2011 Nursing Annual Report - Kaleida Health

nursing 

2011 

annual 

Kaleida Health 

report 

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Celebrating Commitment – 

Expressing Gratitude 

Celebrating Our Nurses 

Jim Kaskie 

President and CEO 

Each May, the nation honors nursing 

professionals with National Nurses Week. 

Starting on Nurses Day and continuing 

through Florence Nightingale’s birthday, we 

pause to recognize our nursing staff for what 

they do each and every day. 

In this annual report, on behalf of all of those touched by your 

care, we salute all the nurses in the Kaleida Health family. Whether 

it is in an acute care, clinic, rehabilitation, long-term care or home 

health setting, our nurses truly impact our patients’ lives. 

The gratitude for your commitment and dedication is expressed 

in the countless letters and notes sent in by patients and their 

families. It is through their words that you can see the impact of 

your work. That is why it is always so heartwarming to receive 

notes complimenting the good things you do. Whether you see 

a patient for a minute, a day, a week or longer, you shape their 

perception of the care they received. 

Using the words caring, compassionate, attentive, professional and 

courteous, patients tell us why what you do is so important and 

how it aids their recovery. 

As we move forward and transform into a new health enterprise, 

the impact nurses have on our patients and in this organization is 

even more significant. 

To achieve these goals, nurses are leading initiatives that are 

evolving nursing care. Specifically, the Magnet Journey, Centralized 

Partnership Councils, Cohort and Residency programs, 

and Dedicated Education Units are all examples of how our 

exceptional nurses are providing extraordinary care and laying 

the foundation for future nursing generations. Moving forward, 

Kaleida Health will continue its commitment to the future of 

nursing and healthcare safety and quality. 

Personally, I can attest to the effect a nurse can have on a family’s 

experience. 

Thirteen years ago, I lost my father at age 79 to cancer, and a 

heart that just could not work any harder. He was an OB-GYN 

physician, and in “retirement” at age 60, became a full fledge 

Emergency Room doctor. Last August, my 92-year-old mother said 

she had “lived a great life” and let go. 

Why do I share this? I can only imagine that many of you think 

of me as just the “CEO,” the one focused only on numbers 

and “corporate stuff.” And you may wonder if I appreciate the 

unbelievable work our Kaleida Health nurses do, day in and day 

out, 24/7, 365 days a year. 

I began my career in health care as an emergency room tech in 

a trauma center in St. Louis. For six years, I worked side by side 

with nurses who amazed me daily. They amazed me with their 

skill, compassion, tireless efforts, and commitment to serve the 

patient seeking their care. 

2 2011 Nursing Annual Report

Every day, for the 35 years that 

I have served in health care 

administration, I have worked with 

nurses and witnessed these same 

efforts every day. However, never 

Gates Legacy Celebration! 

did I truly appreciate the work of nurses 

more than when nurses were at my father’s bedside or attending to 

my mother, especially for the five years she was cared for in a longterm 

care facility. 

So on a professional, a “CEO” level, THANK YOU for your 

outstanding service. Thank you for the healing you bring to our 

patients and their families every day. I am so very proud of you. 

You are making the difference in so many peoples lives. 

Gates Legacy Celebration: A Tribute to Family, 

Friends and Excellence 

Two years ago, Gates Hospital President, Tammy Owen asked a 

group of employees to form a committee to look at celebrating 

Gates “legacy” prior to the collocation and closure of the facility 

in the spring of 2012. Tammy said when she came to Gates from 

DeGraff, she was very impressed by the community hospital 

feeling similar to that at DeGraff, but in a larger teaching-based 

hospital. Despite the excitement about the opportunities that the 

new GVI and collocation to the BNMC would have for staff, she 

knew the strong connections, personal and professional, needed 

to be celebrated before the move. Bev Tate, a 43-year employee, 

was asked to chair the committee with members, Annette Klosek - 

administration, Gina Sutor (the senior legacy committee member 

with 50 years as a Gates employee), Josephine Toldeo - gift 

shop manager, Phyllis Gentner - marketing, Adrienne Doepp 

- librarian, Barb Browning - marketing, Mary Bernosky-Rak - 

clinical education, Carol Rice - radiology, Pat Clabeaux - Human 

Resources, Claudia Pawlak - respiratory and Drs. Franklin and 

Campagna were also members of the interdisciplinary committee. 

The group’s focus was how to celebrate Gates Legacy. Bev says 

that the overriding theme of legacy was evocative of “family.” She 

says in a larger sense, Gates “families” extended beyond units and 

department; staff went to each others’ weddings and baby showers. 

Residents and house staff commented on the sense of teamwork 

they found throughout Gates and the supportive and nurturing 

environment it provided for house staff and students, which 

wasn’t uniformly felt in other hospitals. Gates nurses said they 

had a sense of “Pay it Forward” and everyone helped each other, 

again not defined or limited to units or departments. The legacy of 

nursing excellence was part of the School of Nursing impact and 

the implementation of the first nursing career ladder in the area 

in the 1980s. The career ladder had nurses receiving recognition 

for their educational accomplishments and was supported by one 

of the first tuition assistance programs in the area. Administration 

empowered the nursing staff to look at methods to alleviate the 

nursing shortage of the early 1980s. A committee of staff nurses 


3

came up with 21 

initiatives to improve 

professional nursing 

and administration 

implemented 17 of them; 

the clinical ladder and tuition support were two of them. 

Penny Gast, director of perioperative services at Gates and a 22- 

year “alumns” of the facility, validates the standing of the hospital 

as progressive and innovative. After relocating to Buffalo from 

Alexandria, Virginia, the former laser safety officer was interviewed 

by Nursing OR Director Kitty Hart. Penny 

interviewed at several other facilities but chose 

Gates because it was an exciting innovative 

hospital with a community hospital feeling. Two 

decades ago 

Penny says 

traumas 

frequently 

went to 

Gates, 

especially 

those 

involving re-implants and 

they did over 1,000 hearts annually as well as supporting a, then, 

burgeoning nuero/stroke program. 

Penny says the surgical staff at Gates has a history of innovation 

and excellence; several of the surgeons had patents as well as Gates 

status as one of the first hospitals to do endovascular surgery. She 

remembers the first endovascular triple, which is a procedure 

for aortic aneurysms that dramatically increased survival and 

reduced complications from what was previously 

a sternum to belly incision and several days in 

the unit post-op. Today some patients go home 

the same day as endo surgery. Minimally invasive 

surgery was championed, along with some of the 

first cochlear implant surgeries. She feels the Gates surgical team 

including the post-op care was “extraordinary,” not only because 

they pioneered cutting edge surgery but were always focused 

on patients first. As a nurse Penny felt the teaching atmosphere 

helped all of the nursing staff grow as professionals. She says 

the nurses who comprise 

the nuero and heart teams 

as well as the surgical techs 

are equally committed to 

the patient. Marlene Traden, 

a Gates OR alumnus, was 

instrumental in bringing the 

RN First Assist program to the 

Millards. Another OR nurse 

alumnus and former Director 

of Surgical Services, Sharon 

McNamara, one of Penny’s 

mentors, served as national 

AORN president in 2005. Penny mentioned that Robin Frank was 

also a great mentor and role model: “Robin always encourages you 

to take on new challenges and coaches you to be successful.” She 

feels that the leadership team of Robin, Jodi Witherell and Tammy 

Owen has done a terrific job of assisting with the integration and 

reducing anxiety and promoting collaboration between colleagues 

at BGH and Gates. 

Rose Hansen is one of the Gates employees that had the ability to 


start working with her BGH colleagues late in 2011. Rose, a 24- 

year alumnus, is a Gates diploma graduate who started working 

on her BSN when she knew the hospital would be integrating with 

BGH and the GVI. She completed her BSN in 2007 and her FNP 

in 2010; she did her thesis on stemis. As a new graduate in critical 

care, she worked in cardiac intervention before joining the team 

in the cath lab in 1997. Rose, like Penny, is proud of the history of 

family, teamwork and excellence she feels Gates is synonymous 

with. She gives Dr. Masud credit for the colleagueship among 

nurses, 

physicians 

and other 

support 

departments 

such as 

radiology, she 

notes he was 

instrumental 

in bringing 

angiography 

to the WNY area. Rose is very excited about the new TARV 

procedure and was a member of the team that went to New York 

City for training in November. Rose says she loves being part 

of this procedure that only a very few hospitals (7%) across the 

country have been authorized to perform. She sees this as similar 

to the feeling she gets with stemis. The ability to give hope and 

life to people who might otherwise die, is thrilling to Rose. She 

has been involved in two procedures but looks forward to the 

move to the GVI when the entire team, nuero, cardiac, vascular 

and radiology will be in the same area. She says they anticipate 

screening over 700 patients annually and performing around 100 

procedures in the 

first year. She feels 

lucky to be able to 

work in a world class 

cath lab focused 

on innovation, 

education and 

research, with people 

like Patti Arbogast, NP, and 

Dr. Iyer. 

Rose says she has scheduled herself to work the last day of 

the integration. She will miss Gates but knows that creating 

a sense of family, caring for patients and being excited and 

engaged in education and excellence are all commodities that are 

transportable to her new home. Her dream is to be able to be an 

advanced practice nurse in the cath lab and never stop learning or 

caring for her special patients. 

Rose Hansen, Gates 

Nurse Practitioner, 

excited about GVI 

Legacy celebration for Gates – June 2011 

– Connie Vari, COO with educators, Nurse 

Recruiter Lori Stoudmire and staff 

Robin Frank, Director of Surgical Services, 

and Jodi Witherell, Director of Nueroscience 

Services, came to Gates within a year and 

a half of each other and both commented 

on the warm welcome they received and 

what an accepting environment it was. They 

were impressed within their own specialties 

about the level of professional expertise and 

practice. They both feel the opportunity 

to have all the specialties under one roof 

will enhance patient outcomes and practice 

opportunities for their nursing staff. 


5

The “Legacy Celebration” sold 730 tickets with participants 

coming from other states and many senior alumni. Several 

retired MDs, nurses and other staff members came from as far 

away as Michigan to celebrate and reminisce with their “family.” 

Participants said it was more like a family reunion than work 

celebration. Swanne Graves, a retired nursing supervisor who 

turns 85 this year, attended along with Marge Arnold, a former 

Gates DON, and Linda Scharf, a committee member and former 

Gates CEO. 

Committee members said the response to the event and 

accompanied sale of “momentoes,” cookbooks, jackets, Christmas 

ornaments and pins was overwhelming and exceeded the 

planning committee’s expectations. The timing of the event 

was to celebrate the 100 years of the original building erection, 

January 4, 1911. The theme, “A Century of Caring,” was printed 

on commemorative pins with the façade of the old hospital. 

Committee members were especially proud of the cookbook as it 

had personal memories of employees’ experiences at Gates along 

with recipes; a labor of “love.” 

Leadership and Empowerment 

at Every Level 

Kaleida Nurses attend 2011 Magnet Conference 

in Baltimore and Come Back Wowed 

A second contingent of Kaleida nurses attended the national 

magnet conference in Baltimore this past October. Five Kaleida 

nurses representing each of our acute care sites attended with 

nursing leadership. It was the largest conference to date with 

7,500 participants, mostly staff 

nurses, celebrating excellence 

in nursing and patient care. 

Donna Gatti, BGH 

Donna is a 1982 BGH diploma 

graduate and has spent 23 

of her 24 years in behavioral 

health. Before she went to the 

magnet conference she didn’t 

really know a lot about it. As chair 

of her UPC and member of site 

and corporate UPCs, Donna is interested in making changes to 

improve nursing and patient satisfaction. 

Marygrace Piskorowski, Lisa Loffredo and 

Marybeth Farruggio at Magnet Conference 

Donna was blown away by the energy of the 7,500 nurses at the 

national magnet conference who, she says, clearly expressed 

their passion for the profession of nursing. She returned with the 

conviction that “magnet is simply being the best nurse you can,” 

October 2011 

National Magnet 

Conference Baltimore 

6

she feels it is how she has cared for 

her patients throughout her career. 

She wants magnet for Kaleida nurses 

because of what it means with respect 

to quality care, evidence based practice 

and nurses being highly respected. 

As a diploma graduate, she felt she 

got a great education but understands 

both the importance of the “BSN in 

Ten” and professional certification. Donna 

understands the need for all nurses to stay 

current and incorporate “best practice” into their practice. Donna 

hopes to be a member of the Cohort V for Executive Leadership 

and Change program with Daemen College. Magnet is about life 

long learning and this, Donna feels, is definitely professional 

nursing. 

Lisa Loffredo, MFSH 

Marybeth Farruggio and Lisa Loffredo 

at Magnet Conference 

Graduating in 1994, Lisa attended nursing school at Millard 

Fillmore Hospital School of Nursing. She later returned for her 

BSN at the University of Buffalo. Lisa has been an employee at 

MFG since her graduation in 1994. She started at MFG as a staff 

nurse on a medical step down unit. After 2 years, she transferred 

to MFSH as a critical care float RN. After another 2 years, she 

was offered the opportunity for a nursing supervisor position. 

Her career includes critical care, charge and a year long diabetes 

research position before returning to supervision at MFSH. Lisa 

sees nursing supervision as her true calling; “I love to have the 

ability to work with nurses and staff throughout the entire hospital 

every day, supporting, coaching and teaching the nurses.” Lisa 

loves the variety of the role of supervision. She sees every day as a 

different challenge. Lisa feels her main job is to keep staff positive 

and motivated; in turn she hopes that she makes a difference in the 

care they give. 

Lisa was thrilled with the opportunity to attend the magnet 

conference. “We were celebrating ourselves, our profession and 

our accomplishments in nursing, it was awesome,” Lisa shares. 

