News & Events :: Media Mentions

Always On Their Toes: The emergency department team at Regional Medical Center of San Jose gives care from the heart

Vol. 4 •Issue 20 • Page 12
By Mansi Bhatia
View Print Version Here

With 30-35 ambulances, one or more helicopter patients on average and almost 200 patients with diverse backgrounds and even more diverse ailments, the emergency department team at Regional Medical Center of San Jose has its hands full every day.

Instead of buckling under the pressure, the ED team has risen to the occasion time and time again. In 2005, the group earned the coveted Emergency Department of the Year award from CEP America, the largest provider of physician staffing and comprehensive management for EDs in California. That same year Santa Clara County designated the hospital a trauma center, increasing the acuity of Regional's patients. The recognition is a testament to an ED staff that provides excellent patient care leading to a high level of patient satisfaction.

Innovative Program, Friendly Staff

"I think the friendliness of the staff is what makes the ED at Regional so successful," said Jean Parrish, BSN, RN, interim ED director. Another factor contributing to its success is a newly established rapid medical evaluation program that has helped reduce patient wait times by 15 percent. "It's a critical and highly used service," Parrish observed. "We are trying to decompress the department by having patients with less severe problems be seen in a small area without using the ED's beds."

This service also has helped the ED handle a 50 percent increase in volume.

Critical Service

Regional has served the healthcare needs of San Jose residents for more than 4 decades. The ED staff alone treats approximately 65,000 patients a year.

"Everyone comes into the ED," said Colleen Vega, RN. "We get the common things where a child has stuck something up his nose or swallowed mom's medicine by accident, to the more extreme suicide and stabbing cases."

With 34 beds and a highly accomplished team of emergency physicians, nurses and support staff, the ED caters to the varied medical problems of a diverse local population with aplomb.

"The City of San Jose is very diverse and we see that reflected in our patients," Parrish said. "We have people on staff who speak Spanish and Vietnamese and translator phones are available for other languages. Since the international airport is not too far away, we sometimes get people who neither speak nor understand English, and it's absolutely critical we have the resources available to be able to provide them with the assistance they need."

Family Matters

Another strength the team brings to the fore is the compassion and care for families of patients who pass away in the ED.

"Most of the time a death in the ED is an unexpected event for the family members," Vega said. "It is a traumatic time for them and we want them to know we're here to help."

To that end, Vega helped initiate a bereavement committee in March, soliciting help from nurses in putting together a packet of helpful information for the loved ones of the deceased with the names of social workers, mortuaries and the coroner's office, among other things. Vega said she based her initiative on a study published in the Feb. 1, 2007 edition of The New England Journal of Medicine, showing 67 percent of family members of patients dying in the ICU experienced posttraumatic stress. The number dropped to 45 percent when family members received bereavement support or some sort of proactive communication from the staff. As part of Regional's program, doctors and nurses who attended to the patient follow up with the families to see how they're doing and send a signed card as a token of reassurance.

"I've been a nurse for 5 years and have seen doctors do a 'hit and run' where they just pull the patient's family aside, tell them about the death and walk away," Vega shared. "To me, that just doesn't feel right. We have a responsibility toward not only our patients but the entire family unit — we want them to know their loved one was not just another face in the crowd for us."

In-House Support

Not only does the ED staff provide comprehensive care to its patients, but the staff also takes care of its own in times of need. A charitable organization for the ED, the Sunshine Club, acts as an in-house support group.

"The Sunshine Club was formed out of adversity," said club president Spencer Miller, RN. "Two of our nurses on an educational trip in Scotland met with a car accident, where one died and the other was seriously injured. A frantic call went out through the ED for a donation to send the families overseas. When the crisis was over, several people started a small fund to keep in reserve should something similar happen again."

Today, members make a voluntary donation of $1 a week to the kitty and the club organizes donation drives, bake sales, car washes and cookouts.

"Last year we raised more than $1,600 in gift cards for less fortunate families," Miller recalled. "One of our nurses lost most of her possessions in a house fire and we were able to step in with assistance. During Christmas, we became aware of an 18-year-old girl living out of her car while she finished high school and we were able to assist her with a gift card basket, some cash, and more importantly, assistance through local agencies for housing.

"We made a lot of smiles out of frowns."

Up for Any Challenge

Even as Regional's $160 million expansion under way is expected to be completed by 2009, the hospital's 34-acre campus is not nearly big enough to handle the volume of patients it receives every year.

"Limited physical space is a big challenge for us," noted Regional CNO Darina Kavanagh, MS, RN, CPHQ. "The ED is big and busy, like all EDs, but the challenges are most often seen during flu season with bed allocation."

Once the expansion is complete, work flow and the environment for patients and staff in the ED will be improved, with more beds, a dedicated radiology area with a 64-slice CT scanner and a permanent helipad just outside of the ED. In the meantime, Kavanagh offers a positive outlook.

"The challenges are what make it interesting for people to work here," she said. "And our staff, in particular, loves the challenges our diverse patient community provide."

Parrish echoes Kavanagh's thoughts.

"There's always something different and you're always learning something in the ED," she said. "I couldn't do the same things in another part of the hospital — not at the same pace, at least. You never know what's coming in the door — it's part of the challenge and part of the reason I love the ED."

Catching Them Young

Along with meeting these challenges successfully, the ED has undergone a transformation. "Over the years we have had to change the philosophy in the ED as far as accepting new graduates," Parrish explained. "Years ago you would not have heard of a new grad entering the ED, but nowadays, because we need to expand our staff, we have been training and making fresh graduates feel comfortable in our setting. It takes a while to get the experience you need to function well in an ED — you have to have a really good support system for an inexperienced person, and I think our department is able to provide that."

But how daunting is it for a fresh graduate to become part of the hustle and bustle and non-stop action of the ED?

"I was apprehensive starting out in the ED fresh out of school — there is a huge difference between 'school' nursing and 'real-world' nursing," shared 24-year-old new grad Bethany Garcia, BSN, RN. "Thankfully, I was able to spend my last semester of clinical in Regional's ED. The staff here handles incredibly stressful and hectic situations while providing quality patient care and maintaining a positive work environment. I am continually amazed at their level of teamwork and, as a new grad, I feel confident coming to work knowing I have such an awesome support system."

Mansi Bhatia is a writer and communications specialist.