The role of a newly hired nurse at Sylvester Comprehensive Cancer Center is an exciting time for nurses who are ready to engage in the role of oncology nursing. With plans to open a 4th oncology unit on 11S at UHealth, a dynamic hiring process was underway to add registered nurses, patient care assistants, and unit-based secretaries to the UMiami family. To meet the needs of the patient population for the new oncology unit, most of the nurses hired had approximately two years of previous oncology experience. “We are very protective of our patients, so we wanted to hire nurses committed to the care of oncology patients,” stated Donnamarie Fernandez, Executive Director of Nursing, Oncology Inpatient Services of the Sylvester Comprehensive Cancer Center and UHealth Tower, Bone Marrow Transplant Clinic, Oncology Care Clinic, and Apheresis/ Photopheresis. However, the hiring process for the new unit coincided with the rising number of COVID-19 cases locally, nationally, and globally—thus leading to complex staffing and hiring challenges.
As the organizational resources were evaluated to accommodate the rising number of patients diagnosed with COVID-19, the resources on 11S, which had not yet opened to oncology patients, were transitioned to become a medical unit to care for patients affected by COVID-19 and to serve as a holding unit for patients awaiting test results. The newly hired staff, comprised of fifteen nurses, four certified nursing assistants, and three unit-based secretaries were poised for the challenge. Even as the unit for which they had been hired was transformed into a COVID-19 unit, they embraced courage, commitment, and flexibility—ready to care for any patient in need. Learning to care for the patients was an experience that solidified the newly hired staff as a cohesive team, building trust and clinical expertise on their unit.
In addition to newly hired staff, the unit’s interim manager Yamile “Yami” Zayas, MSEd, BSN, RN, OCN, was inspirational. Zayas—who sacrificed seeing her own family during the COVID-19 intense period because of fear of transmitting the virus to family—viewed each staff member as key to the success of the unit’s transition. Because of their shared experiences as a newly hired group, the staff led courageously in their clinical practice and unit leadership.
The 11N staff strengthened the team on 11S and welcomed them to UHealth while orienting them to the organization’s policies and procedures. In addition to the newly hired nurses, Mitchel “Mitch” Diaz, BSN RN, a nurse on a unit at the Sylvester Comprehensive Cancer Center, was temporarily assigned to 11N. Building his already solid clinical expertise and autonomy to advocate for patients was a unique opportunity for Diaz. Further he gained additional critical thinking skills in caring for more seriously ill patients and utilized the expertise of his more seasoned colleagues for guidance and mentorship. His experiences prepared him to begin to assume the charge nurse role on his home unit. Diaz praised the staff on 11N and 11S, who were team-focused among registered nurse, nursing assistant, and unit-based secretaries—a truly team-focused staff aimed at assuring optimal quality care. Patient and family communication was complex since patients had no or extremely limited visitation. Modes of communication included phones and iPads to facilitate connections among patients and families. The unit secretaries and other support staff contributed in important ways to address patient safety and many were trained to serve as observers of the donning and doffing of personal protective equipment. “It was so impressive to see the team grow,” said Donnamarie Fernandez.
The beauty of teamwork is said to be visible when its members have worked together over time and have problem-solving skills to ensure positive patient outcomes. Seasoned teams develop harmony and trust each other. It is evident, though, that the newly hired members of the 11S team, with limited experience working together, coalesced in providing exceptional care for patients with COVID-19—willingly and compassionately. The UHealth/University of Miami Health System Nursing Professional Practice Model at its finest.