighted to share some exciting news that reflects the dedication and excellence of our Pediatric Intensive Care Unit (PICU) team! The American Association of Critical-Care Nurses (AACN) has honored our PICU with the prestigious Silver Beacon Award for Excellence, a testament to the outstanding care and commitment demonstrated by each member of this unit.

The Beacon Award for Excellence is a remarkable achievement, symbolizing the commitment to exceptional patient care and fostering a healthy work environment.

This recognition represents the diligent efforts of our PICU team to enhance patient outcomes and align practices with AACN's six Healthy Work Environment Standards. Our PICU staff earned its silver award by meeting the following evidence-based Beacon Award for Excellence criteria:

• Leadership Structures and Systems
• Appropriate Staffing and Staff Engagement
• Effective Communication, Knowledge Management and Learning and Development
• Evidence-Based Practice and Processes
• Outcome Measurement

“At Cook Children's Medical Center, we strive to provide excellent patient care and the silver-level Beacon Award reflects our commitment to strong leadership, staff engagement, effective communication, using evidence-based practices, and demonstrating quality outcomes,” said Cheryl Petersen, Senior Vice President and Chief Nursing Officer at Cook Children’s. “These are all part of our Promise to improve the well-being of every child we care for and in the communities we serve.”

To our entire Cook Children's staff, we extend our heartfelt appreciation for your unwavering commitment to excellence. This recognition is a reflection of each employee's dedication to the "everything for the child" philosophy, making a positive impact in the communities we serve. Together, we continue to set new standards and elevate the patient experience.

AACN President Terry Davis, PhD, RN, NE-BC, CHTP, FAAN, applauds the exemplary efforts of the caregivers at Cook Children's for working together to meet and exceed the high standards set forth by the Beacon Award for Excellence.

“These dedicated health care professionals join other members of the exceptional community of nurses who set the standard for optimal patient care,” Davis said. “The Beacon Award for Excellence recognizes caregivers in stellar units whose consistent and systematic approach to evidence-based care optimizes patient outcomes. Units that receive this national recognition serve as role models to others on their journey to excellent patient and family care.”

By Kaley Johnson 

Hannah Davis, PA., has only worked at Cook Children’s Medical Center-Fort Worth for four months, but she has already had an unprecedented impact on patients’ lives.

Over the last year, fewer patients have gotten the flu shot than in previous years, reflecting national statistics of more vaccine hesitancy among patients.

When Hannah started in her role as Endocrine Physician Assistant at the end of August, about 19% of patients in the Endocrine unit received the flu vaccine.

The department took action by having Hannah talk to patients about the vaccine specifically before they are discharged. She started to meet with patients who are eligible for the flu vaccine in mid-October.

When Hannah talks with patients, she said she meets them where they are. She listens to their concerns and does not try to scare them into getting the vaccine; instead, she focuses on empowering patients.

“So much of medicine is out of someone’s control, and the things you can do on your own to actively prevent any major illness or complication are often overlooked,” she said.

She compares the flu vaccine to a seat belt -- whether or not you get into a car crash might not always be in your control. But an extra safety measure can mean the outcome is less serious.

“I always tell patients, I am glad to meet you in the hospital, but I hope I never see you in the hospital again,” Hannah said. “Our goal is always to improve patient care.”

By the end of October, 78% of patients in the unit received the flu vaccine -- a 311% increase.

Hannah, who is extremely humble, emphasized that the results are a team effort. She lauded the nurses who also talk with patients and give the flu shots.

Emily Deiters, R.N., said Hannah “does a great job teeing us up for the flu shot,” by focusing on informed consent.

Bethany Robinson, R.N., said Hannah has made a huge impact with diabetic patients in particular, which is important since comorbidities can increase complications from the flu.

“That’s a good encouragement, not just hearing it from the nurses but hearing it from providers as well about the importance of it,” Bethany said.

“It is a group effort, but (Hannah) has made a big impact by mentioning it to patients at discharge,” Bethany said.

By focusing on education, empowerment and encouragement, Hannah has helped improve the lives of patients, likely for years to come.

Photo pictured: left to right

Bethany Robinson, RN

Hannah Davis, PA

Emily Deiters, RN

Helen Sweeney, RN

Magnet designation is considered the international gold standard of nursing excellence. To nurses, Magnet represents education and professional development through every career stage, leading to greater bedside autonomy. To patients, Magnet signifies the highest quality of care.  As a four-time Magnet® hospital, Cook Children's continues to set the standard for excellence while embracing an inspiring Promise – to improve the well-being of every child in our care and communities. 

Please click the link under Downloads on the top right of this page for the recipients!

Rachel Mark, DNP, APRN, CPNP-PC, learned firsthand that conversations with patients about mental health could save lives. During Rachel’s first year as a nurse practitioner, the number of mental health appointments assigned to her was overwhelming. She feared she would say the wrong things to this population and cause them more harm. 

Rachel’s personal growth in helping those with mental illness stimulated her to focus her doctor of nursing practice (DNP) project on an intervention that would empower nurses with the confidence to communicate with patients and their families about mental health concerns. 

“A psychiatry case manager initiated a suicide screening tool in the Emergency Department, and her research found that some nurses are uncomfortable communicating about mental illness,” Rachel said. “There is a stigma toward patients with mental health disorders.” 

Rachel networked with organizations across the nation collecting video productions she would use in her “A Walk in My Shoes” behavioral health stigma reduction bundle. These videos would potentially connect nurses with stories of those who have a mental health illness, and a history of health care stigma while providing communication tips for this topic. 

Rachel also met with This is My Brave, an organization whose mission is “to empower individuals to put their names and faces on their true stories of recovery from mental illness and addiction.” A mother from that organization shared in writing the personal story of her son’s death by suicide. 

Rachel and her project team members developed an interactive computer-based training education on behavioral health stigma, risk factors, and communication tips. Participants watched videos, read the letter on behavioral health concerns and stigma, and completed the Opening Minds Scale for Healthcare Providers' Attitudes subscale before and after the intervention. 

The pre- and post-survey results showed a statistical improvement in confidence in helping those with behavioral health illnesses. Monthly inpatient clinical therapy referrals orders increased. 

In conclusion, participation in a computer-based training program with education and video contact is associated with behavioral health stigma reduction and increased access to care for behavioral health concerns. 

“Having the confidence to initiate these conversations can be lifesaving. I’m proud of what I perceive will happen with this initiative,” said Rachel. 
 

Elizabeth Whelan, CNM, APRN, is a breastfeeding guru, a gestational diabetes expert, and an advocate and encourager to mothers of our tiniest patients. As a Certified Nurse Midwife -- and the only one at Cook Children’s -- Beth is involved in caring for patients with high-risk pregnancies, and providing exceptional follow-up care.

Cook Children’s has a growing Maternal Fetal Medicine program in Abilene. As a CNM, Beth manages high-risk pregnant patients with conditions such as hypertension, diabetes, maternal congenital heart disease, blood disorders, connective tissue disease, seizures, preterm labor, preeclampsia, and many others. CNMs also manage fetal abnormalities such as anemia, heart defects, neural tube defects, and growth abnormalities. The program is an incredible resource for patients who live west of Fort Worth.