She said she loved watching the nurses who had obtained magnet 

for the first time, and noted how much pride they had in their 

accomplishment and in their hospital. Lisa said it was like being at 

a pep rally, watching the nurses with pompoms, banners, confetti 

and clappers, running through the aisles in celebration. Lisa feels 

she and all Kaleida nurses are the primary reason patients come to 

hospitals, saying “we spend more time with our patients than any 

other profession, we are the faces of Kaleida.” All Kaleida nurses 

need to promote Kaleida nursing. After attending the conference, 

Lisa, as chair of MFSH’s Central Partnership Council, CPC, felt her 

goal was to promote and build the shared governance model, help 

enhance professional pride, and as a nurse, take accountability for 

the quality of patient care. At her first CPC meeting after attending 

the conference, Lisa said she was able to extend a new excitement 

to the staff; five additional nurses have joined since she came back. 

Lisa said the conference break-out sessions gave her a lot of great 

ideas for working on CPC goals. She hopes to have a few of the 

initiatives in place by Nurses Week 2012. 

Peggy Meyer, DeGraff 

Peggy Meyer, a 13-year veteran of DeGraff and a 1998 graduate of 

ECC, said the conference helped her identify the need to focus on 

strengthening their CPC, providing more structure so nurses can 

really make a difference. Peggy shared, “It made me realize how 

much work we have to do, but how many opportunities to make 


7

Chuck Baker, Sandy Nizinkiewicz 

and Peggy Meyer 

a difference we have if we do the 

work.” She feels that having more 

structure and setting attainable 

goals for each meeting could really 

drive progress. 

Peggy, a “second career nurse,” 

had five children when she started 

back to school while working as 

an aide at DeGraff. Her children 

ranged from 1 to 8 years old but 

Peggy was determined and she 

said she got a lot of support and 

flexibility from her manager regarding nursing school. Peggy 

transferred to the OR 4 years ago and loves it; “everyone really 

works as a team, no titles, the patients come first.” 

Peggy said she was involved in reigniting the spirit and 

corresponding CPC a few years ago. She feels CPCs and UPCs 

are a great way to get things done and quickly resolve little issues 

so they don’t turn into big ones. She is inspired by the ability to 

solve problems at the staff and unit level; she feels it enhances 

the respect and value for bedside nurses and feels it challenges 

nurses to grow and become leaders. Peggy feels the advocacy role 

establishes nurses as bedside leaders. Magnet, as Peggy views it, “is 

all about nurses doing all they can for their patients.” Peggy feels 

that DeGraff nurses are ready to embrace magnet and is excited to 

be part of it. 

Marygrace Piskorowski, WCHOB 

Marygrace Piskorowski, a L and D nurse at WCHOB and another 

“second career nurse,” completed a bachelors in social work 

before completing an AAS at Genesee Community College 2 years 

ago. Marygrace found the magnet conference was personally 

and professionally life altering. Recently she had enrolled in the 

NP program at Daemen but is now planning to change to the 

Executive Leadership and Change program. Marygrace said it 

was so exciting to see what other staff nurses were accomplishing 

throughout the country. She said she was interested in magnet 

when the position for a magnet champion was first posted at 

WCHOB and she was thrilled to be able to attend the conference. 

Marygrace said she now feels empowered after listening to other 

staff nurses at the conference and hear what they were able to 

accomplish without looking to their manager to do it for them. 

She feels now is the perfect time to take responsibility for patient 

care problems and move forward. Through the UPCs and CPCs, 

Marygrace feels “the voice we have together as staff nurses is 

powerful!” Magnet recognition is the reward for a job well done; 

Marygrace tells nurses, “forget about the title, magnet is about 

doing it better for yourself, your colleagues and your patients.” 

Sandy Nizinkiewicz, Gates 

Sandy Nizinkiewicz works in the GVI, in the cardiac cath lab 

previously at Gates. Although she was sad to see Gates close, she 

loves the GVI and the opportunities to practice there. Sandy said 

taking call at BGH helped with the transition and having familiar 

faces before the collocation. She felt rejuvenated by the magnet 

conference. Sandy said she was intrigued when she viewed a video 

of nurses obtaining magnet at a Rochester facility and wanted that 

for herself and her colleagues. The magnet experience in Baltimore 

“was phenomenal.” Sandy shares. She wishes every Kaleida nurse 

could have the opportunity to attend this. Sandy describes the 

culture of magnet as something she wishes she could bottle; “it’s 


just about being in the best hospital, with the best nurses and 

being the best you.” Sandy says the conference has changed her 

professionally as well. She feels the need to find a way to “get her 

BSN.” Sandy admits she never really thought about this before she 

attended the national magnet conference. She feels those nurses 

that don’t embrace magnet don’t understand what it is. She feels 

the answer is to talk about magnet and don’t stop; help nurses see 

the big picture that magnet is a major culture change that helps 

everyone. She feels managers can help by empowering nurses. She 

said one of her favorite seminars at the conference was one with a 

nurse manager relating her story of reversing a high turn-over, low 

staff and patient satisfaction unit. Sandy said the manager turned 

the unit around by involving the staff in every aspect of change. 

“It was the magnet, shared governance model, with the manager 

giving the nurses ownership for creating the type of unit they 

wanted to work in.” 

Future of Nursing at Kaleida Health - 

(Kaleida participates in Future of Nursing Conference 

at Roswell) 

Kaleida Nursing is making tremendous strides to pave the way for 

a future of health safety and quality in the metropolitan Buffalo 

area. The national Robert Wood Johnson Foundation Initiative 

on the Future of Nursing, at the Institute of Medicine (IOM), 

published a report in 2011 that serves as a road map for regional 

nurses to begin needed transformation in our healthcare systems. 

Nurses are encouraged to download this report or the report brief, 

free of charge at http://www.iom.edu/. 

Kaleida nurses were invited to attend a free event on November 

16, 2011 at Roswell Park Cancer Institute, to learn the details 

about the Future of Nursing report and ask questions about how 

it relates to their personal practice from the Vice Chair of this IOM 

Committee, Linda Burnes Bolton, DrPH, RN, FAAN. Amy Klopp, 

RN from Millard Fillmore Gates Circle, recounted the event was 

“energizing, to see what a difference nurses can and must make in 

hospitals and it was helpful how all of the research was presented 

in a way that a staff nurse could clearly understand.” 

Kaleida nursing collaborated closely with Roswell Park Cancer 

Institute’s Nursing Research Council to plan and prepare the event 

that over 200 regional nurses and nursing students attended. 

Through poster presentations, Kaleida nurses proudly showcased 

their work on preventing falls, enhancing safety during patient 

hand-off and shift report, leading support groups, building 

teamwork and teaching self-care to new graduate nurses. 

“The event was very affirming, to see how much of the nationally 

recommended work Kaleida nurses have already begun,” reports 

Michele Natwora from clinical education. The IOM report includes 

eight recommendations. The first three recommendations from 

the report and nurse-led Kaleida initiatives are as follows (with 

additional recommendations to be addressed in future articles): 

1. Remove scope of practice barriers. The values and philosophy 

embedded in nursing practice includes care that is centered on the 

unique needs of individual patients, known as person-centered 

Dr. Burnes Bolton (second from left) with WNY panel on Future of Nursing 


9

care. National initiatives to change healthcare focus on access, 

quality and value-driven principles inherent to nursing education 

and practice. While the IOM report focuses on advanced scope of 

practice and reimbursement variations, the importance of hospital 

nurses practicing to their full knowledge-base was also addressed. 

Supporting bedside leadership via our AHEC Leadership program 

and Daemen/Kaleida partnership along with self governance 

via CPCs,UPCs and NAC are all strategies to increase the 

ability for nurses to drive quality and innovation at the bedside. 

The utilization of TeamSTEPPS tools throughout Kaleida as 

opportunities to enhance patient quality and safety encourages 

nurses to “fully practice.” 

2. Expand opportunities for nurses to lead and diffuse 

collaborative improvement efforts. Nurses are in a key position to 

lead and develop innovative models of care and solutions that will 

improve outcomes and infuse a patient-centered philosophy into 

existing care processes. 

Managers have focused on educating staff regarding quality 

indicators as barometers for practice and utilizing the information 

to craft performance improvement projects. Nurses at BGMC and 

MFSH have focused on reducing VAP rates and central line infection 

rates. Innovative skin care projects as well as falls prevention 

programs are being implemented throughout the five acute care 

sites. The “White Wreath” program and Schwartz Rounds at 

WCHOB and BGMC are activities that nursing has taken a lead in 

to enhance compassion for caregivers, patients and families. 

3. Implement nurse residency programs. The skills and knowledge 

needed to deliver safe, quality care need refinement and continued 

learning after graduation. Nurse residency programs support the 

transition from school to practice by offering tailored professional 

development for new graduate nurses. The Future of Nursing 

report stresses that nurse residency programs need to reach 

community settings in addition to hospitals. 

Thanks to the generous support of the John R. Oishei Foundation 

and the collaboration of WNY area Chief Nursing Officers, 

the new graduate nurses hired in the summer months of 2010 

and 2011 at Kaleida, Roswell Park, ECMC and the VA, have 

participated in a collaborative nurse residency program. The 

first program of its kind in WNY, Kaleida Health provided the 

leadership for this program and the 12 modules that comprise 

the year-long program. Jessica Castner, faculty coordinator (on 

loan from D’Youville College), helped actualize the program along 

with a education team from all 4 partners. The program fosters 

opportunities to practice bedside leadership skills. In the spirit of 

the Future of Nursing report, the program is also supporting and 

assisting Hospice Buffalo and networking with the Catholic Health 

System to implement nurse residency programs. 

Remaining recommendations from the Future of Nursing Report 

to be addressed in future articles: 

4. Increase the proportion of nurses with a baccalaureate degree to 

80 percent by 2020 

5. Double the nurses with a doctorate by 2020 

6. Ensure nurses engage in lifelong learning 

7. Prepare and enable nurses to lead change to advance health 

8. Build an infrastructure for the collection and analysis of interprofessional 

health care workforce data. 


Kaleida nursing leadership is proud of the organizational efforts 

and structure set to prepare for the future of nursing. Nursing 

leadership at Kaleida is committed to advancing our organization 

toward an ideal vision of the “Future of Nursing.” 

Acknowledgements: Sincere thanks and congratulations to the 

following nurses from Kaleida who presented or co-authored 

posters: Anthony Szarzanowicz, Donna Gatti, Kristen Kennedy, 

Kristina Marquez, Mary Krebs, Mary Kennedy, Diane Ceravolo, 

Kelly Foltz-Ramos, Michele Natwora and Renee Sylvies. 

Shared Governance 

All four CPCs have begun the work of creating magnet champions 

in their membership. Although it is early in our journey towards 

magnet, our rally cry, “Exceptional Nurses providing Extraordinary 

Care” is something all CPCs have embraced with pride. 

Additionally, the CPCs all plan to provide greater education to 

their colleagues through UPC regarding the “evidences of magnet” 

and linking them to current Kaleida nursing initiatives. 

BGH/Gates 

The two CPCs joined together several months ago to focus on 

integrating the two committees prior to the March collocation. The 

group has reached out to support services to work on solutions for 

identified problems. They have also used the group as a forum to 

promote patient safety by discussing near misses, actual events on 

patient units and to minimize chance of reoccurrence. The group 

also utilizes the monthly meeting to discuss EMR concerns and 

troubleshoot solutions. The committee will support issues central 

to the success of the merger and staff impacted during 2012. 

DeGraff is continuing to focus on growing its membership. Its 

main focus has been on decreasing the time for ED admits to 

get to the unit. Unit nurses were frustrated at what appeared 

to be multiple admits with staff perception of indifference to 

patient safety. ED nurses perception was that unit nurses were 

not sensitive to their and their patients’ need to get to a unit 

expeditiously. Both groups were aware of the negative impact 

on the patient. The group worked on a flow chart to assist in 

decreasing the time frame from ED to unit. Anyone interested in 

joining should contact Paul Peterangelo, chair. 

MFSH with chair, supervisor Lisa Loffredo, as with DeGraff and 

BGH/Gates CPC, sees facilitating and enhancing communication 

within the nursing and interdisciplinary staff a critical need for 

the group. Their group provided leadership and dissemination of 

education on a variety of initiatives such as MOLST Question and 

Answer Quick Reference sheet for units, process of Immunizations 

given on admission to improve compliance (previously some 

units gave on discharge), reducing hospital acquired infections via 

encouraging hand washing at unit level, support for EMR Go- 

Lives, facilitation of questions and answers and support for Hourly 

Rounding. The group has supported processes that improve 

quality indicators, including skin care, falls and patient satisfaction. 

Included in their goals for 2012 are focusing on nurses and patient 

satisfaction and hospital acquired infections. 

WCHOB Central Partnership Council, with co-chairs Lisa Gunn- 

Taylor and Michelle Szefler, have been supporting a number of 

system initiatives such as enhancing the communication throughout 

their site and the system through Unit Practice Councils, UPC, 

and the Nursing Advisory Council, NAC. The group provides 

support and communication for all interdisciplinary projects such 

as dietary reports, EMR, interdisciplinary Round Tables, Schwartz 


11

Rounds, TeamSTEPPS tools and new project support such as 

nursing peer review. Future goals include identifying initiatives to 

enhance patient and nurse satisfaction. 

NAC, Nursing Advisory Council- 

Corporate Shared Governance 

NAC members also participate in their site central partnership 

and/or unit practice committees. Their focus for 2011 was the 

development of educational materials and posters to assist their 

colleagues in understanding the importance of a magnet journey. 

All members participated in visiting the site central partnership 

meetings with a “Magnet Traveling Road Show” to foster 

understanding and generate excitement for magnet. The posters 

and presentation highlighted the forces of magnetism and what 

opportunities exist to work toward this. They also brought this to 

the Nursing Executive meeting to ensure nursing leadership was 

on the same page regarding the importance of magnet. What the 

NAC members think is the most important take away from the 

presentation, “magnet is about what happens to you as a nurse 

and a department on the journey to magnet; it’s the right thing to 

do for nurses and patients.” 

