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Providing Comprehensive Care in the NICU through Creative Improvement

Nurses Leading Innovation
March 14, 2018
Providing Comprehensive Care in the NICU through Creative Improvement

In an environment like a neonatal intensive care unit (NICU), constant improvements and dedication to patient safety are essential to provide efficient, up-to-date care. Maureen Maurano, BSN, RN, NICU nurse manager at Children’s National in Washington, D.C. – the nation’s top hospital for babies, according to U.S. News and World Report – knows firsthand how important patient-focused care is and has implemented initiatives at the hospital that ensure top-level care for the smallest, most fragile patients.

Maureen has streamlined processes for team communication, introduced bar coding systems for medications, optimized safety protocols, initiatied new patient-focused programs, and more, all in an effort to provide comprehensive care for babies and mothers. We recently spoke with Maureen about the importance of patient-focused innovation, leadership in nursing, and her passion for the NICU.

Nursing Notes: Can you share some of your nursing background?

Maureen Maurano: I graduated from Johns Hopkins School of Nursing in 2003. During my final semester practicum, I was fortunate to be placed at Children's National. During those six weeks, I absolutely fell in love with the hospital and knew this was where I was meant to be.

After about three years working as a clinical nurse, and training to be a preceptor and then a charge nurse, I also became involved in projects like new IT initiatives and a new NICU design team, and I served  as co-chair of our Shared Nursing Leadership forums. I found that I enjoyed the extra responsibilities, while also being able to initiate positive change and serve as an advocate and leader for the clinical nurses and NICU staff. 

Nursing Notes: What led you to become a NICU nurse?

Maureen: My family and I always say that I "grew up" at Children's National. Many years of my youth were spent here, from specialty appointments to several major surgeries, over a span of years. I vividly recall special moments interacting with the staff who cared for me; those moments have shaped me into the nurse and person I have become. I've come to realize that the daily impact we have on others as nurses can shape their future, which is an incredible honor.

Nursing Notes: What are your roles and responsibilities as NICU nurse manager?

Maureen: At Children's National, nurses and nurse managers have a lot of autonomy in practice. In addition to nursing practice, our scope includes things like regulatory readiness, budget oversight, nurse staffing, patient safety, occupational and employee safety, patient satisfaction, and involvement in special projects, like when we designed a new unit.

Nursing Notes: What are some of the innovative approaches that you have introduced in the NICU?

Maureen: One project I really love is the growth of our lactation support program. As a freestanding children's hospital, NICU moms aren't our patients. However, what benefits the mom also benefits the baby. We've been able to institute a few things that are a little bit "out of the box" for children's hospitals, and we're really proud of that.

For example, we give free meal vouchers to lactating moms to encourage them to eat healthy meals and get enough hydration while they're nursing or pumping. We also have a free pump rental program for identified NICU moms who might be on a waiting list for subsidized hospital-grade pump rentals; otherwise, they sometimes lose milk supply entirely and the baby misses out on all the crucial benefits of the mother's milk.

Nursing Notes: Why is it critical for nurses to lead the way in innovative care?

Maureen: We say nurses are the gatekeepers, and they really are. I can think of few other roles where continuity of care and assessment skills are as critical as they are in nursing ─ and in NICU nursing, you truly have to be the voice for your patient, who can't yet speak to tell you what's wrong. It's an honor and a privilege to be on the forefront of care for these vulnerable children. Nurses truly can make change happen, especially here at Children's National.

Nursing Notes: What are the most rewarding and challenging aspects of your position as NICU nurse manager?

Maureen: I always say we have dual responsibility ─ to patients and their families, and to our colleagues. Seeing new clinical nurses go through orientation and learn to be experts and advocates is very rewarding. And the patients ─ seeing those tiny, critically ill babies whose clinical status was so tenuous when they first arrived, go on to discharge home with sometimes absolutely unbelievable outcomes – there's really nothing like it.

On the flip side, there can be challenges and heartache in working with such fragile infants, both physically and emotionally. Teamwork is extremely important in a unit like a NICU, and I'm thankful for the amazing team that we have. 

Nursing Notes: What advice would you give to a nursing student who is interested in a career in NICU nursing?

Maureen: Find a goal and stick to it. You learn something at every step toward your ultimate "dream" career, so make it count. Continue to seek out opportunities for growth, as you might be surprised to find what you truly enjoy!

Interested in a NICU nursing career? Learn more on DiscoverNursing.com.

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