Beth says that her days are filled with appointments with patients who need ultrasounds or non-stress tests after the patient meets with her physician or advanced practice provider. 

“My job is comprised of happy days and sad days. We are caring for patients during such a vulnerable time in their life,” Beth says. “Watching a patient lose a baby or having to cope with difficult news about their baby is never easy, but being able to provide them with some happy memories of their baby (special ultrasound pictures, videos, heartbeats) and/or being able to celebrate them when things are healthy and new life comes is such a gift and privilege.”

As we celebrate Certified Nurse Midwife Week Oct. 1-7, we say thank you, Beth, for all of your expertise and knowledge that you contribute to the Maternal Fetal Medicine Program. We are so thankful to have you as part of our team.

Valerie Shorten, BSN, RN, and her son Marquis are no strangers to overcoming obstacles. Each one has led them to where they are today.

“My brother was murdered, and I always thought about what I could have done to help him had I been there,” Valerie said. “That’s when I knew nursing was my calling.” 

In 2011, Valerie found out about an open position at Cook Children’s – a place she had visited a few years before when Marquis had a minor injury while playing with his brother. 

“I remember how caring everyone was and thinking with three boys it was probably not the last time I would be there,” Valerie said. 

Journey to Becoming a NICU Nurse 
She landed a job in the cafeteria where her love for serving others was evident. Fifteen months into joining Cook Children’s, Valerie applied for a secretary position in the Neonatal Intensive Care Unit. She quickly realized her new boss was a familiar face. 

“I knew her food order,” Valerie said. “I was so focused on doing my job at the time that I didn’t realize she worked in the NICU. Customer service is everything to me.” 

Once in the NICU, Valerie’s passion to become a nurse grew stronger. Her husband DeMario became sick which motivated her to enroll in nursing school. She started by taking two classes at a time with help from the hospital’s tuition reimbursement program. In May 2021, Valerie graduated from nursing school and started her first day as a nurse resident ten years from her first day in the cafeteria. She rotated through all the ICU’s and the Emergency Department for one year. 

“It was great to see other areas in the hospital and gain respect for what they do,” Valerie said. “But my heart was in the NICU because I had been there so long. It felt like home. It has been amazing to grow into something I’ve always wanted to do.

This group I get to work with every day is very supportive, and I’m grateful for the opportunity to learn from them.” 

Valerie relates to her patient families and treats the babies as if they were her own. 

“I know that no one chooses to come into this hospital,” Valerie said. “You never know what a person is going through, so I make sure I always give the kind of treatment I would want for my child.” 

Shocking Diagnosis 
In April 2022, Valerie was in the middle of her nursing shift when she received a text from Marquis that read “My spine hurts.” She told her son to take ibuprofen thinking it could be related to his running. 

“Marquis is a runner and was number one in the district,” Valerie said. “He was slated to run in the regional meet to see if he would qualify for state. I thought the pain could be from a pulled muscle or running injury.” 

Valerie told him to rest and let her know if it worsened. Marquis drove himself to the ED at Cook Children’s and at that point could not feel his right leg. 

“I met him at the ED but didn’t think it was anything too severe,” Valerie said. 

An MRI revealed a spinal epidural hematoma which required emergency surgery. If too much time passed, Marquis would be paralyzed. 

“Everything was a blur, and I remember being overly emotional as Marquis continued to lose the feeling in his legs,” Valerie said. “But I knew he was at the right place.” 

Marquis was quickly wheeled to the operating room where Daniel Hansen, M.D., Pediatric Neurosurgeon, removed the large blood clot that was compressing the spinal cord. 

Recovering Physically and Mentally 
Valerie became anxious thinking about his mental state when he woke up and realized all he worked for was not going to happen that year if at all. 

“A nurse pulled his father and I aside and told me that when Marquis woke up, he asked when he would leave that day because he had a track meet in a few days,” Valerie said. “The real pain came when all the times were posted from the race he missed.” 

Valerie and DeMario helped Marquis work through his emotions but did not let him stay down too long. 

“I told him he could decide to lay there and be sad or decide what’s going to happen next,” Valerie said. “My life motto is that you are the writer of your story.”

Nurses realized how hard it was for him to face the reality that he missed the regional meet and was not sure what running would look like in the future. During the 10-day stay in the Pediatric Intensive Care Unit, Marquis says the nurses went above and beyond to bring him comfort. On a particularly hard day, the café was out of Chick-fil-A milkshakes, so the nurses gathered all the supplies and made him one. 

“They did everything I needed before I even asked for it,” Marquis said. “They fixed my pillows a certain way, brought me the Gatorade flavor I liked with a straw, broke up pills because I couldn’t move my neck to swallow and positioned my toes for me when I couldn’t move them.” 

Back on Track 
Valerie says everyone was surprised how fast Marquis progressed. He was cleared to jog four months after surgery and in January 2023 ran in his first race since surgery at Texas Tech University. 

“My parents kept me going,” Marquis said. “My track coaches Jesse Heard and Sa’Donna Thornton also were there for me. Coach Heard gave me a love for track and all he instilled in me is a big reason why I treat everyone with kindness. He has sacrificed countless hours just to help me succeed. Coach Thornton played a huge part in helping me gain my confidence back and keep my positive outlook about the situation. I knew God had a plan and it would turn out OK.” 

A Lifelong Dream Come True 
Marquis says coming back from a major illness has only made his passion for running stronger, and he wanted to prove to everyone he was just as good. He has accomplished that and more. He recently graduated and received his high school’s Optimist Award. This Fall, Marquis will attend Texas Christian University on a full track scholarship – a goal he set for himself at only 10 years old. 

“Marquis decided in fourth grade that he would one day attend TCU,” Valerie said. “Jokingly, I expressed how his father and I did not budget for TCU. At the time, our fourth grader looked at me on the car ride to school and said, ‘Don't worry, I'm going to get a scholarship.’ His dreams came true.” 

Dr. Hansen said: “The most gratifying part of my job is seeing kids through their illness to the other side. For Marquis, that means a life that is everything he has always wanted.” 

 

Nursing Value: Imagination

As a nurse on the Oncology and Bone Marrow Transplant floor, Shelly Litchfield, BSN, RN, walks parents through some of the toughest times of their children’s lives. She says the little moments, like making friendship bracelets and playing Nerf gun “wars” in the hallway, make her realize how close she gets to patients and families.

“Many times these kids don’t fully know the gravity of the situation they are in, so we try to make the experience as enjoyable as possible,” said Shelly. “It’s during those times that I realize how much they depend on me and trust me.”

Sometimes that trust does not come easily or quickly. But Shelly knows just what to do for each patient. For birthdays, she surprises her patients by decorating their rooms while they are sleeping. For the younger patients who love the nurse badges, Shelly makes them a badge of their own.

 “It is a great distraction when you are trying to get them to sit still for you to take their vitals or do your assessment. It also is really fun for them to see their faces on the badge. Most of them love to parade around the hallways with a stethoscope and listen to everyone’s hearts or take their temperature,” said Shelly.