White Wreath project Developed by Bedside 

Leaders from MICU UPC 

After attending an End of Life Nursing Education Consortium in 

August, Cathy Papia, Family Liaison Nurse in the MICU, wanted 

to do something more to make the process of dying in the ICU 

less traumatic, so she brought the issue to her UPC, Unit Practice 

Council. After a brainstorming session about how they 

could support patients and families of terminal 

weans, the idea of placing a wreath on the door 

White Wreathe Program-Buddhist 

to designate 

the patient’s 

terminal 

status was 

identified. 

Along with 

the wreath, 

the unit 

identified 

additional 

items and 

MICU staff with “white wreath” basket 

ideas that could 

make the environment more nurturing and supportive. The group 

felt it would be great to have a collection of music that might 

support the family as well as the patient, placing white flowers on 

the secretaries’ desk to make all members of the team aware of the 

imminent loss of a patient, having scented lotion families could 

use to rub the arms of their loved one, were all part of the project. 

MICU RNs, Rose St. Pierre, Cynthia Hamm, Kimberly Dale, 

and Loraine Hawthorn (who personally shopped for the “White 

Wreath” items) were part of the UPC brainstorming group that 

developed the idea. Start-up funds for the program were provided 

by Lucy Campbell, MD, MICU medical director and Pat Holtz, 

nurse manager for the MICU 

The “White Wreath” protocol helps create a cultural awareness 

and respect for an individual’s ethnicity, age, religion and 

spirituality; allows for the appropriate modification of the ICU 

environment for an actively dying patient, (minimizing noise, 

conversation and lights when possible) and provides support for 

the ICU nurse providing end-of-life care. When a terminal wean or 

dying patient is identified by the team, the “White Wreath” basket 

12

is brought out, containing in addition to the items mentioned 

previously, a Bible, Koran, prayer rug, room fragrance and a new 

fleece blanket and angel pin for the patient’s gown. The last two 

items are given to the family as a remembrance. 

Cathy said staff was skeptical when the program started this past 

October. Several staff members said, “oh great, one more thing 

to do.” In a very short time period the staff was won over by the 

family’s response to the protocol. Cathy said she had started the 

project by placing the wreath on the door after speaking to the 

family and filling out the MOLST form. She was concerned about 

engaging the night shift but in the second week of the project, she 

came in to find a night nurse had initiated the process by hanging 

the wreath on the door of a terminal wean patient. She was thrilled 

that most of the committee was comprised of her most seasoned 

nurses with the exception of Kim Dale. Cathy mentioned that after 

the program was highlighted in OneVoice on KaleidaScope, she 

had non-clinical people stopping by to tell her how wonderful they 

thought the program was. 

Historically, Cathy said that most families, no matter how 

supportive the unit has been, do not follow up with a note; she 

feels it is very difficult to write about the experience. She has, 

however, had many families return to thank the staff or bring 

food. The families in the white wreath program have all taken the 

blanket and pins when the family member expired. Cathy said 

everyone has become engaged in this project; recently a family had 

requested AC/DC music for their loved one who was in his 60s. 

This wasn’t a part of the MICU music collection so their attending, 

Jim Hereth, brought his iPod in and downloaded the music for 

a very grateful family. More recently the MICU had a practicing 

Buddhist whose family was very spiritual; the family was extremely 

grateful for the white wreath protocol and donated some items to 

support a Buddhist patient in the future. They were touched with 

the staff’s interest in their religious customs and appreciated the 

CD player, although they brought their own music reflective of 

their brother’s personal taste. They were also touched by the fleece 

blanket which was theirs to keep. “Everyone is trying to find a way 

to meet the needs of the dying patient,” Cathy shares. One patient’s 

family member, an elderly retired nurse, shared how wonderful she 

felt this program is. 

Hi Cathy, 

I just read the article on the white wreath protocol that you initiated 

and I wanted to share something with you. My dad died of lung cancer 

with brain mets over 26 years ago and to this day I still remember one 

seemingly insignificant incident that happened in the ICU. Dad was 

having a very bad day, struggling just to take a breath and obviously 

it was a very stressful time for all of us. Watching someone you love 

not only dying but dying a slow, agonizing death is totally consuming 

to everyone involved. There is no world around you; there is only here 

and now, this moment, this place. You can’t even imagine that there 

is anything else, let alone care about anything else. My mother, sister 

and I stood by dad’s bed, hopelessly trying to comfort him, wishing we 

could breathe for him, holding back tears while looking at the panic 

in his eyes as he struggled to get air into his lungs that were rapidly 

failing him. Suddenly we were all made acutely aware of where we 

were. There was the very loud sound of laughter coming from the 

nurse’s station. A group of 3 or 4 ICU staff members were sharing 

a humorous moment and even though I had no right to be upset by 

someone’s happiness, I felt so hurt by this. I guess I resented the fact 

that we were going through the worst time of our lives, watching 

someone we all loved so much dying slowly, painfully. All I could think 


13

was, “how can you laugh when we are in so much emotional pain?” 

It felt cruel and insensitive at the time, even though it was totally 

unintentional. So, I want to thank you for the people that you will 

provide comfort to in the future with the white wreath protocol. 

Donna Sauer, RN, BSN, Director VNA immunization program 

The loss of a loved one is one of the most difficult experiences a 

family can go through. The ability to create memories within an 

acute care setting that acknowledge the uniqueness of the patient 

and family and express a collective honor and respect for the loss 

can have a significant positive impact on the grief process for the 

family. 

The “White Wreath” protocol is also being expanded to include 

the ILCU. ILCU staff embraced the idea of offering support and 

comfort to the families of a patient with a terminal wean. They 

took cues from the MICU and put together bereavement trays, a 

coffee maker was donated along with a lamp and picture to place 

on the unit when this is occurring. 

This article/program has been published in the ELNEC, National 

Organization’s Winter Connections Newsletter, End of Life in 

Nursing Care. 

Anyone who would like to donate new fleece blankets or $5 Tim 

Horton’s cards (for families) please contact Cathy Papia. 

Kaleida uses AHEC Manager Training Grant Money 

as Opportunity to Develop Bedside Leaders 

RAHEC, Rural Area Health Education, a federal government 

funded, not for profit, whose mission is to provide education and 

training to healthcare workers and organizations, approached 

Kaleida Health Nursing Leadership in 2011 with the opportunity 

Bedside leaders attend 

National Emergency 

Nurses Convention (L to R) 

Roseann Mohney RN, CEN, 

CPEn (Lakeshore Hospital); 

Karen Taggart RN, CEN 

(BGH); Cheryl Marcel RN, 

CEN (BGH) 

to train nurse managers. AHEC had contracted with Daemen 

College to provide the leadership training. Since 2008 Kaleida 

Nursing Leadership has had a contract with Daemen College, 

initially focused on developing our front line nurse managers but 

in its second year, focused equally on developing bedside leaders, 

staff nurses. We asked AHEC if we could model the curriculum 

after our Kaleida Daemen partnership which provides 6 graduate 

credits in Executive Leadership and Change. We also suggested, 

based on the Institute’s of Medicine’s, IOM, report, the need to 

have staff nurses fully practice required support for leadership 

skills. We then asked to select 25 managers and have them select 

25 informal staff nurse leaders to partner with and go through the 

two-day training together. The first training session took place on 

September 13th (it also provided the opportunity for our cover 

and theme: Leadership at Every Level) and the second, two and 

one half hour class on November 1st. 

Dr. Mary Lou Rusin, chair of the Department of Nursing at 

Daemen College, presented the first module entitled “Leadership, 

the Driver of quality and safe patient care.” She covered a variety 

of topics including, the Code of Ethics for Nurses (ANA 2001), 

which places the focus of care around the patient and gives 

the RN the responsibility to work to improve the healthcare 

environment. She spoke to the unique role RNs have to change 


culture, empower colleagues and ensure safe, quality care. She 

reinforced the power inherent in the team, rather then the team 

leader. Citing research, she emphasized that the “best CNO can’t 

change culture and practice, staff nurses can and must.” Sharing 

information regarding transformational leadership and Covey’s 7 

Habits of Highly Effective People, she emphasized the importance 

of strong convictions and a win/win attitude regarding conflict 

along with the encouragement to, “find your voice” and encourage 

others to find theirs. Robert Greenleaf’s Servant Leadership model 

was also discussed with the focus on staff identifying barriers to 

patient care and then solutions, so the manger can effectively work 

to empower staff to deliver the best possible care. In discussing 

nursing turn-over, Dr. Rusin cited multiple research studies that 

manager behavior and leadership styles do impact nurse turnover. 

She showed a You Tube video, “Leadership lessons from The 

Dancing Guy,” to emphasize the important relationship between 

leaders, followers and the equally significant impact of both on 

outcomes. 

On November 1, 2011, the 25 managers and their staff nurse 

leaders attended the second part of the two-session series, a lecture 

on Emotional Intelligence. E.I. is the constructive ability for self 

awareness; empathy and the ability to self regulate our emotional 

environment. The speaker, Lisa Ball, RN, DNP and Daemen 

Nursing faculty and researcher, believes it is the hallmark of a 

great nurse. The speaker discussed the difficulties in caring for 

patients and remaining caring in today’s challenging environment. 

She shared current E.I. research that suggests that the greater 

the emotional intelligence of the nurse manager the greater the 

retention, productivity and commitment of employees and more 

positive work culture. She also spoke to the issue of ownership and 

accountability, nurses needing to hold each other and support staff 

Daemen 

Graduation- 

Cohort III 

accountable to the patient. Lisa said, by utilizing E.I. concepts, we 

can develop a positive culture and be in the position of finding 

respect and happiness in and at work. Evaluations of the twosession 

program were overwhelmingly positive with both leaders 

and staff members acknowledging the opportunity and desire to 

utilize the idea of emotional intelligence and accountability in their 

professional practice. 

Daemen Cohort III graduates 

Cohort IV began January 2012 

The third year of the Kaleida Daemen Leadership Partnership 

finished with a third graduation this past November. The 

11-member cohort presented their performance improvement 

projects during the graduation ceremony to recognize their 

completion of 6 graduate credits in Executive Leadership and 

Change. Cohort IV will have 11 staff nurses out of the 17 

participants. The program originally began in 2009 and focused on 

developing leadership skills in nurse managers. In its second year, 

Cohort II included staff nurses supporting the IOM’s report on, 

The Future of Nursing and the need to grow bedside leaders. 

Feedback from the third cohort mirrored sentiments of the first 

and second, the significant impact of the leadership courses on 

their practice. Jim Giallella, 13 North manager, said the passion 

as well as knowledge of the professors is something he takes 

back to work and helps to energize him. Chris Moden, ED 


15

Leadership presentation on response to call lights- 

Deb Boss, Sofia Arutunian, Chris Moden and Jim 

Giallella 

manager at MFSH, 

feels that the 

professors provide 

an outsiders’ 

perspective on 

issues that help 

him become more 

objective and gives 

him new tools to 

do his job. Lem 

Mogavero joined 

the program as 

a staff nurse and found he loved the opportunity management 

provided for a greater impact on 

patient care. When he graduated, 

he moved to the role of supervisor 

on the stroke unit at Gates. He feels 

the program has helped him grow 

professionally and personally and 

as a new leader provided essential 

leadership skills. Lem says he now 

sees problems as opportunities and 

feels more successful in dealing 

with them proactively. Staff nurse from 

MFSH, Michelle Monte, said that she has always felt she was a 

good nurse but now has a greater understanding of the need for 

effective communication. Michelle shared she now feels inspired to 

“go back to her floor and knock down negativity and build more 

trusting relationships.” She feels that bedside leaders can drive a 

positive culture change. 

Professor with (left to right) Mickey Monte, Lem Mogavero, Anne Hoar, 

Luanne Finiki and Andrea Daniel-Sanders 

Luanne Finiki, manager in the ICU and SCU at DeGraff, shared 

that she was struggling in her leadership role; finding it very hard 

to find work - life balance. She said the class helped her to focus 

on becoming a transformational leader, she says she feels she can 

both grow and let the “small stuff” go and focus on the “big stuff.” 

Debbie Boss found the classes empowering and said her biggest 

discovery was self insight, realizing the only thing she can control 

to any extent is herself. 

Performance improvement projects were presented by cohort 

III at the February Nursing Executive meeting which included 

representatives from NAC. The goal is to have the projects 

replicated throughout Kaleida, a summary of the two projects are 

as follows: 

Reducing Infection rates: Team - Lem 

Mogavero, RN supervisor Stroke, Michelle 

Monte, staff nurse MFSH, Luanne Finiki, 

manager ICU DeGraff, Anne Hoar, IST 

MFSH and Andrea Daniel- Sanders MICU 

RN BGH. 

Hospital acquired infections are no longer 

being reimbursed by the Center for 

Medicare/Medicaid Services. Our group 

picked a project targeted at reducing and/or 

preventing hospital acquired infections. We looked first at theory 

involved in change. We knew engagement and empowerment of 

staff nurses was critical; in order for a group to change they must 

feel empowered. 

Using education and empowerment as our tools and aptly named 

“Clean Freaks,” our team received the support of the Manager 


on 2 Southwest, Michele Hubert, a member of Daemen cohort II 

and a scholarship recipient currently completing her Master’s in 

Executive Leadership and Change, to pilot our project there. Our 

goal was to decrease the rate of hospital acquired C-diff infections. 

The project took a multidisciplinary approach utilizing a pre/post 

survey to assess level of knowledge, perceived barriers as well 

as staff’s view of their ability to address the problem. Following 

our pre-survey assessment, the cohort developed and instituted 

an educational/empowerment blitz of the unit. We followedup 

with coaching and educational reviews to staff at specific 

periods over the next several months. In our three-month time 

period we did not see a significant reduction in C-diff. Our post 

education survey however did reveal a significant increase in the 

knowledge regarding C-diff and a greater sense of empowerment 

on the part of the nursing staff. We felt that the time frame was 

not extensive enough to see the results of our education and 

coaching on infection rates but the increased knowledge did 

suggest that this could improve over the next quarter. Manager 

Michele Hubert says, “the staff are definitely engaged in finding a 

solution and since the project rollout of the Clean Freaks, we have 

identified some other ways that may have affected the transmission 

(cleaning practices) as well as educating families and staff about 

the importance of proper hand washing and empowering them to 

address improper practices.” Michele said this is discussed in the 

staff’s quality meetings with the focused on reducing the hospital 

acquired infections on their unit. Michele said that they have 

had numerous patients on the unit that have been transferred or 

admitted and appropriately identified by staff as having C-diff on 

admission or transfer. Michele feels the heightened education and 

empowerment on the part of her staff points to the success of 

the project. 

