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Crosstraining of Ambulatory Nurses to UHealth Tower

Transformational Leadership

During the COVID-19 pandemic, Transformational Leadership was exemplified by clinical nurses and nursing leadership of Ambulatory and UHealth Tower nurses who forged a key partnership to assure optimal patient- and family-centered care to assure the vision, mission, and values of UHealth—the University of Miami Health System. As COVID-19 emerged and patients were admitted to the UHealth Tower and care settings pivoted to primarily care for the growing numbers of COVID-19 infected patients, nursing staff created a vision for providing care by leading in assuring optimal cross-training of staff from the ambulatory to acute care settings. One of the most important avenues to assuring the success of this cross-training initially occurred with a survey of all nurses in the ambulatory settings regarding their past professional experiences in medical-surgical, intensive care, oncology, and other settings. All Ambulatory nurses shared their recent experiences, ideas on shifts and planned scheduling, as well as extenuating circumstances—health conditions and family circumstances that might impact their cross-training and assignments.

A team that included clinical nurses Susan Sanchez, RN, OCN and Randy Stein Hagen, RN, OCN along with nursing leaders Cynthia Bradley, DNP, MS, RN, OCN, Nurse Manager of Ambulatory Radiation Oncology; Hilda H. Brito, MSN, RN, NPD-BC, Executive Director of Professional Practice and Watson Caring Science Caritas Coach; and Deborah Piehl, MSN, RN, Executive Director for Nursing Professional Practice and the Magnet and Nursing Accreditation Programs. Clinical nurses Sanchez and Stein Hagen were instrumental in assuring optimal inpatient care from their ambulatory roles since both are oncology certified nurses through the Oncology Nursing Society. Both also had extensive previous inpatient oncology experience, thus assuring that their oncology backgrounds would offer clinical expertise and wisdom in the inpatient setting. As Piehl noted: “We identified which clinical nurse would be best matched with unit needs and their own areas of expertise. We also developed our staffing office and utilized the expertise of clinical nurse specialists to assure that staff were fully comfortable with their expertise for patient care in the inpatient setting.” Brito suggested that among the many accomplishments were that educators were fully available to meet with ambulatory nurses who were assigned to inpatient units, assure fit testing, and engage in clinical support for patients. Bradley described that: “As a team, we were all fully committed to the mission and vision of UHealth and had the lens of our Nursing PPM at the forefront. All nurses felt committed to contributing to the crisis we confronted during COVID-19. There was a lot of beauty amidst the chaos presented during the COVID-19 pandemic.” As Sanchez described: “I previously worked on an inpatient oncology unit in the UHealth Tower and led as the head nurse. I realized that I had not lost any of my clinical skills and was exceedingly comfortable with being cross-trained and sharing my nursing knowledge.” Stein Hagen offered that priority setting in transitioning from ambulatory to the inpatient setting was an excellent refresher course in assuring optimal patient care. Finally, Brito noted that the COVID-19 pandemic illustrated that you can see the patient full circle and that Ambulatory nurses could bring their inpatient oncology experience as a refresher to assure that their Radiation Oncology Ambulatory practice would be enriched to offer optimal patient- and family-centered care.

UHealth Nurses
Each ambulatory nurse was assigned an educator as a resource, so they would not feel alone. Prior to starting on the unit, the nurses gathered in the lobby to meet their educator and each other. They were taken in small groups to the Employee Health Office for Fit Testing, if they had not done so in over a year.
Maureen Fagan and Doreen Ashley
Nurse Leaders, including Maureen Fagan, CNE and Doreen Ashley, Executive Director of Critical Care, rounded on the Ambulatory Nurses on all shifts to show their support and encouragement.
Several UHealth Nurses
Nurse Leaders, including Ellie Smith, CNO and Doreen Ashley, Executive Director of Critical Care, with Brenda Molina, Executive Assistant, brought treats for the nurses on all shifts.