Oftentimes, patients can have planned admissions, and Shelly is so honored when patients ask if she can be their nurse again.

“We get to make these really special relationships with our kids since they are here for a week or even two months. We show them that not all interactions with a doctor or nurse are scary or end with them being hurt or poked. I always remind them that there will be hard times, but I will be with them through it all.”

To learn more about our incredible nurses at Cook Children's, view the 2022 Nursing Annual Report. 

• Role of the mother as an ever-present manager of care for the hospitalized child 
• Parents felt negative feelings about their child being in the hospital, but said their child received good care 
• Parents expected nursing care to be kind, compassionate, attentive and considerate 

Jennifer discovered parents did not realize they had a right to an interpreter. She wanted to empower them and let them know how to access language services. 

“The goal is to put processes in place that are automatic and make it smooth and easy for these families to have the language access they need,” Jennifer said. 

Jennifer’s manuscript was published in the Journal of Pediatric Nursing, and presented at the Society of Pediatric Nurses conference in the spring of 2023. 

“The whole process was very enlightening,” Jennifer said. “For these parents, taking the time to communicate meant that you were caring. My hope is to help develop processes and interventions through participatory action research that will facilitate communication with nurses and parents.” 
 

Amber Harkey, BSN, RN, CPN, has a special connection with the moms of the patients she treats. For Amber, being away from her own kids is a challenge, but when a mom hugs her at the end of a shift, it is all worth it. “There are times when a mom will cry and tell me she really needed me that day, and that’s when I’m reminded I’m exactly where I need to be,” Amber said. 

One mom, in particular, left a mark on Amber. The patient has come in several times throughout the years; the first when she was just a baby with a fever. 

“We all had more questions than answers, and the mom didn’t speak English. I was still in the process of learning Spanish so the conversations we had were very small, but we were still able to communicate and connect. They were scared and tired and it felt so good to be able to love on their daughter and hug the mom,” said Amber. “The child did get a very hard diagnosis and we have seen each other several times, but each time it has been bittersweet because we get to see milestones she is meeting. It’s hard to see someone walk through something so hard, like a life-changing diagnosis for their child. But just something as simple as offering them a cup of coffee and being available for the broken small conversations really helped them, too. She holds a special place in my heart.” 

Amber has worked on the respiratory and infectious disease floor for seven years. She cares for patients with cystic fibrosis and says she gets to know all about their lives and families. She says the most rewarding part is sending kids home after helping them through a particularly rough time, such as the babies with RSV. 

“It’s a complete 180 for those babies,” Amber said. “The moms are also in a much better state.” 

Amber says she has an incredibly close team with a blend of people who have worked at the hospital for three to 20 years and bring different experiences to the group. Some have worked in the Hematology and Oncology Center and are well-versed in central lines and ports, while others have experience in IVs or catheters. 

“I love my team and my manager is awesome. We support each other outside of work relating to maternity leave, financial burdens, and being a parent, and we all share our struggles. It helps us work really well together. We know what each other’s tones of voice mean and can tell when someone needs help."

“A few years ago, our team started lobbying for a solution,” Lisa said.

The hospital has seen a large increase of high-risk behavioral patients including an over 40% increase in suicide attempt patients on non-psychiatric floors. Since the pandemic began, there has also been an uptick in children presenting with disruptive and aggressive behaviors, as well as those with autism or delays, whose families have been in crisis mode and could no longer manage these symptoms at home.

Additional employees were hired and the program specialists, who are direct caregivers on the psychiatry unit, became the responders to these behavioral events. Nurse residents completed a project with extensive research on the effectiveness of a group of staff members trained to react to escalations. This planning team utilized this research to understand Cook Children’s needs, in order to develop the response team and policy. The BERT team was then created.

Jennifer Horn, MSN, RN, CPN, CPPS, Quality Improvement Coordinator in Clinical Collaborative, works with Solutions for Patient Safety, a clinical collaborative of 145 pediatric hospitals which focuses on patient safety initiatives and reducing harm. Since 2018, Jennifer has worked closely with Occupational Health, which tracks employee injuries as a result of patient actions, such as kicking, hitting or biting.

“Our first planning meeting came just in the nick of time because we saw a big influx of high-acuity behavioral patients,” Jennifer said.

“We are very grateful to you for what you do every day, and we are very grateful for everything your team has done to elevate DAISY once again and make it truly special for you,” she said.

The DAISY Foundation was established in 1999 by the family of the late J. Patrick Barnes, to honor his memory by recognizing exceptional nurses everywhere who make an enormous difference in the lives of so many people by the super-human work they do all year round.

We normally offer this luncheon every other year to recognize all previous DAISY Award recipients from Cook Children’s who are still employed here. We were unable to have this luncheon during the pandemic, so it’s been a while since we had the last one. That makes this year's event even more amazing.

Rachel Harless, BSN, RN, has been on both sides of the hospital – as a patient and now a nurse. After being born at 30-weeks gestation, hospital visits were a big part of her childhood. 

“Being in the hospital as a kid, you learn that the people around you make a difference in your day,” Rachel said. “That makes me want to be a better nurse.” 

Starting out as a nurse for adults, Rachel says she picked up skills that help her tune into the children and families she cares for, such as when parents need an advocate. On the floor that treats patients from Endocrinology, Rheumatology and serves as an overflow for Psychology, she watches for parents who don’t feel comfortable and need more questions answered. Rachel facilitates all the different people involved in their medical care to get them on the same page. 

“I love what I do. I’m really close with every single nurse on my floor. We’re all each other’s support system,” Rachel said.

Photo: Rachel Harless, pictured top row, second from the right

One of those patients was a child who was scared of being in the hospital. Adrea worked on making a connection with the mom first and then the child by checking the teddy bear’s blood pressure. 

“As the night went on, this child let me do everything without being fearful and progressed so much he was able to go home the next day,” said Adrea. “A big part of pediatric nursing is connecting with the family.” 

Adrea’s love for kids matched with a team who works well together makes an ideal work environment. 

“I love the people I work with at Cook Children’s. We all help each other on the night shift and feed off each other’s vibes,” Adrea said.

Photo: Adrea Crump, third from the right, and her colleagues celebrate teamwork

Congratulations to the very first DAISY Nurse Leader Award winner: Samantha Corkum, MSN, RN, RNC-NIC, Neonatal Program Coordinator. She works in the NICU. 

The award was presented to Samantha during Nurses Week.

The DAISY (Diseases Attacking the Immune SYstem) Award is an international recognition program that honors and celebrates the skillful, compassionate care nurses provide every day.  The DAISY Foundation was established by the family of J. Patrick Barnes after he died from complications of an auto-immune disease in 1999. During his hospitalization, they deeply appreciated the care and compassion shown to Patrick and his entire family. When he died, they felt compelled to say “thank you” to nurses in a very public way. 

The DAISY Nurse Leader Award recognizes nurses who are extraordinary in the impact they have on compassionate patient care. Honorees can be any nurse leader who impacts patient care directly including supervisors, managers, educators, or nurses who specialize in case management, informatics, or patient flow.