Hourly rounding to enhance response time to 

answering call lights: Team - Nurse Managers, Jim 

Giallella, Chris Moden, Debbie Boss and supervisor, Sofia 

Arutunian 

Our group wanted to make an impact on patient 

satisfaction at Kaleida Health. Understanding the patient 

experience and measuring patient satisfaction is becoming 

increasingly important as healthcare organizations strive 

to improve processes, become more patient focused/ 

patient centered and improve profitability. The team did 

patient rounding on 13 North as an opportunity to gain 

information about the patient’s perceptions and then met 

with staff to introduce the project, brainstorm, identify 

barriers and engage the stakeholders. The question on 

the patient focused survey was: “After you pressed the 

call button, how often did you get help as soon as you 

wanted it?” 

Purposeful hourly rounding was implemented to improve 

the identified patients concern that this was not happening 

on a regular basis, from their perspective. The availability 

of a nurse and nursing presence at the bedside are known 

predictors of patient satisfaction. Routine purposeful 

rounding is when a nurse or member of the nursing 

team goes into a patient’s room every hour to assess and 

meet patient needs proactively. Because patients perceive 

their needs are being met in a timely manner, it fosters 

satisfaction with their care. In addition, the team provided 

customer service training (Achieving Service Excellence) 

which took approximately 45 minutes to one hour per 

session and included using the AIDET tool. 


17

Throughout the training, the team was able to interact with the 

staff and reaffirm the need to be responsive in answering call 

lights and anticipating a patient’s needs. The team stressed to 

the staff that the implementation of hourly rounding, timely call 

light response and better teamwork/communication would serve 

two purposes. First, it would have an immediate impact on the 

Press Ganey scores as they relate to the promptness of call light 

response and second, it would actually decrease their workload. 

This new approach of asking patients if they needed anything else 

before they left the room, identifying when they would be back to 

see them again and the increased awareness of the team concept 

would increase job satisfaction and better teamwork would 

decrease individual work. 

Measurement of Success: the team continued to monitor the Press 

Ganey Survey results through the process. Baseline, 

year to date (YTD) survey results specific to this 

question was 76%. After the staff meeting and 

brainstorming session, just bringing the problem 

to light for the staff, the results improved to 84%. 

After implementing purposeful hourly rounding, the 

September results were 79%. October results were 

87.5%, the YTD results were 79.5% or an increase 

of 3.5%. Now, the challenge is to maintain the gains. 

Staff has asked for ongoing staff meetings to keep 

focused on patient satisfaction and achieving service 

excellence (customer service). They realize that the 

implementation of this plan was just the beginning 

of the process and have concerns about maintaining 

the momentum and how to deal with those staff 

members who remain resistant to change. 

Daemen Leadership Cohort I Scholarship recipients with 

Mary Beth Campo; front row: Linda Eschberger, Mary 

Beth and Sue Brooks - back row, Sandy Boneberg, Peggy 

Schlotterbeck and Michele Hubert 

Stroke Nurse Manager is one of first Scholarship 

Recipients and Graduate of the Kaleida Daemen 

Leadership Program 

Ask Sue Brooks what is different about her since starting as a 

part of the then pilot, Cohort I (we are now into Cohort IV), in 

the annual Kaleida Daemen Executive Leadership and Change 

program, and she might reply, “Everything. The program taught 

me how to think differently, to develop a perspective that includes 

that of my team, our patients and other departments. It opens up a 

myriad of possibilities on finding the best solution, not limited by 

one perspective. I have also understood the value and importance 

of a shared vision with concrete measurable goals for the team. 

You can’t improve if you don’t know where the bar is set. As with 

understanding the value of multiple perspectives, I am now acutely 

aware that there is not a singular path to 

goal achievement and everyone on the 

team has something to offer on the best 

way to get there.” 

Sue says she has come to believe that 

a lot of leadership is communicating, 

communicating, communicating and 

making sure the message you sent is 

what your team receives. She is also 

committed to be empowered, knowing 

this is critical in order to pass the 

empowerment on to her staff. She 

feels one of the perks of investing and 

developing her team is that they in turn 

develop and challenge her professional 

growth. Sue is thrilled that several of her 

staff members have returned to school 


and shared with Sue that it was her example that motivated them 

to do so. Sue had one of her long-term nurses, 20+ years, complete 

her BSN recently and she says, “I couldn’t be prouder of her.” 

Sue shares that her change in thinking and “doing” has impacted 

her personal life as well. As mom to three boys, Sue has role 

modeled the importance of being a continual learner. She also 

says her boys, whom she sees as natural leaders, have emphasized 

to her the importance of caring and compassion as a leader and 

agrees that by doing so, staff is likely to follow. To colleagues 

contemplating returning to school Sue shares, “find the time, there 

are plenty of reasons not to, but who you might become on the 

journey could be amazing.” 

Supporting the WNY and 

Global Community 

Kaleida Nurses Feed the WNY Community 

The idea for the Food Bank Holiday drive orchestrated by 

Kaleida nurses came from WCHOB Nursing Advisory Board, 

NAC, members Lisa Gunn Taylor 

and Michelle Szefler. Lisa and 

Michelle shared the information 

about WCHOB’s cereal drive with 

their NAC colleagues; the project 

supported by WCHOB’s Central 

Partnership Council benefited 

economically disadvantaged school 

age children who receive breakfast 

at school but do not receive this 

during the summer. The cereal 

NAC members with Polla Milligan-Food Bank of WNY 

drive is a national program originating with a consortium of 

children’s hospitals. WCHOB participated in this during this past 

summer (2011) via the Food Bank of WNY, which serves Erie and 

Niagara county residents. WCHOB readily embraced the idea of 

helping children and families with the most basic of needs, fighting 

childhood hunger. Over 100 boxes of cereal were collected in the 

week-long drive in June of 2011. 

Polla Milligan from the Food Bank of WNY attended the 

September 6 NAC meeting and gave the group the background 

on hunger in WNY. Polla, who loves her job and thinks “it is 

the best job ever,” shared her respect and admiration for nurses 

who have the ability to make a significant difference in the lives 

of the community every day. Polla whose energy and passion is 

infectious, shared a bit of her background with the group. 

She started as a rock musician and lived and worked in 

L.A. for over 2 decades, making, according to Polla, “a 

lot of money” writing jingles. She had lived in Buffalo as 

a teenager when her father accepted a faculty position 

in the history department at UB. She graduated from 

Bennett High School and is most proud of her position 

as President of the Black Student Union; she says she has 

always been a great believer in causes. Polla left L.A. and 

returned to the WNY area to care for family. She can’t 

say enough about the Food Bank of WNY and through it 

NAC -WNY Food Bank 


19

her ability to be part of ensuring that basic needs, such 

as food, are met for our community. A prolific grant 

writer, Polla is both creative and relentless in her passion 

for serving the food needs of our community; 93,000 

people receive food via the food bank monthly. The food 

bank serves Erie, Niagara, Cattaraugus and Chautauqua 

counties. It supports 385 agencies with food, including 

the “Meals on Wheels” program, after school programs, 

food banks, soup kitchens, City Mission, senior 

programs and group homes. Additionally they sponsor 

community gardens to help people grow their own 

fresh fruits and vegetables, a back pack program to send 

food home for the weekend to those children in the breakfast 

and lunch program. In the “back pack program,” the food bank 

provides food to fill a child’s back pack with nonperishable foods 

on Friday to ensure the child and the family have food to eat over 

the weekend; $385 supports one child and their family for a year. 

Polla goes into the school programs and educates children on 

nutrition and has cooking programs for adults in group homes on 

how to prepare nutritious meals on a budget. Anyone interested 

in more information on any of the programs can contact Polla 

at pmilligan@foodbankWNY.org. For every $1 donated the food 

bank is able to purchase 7 pounds of food. The drive ran from 

November 1, to the 14th with barrels at all five acute care sites. 

Thanks to the generosity of Kaleida employees, the holiday drive 

collected over 1290 pounds of food at the five sites with additional 

donations of cash and backpacks for the backpack program. NAC 

members placed this on screen savers, white boards and posted 

flyers thoughout their respective sites. Diana Kornacki had an 

immediate donation of 11 back packs for the back pack program 

and Rhonda Francis started a sign up list at MFSH for volunteers 

to work at the food bank. 

RN Nancy Reynolds in Rwanda 

Kaleida Health Helps Nurse with 

Mission to Train Nurses in Ruanda 

Nancy Reynolds grew up in Western New 

York and attended Holy Angels High School 

in North Buffalo prior to leaving for college in 

Canada. After completing her B.A. in Biology 

with a minor in Psychology, Nancy returned 

to Buffalo to complete a BSN at D’Youville in 

1981. Her first position was a staff nurse at 

BGH on a med-surg unit. Nancy says she knew 

during her years at D’Youville her decision to 

switch her original career goal from medicine to 

nursing was correct: “I was surrounded by nursing faculty at D’YC 

who had passion for what they taught and emphasized our ability 

as student nurses to make a difference. As a result, I was fully 

drawn into nursing.” 

Nancy’s first year at BGH was cut short when she married a 

man with a career in international banking. The family moved 

frequently, every 2-3 years for almost three decades spending 

time in, Toronto, Dublin, Trinidad, St. Marten, Grand Cayman 

and London, where the family currently resides. Nancy said she 

worked as a nurse at Toronto’s Sick Children’s Hospital off and on 

for eight years as well as in the Caribbean for a number of years. It 

was challenging to work in 

hospitals in the Caribbean, 

Nancy says, as even with 

basic resources, 

equipment and 

technology, 

nursing education 

Nancy 

Reynolds 

in Rwanda 


and practice was not at U.S. standards or even clearly defined. 

Critical care for adults and pediatric patients was limited; as a 

result patients requiring this level of care often had poor outcomes. 

It was the impact of the educational and 

economic disparities in the Caribbean, 

and facing them on a daily basis, that left 

Nancy feeling a need to “do something.” 

She initially became involved in teaching 

literacy skills in the hills of Trinidad. 

According to Nancy, these were the people 

who worked as gardeners and maids and 

lived in abject poverty. By teaching them 

to read and write a minimum amount of 

new words a month, within 6 months 

they could read and write enough to fill 

out government forms that could enhance their 

quality of living and dramatically change their lives and that of 

their families. Nancy said this was so humbling for her – that 

just the most basic of vocabulary could make such a profound 

difference; how could she not help? 

In 2009, Nancy and her husband had the opportunity to travel 

to Kenya for two weeks. Her intent and that of the business 

organization she traveled with, was to set up a clinic on Lake 

Victoria for an isolated population of 5,000 women and children 

with multiple health issues including rampant AIDS. It was a side 

trip to Rwanda that changed Nancy’s mind and her “mission.” 

Her group was able to meet with the President of Rwanda and 

his cabinet. She was impressed with his focused desire for 

development of his people and his country and his abhorrence of 

corruption. In a subsequent visit with the Director of Nursing in 

Gates 7 West Staff with Nancy Reynolds 

Rwanda, Nancy was told that, if she, and the group she is working 

with, really wanted to make a difference, not to set up a clinic to 

care for people, but to assist in the building of nursing capacity 

and capability, and help them take care of their own. This made 

so much sense to Nancy and was so 

different from the corruption and lack 

of progress in parts of Kenya, that 

she knew she wanted to work with 

the Director of Nursing in Rwanda: 

training nurse educators who could in 

turn train other nurses. 

In Rwanda, the 1994 genocide 

decimated the nursing population 

and education infrastructure; even 

today, there are only about 80 BSN 

prepared nurses for over 10 million people. In the courtyard of 

one nursing school she visited, a grave was in the center. When 

Nancy inquired why it was there, she was told it was the Director 

of Nursing killed during the genocide. The bulk of the country’s 

nursing workforce mainly consists of health care workers with 

2 to 3 years of high school education, with a total of one course 

with a nursing component, who are called nurses and who provide 

some form of health care. There is 

critical need for strengthening of 

nursing education. Many people 

in the rural populations are still 

dependent on traditional healers, 

often unsafe and with medically 

compromising results. 

Nancy Reynolds in a village in Rwanda 


21

Nancy strongly felt she needed an advanced degree if she was 

going to teach nursing educators in Rwanda. She had been away 

from the bedside for almost two decades and enrolled in a RN 

refresher program with the University of Delaware as part of 

her first step toward obtaining her Master’s. She simultaneously 

applied to and was accepted into Georgetown University in their 

Master of Science in Nursing Education program. Her plan is to 

return to Rwanda and train nurse educators after completion of the 

program. It was while Nancy was looking for a clinical practice site 

as a requirement for her refresher program that she reached out to 

the system where she had first practiced and got a warm reception 

from the staff at Gates. 

Nancy readily shares how grateful she is to Kaleida and the staff on 

7W (now 14S-BGMC); “I was accepted right away and felt fully 

part of the staff.” Nancy says the quality of the experience on 7W 

offered “much better learning” then her traditional program, so 

she gives high marks to her time on 7W. Nancy says her preceptor, 

Theresa Morgan was terrific, a very gifted and competent teacher, 

and made her feel she could do this, safely and well. Her first few 

days were by Theresa’s side watching and learning. The first night 

shift she worked Nancy said she couldn’t even understand report 

but by day three this had changed for her. She said in precepting 

with the charge nurse she was able to see a broad picture and is 

emphatic about how positive it was: “If I was living in Buffalo, this 

is the staff I would want to work with,” Nancy shares. 

