Nursing Department Patient Centered Care 
by Kathryn Moery
Misericordia residents enjoy a proximity to nursing care that is hard to beat. Each residential community is assigned a nursing care staff. Many residential areas on the campus require nurses to administer medications, e.g. McAuley, McGowan, Marian Center, etc., and have dedicated nursing staff assigned to each location on each shift. The residences that do not require staff nurses, e.g. the Village, Mercy Glen, Shannon and the Community Homes (CILAs), have primary nurses assigned to each unit, who train the direct care staff members to administer the medications.
Aside from administering medication, the nursing staff performs a vast array of services. According to Megan Christiansen, the designated CILA nurse, who has worked at Misericordia for 11 years, the nursing department provides wound care, tube feedings and catheter care, monitoring of glucose levels, and if needed, direct care. In addition to staff education, they provide training for families. “Don’t delay care” is the overriding mission of Misericordia nursing, and staff is given autonomy to recommend care or call for assistance. Nurses can refer the care concern to the medical provider affiliated with Misericordia, to three nurse practitioners on staff, or the Directors of Nursing. The medical provider and the director are always on-call. If the resident’s provider is not on staff, the nurses will refer the resident to urgent care or the resident’s personal provider.
When reflecting on the pandemic and the roles and responsibilities of the nursing department, Megan shared that “it was imperative to lead by example by donning proper PPE, engaging in frequent handwashing, and staying home when ill to limit exposure.” Nursing tracked residents and staff outbreaks, and infection rates. They educated staff on how to recognize COVID infection, and administered COVID tests and results, in addition to helping with the COVID vaccination clinics. In the residential areas, nurses visited daily to monitor vitals and check on high-risk COVID positive residents, in addition to training staff to monitor symptoms for ongoing infections.
Nurse Megan typically sees the CILA residents on campus. In addition, nurses for residents who need in-home support at residential locations, can make house calls to assess the resident, help lift residents, and give hospice care. Nurse Megan also provides hygiene care, including nail clipping, lab and specimen testing, and pain monitoring. When asked about her ‘bedside’ approach for residents experiencing fear or anxiety, she said that trust and transparency are essential. She first explains what she needs to do, then she has them take deep breaths to calm down, and, finally, she waits for the resident to let her know when they are ready to proceed.
Megan works with a variety of other departments. When needed, she provides relief to fill nursing assignments in the Marian Center, and she also interacts on behalf of her residents with the physical therapy, social services, behavioral health and staff development areas.
In addition to being available at her on-campus office, she also assists two on-campus psych clinics.
When asked why she worked her whole nursing career at Misericordia, she spontaneously answered, “(The residents) draw you in.” She responds to parents’ questions and remains in close communication with them. Megan ended the conversation by effusively praising her Director of Nursing, Mariana Montes, who assumed this role two weeks before the pandemic. Megan says her supervisor was “amazing during the pandemic,” was an invaluable resource for nurses, giving trust and always approachable. ”She is what leadership should look like.” In healthcare, Misericordia is a haven for residents, and a comfort to family members, who can be assured that their loved one is known to the staff, and is given exceptional, continuous medical care within their residential community.
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