This Nurse Leader impacts staff and/or the patient care they manage by:

• Role modeling extraordinary behavior     
• Creating an environment where attributes of trust, compassion, mutual respect, continued professional development, and ethical behavior are modeled and supported
• Motivating staff with a shared vision and enthusiasm to achieve better outcomes for themselves and for their patients
• Promoting and enhancing the image of nursing within the organization, the community, and the profession

Here's what her nominator wrote when submitting Samantha for the award: 

"2022 was probably one of the most trying years in our NICU.  We had a record average daily census and acuity, a significant transition of our medical and nursing leadership, numerous new hires to the unit, and to top it off, our designation survey to remain a Level IV NICU and serve our tiniest Texans at our very best. 

"But the chaos of the year could not have been managed without Samantha. As our Neonatal Program Coordinator, she led a quality team to provide real-time feedback on what worked and what needed to be done to improve the outcomes of our babies and our unit. She was a trusted advisor to help the new medical and nursing directors and nursing managers settle into their roles. She led orientation sessions for our new hires and regularly checked in on them to make sure they were doing okay when chaos reigned all around them. Burnout is real and she worked tirelessly to help combat it. And she led a designation team for us to have a flawless survey, allowing us to provide care at our utmost potential. 

“Every baby that has graduated from our NICU has been impacted by Samantha. Every person working in the NICU has been impacted by Samantha. She has created an environment where trust, compassion, respect, and continued personal and professional development can be attainable. She is the leader all units should strive to have and I, like others, consider ourselves fortunate to have her battling for us, our babies, and our families. I struggle to come up with the right words to describe how invaluable she is to the NICU, but I hope I do her justice in what I have said as she is highly deserving of the Nurse Leadership Daisy Award. ”

Pictured: Hevil Shah, M.D, Samantha Corkum, Deborah Boudreaux, Brittany McLaughlin        

Recipients are: Lisa Bashore, Kristen Cook, KaLinda Evans, Sarah "Alli" Herring, Sherry Kuykendall, Emily Percy, Laura Portillo, Ross Richardson, Katelyn Terry, and Amelia Vinson.Thank you to all Cook Children's nurses, for all that you do for our patient families.

Watch the ceremony here (you must be on the network).

Front 1^st Row: Kalinda Evans, Ross Richardson, Katelyn Terry, Debbie Boudreaux 

Middle 2^nd Row: Laura Portillo, Lisa Bashore, Kristen Cook, Orlando Chapa 

Back 3^rd Row: Emily Percy, Sherry Kuykendall, Cheryl Petersen 

Not pictured: Sarah "Alli" Herring,  Amelia Vinson

"I was 13 years old when my grandfather was diagnosed with stage 4 lung cancer. Within a 6-month period I saw a once healthy man wither from the ravages of his disease process and pass away. He was 58 years old. The impact it had on me was tremendous. I remember feeling helpless and hopeless and vowed to find a way to help others who couldn’t help themselves. Nursing was the obvious answer for me, and it is all I ever wanted to do. It was not just a decision I made, but as a person of faith I feel it was a calling. I have been an RN for the past 38 years and I have enjoyed a wonderful career. I would highly recommend it as a career path for anyone who likes a challenge, loves caring for others, and wants a career with many opportunities for growth and advancement in a variety of settings. I have a coffee mug that says, “Nursing is a Work of Heart”. It is not for everyone but for those who have a deep compassion and willingness to care our fellow humans at the most vulnerable stages of their lives." 

Jordan Staggs

“I became a nurse because I wanted a career in which I could help people, be financially secure, and have opportunities to work regardless of geographical location. I enjoyed the challenge of nursing school and immediately fell in love with pediatric nursing. Although I loved my job and the challenges that nursing brought, I didn’t truly find my passion for this profession until later on. In 2017 I was diagnosed with cancer for the first time and had to go from being a healthcare provider to being the patient. This experience sparked creativity, passion, and drive that I now pour into my career here at Cook Children’s. Having experienced the vulnerability that comes with being repeatedly hospitalized, I now am a better advocate for my patients as well as the nurses here within our organization. I strive to develop and support innovative and evidence-based initiatives that will promote patient safety and have a lasting impact on our culture of Zero Harm here at Cook Children’s. When I encourage individuals to choose nursing as their profession, I advise them to consider their reasons for wanting to be a nurse. Recognition and riches are not strong enough convictions for success in this profession. If you desire to serve others and be the hands and feet of Jesus to the most vulnerable populations then nursing will be the most rewarding privilege you will ever experience.” 

Ryan Hoover

“I became a nurse becuase of the care and attention I received here at Cook Children’s Medical Center when I was personally diagnosed with type 1 diabetes in 2002. Because of the great team of CDEs here, I knew that was what I wanted to eventually do. I am beyond blessed to be doing just that in the place that gave me so much! I would encourage anyone with a caring heart to become a nurse because it can be SO rewarding to make positive changes in the lives of patients and their families.” 

Amy Hopkins

“I became a nurse because I saw my Mom THRIVE at being one. Growing up, from a young age, my parents always said I knew exactly what I wanted to do – be a Nurse! My Mom was an LPN (equivalent of an LVN) since college; she worked in a Nursing Home, as a Medical Receptionist in Orthopedics, tried school Nursing for a while (at the elementary school my sister and I attended) and ended her career at her beloved Cornell Health (formerly Gannett Health Services.)

Once I graduated from Nursing school, I started in acute care (on a Specialized unit which, at the time, was quite an accomplishment!) I then moved on to an OCFS Residential Facility for girls; then, my career came full-circle when I started at Cornell Health! I’ve since worked in a few other settings, all of which taught me new and exciting things that I carry with me and use in my practice every day here at Cook Children’s. Attached are 2 of my favorite Nursing photos of all time… One when I went with my Mom to a “Take Your Child to Work Day” at Cornell Health; and one from the infamous “Cornell Slope Day” with a colleague. I would encourage all who get fulfillment and enjoyment out of helping people and their families (in all ways), educating others on topics they’re experts in, and feel a sense of pride from talking about their career and accomplishments, to become a Nurse. I saw my Mom do all of these things and come home happy (albeit exhausted at times!) to have contributed to the success and health of other people on a daily basis – that’s what I strive for every day… and will until my body won’t let me work anymore!”

Want to share your story? Email us at InternalCommunications@cookchildrens.org 

Send us a paragraph answering these questions:

• Why did you become a nurse?
• Why would you encourage someone else to become a nurse?  

Please send photos that represent either or both of these questions -- you have wide latitude here but be sure that the image does not include patients, families, or private health information.

 RNs Jordan Staggs and Andrea Knott, will present a session titled “Steps towards Savings: A Frontline Clinical Nurse-Led Research Project to Evaluate the Impact of an Early Ambulation Device.”

Natalie Palau, a Clinical Nurse Leader, Ashley Chreene, a Nurse Manager, and Leigh Anne Campbell, a Clinical Education Coordinator will present “Connecting the Dots for High Fall Risk Patients: Implementation of Acute Fall Risk Interventions and Education on an Inpatient Neuroscience and Epilepsy Monitoring Unit.”