Nancy is excited about the opportunity for both her and her 

husband to help. Her husband is already working to help “develop 

entrepreneurs” and business acumen for the people of Rwanda as 

Nancy works to educate nurses. She says the President of Rwanda 

has reduced the percent of foreign aid to support his budget 

to 37% versus many other African countries where it is closer 

to 80% and higher. She loves his “can do” approach, built on 

education and expertise for his people. At Kaleida we are grateful 

to have been a part of Nancy’s vision and look for opportunities to 

continue to support this is the future. Nancy gave a talk with slide 

presentation to a group of Kaleida nurses on August 9th as her way 

of thanking us for the opportunity to complete her requirements 

for the clinical portion of her refresher course. The presentation 

included pictures of the Rwandan people Nancy hopes to help 

by supporting nursing training, standards and scope of practice. 

She has touched all of us and we welcome opportunities to make 

a difference in the nursing global community by supporting her 

mission. 

Nursing Education, Innovation, 

Quality and Research 

Education Update 

Jen Jennings, RN, FNP, DNP 

Manager of Clinical Education 

The changes occurring throughout our system, including 

the consolidation of campuses, has presented a number of 

opportunities for clinical educators to support the transition of 

staff into new roles, services and/or units. We have supported 

staff learning needs created by the integration of BGH and Gates. 

Through the creation of integration teams, the specialty educators 

are paired with specialty managers to focus on the “need to know” 

education, with particular attention paid to providing safe and 

competent care. Our projects have targeted bedside care, patient 

safety and best practice for caregivers. Interdisciplinary teamwork 


across the system has helped drive consistency in protocol and 

practice (based on national guidelines and best practice) for RNs 

and UAP. We have revised the glucometer recertification policy 

and engaged educators in working with managers and staff to 

devise a train the trainer program to ensure compliance with 

regulatory requirements across our acute care sites. This multisite, 

multidisciplinary task force 

is representative of laboratory 

leadership, clinical educators 

and union representatives from 

each Kaleida Health site. The 

old adage “The only constant is 

change” has been our mantra 

this past year and we have 

worked hard to embrace change 

together as a team, with a focus 

on working smarter not harder. 

Oishei Residency Planning Committee 

We continue to collaborate on chemotherapy education with 

our colleagues at Roswell. With the support of a nursing team of 

directors, managers and educators representing each site, we were 

able to forge a partnership, with RPCI nurses attending Kaleida 

ACLS training and our KH nurses receiving chemo training, after 

successful completion of the Oncology Nurses Society (ONS) 

chemo program. A core group of educators have attended the 

training and follow-up practice in the Roswell out-patient chemo 

clinic, in order to trouble shoot and support staff who will be 

administering chemotherapy to Kaleida patients. They have 

designed some simulation education for our staff targeting chemo 

administration, potential complications and safe disposal of 

chemotherapeutic agents post infusion. 

Through best practice re-assessment, we have consistently 

reviewed the literature and collaborated with centers such as 

Johns’ Hopkins and Baylor to revise our Central Venous Line 

(CVL) removal practices for ICU RNs. This will ensure that we 

are cutting edge with evidence based practice and our patients are 

receiving the best and safest care. Orientation of our new nurses is 

being streamlined without reducing 

quality or effectiveness. Our Kaleida 

Nursing Advisory committee, 

which includes chairs and Deans 

from WNY Nursing Programs, has 

been expanded to include nursing 

leadership from Roswell, CHS, VA 

and ECMC; our focus is creating 

educational assessments for senior 

nursing students that would 

enhance transition into practice 

anywhere in WNY. In response to an identified need, nursing 

education also designed a generic curriculum/template for onboarding 

new Nurse Practitioners. 

Mosby will become an enhanced database for our nurses and staff 

to access in 2012. A nursing focus group has worked diligently 

to link any unique Kaleida procedures to the corresponding 

Mosby policy for ease of use reducing duplication of resources 

in creating Kaleida policies that already exist in Mosby. Using a 

prospective approach, we will begin to analyze “Mosby updates” 

through specialty committee chairs for approval and the ability 

to “Kaleidasize” the index located on the Mosby site. Once each 

committee examines the recommendations and analyzes the 

evidence, they will then approve, disapprove, or approve with KH 

updates or nurse alert. Staff will have to rely less on lengthy policy/ 


23

procedures and can access Mosby, best practice based and user 

friendly, to identify the KH approved procedures. 

Educators are also involved in nursing research that has the 

potential to reduce costs and improve care. We look forward to 

enhanced technological advancements, such as our bar code 

scanners, to scan employees ID badges and be uploaded directly 

to Talent Management, reducing human error and enhancing 

efficiency. In addition, we are using “I clickers” to enhance 

participation in classroom activities, soliciting real time feedback 

and adjusting the education accordingly. Early in 2012 Nursing 

Education moved from Gates to its temporary home at 1028 

Main Street. 

WNY Residency Program Begins Third year 

Michele Natwora, nurse educator under the guidance of Jessica 

Castner, took over coordination of the WNY Residency program 

in its second year which began 

in September of 2011. The 

community collaboration with 

partners Roswell Park, VA and 

ECMC incorporated “lessons 

learned” in year one to modify 

the program in its second 

year. The Western New York 

Nurse Residency Program is 

an investment that supports 

the transition for new graduate 

nurses, which involves a 

steep learning curve which can be 

negatively impacted by personal stressors. The residency program 

continues to offer simulation in rapid response and code response 

preparation, along 

with providing 

education on the 

importance of self 

care for healthcare 

workers. 

The 2011-2012 

WNY NRP 

cohort has 45 

participants from 

Kaleida Health. 

Oishei Resident with manager 

Participants continue 

to meet every other month with our community partners, in 

addition to meeting monthly as an organization. Included in 

the facilitation process this year, are past nurse residents, who 

associate their successful transition with attending the first nurse 

residency program with Kaleida Health 

in 2010. They, along with their nurse 

managers, recognize the importance of 

supporting this transition and they assist 

with small group facilitation for the 2011 

group of nurse residents monthly. Mentoring 

continues to be an essential component 

of the residency program; an experienced 

nurse offering emotional support to enhance 

the mentee’s confidence and success. These 

partnerships ideally can be a career long 

Residency Coordinators Jessica Castner and Michele Natwora, with 

Connie Vari, UB faculty Linda Steeg and Mimi Haskins 

relationship and unlike that of a preceptor, 

does not necessarily end with orientation. The 

largest group of mentor volunteers came from our 2010 resident 

graduates. Nurse Residency Programs are identified as future best 


Educators Mary Marohn and Kelly Foltz-Ramos during 

Residency self care day 

practice and are being considered a requirement by the National 

Council of State Boards of Nursing for first license renewal. 

Changes to year two include, starting the program after orientation 

completion and nursing state board exams, NCLEX, creating 

more opportunities for Residents to network and share stories and 

utilizing first year “graduates” as mentors and program facilitators. 

Residency Self-help posters 

Manager of the CVICU and SICU 

is a Champion for the Oishei Residency Program 

Peggy Schlotterbeck is the manager of the CVICU and a strong 

believer in the Oishei nurse residency program. She believes the 

program assists the new graduate to effectively assimilate into 

practice. Peggy feels when that assimilation is into a critical care 

unit the residency program can be an essential tool to ensure 

success. Peggy says she is a bit in awe of the new graduate who 

wants critical care; she says she was not ready for it when she 

graduated from D’Youville College 28 years ago. 

Peggy feels the cohort model and the collaboration with ECMC, 

VA and Roswell provides the resident with a unique perspective; 

“the ability to learn from new nurses from around the WNY area 

makes for a great experience and a stronger resident.” She likens 

the residency program to giving residents the skills to “build 

skyscrapers.” She said some of her new graduates thought it was 

redundant but she encourages them to take advantage of the 

opportunity and feels the support for self reflection is important to 

enable new nurses to build a solid foundation from which to grow 

professionally. 

Peggy spent her first five years as a new graduate at the University 

of Virginia, first in neurology, and eventually in critical care. She 

worked as a travel nurse for 5 years before returning to Buffalo and 

taking a position in critical care at BGH. She’s worked in critical 

care education but feels management is where she can really make 

a difference. A member of the first Daemen /Kaleida Leadership 

and change cohort, Peggy was also one of the first scholarship 

recipients and completes her Master’s this month. She encourages 

Kaleida nurses, staff and managers to consider the program in 

which she says she has learned as much about herself as a leader 


25

as she has about leadership theory. She feels she is a more effective 

manager and is conscious of how she questions her staff, such 

as, “in what way might we do this, rather then why are we doing 

this.” She says she has also learned not to sweat the small stuff. 

Peggy feels her staff is empowered and comes up with great ideas. 

They have been “Huddling” consistently for about 18 months. She 

says it is definitely hard wired in the CVICU where they huddle, 

as an interdisciplinary team, three times a day. Peggy shares she is 

so proud of her staff saying, “they come up with great ideas, they 

see the big picture of critical care needs not just the CVICU,” She 

is amazed at what they are willing to do to help. Peggy is currently 

working to hardwire Huddles into SICU practice. 

2010 Residency Graduate is now Mentor and 

Facilitator for 2011 Residents 

When requests went out to managers and 2010 resident 

participants for facilitators for the 2011 Residency group, Kristina 

Marquez, RN in the CVICU, wanted to volunteer. Her manager 

Peggy Schlotterback arranged 

her schedule so the one day 

per month of the program 

would be one of her work 

days. Kristina says, “Peggy is a 

strong supporter of education 

and looks for opportunities 

for her nurses to grow 

professionally via certification 

and formal education.” 

Kristina, a 2010 graduate 

of the University of Buffalo 

Kristina Marquez, WNY Nurse Residency facilitator 

and a participant in the first WNY Residency class, was a second 

career nurse. She had a Bachelor’s in exercise physiology and was 

a personal trainer before joining the Air Force where she served in 

Iraq as a respiratory therapist. She completed a Master’s in Public 

Health and then her BSN. 

Kristina admits the facilitator role was scary at first; she didn’t 

have any experience speaking in front of a group of people. She 

says she was a bit intimidated that so many people had so much 

clinical and teaching experience. However Kristina shared that 

“everyone went out of their way to make me feel comfortable and 

I had a ‘buddy/co-facilitator’ for the first session.” The skill stations 

were more comfortable for Kristina who says she can’t believe how 

much she has learned and grown in 18 months; “chest pain or 

cardiac, I’m amazed at how much I know.” Kristina says she has 

learned a lot from the educators, “they have such phenomenal 

clinical experience and are able to develop limitless scenarios.” 

Kristina says watching the new graduates has brought her first year 

as a new nurse full circle; “Wow, I realized now even more acutely 

that the fears, anxiety and lack of confidence is a global experience 

for all new graduates from across all facilities.” Observing these 

new graduates, Kristina states, validated the universality of the new 

graduate experience. “I am amazed where I am in just 18 months, 

I don’t worry that I will forget everything if I’m off for 2 days.” 

Kristina says the residency program is a critical part of successful 

transition and also gives credit for her transition into confident 

nurse to her two extraordinary preceptors, Carol Varga and Judy 

Lawson. Kristina says they are phenomenal and still support her, 

teaching when she gets a very complex patient. Carol just got 

her CCRN and Kristina received hers early in 2012. “I really feel 

confident in caring for patients and in teaching the new graduates 

how much I do know; it’s really neat, I really am a nurse!” 


DEU model encourages Kaleida 

Nurses to continue their 

Education 

The DEU, Dedicated Education Unit, an 

innovative student nurse teaching model, 

celebrates the completion of its fourth 

year at Kaleida, this month. The model, 

just a decade old, was brought to the U.S. 

from Australia by Dr. Susan Moscato, professor 

emeritus of Portland University. At a conference last July in 

Portland, Dr. Moscato complimented Kaleida on its passion for 

the model and its ability to see a broader picture, partnering with 

multiple nursing programs and engaging other systems in DEU 

research and dialogue. Although formal research on the model is 

still limited, preliminary research does suggest that utilizing our 

expert nurses as CIs, clinical instructors, results in a 25% increase 

in RNs returning for BSNs and MSs on DEU units. We have seen 

a number of nurses through-out Kaleida and on our DEU units 

return to school for further education. The following are a few of 

your colleagues and their stories about why they are investing in 

themselves and their careers. 

During DEU orientation this past fall a panel of Kaleida nurses, 

nurse manager and CI’s from 9S shared their passion for the DEU 

model and what it does 

for the unit, the student 

and the CI. Ann Strong a 

seasoned 9S nurse and CI 

shared that the opportunity 

to guide and teach students 

Theresa Morgan, RN, Nancy 

Reynolds and Manager Sue Brooks 

and imbue high standards for 

patient care was important to 

her as a nurse. She also shared 

that the opportunity to role 

model professional passion 

to the students was equally 

important to her. Ann admitted 

that as a seasoned nurse who 

13 North DEU-student “Thank-You” to CI Laura Overhoff, Jim Giallella, manager 

CI, Josh Schouldice and faculty Theresa Arida 

has precepted “about a million 

nurses,” she was starting to get 

a bit burned out; the students reignited her passion for precepting. 

She also said she loves seeing the students gain confidence and 

lose their fear and truly become part of the team on the unit. She 

also notices the difference between first and second semester 

students, especially those who have been exposed to a DEU. 

Yasmine, a staff nurse at Gates, who also had her DEU experience 

there, said it was amazing and a lot of her confidence as a new 

graduate nurse came from the DEU experience. Marlene Schiferle, 

the nurse manager on 9S, said it is truly a partnership between the 

faculty members, managers, CIs and students. Everyone has to 

be committed to making it work; having staff prepared to be a CI 

both through the Kaleida preceptor program, the academic partner 

orientation and non CI staff commitment to ensuring the CIs work 

the same days consistently during the semester. Faculty partners 

shared the “contagious” quality of DEU excitement; the ability for 

CIs to professionally develop new nurses is thrilling for faculty to 

observe. Another faculty member shared the ability of staff and 

faculty to better understands each other’s perspective, “we’re no 

longer guests, we’re part of the team.” Ashley a new nurse on 9S 

and a DEU student said the hardest thing after a DEU experience 

is not having another one. April, another 9S nurse from a DEU 


27

experience, shared that her preceptor as a new graduate nurse, 

Marquita was also her CI when she was a student and it was, 

“wonderful.” 

