Nurses Leading the Workfore with Care

Nurses Leading the Workforce with Care is the theme for March. Nursing is a multifaceted job, and it requires a lot of flexibility, not to mention innovation and creative thinking. Those things are also critical for any kind of leadership. We celebrate those in leadership this month and share their stories to inspire both current and future nursing leaders in our midst.

“Intense, Inspiring and Scary”

Lara Comstock, RN
Director of Nursing
New York, NY

Lara Comstock, RN, the Director of Nursing at Callen-Lorde in New York, is used to creating solutions when crises arise.

Several months ago, a car ran into one of Callen-Lorde’s health centers.  Lara was part of the team that had to quickly move all patient care services to another site nearby.

With the emergence of the COVID-19 pandemic, Lara’s day-to-day life has changed considerably, as she responds to this current crisis.  She shares:

“I have been part of a fantastic team of Callen-Lorde staff, working with Housing Works and Department of Homeless Services staff, to open an isolation site for folks experiencing homelessness and who need a safe place to isolate and heal from sub-acute COVID or COVID-like symptoms. This project came together in a week. We are housed in a hotel which has been rented for this purpose and the project will last for about six months. I’ve never in my entire life been involved with something this intense, inspiring, and scary, and it has been an amazing experience to see folks come together and put systems in place to care for up to 173 people in one week. I work at the site 2-3 days per week, as a clinical RN and as an administrator, attempting to codify workflows and resources we’ve come up with since this project began. We feel we’re making an important contribution to containing the pandemic, and also attempting to treat people (patients and staff) with the dignity everyone deserves”.

Lara’s nursing role at Callen-Lorde has been centered around the importance of personal and professional development.  Before nursing, Lara had many different “lives.”  She worked with people with developmental disabilities, was an editor, then chef, and worked with a food co-op.  After becoming a nurse, she started in hands-on care, eventually moving to leadership and administration.  One way that Lara is “Leading with Care” at Callen-Lorde is the development of a mentorship program.  She has worked with four other managers that mentor from within to develop leaders which represent the community well in both diversity and equity.  There were five in the first cohort, and six in the second cohort.

Lara’s advice to others looking into nursing is to get involved in the administrative aspects of the role, learn the ins and outs of the role, and add to your education if possible.  Volunteering for different committees and seeking out mentors who are in the role you want is also important.  Finally, taking on small projects or finding opportunities to speak or present can also lead to professional development within nursing.

Norma Quinones, LPN
Nursing Services Manager
Clinica Family Health
Lafayette, CO

April 2020 Update: COVID-19

How does your day-to-day life look different in the age of this pandemic?

My day to day life during the pandemic consists of meetings, trainings and implementation of new workflows/ processes and keeping up with CDC recommendations and learning new skill sets.

To minimize potential COVID exposure, I wear the appropriate PPE and practice low-level disinfection religiously, monitor that other staff do as well, and wipe down our high-touch surfaces every 30 minutes with a bleach/water solution. The only items on my desk are masks, laminated documents, phone, tablet and hand sanitizer.

During work hours, I practice self-care with my team, daily by participating in a 7 minute workout twice daily and one minute of mindfulness once daily, Monday thru Friday.

March 2020

Norma Quinones, LPN, has a long history at Clinica Family Health in Lafayette, Colorado. Applying to work as a Medical Assistant in 1992, Norma remembers back when Clinica was one clinic site with six exam rooms and a total of about 25 employees. Since then, Norma completed LPN school, filled a nurse manager role for several years and is now the Nursing Services Manager for Clinica.

Norma sums up her role as this: “I get to dedicate my time to staff and students as they deliver medical, dental and mental health care.”

A typical week in her life includes oversight of NIMAA (National Institute of Medical Assistant Advancement) as a skills coach and program coordinator, managing employee health for 600+ staff, and partnering with Human Resources to welcome new Clinica hires in the New Hire Orientation.

Norma has also dedicated herself to patient care. She recalls one of the most memorable patients she has cared for:

“My 50 year old patient had been diabetic for many years and could no longer control her diabetes with oral meds.  Her provider had been trying to switch her to insulin for a couple of years but was unsuccessful. While doing glucometer and insulin teaching, she let me know she had a huge fear of needles and shared with me  misinformation about insulin. 

During the visit, together, we came up with a plan. She came in to see me every day for four weeks until she was able to demo back how to correctly draw insulin from a vial, safely administer it, and properly dispose of sharps.”