Sandy Manoushagian, a Clinical Education Coordinator, and RN Jordan Staggs will present “Something New is Taking Shape: Design and Implementation of a Standardized Bedside Shift Report Using the ISHAPED Algorithm.”

Inpatient Psychiatry RN Christina Tan, Hematology & Oncology RN Andra Alfaro, and Valerie Shorten, who started as a cook in the Cook Children’s cafeteria and worked her way up to unit secretary and then a NICU RN after earning her BSN, will present “Bundle Up & Sleep Tight! An Evidence-Based Project to Increase Awareness On Healthy Sleep Hygiene Habits and Interventions for Pediatric Patients with Behavioral Health Needs.”

Nursing Quality Improvement Coordinator Nancy A. Russell, Wound/Ostomy Nurse Coordinator, Mitsy McCutchen, and PICU Clinical Nurse Leader, Cammie Larson will present “Hard-wiring Skin Assessment to Reduce Cervical Collar Pressure Injuries.”

Clinical Nurse Ceileigh King and Clinical Practice & Advanced Education Specialist, Level II, Stacey Bancroft will present “Transpyloric Feeding Tube Placement at the Bedside: Streamlining Measurement, Insertion and Maintenance.”

Renee M Twaddle, an RN in the Ear, Nose & Throat Clinic, will present “Examining Pain Memory in Pediatric ENT patients with Foreign Body Removals: An Interdisciplinary Evidence-Based Practice Project.”

RN Theresa McMinn will present “Building an Educational Bridge with Evidence-Based Practice on the Use of Near-Infrared Spectroscopy in Pediatric Critical Care.”

Julie Van Orne, an EBP/QI Coordinator, will present “The State of Tracheostomy Education Programs Across the United States: A National Survey of Children's Hospitals” with a colleague from Texas Children’s Hospital.

Katy Walthall and Abbie Garcia, Clinical Practice and Advanced Education Specialists II, will present “Virtual Preceptor Workshop: Bridging the Gap Between Preceptor Demand and Traditional In Person Learning.”

Jennifer Stephen, a Clinical Practice & Advanced Education Specialist and Vicki Kelly, Assistant Direct of the Family Services Department, will be joined by a parent mentor to present “Connect, Collaborate, and Elevate the Patient Experience: Outcomes and Successes of an Interdisciplinary Hispanic Family Advisory Council.”

Jennifer Horn, a Quality Improvement Coordinator and Alex Frejer, a Psychiatry Nurse Manager, will present “Implementation of a Behavioral Emergency Response Team in Pediatric Medical Center to Support Bedside Nurses and Improve Safety Outcome.s”

Jennifer Stephen, a Clinical Practice & Advanced Education Specialist will present “An Ethnonursing Study Exploring the Culturally Congruent Care Needs of Spanish Speaking Parents, Who Speak Little to No English, Whose Children Were Hospitalized.”

Mary Cazzell, the Director of Nursing Research and Evidence-Based Practice, will present “Relationships among Psychological Safety, High Reliability (HRO) Perception and Safety Reporting Intentions in the Pediatric Nursing Workforc.e”

Barbara De Leon, Education Coordinator in Specialty Clinics, and Chansey Pullen, RN in Pain Management Services, will present their poster: “Bridging the Gap: Retrospectively Discovering the Value of Kotter’s Change Model Following the Implementation of a Nurse-Administered Aromatherapy Program.”

Jennifer Stephen, a Clinical Practice & Advanced Education Specialist will present their 60-minute presentation: “Not Just for Exam Prep: How Students, RNs, and Educators Can Maximize the CPN Content Outline.”

·         RNs Jordan Staggs and Andrea Knott, will present a session titled “Steps towards Savings: A Frontline Clinical Nurse-Led Research Project to Evaluate the Impact of an Early Ambulation Device.”

·         Natalie Palau, a Clinical Nurse Leader, Ashley Chreene, a Nurse Manager, and Leigh Anne Campbell, a Clinical Education Coordinator, will present “Connecting the Dots for High Fall Risk Patients: Implementation of Acute Fall Risk Interventions and Education on an Inpatient Neuroscience and Epilepsy Monitoring Unit.”

·         Sandy Manoushagian, a Clinical Education Coordinator will join RN Jordan Staggs to present “Something New is Taking Shape: Design and Implementation of a standardized Bedside Shift Report Using the ISHAPED Algorithm.”

·         Inpatient Psychiatry RN Christina Tan, Hematology & Oncology RN Andra Alfaro, and Valerie Shorten, who started as a cook in the Cook Children’s cafeteria and worked her way up to unit secretary and then a NICU RN after earning her BSN, will present “Bundle Up & Sleep Tight! An Evidence-Based Project to Increase Awareness on Healthy Sleep Hygiene Habits and Interventions for Pediatric Patients with Behavioral Health Needs.”

·         Nursing Quality Improvement Coordinator Nancy A. Russell, Wound/Ostomy Nurse Coordinator Mitsy McCutchen, and PICU Clinical Nurse Leader Cammie Larson will present “Hard-wiring Skin Assessment to Reduce Cervical Collar Pressure Injuries.”

·         Clinical Nurse Ceileigh King and Stacey Bancroft, Clinical Practice & Advanced Education Specialist, Level II, will present “Transpyloric Feeding Tube Placement at the Bedside: Streamlining Measurement, Insertion and Maintenance.”

·         Renee M Twaddle, an RN in the Ear, Nose & Throat Clinic, will present “Examining Pain Memory in Pediatric ENT patients with Foreign Body Removals: An Interdisciplinary Evidence-Based Practice Project.”

·         RN Theresa McMinn will present “Building an Educational Bridge with Evidence-Based Practice on the Use of Near-Infrared Spectroscopy in Pediatric Critical Care.”

·         Julie Van Orne, an EBP/QI Coordinator, will present “The State of Tracheostomy Education Programs Across the United States: A National Survey of Children's Hospitals” with a colleague from Texas Children’s Hospital.

·         Katy Walthall and Abbie Garcia, Clinical Practice and Advanced Education Specialists II, will present “Virtual Preceptor Workshop: Bridging the Gap Between Preceptor Demand and Traditional In-Person Learning.”

·         Jennifer Stephen, a Clinical Practice and Advanced Education Specialist, and Vicki Kelly, Assistant Direct of the Family Services Department, will be joined by a parent mentor to present “Connect, Collaborate, and Elevate the Patient Experience: Outcomes and Successes of an Interdisciplinary Hispanic Family Advisory Council.”

·         Jennifer Horn, a Quality Improvement Coordinator, and Alex Frejer, a Psychiatry Nurse Manager, will present “Implementation of a Behavioral Emergency Response Team in Pediatric Medical Center to Support Bedside Nurses and Improve Safety Outcomes.”

·         Jennifer Stephen will present “An Ethnonursing Study Exploring the Culturally Congruent Care Needs of Spanish Speaking Parents, Who Speak Little to No English, Whose Children Were Hospitalized.”