Theresa Morgan has been a nurse for a short time but is passionate 

about nursing and the importance of continuing education. She 

serves as a CI, for the DEU on her unit 14S and loves her students. 

A 2008 graduate of Trocaire College with an AAS in Nursing, 

Theresa completed her BSN in May 2011. Theresa started out at 

Kaleida as a CNA in 2006, became a LPN a year later, graduating 

from the LPN program at Trocaire. Theresa said her decision to 

return to school was about professional pride. She definitely feels 

the BSN program at D’YC has helped make her feel more prepared 

to deal with complex patients and nursing care in general. Theresa 

plans to continue her nursing education and perhaps teach 

nursing. Theresa says she has gotten “so much” out of each level 

of her nursing education and practice. She loves Bridge and the 

EMR and feels the impact they have on patient safety is critical 

and worth the challenges each presented initially. Theresa was 

the preceptor for Nancy Reynolds featured in, “Kaleida in the 

Community.” Theresa said she was so inspired by Nancy and 

her stories regarding nursing in Rwanda; the most basic safety 

equipment that we take for granted here is unavailable in third 

world countries like Rwanda. As a result there is a high incidence 

of nurses with needle stick injuries. The seriousness of this is 

further defined by the high number of AIDS and HIV patients in 

the general population. Theresa says the experience of precepting 

Nancy and hearing her stories, has made her value the resources 

we have for nursing practice, including Mosby’s. Theresa loves her 

unit, nursing and education and isn’t planning to stop anytime 

soon. 

Nurses returning for BSN Sue Brooks and 

Debbie Jankowiak 

Debbie Jankowiak is 

not new to nursing. 

She celebrates her 27th 

year as a professional 

nurse this month, 

graduating from ECC 

in 1984. Debbie’s first 

RN position was as a 

substitute school nurse 

and she also worked 

in LTC prior to joining 

Kaleida in 2005 at 

BGH. Debbie said she was attracted to the 12-hour shifts offered 

at Gates and transferred to 7W in 2006 to work them. Debbie left 

briefly to work on a telemetry/cardiac floor at MFSH but said she 

missed the patients and her colleagues “too much” and returned 

to 7W, now 14S. She “loves her stroke patients.” She feels there is 

so much to learn and she enjoys this. Debbie has been a CI on her 

unit since its inception and said it was one of the motivators for 

her to return to school for her BSN. Debbie says she had previously 

made a few attempts to return to school, but the time wasn’t right. 

She says working in the role of CI made her feel she needed the 

same educational preparation as her BSN students. Debbie says 

she encourages her colleagues to consider returning for their BSN 

and loves the program at Daemen College where she feels she has 

learned the importance of nursing research, particularly at the 

bedside. Graduating this past December, Debbie is thrilled about 

her accomplishment and shares her gratitude for the support her 

manager, Sue Brooks has supplied. The fact that her manager was 

also a student was inspirational; role modeling the importance of 

education at every level. 


DEU Experience 

for 13 North Nurse 

Comes Full Circle 

Laurie Overhoff, a 2010 

D’Youville College graduate, 

became a DEU CI this 

past September of 2011. 

“In just a short time I’m 

helping students learn, it’s 

unbelievable,” Laurie shares. 

She was hired on 13 North in 

September of 2010; it was the DEU unit where Laurie had her 

senior experience and where she wanted to work. Josh, Laurie’s 

preceptor as an orientee on 13 N, was a clinical instructor, CI, 

when Laurie had her DEU experience there. Laurie says when the 

DEU faculty, Theresa Arida (her former professor), asked her to 

consider becoming a CI, she was honored. Laurie said the idea that 

she had something to offer new nurses and could help them learn 

was very satisfying. “Having the students ask me questions and 

look up to me makes me realize how far I have come in a short 

period of time,” Laurie explained. Laurie said she also thinks the 

students find it reassuring that she was so recently a student from 

the same program. 

About future goals Laurie is uncertain, she says she 

loves her floor and can’t imagine moving away from the 

bedside. Laurie says she works at being a team player 

and keeping good working relationships with all of her 

colleagues. She admits it can be challenging but believes 

in honesty and respecting her colleagues by sharing her 

concerns directly with them. Laurie says her manager 

Jim Giallella, 13 N Clinical Instructors and students with Laurie 

Overhoff (front center) 

Jim Giallella is great, “he speaks a lot to us about the 

importance of teamwork and dealing with conflict.” 

Laurie is considering joining her UPC in the future; she 

is currently the rep for the skin care team on her floor. 

When asked what she would say to someone 

considering becoming a CI, Laurie replies “it’s the 

opportunity to help someone be a better nurse. You can 

give a student a lot of confidence and an experience so 

much better then the traditional model where students 

spend a lot of their time waiting for the instructor.” In 

the DEU model, Laurie explains, “you really get to see what a 

nurse does and feel like part of the team.” To her students Laurie 

says she tells them, “I’ve been here over 18 months and I still ask 

questions; as a nurse you’re always learning.” 

Will I be Good Enough? 

Jessica Castner, RN, MS, CEN 

I was privileged to attend a recent Gates-BGH Central Partnership 

Council where frontline staff met to discuss some of their 

concerns about the upcoming integration of the two hospitals in 

an exercise led by educator Michele Natwora. A recurring theme 

in the discussion was nagging feelings of inadequacy as nursing 

staff imagine new work 

teams, patient populations, 

group norms and tasks 

that lay ahead. With 

compelling honesty, expert 

and experienced nursing 

Jessica Castner, Judy Laurenzi, Kelly 

Foltz-Ramos, Denise Sullivan and 

Bonnie Burmaster 


29

staff who I admire implicitly revealed their doubts: Will I be good 

enough? 

The questions got me thinking about an inspiring nursing journey. 

Picture Mary Jo Satusky, a nurses’ nurse who needs to stand on a 

box to reach podium microphones. She had 20 years of nursing 

experience and had been prepared with a hospital diploma in 

nursing. Her husband’s job moved them around quite a bit; and 

she was faced with the challenge of starting in a new specialty with 

a patient population she’d had almost no experience: Orthopedics. 

Mary Jo took on the challenge and nagging doubts of inadequacy 

by studying for her certification in orthopedics, which she 

achieved two years after her new job in the specialty. 

Mary Jo didn’t stop at certification, like a gateway drug to learning; 

her journey for certification lit a fire for her to return to school 

for a bachelor’s degree in nursing and to take active roles in 

her nursing organization. Today, Mary Jo is the president of the 

National Association of Orthopedic Nurses. Keep in mind she 

started the journey because of a new job in a new specialty—an 

experience many Kaleida nurses are about to face. As I looked 

around the Gates-BGH Central Partnership Council, I got the 

chills imagining such an amazing journey may lie ahead for each 

and every member of the 

Kaleida nursing staff should 

they choose to take it—you are certainly good enough! You can 

learn more about Mary Jo’s story at www.nursingnoteslive.com 

We don’t have to look to the national stage for inspiring stories 

about certification and lifelong learning. Cheryl Marcel is a 

certified emergency nurse in the BGH emergency department. 

While she and fellow nurses did take a certification review course, 

Cheryl found that bedside nurses teaching bedside nurses was one 

of the most gratifying parts of the certification journey. A group 

of nurses got certification review books (thanks to a generous 

donation from a physicians group)–when one got stuck on a 

question or rationale, they would ask the other bedside nurses 

for input and encouragement. “We found it really empowered 

us to find our voice. We knew the rationale for what we were 

doing because of those questions and we could speak up for 

patients to teach patients, inform other nurses, or collaborate 

with physicians.” Peggy Schlotterbeck, manager of BGH CVICU, 

reports that a core group of certified critical care nurses in her unit 

are encouraging and mentoring a second cohort to study for their 

certification as well…Imagine how nurses could raise empowered 

voices and improve practice all over Kaleida if each unit had a core 

group of nurses just reviewing practice certification questions 

and rationales! 

Research on adult learning shows the number one motivator 

for new learning is a major change at work. The integration, 

and all the doubts that accompany the changes, can become a 

constructive experience for nurses who begin the certification 

journey. But many of us get hung up on a hate for exams and a 

fear of failure. Personally, I bought a certification review book to 

informally review the questions and rationales without intending 

to sit for the exam—the review was an excellent way to update my 


nursing practice. 

Like Mary Jo, 

my family had 

been relocated 

and I was having 

doubts that I was 

good enough or 

knowledgeable 

enough about the new patient population. I did eventually take 

the exam, six years later, and my CEN is my proudest credential to 

date. 

As a nurse, you can get board certified in medical/surgical, 

oncology, pediatrics, critical care, emergency, ambulatory care, 

and a myriad of other types of specialties. Many certifications are 

obtained through the ANCC (http://www.nursecredentialing.org) or 

through your specialty professional organization. Most bookstores 

offer nursing certification review books that offer an excellent way 

to start the journey at your own pace. 

The journey to certification can help answer the question with 

confidence, “Will I be good enough?” The answer is, 

certifiably, yes! 

Kaleida Health Coordinates BSN dialogue 

with WNY Health Care Systems 

On September 21st, Dr. Barb Zittell, formerly with the NY State 

Office of the Professions and for several decades, the authority on 

professional practice in NYS, visited Buffalo. She is the immediate 

past Executive Secretary to the NYS Board of Nursing. Zittell was 

responsible for licensure, scope of practice and discipline for over 

340,000 nurses. The trip was the first in NYS, with Buffalo as a 

pilot, for dialogue with health care leaders, Nurse Managers and 

staff nurses regarding the importance of the currently proposed 

legislation (BSN in Ten) to nurses, patient and families. Dr. Zittell 

shared her own entry into practice via an AAS program and her 

doctorate obtained after age 40. Dr. Zittell recently retired from 

the NYS Department of Education to promote the legislation. Jodi 

Witherell Director of Stoke services at Kaleida Health and current 

president of the local chapter of Nurse Executives and Diane 

Ceravolo, Director of Nursing Practice coordinated the event for 

the WNY area. Dr. Zittell was impressed with the collaboration 

among the WNY area nurse leaders and their support of nursing 

education. The 

Catholic Health 

System, Erie County 

Medical Center and 

Roswell Park along 

with Kaleida Health, 

hosted Dr. Zittel in her 

day long lecture series. 

She began her day at 

Gates and shared data 

dating back to 2003 

with the Linda Aiken 

study which first identified 

reduced mortality rate in 

BSN in 10 event-back left to right: Cecilia 

Ahenkan, Theresa Morgan, Jodi Witherell, 

Mary Beth Campo, front left to right: Connie 

Vari, Claire Murray and Diane Ceravolo 

patients based on the percent of BSN graduates in an institution. 

The study was replicated in 2005 by Estabrooks, by Tourangeau in 

2007 and most recently by Blegen and Goode in 2009. Blegen and 

Goode’s 2009 study involved 21 US hospitals and results validated 

that hospitals with a higher portion of BS nurses had, lower rates 

of CHF mortality, fewer hospital acquired pressure ulcers and 


31

lower rates of failure to rescue and shorter hospitalizations. 

Dr. Zittel also discussed the changes in nursing and medical 

technology, decreased lengths of stay, increase in multi cultural 

patients, required increased educational preparation in order 

to competently practice safe and quality care. She pointed to 

pharmacists and physical therapists who increased their education 

from a bachelor to doctorate level as a result of the increase 

in information and skill required to be competent; the drug 

formulary increased from 6,000 to 12,000 medications. She also 

shared the trend internationally to move nursing to a four-year 

degree. England and the European Union, Australia, Canada 

and the Philippines all require a BSN as entry into practice. 

Dr. Zittel recognized the importance of allowing perspective 

students to access nursing through both AAS and BSN programs. 

She emphasized the positive impact all nurses, diploma, AAS, 

BSN and advanced degree nurses have on patient care and the 

profession. We are fortunate in WNY to have a number of RN 

to BSN programs for nurses to select from, many programs offer 

a one day option plus on-line courses to accommodate adult 

learners and minimize impact on personal responsibilities. AAS 

and BSN program faculty participated in the event and highlighted 

their desire to support current nurses who want to continue their 

education. They asked the audience of staff nurses how they can 

make it easier for them to return to school. One of the staff nurses 

currently enrolled in a BSN program said, “Treat us like colleagues, 

help us with acquiring high school transcripts and filling out a 

FASFA and make class scheduling reflect personal responsibilities 

of adult and working students.” 

The BSN in Ten legislation (giving nurses 10 years from date 

of implementation to complete a BSN), which is before the NY 

State Senate and Assembly, would grandfather in all current 

nurses without a BSN, including any perspective students and 

those on nursing school waiting lists. It would not eliminate 

AAS programs but encourage them to partner with colleges and 

Universities as many in WNY already have, to allow AAS prepared 

nurses to easily transition post graduation and licensure into a 

BSN completion program. Theresa Morgan, a FT nurse on 14S 

(previously 7W at Gates) and an AAS and BSN completion student 

shared her story. Theresa, a recent AAS graduate completed her 

BSN in two years, combining FT work and school and caring for 

her two young children and husband. Theresa shared that she 

is a better nurse and a more confident bedside leader as a result 

of her BSN education. Although FT school, work and family 

were challenging, Theresa said that her investment in her career 

and education was a positive role model for her young children. 

Several BSN completion nurses shared that they hadn’t expected 

the ‘”degree” to change their practice and were surprised when 

it did. One of the Roswell Park nurses shared that she started 

out as a lab tech but wanted to be more involved with patients. 