Norma Quinones has been Leading with Care at Clinica Family Health for almost 30 years and gives this advice to those interested in working in a similar role: “There is no such thing as a non-compliant patient, it just means we have not figured out what’s going on in their personal life or what best works for the patient.”

Margarita Vroman, RN BSN, CIC
Director of Ancillary Nursing, Infection Control Officer
Borinquen Medical Centers
Miami, FL

“You have to be flexible – you start the day with your day in mind, and sometimes you mark off what you have on your white board, sometimes you don’t.”

We spoke to Margarita Vroman, Director of Ancillary Nursing and Infection Control Officer at Borinquen Medical Centers in Miami, Florida, back before the COVID-19 pandemic struck the U.S. Little did she know at the time the meaning those words would take on in just a few months. Margarita’s original story is below, followed by a recent update.

“The day is long and full of meetings!” As the Director of Ancillary Nursing at Borinquen, Margarita oversees both nursing and ancillary services and also QI, referral, logs, clinical staff training, employee health, and acts as the infection control officer. Her work week fluctuates greatly, often including many meetings and other urgent matters.

Margarita has been fortunate to work for Borinquen in a number of new and unique roles. All positions she has held have been created because there was a need. This has brought Margarita a lot of joy, in that it has allowed her to “to think big and have the support be a creator and decision maker that supports both patient and employee needs”.

Margarita is especially passionate about advocacy. She points to the fact that many of Borinquen’s patients have to take three to five buses to get to the health center, or have to make decisions about whether to eat or buy medication. Margarita is determined to create policies in her community around how to best serve patients.

When asked what advice she would give to people who are interested in community health nursing, Margarita offers this:

“Don’t do it for the money—do it for the true love of nursing. If it doesn’t give you goosebumps or make your heart leap, it’s not for you. Working at a FQHC is so rewarding in so many ways. Don’t be afraid to take chances and think big. Even for the scariest project–hunker down, get it done and get rewarded.”

We spoke to Margarita again recently for an update on how she is faring in the midst of the COVID-19 pandemic:

“My days now consist of every day reviewing messages coming in from our communication center and from departments to ensure nurses and department staff are being guided correctly,” she says. “I am coordinating every day for COVID testing and delegating nursing staff to contact negative employees as well as coordinating telehealth visits with employees to clear them to return to work if they have been out sick with something else or had been formerly positive for COVID.

I also once a week have to attend a Zoom meeting with clinical managers, once a week with all providers and twice a week I attend our senior leader meetings to report the latest information as a member and to work with my fellow members on how to improve workflows and address the needs of the different departments to ensure patient and staff safety across the organization.”

One Career, Many Roles

Judy Taennis, RN
Practice Manager
The HealthCare Connection
Cincinatti, OH

Judy Taennis has worn many hats since joining The HealthCare Connection (THCC) in Cincinnati, OH, 27 years ago as a Registered Nurse (RN). Taennis has worked at all of THCC’s sites through the years. She’s had stints in OB, pediatrics and adult medicine, and has held many roles including Supervisor, Director of Nursing and now Practice Manager of THCC’s Lincoln Heights Health Center and Forest Park Health Center since being promoted in 2011. In her current role, she manages the day-to-day operations of the practices, collaborating with all locations to ensure patients receive the best quality services. She is the first nurse in the Practice Manager position, a high-level job reporting directly to the Chief Operating Officer.

What hasn’t changed since she joined THCC is Taennis’ long history of leading the clinical workforce – whether that be through problem-solving, supporting clinical staff, working with employees on job satisfaction, or directing trainings or meetings to motivate staff. She is also a part of the quality team helping to sustain level 3 NCQA accreditation. “It is fulfilling to have the clinical support staff grow,” Taennis said.

One hat she never imagined wearing when she started as an RN is leading the Electronic Health Records (EHR) efforts at THCC. Since 2012, she’s been intimately involved with their EHR vendor during each upgrade, providing EHR trainings to her clinical team. Her goal is to ensure each upgrade launched helps with the clinical workflow and is user friendly.

“We want to help providers as much as possible so they are available to see patients. I deal with making sure the billing coding is correct so providers can get their encounters done in a timely manner,” Taennis said.

At the end of the day, for Taennis it’s not only about her clinical staff but the patients. Taennis pitches in when they are short-staffed and gets things done. Getting to work in this atmosphere is fulfilling to Taennis and her favorite part is getting to know her patients and them getting to know her.