·         Mary Cazzell, the Director of Nursing Research and Evidence-Based Practice, will present “Relationships among Psychological Safety, High Reliability (HRO) Perception and Safety Reporting Intentions in the Pediatric Nursing Workforce.”

Conjoined twins AmieLynn and JamieLynn Finley won the hearts of the nurses who fed, diapered and bathed the girls a little differently from other babies in the Cook Children’s NICU.

For the first three and a half months of their lives, AmieLynn and JamieLynn were joined from their breastbones to their bellies. The girls could lie only on their sides, face to face, because their chest/abdomen areas were connected. Caring for them in the NICU required some modification of the usual tools and techniques for infants.

Surgeons at Cook Children’s separated AmieLynn and JamieLynn on Monday in a rare and complex operation, a first for our medical center. Two separate isolettes brought the girls back to the NICU to recover under the watchful eye of the neonatologists and nurses who know them best.

“I’m excited that we’ve been part of their story,” said NICU Director Brittany McLaughlin, RN. “The team’s been very creative and innovative.” 

Born in October at Texas Health Harris Methodist Hospital Fort Worth, the pair were transported at five weeks to Cook Children’s, where the NICU staff stepped up to the unique challenges of caring for conjoined twins. Consider diaper changes, for instance: “There’s lots of legs flailing everywhere. When they’re both awake and moving, you have to kind of wrangle one’s legs away while you change the other one,” said Brianne Galvan, RN. “You have to be fast.”  

Or lifting their combined weight of about 22 pounds: “You’re not just picking up one heavy baby. It’s a lot more positioning,” said Raye Urbanek, RN. “You have double the number of wires you’re trying not to tangle as you’re taking them from the bed.”

Brianne has been JamieLynn’s primary nurse and Raye has been AmieLynn’s primary nurse since their arrival in November. NICU Manager Megan Maxwell, RN, prepared the setup for their room, which required a bit of layout reconfiguring for monitors and other equipment. Color coding – green for AmieLynn, purple for JamieLynn – designated the name bands, cords and other gear on each girl’s side of the bed.

An additional step to safeguard patient identification happened every time the nurses turned the girls over. Nurses would alternate the spot where the girls’ heads and feet went in the bed to keep AmieLynn always on the left and JamieLynn always on the right after they were turned. “That’s so that we’re not confusing which one’s on which side,” Megan said. “That was obviously a big point of concern. We wanted to keep them safe.”

During the time they were conjoined, the girls’ faces were so close that they could suck on each other’s mouths. That made it tricky to feed them. Speech therapists at Cook Children’s helped by recommending ways to angle the twins’ heads to accommodate bottles.

Bath time required a round TurtleTub rather than the narrower standard model. The girls wore mittens even during their baths to cover their fingernails.

“We just swaddle them up and keep mittens on them because they will start to scratch on each other and then get angry,” Raye said. “If you keep the mittens on, then you can position them in the TurtleTub and have padding for their heads. They’re calm and happy and they love bath time.”

The twins could be propped up on a Boppy pillow or under a jungle gym for playtime. Other stimulation included music, physical and occupational therapy. Stretching exercises helped with the tight muscles in their necks and arms.

Family visits were key too. Their parents, James and Amanda, came to the NICU every day from Saginaw to feed and hold the girls. The babies liked to watch their entertaining 7-year-old brother and be soothed by the songs their grandmother sang to them.

Despite their shared anatomy, the twins developed distinct personalities. JamieLynn is known for her sass and strong will, while AmieLynn is easygoing and observant. Nurses say the girls used to arch their backs like they were trying to get away from each other. It wasn’t easy to keep a fussy baby from waking up her sleeping sister when they’re joined together.

“Amie’s gotten pretty good at sleeping through a lot of Jamie’s antics. But sometimes Jamie’s just punching her and it wakes her up and she is not happy,” Brianne said.

The nurses use words like “amazing,” “feisty” and “beautiful” to describe the twins. They look forward to cuddling the girls one at a time. Now that they're recovering in separate beds, Brianne predicted that AmieLynn and JamieLynn would miss the constant close proximity of being connected. “We’re going to have to figure out something so they can see each other in the NICU.”

Mary Frances Lynch, M.D. is the neonatologist for JamieLynn. Chad Barber, M.D. is the neonatologist for AmieLynn. Each has 16 years’ experience at Cook Children’s.

Dr. Lynch cited some medical complications that arose from conjoining:

• Limited mobility. The twins couldn’t be placed on their backs or tummies. They had to be turned frequently to prevent positional deformities and skin from breaking down.
• Breathing issues. JamieLynn needed oxygen by nasal cannula.
• Feeding concerns. IV nutrition and nasogastric feeding tubes allowed them to get their full feeding if they weren’t able to bottle feed. One twin grew significantly more than the other, likely related to their shared blood supply.

“Our primary focus in the NICU prior to surgery was to optimize their nutrition so that they could grow as much as possible,” Dr. Lynch said. “The bigger they are and the better their nutrition is, the easier their recovery after separation.”

During their post-surgery stay in the NICU, Dr. Barber said, major concerns include respiratory support and pain control. He and Dr. Lynch feel fortunate to take care of sick babies alongside the entire NICU team.

“It’s a big honor to be trusted by parents in the NICU,” Dr. Barber said. “Every day we have parents who are basically turning their child’s life over to us and believe in all the decisions that we make.”

Two of our nurses were selected for the prestigious 2022 Graduate Nursing Student Academy PhD-DNP Collaboration Excellence Award for their submission: “The Magic of Collaboration and Innovation! A PhD-DNP-Led Center for Nursing Excellence and Innovation to Promote Nursing Science and Sustain Practice Changes.”

Congratulations to Julie Van Orne, EBP/QI Coordinator and a Ph.D. student at Texas Woman’s University in Houston and Kaylan Branson, Director of Nursing Quality and Magnet and a Doctor of Nursing Practice (DNP) student at University of Texas Medical Branch in Galveston, Texas.

They received the competitive award at the 2023 American Association of Colleges of Nursing (AACN) Doctoral Education Conference in Coronado, Calif. on Jan. 19, 2023.

This award is granted in recognizing excellence in collaboration among students in Ph.D. and DNP Programs.

By Malinda Mason Miller, PRN

In 1978, young Deborah Rubinson and her husband David were expecting their first child, and decided it was time to move back to Texas from Saint Louis. The Rubinsons looked for a place where they could settle down and raise a family. Deborah applied at what was then called Fort Worth Children’s as a nurse. The rest, as they say, is history.

It wasn’t a difficult decision to pick Cowtown for starting a family. Fort Worth is where the Rubinsons met, and where Deborah received her undergraduate degree in nursing from TCU. It felt good coming home.

It also felt good coming to work at a place that embraced Deborah's pioneering spirit and desire to make things better, beginning with her patients and ending with a system that grew up around her. 

 “I like to make things better,” Deborah said of her more than 40-year tenure of bringing ideas, challenges and upgrades to Cook Children’s Health Care System (CCHCS).

Deborah credits the Cook Children’s Medical Center and system leadership with allowing her to continue to “make things better,” providing resources and support, where needed, to do so.