After graduating from an AAS program and working on the Bone 

Marrow Transplant Unit, BMT, she said she knew she needed more 

education. She feels that not only did the BSN completion help 

her with leadership skills as both a charge nurse and a preceptor, 

but as a result of understanding the importance of, Evidence 

Based Practice and nursing research she is a “stronger, more 

compassionate and holistic nurse.” A nurse at ECMC shared that 

with the movement to interdisciplinary rounds everyone on the 

team had a minimum of a Bachelor’s education and she felt as a 

nurse and the only one with 24/7 oversight for the patient, she 

should have this as well. Debbie Heigel an ECMC nurse shared 

that her BSN education helped her become a “more articulate” 


voice to advocate for herself and her patients. Tina, a CHS nurse 

said the BSN made her feel empowered; she recently completed 

her BSN via the Roberts Wesleyan on-campus program. She 

shared that reading professional journals and now being able to 

understand them was a skill from her completion program. As 

a result, she said she feels as if she can do anything and is herself 

a champion for nursing education. Anyone interested in 

additional information on RN to BSN programs, e-mail 

dceravolo@kaleidahealth.org. 

Schwartz Rounds Keeping Compassion in 

Healthcare 

Schwartz Rounds ended 

the 2011 year in November 

with the topic of “Medical 

Error.” The panel 

comprised of a nursing 

supervisor, pharmacist and 

clinical nurse specialist 

presented a patient case in 

which the patient ultimately 

died due to an error in 

medication administration. 

The topic was a difficult one and several members of the audience, 

including house staff shared experiences where an error resulted 

in death. One attending discussed what she believed families need 

to hear after the loss of a loved one due to error. She said it is what 

she or any of us would need to find closure, the truth and as much 

transparency as we can provide and allow the family to “be.” 

Schwartz Rounds which began at WCHOB almost 2 years ago had 

its first “presentation,” at BGH in Swift Auditorium in July of 2011 

with 134 participants. 

The topic, “When patient 

outcomes are not what 

you or the patient hoped 

for,” was presented by 

a interdisciplinary team 

comprised of a nurse, 

chief resident, patient 

care liaison and PT. 

The panel discussed the 

challenges, frustrations and 

discouragement these incidents can create in caregivers. The 

second Rounds in September, “What do you do when you patient 

is afraid of dying?” captured 84 interdisciplinary staff members 

with a panel comprised of a nurse, housekeeper and family nurse 

liaison. 

The Rounds are supported by an endowment from the Schwartz 

Center in Boston, Massachusetts and supports healthcare facilities 

in providing “Rounds” through the subsidy of a lunch, to attract 

participants. Unlike clinically focused rounds, Schwartz Rounds 

provide a safe place for care providers to discuss the inherent 

challenges, frustrations and anxiety that caring for patients 

involves. The focus of the Rounds 

is not clinical, although a patient 

is presented, the focus is not about 

changing the outcome or doing a 

root cause analysis, but rather a 

Schwartz Center Rounds - Lem 

Mogavero-supervisor neuro, Cathy 

Papia-family liaison, Dr. Lucy Campbell- 

MICU, Father Richard Augustyn Back 

Row: Dr. Naughton, Dr. Brewer 

Schwartz Center Rounds-front left to right: 

Elaine David, Fannie White, Norm McCarter, 

back Dr. Brewer 


33

discussion of how it made those 

involved feel. The audience is 

encouraged to share similar 

experience and feelings. Dr. 

John Brewer does a great job of 

facilitator and Dr. Robert Milch 

Schwartz Center Rounds is the moderator for the program. 

An interdisciplinary planning committee coordinates the Rounds. 

It is through this experience of providing a safe place to share 

feelings that the ability for staff to continue to be able to deliver 

compassionate care is supported. Rounds continued in 2012 with 

the first Rounds in January entitled, “When your patient is morally 

offensive to you.” Rounds are open to all staff, students and 

volunteers; CME credits are provided. 

Collaboration Results in Reduction of VAP rates 

at BGH and MFSH 

Deb Grande, ICU manager at MFSH, 

is thrilled with her team’s success with 

VAP rates. She ended 2011 with a less 

then 1% VAP (Ventilator Acquired 

Pneumonia) rate, a reduction from 

the 2010 rate of 2.48%. Deb shares 

her success with BGH MICU manager 

Pat Holtz who had, via Critical Care 

standards and with support from BGH 

pharmacist Kim Zimmit, developed 

a sedation protocol. The change in 

Debbie’s unit’s sedation protocol along 

with a “VAP Bundle” resulted in a significant reduction in MFSH’s 

ICU VAP rates. 

ICU Manager Deb Grande with MFSH ICU staff 

Pat Holtz shared that the Critical Care Standards Committee 

first started exploring the issue of sedation in 2010. Kim Zamet 

had found Vanderbilt Medical Center’s web site on delirium in 

reference to ICU ventilator patients, www.ICUdelirium.edu. Best 

practice suggested that drips such as Antivan and Versed, used to 

sedate ICU ventilator patients, increased the difficulty in weaning 

them from the ventilator and consequently increased vent days, 

LOS and increased the patient’s risk for VAP. Additionally, the 

web site research suggested that heavy sedation via IV drips could 

create episodic delirium up to 6 months after the sedation was 

discontinued. The new protocol decreased ventilator days and ICU 

delirium. Pat’s nurses, similar to Debbie’s, were not immediately 

comfortable with the new sedation protocol. “It was a change in 

culture,” Pat states, “ICU nurses want their ventilator patients 

to be comfortable for effective ventilation and they associate this 

with sedation.” Utilizing the same drugs except in bolus form in 

the first 12 hours after intubation, the nurses 

have been able to minimize the use of drips and 

consequently have realized a reduction in VAP 

by 75% as well as LOS and vent days. In the first 

quarter of 2011, Pat saw an increase in VAPS; 

the committee reviewed their VAP bundle and 

added Chlorhexidine mouthwash to their oral 

care in addition to elevating the HOB higher than 

30 degrees, oral pharyngeal suctioning every 4 

hours, turning and positioning every 2 hours and 

early extubation. As a result of these changes, 

their rate went from 3.3 to 1.8 %. Pat’s VAP 

Bundle is slightly different then Debbie’s but she says the 

most effective items on the protocol are the simplest, keeping the 

HOB elevated and giving good oral care with suctioning. 


Like Pat’s Bundle, Debbie’s protocol includes 

minimizing the use of drips such as Versed 

and instead prescribing them as prn. She has 

also realized a reduction in total vent days. 

Debbie had sent several of her nurses to the 

MICU in the spring of 2010 to observe the new 

sedation protocol and VAP Bundle. Debbie’s 

nurses rounded with the physicians and MICU 

nurses and were able to see and verbalize the 

impact of the change in the sedation protocol 

on the vent patients. Debbie said her experience 

in rolling it out in her unit met with some of the 

same resistance, for the same reasons, as Pat’s did; nurses were 

concerned that the patients wouldn’t be managed as comfortably, 

might even be attempting to climb out of bed and pull at tubes 

and that families would be upset if patients were perceived to 

be less comfortable. Debbie thanks her clinical education team, 

Diana, Judy and Janeen for their help in educating staff on the 

new protocol. She said within a short period of time “everyone 

was a believer,” as patients were able to be extubated sooner and 

ICU length of stay started to drop as well. They saw no significant 

difference in the comfort level of patients with the change from 

drips to prn orders. Vent days dropped from 2,815 in 2010 to 

2,000 at the end of 2011. 

Debbie charged her UPC with the job of assisting with the 

reduction of VAP rates. Unlike BGH, the suctioning sets at MFSH 

didn’t have a Y-connector so the staff used oral kits that had a 

compatible Y-connector. As a result it wasn’t a closed system; 

the team identified the opportunity to reduce infection rates by 

utilizing the same type of suction kits as BGH with a Y connector 

that was compatible and a covered Yankauer. Simultaneously, they 

Interdisciplinary focus changes MICU patient 

outcomes; Kim Zammit, Pharmacist; Dr. Lucy Campbell; 

Nurse Manager Pat Holtz and team 

introduced gloves for anyone entering the vent 

patient’s room, including MDs, x-ray techs and 

visitors; a sign on the patient’s door underscored 

these instructions. One of her team members, 

Jackie finished her DNP last semester and 

utilized the VAP Bundle as part of her thesis; she 

laminated the protocol and has it posted throughout 

the unit. Although Debbie and her team’s goal 

for VAP rates was “0” for the end of 2011, she was 

thrilled to get it to less than 1%. MFSH presented 

these at Grand Rounds and the VAP bundle is 

available on talent management for the education 

of new critical care staff. 

Cardiovascular Open Heart Program going for 

Three Star Rating 

Our cardiovascular surgery program is .2% away from being 

a three star cardiac hospital, a national cardiothoracic surgery 

program designation awarded by the Society of thoracic surgeons 

for the quality of the open heart by-pass surgery program. 

Only 14% of all cardiothoracic surgery programs receive this 

designation. The turn around in the cardiothoracic program has 

been an intensive three year team 

approach connecting, pre-surgical 

and post-op aspects of care to 

minimize infection and reduce 

mortality rates. 

Cardiovascular Open Heart Program; left 

to right back: Judy Lawson, CCRN, Rachel 

Ludwig, NP, Caryla Clement, CCRN, 

Kristen Kennedy, RN, front Karen Camillo, 

Peggy Schlotterbeck 


35

Peggy Schlotterbeck, CVICU nurse manager and her nursing 

team in the CVICU are thrilled. The team worked with their OR 

colleagues and under the leadership of NP Patti Arbogast, they 

discovered that deep sternal infections occurred in the OR, inside 

out, not post-op. Patti also worked on standardizing care for these 

patients with respect to dressing change, post-op care and added 

nasal swabbing to the pre-op checklist. They could identify MRSA 

pre-op and take precautions to avoid post-op wound 

infection by this organism. Having NP coverage 24/7 

in the unit has also enhanced the post-op care and 

follow-up for these patients. The ASCOM phones 

have enabled nursing staff to remain with the patient, 

providing care while they access the NP or physician 

for orders. SVO2 monitoring has taken cardiac 

output monitoring to the next level by providing 

trending read-outs that allow for more effective 

intervention and care. With the support of nursing 

leadership, Peggy was able to provide 1:1 nursing 

ratios for the first 4-6 hours after open heart surgery. 

Peggy said the nursing and medical staff also looked at the ability 

to limit overflow patients to those without infection or elevated 

WBC’s, use disposable EKG leads from OR to unit to floor. They 

also have changed the post-op placement of these patients to 13N 

versus on a general surgical floor such as 10S. Peggy is extremely 

proud of what the CVICU team has accomplished together. She 

points to the number of nurses who have received their CCRN, 

bringing the percent of CCRN certified nurse in the unit up to 30% 

including RNs, Caryla Clement, Judy Lawson, Carol Varga, Leithe 

Trapper, Kris Marquez, Laura Szczesniak, Karen Ryan and Lisa 

Berlinghoff. 

Left to right (standing): Deanna Galkiewicz, 

Glori Brucato, Gabrielle Sullivan, sitting: Ann 

Mallare and Sharon Logue 

MFSH Mother/Baby Unit Pilot Program 

becomes National Model 

The Mother Baby Unit at MFSH participated in a Department of 

Health initiative along with 10 other hospitals in NYS who had 

high breast feeding rates. The initiatives’ goal was to do even better 

with breastfeeding; to create exclusive units where breastfeeding 

was the norm. The impact of increasing breastfeeding has both a 

health and financial impact; if 90% of US families 

complied with medical recommendations to 

breastfeed for 6 months, the US could save $13 

billion per year and prevent almost 1000 deaths 

(NICH, NYSDOH). Breast fed infants have 

fewer infections including respiratory, GI, ear 

and more serious infections such as meningitis 

and septicemia. It can also provide protection 

against the development of diseases such as type I 

Diabetes, obesity, cardiovascular disease and certain 

childhood cancers such as leukemia, Hodgkin’s, 

nueroblastoma and Ulcerative colitis. Moms also 

realize personal health benefits with breastfeeding their infant. 

Breastfeeding decreases the risk for pre and post menopausal breast 

cancer and some forms of ovarian cancer. 

The unit employed a number of strategies to enhance breastfeeding 

rates, including, initiating breastfeeding within 1 hour post 

delivery, within 2 hours post delivery and breastfeeding exclusively 

throughout the stay, no formula supplements. Having the baby 

“room-in” with the Mom at least 9 hours out of a 12-hour shift 

was another strategy to enhance breastfeeding rates. Recently, the 

CDC began national roll out of this DOH initiative, called the NYS 

model. 


Recognition and Awards 

Mary Beth Campo was 

the recipient of the New 

York State Association of 

Nurse Executive’s Western 

Region leadership award. 

The award is given to 

nursing leaders who 

exemplify creative and 

contemporary leadership 

in nursing practice. Mary Beth 

was recognized for outstanding 

CNO’s recognize Mary Beth Campo at retreat 

left to right: Jodi Witherell, LuAnne Brown, Mary Beth 

Campo and Mary Beth Ferruggio 

leadership in the community and within Kaleida. Her leadership 

for innovative programs was noted, including the WNY Nurse 

Residency program, DEU teaching model, TeamSTEPPS initiatives 

throughout Kaleida as well as our mentorship and preceptorship 

programs. Mary Beth is past president of the WNY region of 

NYONE. Kaleida was also recognized for the third year in a row 

with the NYONE “Best Practice Award” for its Daemen leadership 

program targeted at growing bedside leaders. It won last year 

for the Communication initiatives and the previous year for the 

implementation of the DEU education model at all five sites. 

The Annual Education and Leadership Awards were given 

out at the 4th annual Leadership retreat this past December. 

Peggy Schlotterbeck received the Heart of Kaleida award for her 

compassionate leadership and commitment to excellence and 

to her staff in the CVICU. Peggy is currently the manager in the 

SICU and CVICU. Peggy has been a professional nurse for 28 

years and a Kaleida nurse for 20 of those years. She has 15 years 

of management experience, six years in her current role. Peggy is 

a true “nurse’s nurse who is respected by supervisors, physicians, 

and house staff and by all the nurses she manages, nurtures, 

support and coaches. She is passionate about nurses and nursing 

care. Peggy is a role model for professionalism, high standards 

and the importance of education. Peggy graduates from Daemen 

College with her Master’s in Executive Leadership and Change 

this month. She was in the first Daemen cohort and one of the 

first scholarship recipients. Peggy supported the implementation 

of the TeamSTEPPS Huddle in her unit and has been a consistent 

supporter of engaging her nurses in shared governance through 

ensuring they have time to attend UPC, CPCs, NAC, and the 

Nursing Executive Committee meetings. She is also a strong 

advocate for the Nurse Residency program. She is a highly visible 

leader who is willing to do whatever is needed to support her 

patients and staff. 