In October, Keith Holtz, Chief Administrative Officer and Deborah’s boss, announced her semi-retirement. The announcement included the operational fundamentals of all those that would be promoted in the system to continue Deborah’s trailblazing work. The list of those taking the reins for her many roles was almost as jaw-dropping as the list of folks she hired and led over the years.

New lens on leadership

Over the years with CCHCS, in addition to serving children, Deborah would impact nurses, physicians and other health care professionals. Her main goal was simple: to help these professionals grow and improve their work so they could best serve patients.

“Deborah’s leadership style means she accommodates lots of generations and backgrounds, which is a huge current competitive advantage,” said Cami Dragomirescu, Assistant Vice President, Organizational Development and Team Experience.

In addition to developing and keeping talent at CCHCS, Deborah’s colleagues mentioned her singular ability to find and hire the right talent.

“Deborah finds the diamonds in the dark mining,” Cami said of Deborah’s discerning, awe-inspiring hiring abilities.

Deborah believes there are many ways to develop leaders once they are on board and connection and recognition are important elements.

“If recognition means the employee moves out of your department because they were promoted, you have succeeded as a leader,” Deborah said. “Instead of dreading the effort of finding a replacement to fill that position, I look at it as an opportunity to develop a new leader.”

When Cook Children’s University – a program created to train and coach front line employees – began, there was only one position for a trainer. Now, due to the program's success, demand and the virtual presence of training that came as a positive result from the COVID-19 pandemic, there are three fulltime positions for coaches/trainers.

“Development of leaders can be both strategic and behavioral,” Deborah said. “We have found ways over the decades to provide emotional support to our health care professionals through personal coaching, a program designed to support patient care workers in the trenches.”

Supporting these employees was clearly an important priority before the COVID-19 pandemic hit. The industry turnover during the pandemic shined an even brighter light on the difficulties of working in patient care, and the need to continue to provide emotional support, coaching and helpful resources for employees.

“Well-developed, well-trained employees make for better quality of care at Cook Children’s,” said Joann Sanders, MD, Chief Quality Officer. “I love when I get to be part of a work team with Deb, because the outcome is always improved quality for patients.”

According to Deborah, in addition to better quality, fewer risk issues and medical errors, a workplace’s culture can also be improved by supported employees who feel valued. One of the most important impacts of emotional support is the overall well-being of caregivers, she said. And employee well-being can mean better care for patients. 

“Increased self-awareness is one example of an outcome of Cook Children’s coaching sessions,” Deborah said. “That can be a gift both in someone’s work life, and a positive outcome that improves home and family life as well.”

Considered by many to be Deborah’s professional legacy is the inception of the Advancing Healthcare Leadership (AHL) program, a partnership with TCU created in the same vein as many other CCHCS employee development programs.

Deborah helped design AHL to develop and train physicians on the medical staff at Cook Children’s into leaders.

“The AHL program is one of the most outstanding legacies of Deborah’s marvelous career,” Keith said.

New challenges bring change, change requires leadership

Deborah’s time in healthcare serving Fort Worth area children from the late 1970s to today saw both technological break-throughs and culture changes industry-wide. Deborah recalled some of her greatest challenges and spoke candidly about an example of where leadership made a big difference to making critical changes in newborn healthcare.

In the early 1980’s, there was no ground transport for babies needing neonatal intensive care in the Cook Children’s service area. In an era when a regular Fort Worth ambulance was used to transport newborns, Deborah and another nurse served as the ground transport team that later became known as Teddy Bear Transport.

Deborah saw something that ‘needed fixing.’ High-risk newborns were not getting to Cook Children’s fast enough. She helped CCMC leadership realize that rural hospitals needed extra help and training to best serve struggling premature babies. Many rural hospitals did not have the resources needed to stabilize a neonate for ground transportation.

Deborah quickly realized that to save more babies’ lives – when mere moments mattered – she would need to help the rural hospitals be ready. She wrote a grant to the March of Dimes to begin a program that would train rural hospitals on what was needed – from medical supplies to health expertise – to enable newborn patients to be stabilized and transported to the Neonatal Intensive Care Unit (NICU) at Cook Children’s. The grant included onsite trainings and equipment reviews, led by Deborah and a team from CCMC.

“We developed the outreach program based on The Guidelines for Perinatal Care,” Deborah recalled. “Doing the groundwork in advance saved critical time for infants needing quick access to special medical care.”

It worked. The rural hospitals developed their internal systems so earlier intervention with premature and high-risk babies meant more survived over the years.

It wouldn’t be the only time Deborah would face a challenge, write a grant, or start a program at CCMC. And it would not be the only time she touched lives beyond the walls of CCMC.

What a leader does next

After four decades serving young patients, now Deborah may have a bit of extra spare time for some other children in her life that call her “Nan” – her nine grandchildren.

 Deborah sparkles with pride when she thinks about her family.

But when Deborah looks back at the jobs she held before her time here, in addition to college professorships along the way, the jewel in her nursing cap points to CCHCS.

“Cook Children’s is a gift to this community,” she said with a smile. “I am humbled to have been part of making it that much better.”

That’s what a good nurse and a good leader does. They make it better for all who come after them.

Did you know?

There are two programs for which Deborah Rubinson said she is especially proud: the nurse residency and the simulation programs.

Simulation Program

The simulation program began in 2009 with one high-fidelity manikin and a closet to store some equipment. The program now includes a lab with more than 17 simulators and has logged upwards of 28,000 hours. Simulation bridges the gap between education and real-life clinical experience, which was critical during the pandemic. In 2020, Cook Children’s simulation program became the first free-standing children’s hospital in the world to obtain accreditation in all five areas evaluated by the International Society for Simulation in Healthcare.  

Nurse Residency

The nurse residency program began in 2008 as part of Deborah’s doctoral project. The program developed in response to the Institute of Medicine recommendation for 12-month transition program for newly-licensed nurses. In 2011, it became the first accredited pediatric nurse residency in the United States. CCHCS has hired more than 900 newly-licensed nurses and improved recruitment, engagement and retention through a curriculum that builds confidence, competence and fosters connection.

Emily is a nurse manager on 5ST and exemplifies true leadership at Cook Children’s. Her consistent presence on the unit allows her to role model professional nursing practice. She will step in to help with patient care or any other unit workflow needs including working the night shift. Emily is technically a night shift manager, but she supports staff on both shifts as though they were her own. She is a safe place to discuss issues related to work or personal conflict. She is trustworthy, compassionate, and respectful. She helps bedside nurses find their voice and advocates for them in capacities beyond their reach. She encourages staff to participate in unit and organizational committees. Emily assists with improving patient outcomes. She is instrumental in a research project we are completing with post-surgical patients and an early ambulation device. She is also a huge supporter of the ISHAPED project and has stepped up to ensure her staff support it so that it will be a successful rollout. Emily reminds me of why I went into nursing and I’m so grateful to have her as a leader in multiple capacities throughout this organization. 

Lynne West is an excellent leader on our unit. She worked so hard to open up a new unit and ensure that we had everything that we needed to provide excellent care for our patients. Over and over again she goes to bat for her staff. We know that her advocacy doesn't stop when she is told "no" but instead she figures out who to talk to next. Her commitment to her staff keeps us motivated to continue to show up each day. When issues arise on our unit she is willing to have open and honest communication. She has an open door policy and is welcoming any time you want to discuss a concern, or just say hi. Oh, and she keeps snacks at the ready, which is always a plus when you're having a bad day! Lynne has helped establish a happy and engaged team. I believe our unit is the most connected and cohesive team at Cook Children's. We have few complaints and our staff truly love one another. It is so nice to come to work daily and know you always are working next to a friend. Lynne has helped orchestrate this by hiring excellent nurses, mitigating conflict early and advocating for her staff repeatedly. Lynne deserves to be recognized with the nurse leader award.

Sandy Manoushagian is one of those nurses that form the backbone of this organization. She is instrumental in the orientation and education processes of the staff she serves. In addition to her responsibilities within the education department, Sandy advocates for nursing by serving as a chair of QIC, running the 5ST education committee, participating on the UBC for 5ST, and developing the ISHAPED tool for bedside shift reports. She is in touch with bedside nursing, which allows her to make impactful change at the system level. In addition, she is working to earn her DNP which will allow her to make even more of an impact on the future of nursing. Sandy is an amazing leader and we are so lucky to have her here at Cook Children's.

Elaine is the “go-to” nurse in our unit and is always present, positive and available to our team. It is hard to list everything she does for our unit because it’s a very long list. Her experience and dedication to our unit often goes unnoticed. She is a key part of making the CICU successful every single day. Elaine brings her contagious personality and love for our unit to the forefront of her work. We are lucky to have her as a leader in the CICU!

Cook Children’s Medical Center is proud to announce the reaccreditation of the Nurse Residency program through the Commission on Collegiate Nursing Education (CCNE).  

In September 2021, CCNE visited the medical center to conduct a virtual evaluation of the program. As a result, the surveyors found no areas of concern and awarded a 10-year accreditation through 2032.

The Nurse Residency program was established in 2009 with its mission to support new graduate nurses rising to the peak of professional practice as guided by the Cook Children’s Promise and values. 

As a nationally regarded and highly unique Nurse Residency program, nurse residents rotate through various specialty units gaining valuable knowledge and clinical experiences to accelerate their transition into professional pediatric nursing.

Throughout the Nurse Residency program, nurse residents are afforded the opportunity to:

• Engage with a cohort of peers who are enthusiastic about pediatric nursing
• Develop clinical reasoning skills
• Implement evidence-based practices
• Collaborate with interdisciplinary partners 
• Enhance professional engagement through mentorship and commitment to life-long learning

The Nurse Residency program at Cook Children’s Medical Center was the first pediatric Nurse Residency program in the country to be accredited by the CCNE in 2011. 

As exemplified through reaccreditation, the Nurse Residency program continuously benefits new graduate nurses in regards to stress and anxiety levels, clinical competence, confidence, and professional development opportunities. The Nurse Residency program is highly effective in achieving the mission of supporting newly licensed nurses in the transition to professional pediatric practice.

Former nurse resident Mary Brennan shares, “We were taught about how to become active participants in the hospital system and that no matter how new you are to the nursing profession that you have something to offer the community. I am so incredibly grateful for the Nurse Residency Program and the skills that I gained from it.” The leaders of the Nurse Residency program are extremely humbled and excited to share this accomplishment with all of Cook Children’s. It takes a village to grow and develop new graduate nurses and the nurse residents are blessed to be supported by the Cook Children’s family."

We're spotlighting three nurses this week:

• Patrice Reznicek, RN, Psychiatry 
• Laura Portillo, RN, Hematology-Oncology
• Anthony Garcia, RN, Dialysis 

Watch this video to hear about their favorite nursing moments, nurse heroes and what keeps them going every day!

Kaylan Branson, RN, MSN, has accepted the promotion to the director of Nursing Quality and Magnet Program. Kaylan has been a growing leader within our organization since she joined our nurse residency program in 2011. Since that time she has worked as staff nurse, charge nurse, and preceptor on 4 Pavilion (TCU/RCU). In 2017 she was promoted to the clinical nurse leader role, co-leading efforts to facilitate family discharge, research and

She has had numerous poster and podium presentations for her participation in work related to the boot camp discharge innovation, achievement of quality goals, use of a Gemba Board, trach care and partnership with clinical leaders and educators to improve patient care and nurse satisfaction. 

Kaylan completed her Bachelors of Science in Nursing in 2011 from Tarleton State University, Master of Science in Nursing Education in 2016 from the University of Texas in Arlington, and Clinical Nurse Leader post-graduate certificate in 2019. Kaylan is enrolled in a Doctorate of Nursing program at the University of Texas Medical Branch with a projected graduation of May 2024.

She shall transition from her CNL role on 4NT to her new role on April 24. Please join us in congratulating Kaylan!

“I started as a night manager on the inpatient Surgical/Trauma unit and the rest is history,” Shakyryn said. 

Soon after joining Cook Children’s, Shakyryn finished her master’s degree and in 2014 earned her doctoral degree. As a nursing director for the past eight years, she has always strived for her team to be happy, healthy and psychologically safe. That proved to be a challenge after the sudden transformation of her unit due to the pandemic.  

“As soon as I found out our unit would change from Renal/GI to COVID-19, I immediately let my managers know before scheduling an impromptu staff meeting. Our goal was to slowly roll it out, but that evening we received our first patient with COVID-19.”

Nearly every process would be different. Shakyryn began educating the team on new ways to manage labs, dietary needs and nursing protocols and how to stay safe by using PPE. Conferences with the administration became a regular occurrence, and medical director of Infectious Diseases, Suzanne Whitworth, M.D., made many rounds. Shakyryn said the managers stepped up during such a difficult time and seeing everyone give 100% was a motivating factor for her. She put on her scrubs and joined the bedside nurses to show support.

A room on the unit turned into “COVID alley” – a place of respite with candy, décor and puzzles. The community sent gifts and snacks which helped to lift spirits on particularly rough days.

“As time went on and COVID-19 hit hard, staffing and keeping the morale up for bedside nurses became challenging. I had a lot of conversations with nurses to help them keep going. At that point, it was a lot of reassuring, dispelling myths and answering the question on everyone’s mind – when is this going to end?”

Now Shakyryn has the answer to that question – a few weeks ago, her unit changed back to Renal/GI patients, and everyone is very happy to experience some normalcy. A celebratory pancake breakfast marked the end of COVID-19 on their unit as well as 1,000 days without a central line-associated bloodstream infection (CLABSI). Shakyryn said maintaining CLABSI-free through COVID is an amazing achievement as they cared for many lines and hematology/oncology patients. She is proud of how everyone handled the past two years – unprecedented times that brought many hardships but also changed perspectives.

“COVID let people know that things can change at any moment. It also made people realize that they do have adaptability. Now we all know how strong we really are. We may have had low points, but we rose to the occasion for the kids.”