Michele Natwora received the Educator of the Year Award for her 

leadership during the past year, with EMR support, collocation 

activities, and oversight for the nurse Residency and orientation 

program. Michele has been a nurse educator for two years but 

is a seasoned Kaleida nurse with 21 years at BGH. In a short 

time, Michele has become one of the “go to” educators with her 

proactive approach to challenges and her “thank you for the 

opportunity,” response to requests for assistance. She has been an 

original and engaged member of NAC and a magnet champion. 

She has been supportive of nursing research, the mentorship 

program and feels personally responsible for the success of the 

new nurses under her care. She was a trainer for TeamSTEPPS and 

communication and exemplifies professional nursing passion and 

clinical competence. 


37

The Level Five Leadership Award went to Terri Haist, manager 

of the MFSH OR. Terri has been a RN for 15 years. She started in 

a trauma/ortho unit at Temple in Philadelphia and then jumped 

at the chance for an OR internship at Baylor University in Dallas. 

Terri said her dream was always to become an OR nurse. She 

has been in the OR at MFSH since 1980, serving as manager for 

the past five years. Terri led her team through the OR renovation 

projects a few years ago when 10, state of the art rooms were 

added. The volume of cases in the OR at Suburban has increased 

by 31% over the last year, due in a large part to Terri’s leadership. 

She was a strong supporter of the DaVinci Robot project which has 

increased satisfaction at all levels. Terri manages a staff of 125 and 

is-on-top and current with evaluations. She is famous for her hand 

written notes to thank employees and recognize accomplishments. 

Terri also serves on the board of Directors for her local professional 

organization, AORN. 

Steve Handzel, behavioral health at BGH, was awarded Best New 

Manager. Steve is described as, “hitting the ground running,” 

in the short time he joined the management team in behavioral 

health. Steve started as a critical care nurse at Kaleida five years 

ago, went into nursing supervision at Gates and a year ago 

accepted his current position. Steve was new to behavioral health 

when he joined the team over 18 months ago but immersed 

himself in learning mental health laws and patient care needs. 

His willingness to go above and beyond extends to staff, patients 

and management. His innovation on the unit has led to improved 

patient care work flow. He worked around the clock on the EMR 

implementation and was instrumental in the successful DNV survey 

in 2011 for behavioral health. Steve’s colleagues say he exemplifies, 

“attitude is everything,” he is noted for his willingness to tackle any 

staff or patient need and always with a positive outlook and a smile. 

VNA Telehealth team: back row: Stephanie Haberl, RN, Lynn Larson, RN and Ed 

Green, LPN, front row: Shelee Basile, RN and Pam Hayman, RN 

Visiting Nurses Association 

of WNY 

2011 VNA Nursing year in 

Review 

Lisa Greisler, RN 

VP, Clinical Services Home Care 

The VNA experienced another great year 

in 2011, from financial performance 

and growth to satisfaction and patient 

outcomes. A few highlights are 

noted below. 

From a quality and satisfaction perspective, there were many 

successes. Like other healthcare organizations, CMS reports on the 

performance of home care agencies in relation to patient outcomes. 

These outcomes include specific performance measures such as 

improvement in ambulation and transferring as well as reduction 


in hospitalizations. Process measures look at 

processes of care such as assessment for falls 

risk and pressure ulcer risk assessments on all 

patients. Of the 22 patient outcomes and process 

measures, the VNA finished the year at or above 

the benchmark in 18 out of 22 with marked 

improvement overall. The results we have seen 

in our outcomes are a direct result of the care 

provided by our nurses and therapists through their 

focus on improving patient function, preventing complications, 

and keeping our patients safely in the community. 

Key quality measures for wounds were all at, or above, national 

benchmarks. These include measures related to pressure ulcers as 

well as surgical wounds. At the same time that patient outcomes 

in wounds improved, our wound specialists were able to decrease 

wound supply costs by $120,000 through utilization controls and 

best practices. 

On the satisfaction front, patient satisfaction results from Press 

Ganey showed that the VNA was at the benchmark of 86% for 

patients who would rate 

us a 9 or 10 and at 84% 

(above the benchmark 

of 82%) for patients 

who would definitely 

recommend the VNA 

to others. Our staff- led 

patient satisfaction 

committee was very 

creative again in 2011 in 

implementing measures 

VNA RN Teresa Skowronski with her patient. 

VNA Wound Team: Kelly Toporek, RN, Judy LeFevre, RN 

and Corrine Cintron, RN 

to improve patient satisfaction. As you can 

see from the results they were successful! 

Physician satisfaction for 2011 was at 98% 

while discharge planners indicated a 100% 

satisfaction rate. While a great deal of our 

quality focus for 2011 was on improving 

outcome and satisfaction scores, VNA staff 

also were in a preparatory mode for our 

accreditation survey. VNA made a decision 

to move to CHAP (Community Health Accreditation Program) as 

our accrediting body. This organization solely accredits home care 

organizations making this accreditation more aligned with our 

needs. Accreditation is only required for one small portion of the 

VNA business–we choose to be accredited in order to benchmark 

ourselves against national standards. 

From a growth perspective, the VNA saw tremendous growth 

across the organization in nearly all areas. Some branches, like 

Allegany and Niagara, experienced double digit growth in visits 

during 2011! The Care Transitions program grew 270% and 

Telehealth grew to over 500 monitors 

(from around 400 the previous year). Care 

Transitions and Telehealth are two programs 

specifically designed to impact hospital 

readmissions, and both have been very 

successful in doing so. 

A very generous donation from the Ralph 

Wilson Foundation helped in providing a 

number of services including Telehealth, 

Adult Day Care, Lifeline, Medication 

Planners and Falls Prevention kits to a 


39

number of needy patients. All of these tools are used to reduce 

patient risk, improve patient safety and avoid hospitalizations. 

The success of the VNA in 2011 is a result of the hard work of all 

of our staff from the drivers and warehouse staff; the clerical, office 

and administrative support 

staff; the Pharmacy, Lifeline 

and Home Care Services 

departments along with all of 

our nurses, therapists, home 

health aides and other clinical 

staff. The VNA team is excited 

about the opportunities that 

lie ahead for home care and 

are looking forward to a 

great 2012. 

VNA Expands into 

Steuben County 

The Visiting Nursing 

Association of Western New 

York (VNA) was selected as 

the provider of choice to purchase 

the Steuben County Public Health & Nursing Certified Home 

Health Agency (CHHA) and Long-Term Home Health Care 

Program (LTHHCP). Steuben County is a large rural county 

located directly east of Allegany County on the Pennsylvania 

border. It includes the cities of Corning and Hornell and the 

Village of Bath. In 2010, the Steuben County Public Health & 

Nursing program performed over 22,000 home visits. The notfor-profit 

VNA will immediately start providing care in Steuben 

VNA RN Stephanie with her patient. 

County, beginning with a services and management agreement. 

The agreement will allow the VNA to employ nurses and therapists 

and supply them to Steuben County soon after January 1, 2012. 

“We are very excited to expand the VNA’s reach into Steuben 

County,” said Judy Baumgartner, VNA president. “It is heartening 

to know that another municipality has 

entrusted our organization to serve 

their community’s home health needs. 

On behalf of our dedicated nurses and 

staff, we are honored to be able to care 

for the residents of Steuben County.” 

VNA RN Amy Chandler with her patient. 


Long-Term Care 

2011 was an exciting year for the Kaleida Long-Term Care 

sites. DeGraff Memorial’s Skilled Nursing Facility received 

the AdvisorMed “2011 Great American Nursing Home 

Award” which places them among an elite group of nursing 

homes nationwide who consistently exceed their residents’ 

expectations. The Deaconess 

Center was recognized in 

the US News & World Report 

listing of “Best Nursing 

Homes in 2011.” 

The year ended with the 

opening of HighPointe on 

Michigan. On December 

3 and 4, Deaconess and 

Millard Fillmore Gates 

Skilled Nursing Facility closed their doors as residents 

and staff from both locations moved into their “new 

home” at 1031 Michigan Ave. HighPointe is a newly 

built 300-bed facility with 9 resident care areas 

including: sub-acute/rehab, adult ventilator, LTC pediatrics, 

adult medically complex LTC as well as dementia, 

memory and behavioral care units. 

Thank you to all of the long-term care RNs 

and LPNs for your continued dedication and 

commitment to our residents and the entire 

healthcare team. 


41

Linda Browning•Mary Gebhard-Vandeusen•Blanche Junn•Tina Ford•Jeanine Funnell•Karleen 

Bordonaro•Nancy Martone •Jennifer Carroll•Diane Frankiewic 

•Diane Henninger•Jacqueline Sayeta•Michael Foley •Darlene 

Dolan•Jaclin Phillips•Wendy Green •Danielle Brodfuehrer 

•Elizabeth Nation•Jacqueline Tompkins•Shalondra Evans 

•Maureen Stroka•Amy Carlin•Sandra Leverenz•Karen Toye 

•Julie Chasey•Carol Heverin•Carrie 

LTC 

Peplowski•Mary Nowocien•Marie 

nurses... 

Thermidor•Dana Durkee•Cheryl Milijour•Teresa 

Zephro•Stacy Sperduti•Leslie Sweeney•Linda Lambe•Maureen Caruana•Susan Illig-Certo•Joan Hawco•Sandra Sopko•Eva 

Skompinski•Lorraine McLaughlin•Ralph Guastaferro•Maryalice Cislarski•Cynthia Pett•Heather Martindale•Gloria 

Porter•Deborah Buccilli•Mica Shegog•Patricia Nwokolo•Gertrude 

make 

Siaby•Donna Brown•Maria 

a 

Miles•Dorothy Leonard- 

Brucz•Janet Simmons•Michael Sayeta•Cheryl Brooks•Eve Evans•Shateeka Stevens•Dianna Harmon•Daria Harris•Ramona 

Richardson•Racheal Colom•Theresa Smart•Jamie Cunningham•Briana Campbell•Patrice Hennings•Kathleen 

Grzebinski•Roxane Amborski•Veronica Williamson•Willa Gibbs 

difference 

•Libby Vullo•Jessica Surles•Renee Taschetta•Nekeisha Thompson 

•Mieasha Walker•Kristin Matthews•Gabrielle Schwab•Tamara 

Besstak•Liza Baisa•Colleen McNatty•Patricia Heppner•Anita White 

•Darnelle Eady•Jennifer 

everyday! 

Barczykowski••Yvette Gilmore •Tamika Petty 

•Brandy Triplette•Julie Kuster•Dorena Wagner•Amanda Swain•Lacyana 

Boatwright•Bonnie Saraceni•Colleen Czerwiec•Tina Ojeda•Jody Mazurek 

•Roselyn Rust•Joanne Weber•Denise Hamilton•Renee Lane•Lisa Giglio•Lisa 

Drake•Jennifer Louie•Marlene Sims•Kathleen Semrau•Cynthia Kozlowski•Beula 

George•Rochelle McNeair•Lynette Williams•Sharon 

Watson•Natalie Galbo•Rosetta Heard•Heidi Bowens 

•Michael Howell•Kathleen Zwolak•Beatrice Lash•James Schichtel•Marilyn Jackson•Janet Plummer•Sandora 

Gray•Keira McGlothin•Shar’ron Young•Celia Borak•Amanda Catalano•Beverly Lynch •Sandra Bails 

•Annette Ford•Valerie Martin•Deborah Colkey-Johnson•Lynn Keith•Susan Farry•Bonnie Pirowski •Yalew 

Yohalashut•Maura Kelleher•Kevin Naffky•Jeanine Rhodes•Cierra Morrow•Lisa Stevens •Marisa Longacre 

•Hayley Guzowski•Teresa Thomson•Darlene Lozada •Linda Kelley•Donna Woroniecki•Danielle 

Conorozzo•Aida Babista•Shannon Nixon•Kristen Martin•Jennifer Arcovio•Rachel 

Collins•Taylor Chamberlain•Christina Wolf•Cheryl Serdin•Katherine Long•Seth 

Berchie•Martha Taylor•Lacheri Gordon•Lynn Flens•Elizabeth Mehltretter• 

42

thank you.. 

Our sincere thanks to Connie Vari, RN, COO, 

retiring after 35 years of dedicated service 

to Kaleida Health. A true champion for 

nurses and nursing education. 

She will be missed by all. 


Editorial Staff: 

Nurse Recruiters 

Diane Ceravolo, RN, MS - Contributing Editor Buffalo General Medical Center/Gates Vascular Institute........Sandra Boneberg, RN ~ 716-859-4647 

Cherie Hepp, RNC, BSN - Editor 

DeGraff Memorial Hospital & SNF........................................ Maryellen Demmy, RN ~ 716-690-2136 

Mary Beth Campo, VP/CNO - Editor Ex-Officio HighPointe on Michigan...................................................................Cherie Hepp, RN ~ 716-878-7952 

Kerry Zilka - Graphic Designer 

Millard Fillmore Suburban Hospital....................................... Maryellen Demmy, RN ~ 716-568-3515 

Women & Children’s Hospital of Buffalo.........................................Cherie Hepp, RN ~ 716-878-7952 

Photos courtesy of Kaleida Health - 

VNA of WNY..........................................................................Candyce Thayer-Roselli ~ 716-630-8601 

Medical Photography and Diane Ceravolo 

and Lori Stoudmire, RN~ 716-630-8644 

For career opportunities visit our website at www.kaleidanursing.org 

43

2011 Nursing Annual Report - Kaleida Health

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