Special Interest

Download an article from Nurse.com (published May 6, 2013) that features interviews with two BIMC RNs - Jeanne Kenney and Marie Sakowski - as they speak about BIMC's wellness programs.

Hurricane Sandy response earns entire Beth Israel Medical Enter staff the ADVANCE 2013 Best Nursing Team award. Download the full story here.

Click here to read an essay from our very own Cathy Sullivan, MSN, RN, NP published in the April 29, 2013 edition of Advance for Nurses.

New York state's Secure Ammunition and Firearms Enforcement Act, a sweeping piece of legislation designed to curb the growing incidence of gun violence in the state, has become the center of debate in the mental health community.

In addition to provisions banning assault weapons and high-capacity magazines, the act, signed into law Jan. 15 — about a month after the mass shooting by a man with mental illness at an elementary school in Newtown, Conn. — includes a provision requiring nurses, therapists, physicians and social workers to inform government authorities if they believe a patient is likely to harm himself or anyone else.

This is a necessary step, said Mickey Matos, RN, who also is a nurse manager in psychiatry at Petrie. "Many patients have been mandated into care, and they might be less likely to disclose their access to firearms," she said.

In his announcement after signing the bill, New York Gov. Andrew Cuomo addressed the necessity for the inclusion of a mental health provision.

"People who are mentally ill should not have access to guns. That's common sense," Cuomo said. "That's probably the hallmark of this bill, coming up with a system that allows for mental health screens."

The disclosure requirement has garnered mixed feelings from those who care for patients with mental illness. At Beth Israel Medical Center in New York City, discussions have begun about the requirements, said Hyacinth Hamilton-Gayle, RN, MSN, NE-BC, PNP, director, patient care services at Beth Israel's Petrie Division.

"We all agree that something has to be done," Hamilton-Gayle said, "but breaking the bond of trust between patient and provider will only make it more difficult for the mentally ill to seek care. What we really need is to address the lack of resources for care, treatment and follow-up, especially for the adolescent population."

Nurses in the psychiatric and chemical dependency departments at Petrie said they are glad something has been done to help decrease incidents perpetrated by people with mental illness, and they are taking steps to protect their patients and those with whom they come in contact. Nursing leadership has initiated discussions of the new requirement and several nurse managers have started to have open dialogue with the staff, said Miriam Fridman, RN,C, MSN, CARN, chemical dependency.

"Our group voiced several concerns," Fridman said. "Like, how will this impact on other aspects of the patient's rights? On other laws that apply to mental health?"

Staff is encouraged to know the issue of mental health and its relationship to violent behavior finally is being addressed in a broad forum, said Melody Johnson, RN, MSN, a psychiatric nurse manager at Petrie. "We also realize that we need to take a closer look at existing risk assessments to include specific questions about firearms," she said.

Kendra's Law

The SAFE Act also continues enforcement of a law that has been in effect for more than a decade. Named for Kendra Webdale, a young woman who was pushed to her death in front of an oncoming New York City subway train by a mental health patient who had stopped taking his medications, Kendra's Law allows courts to order certain violent and/or recidivist mentally ill individuals to accept treatment as a condition for living in the community. It also commits the mental health system to providing that treatment.

The law was passed in November 1999 and revised in April 2011 when Assemblymember Aileen Gunther, RN, (D-98th District) introduced A-06987,a bill that proposes changes to the law that would provide for assisted outpatient treatment for people with mental illness who require supervision while living in the community. The SAFE Act will extend Kendra's Law through 2017, expand outpatient treatment from six months to a year and require reviews before such treatment is allowed to expire.

Next step

New York state's law is the toughest gun control legislation in the nation. If legislation in other states follows New York's example regarding disclosure, the need for balance between gun control and advocacy for mental health patients will be a much-discussed issue.

"Many are talking today about the need for balance in treating patients and the issue of gun safety," said Nicholas Croce, MS, executive director of the American Psychiatric Nurses Association, an organization that represents more than 8,000 of the nation's nurses who work in mental health. "The issue is extremely complex. What we at the APNA will care about is coming up with a program that will provide that proper balance. People will want to be careful to not throw the baby out with the bath water. It's important that we don't want to create circumstances that will prevent those who need and want services from seeking them."

Neither Kendra's Law nor the SAFE Act requires that patients take medications for their mental illness. The onus is on the healthcare community to provide as positive an experience as possible for those seeking help so compliance isn't an issue. To do that, Hamilton-Gayle said, more action must be taken.

"Parents and schools are challenged with children with mental health disorders; families are ill-equipped to provide continued care for clients who are at risk," she said. "The availability of mental health services need to take on the same importance as being able to care for cardiac arrest or stroke victims in our society."

Article pulled from January 28, 2013 edition of Nursing Spectrum/Nurse.com
Written by Tracey Boyd, Regional Reporter

Marguerite Pulvirenti Corda, RN, MSN, has joined Beth Israel Brooklyn as Vice President for Patient Care Services. Ms. Corda previously was VP for Cardiac Care and Cardiac Services at Westchester Medical Center in Valhalla, NY and also was associated with Lenox Hill Hospital and Maimonides Medical Center.

A critical care nurse for more than 30 years, she has worked collaboratively in setting nursing performance standards of care to exceed quality benchmarks and achieve high patient satisfaction. She holds a bachelor's in nursing from Hunter College, a master's in nursing from Adelphi University and a post-master's certification in business from the Zicklin School of Business of CUNY/Baruch College.

MANY years ago, when Richard Townsend was still a student at Tufts, he was clever enough to score an interview with the young Audrey Hepburn, then touring Boston in “Gigi.”

He was no stage-door Johnny. “I was much too cool for that,” he said.

He wrote her a letter saying a theater group at school had voted her as the actress of the year (just a small white lie), and she invited him in.“I felt, sort of, in a way, that I discovered her,” Mr. Townsend, 77, said impishly.

Mr. Townsend has a knack for discovery. Years later, he felt, sort of, in a way, that he discovered Jacques Beaumont, now 86, when in December 1972 a mutual friend suggested that Mr. Townsend would be just the person to show Mr. Beaumont, visiting from France, around New York City for a perfect night on the town.

Last month, a few days after they toasted the signing of New York State’s same-sex marriage law, Jacques Beaumont called an ambulance to the home he shares in Chelsea with Mr. Townsend. The two had been ill for some time, and increasingly reclusive. The ambulance took them both to Beth Israel Medical Center, on the East Side of Manhattan. It seemed only fitting that they were admitted together and — at Mr. Beaumont’s insistence — to the same room.

Mr. Beaumont was found to have leukemia. The prognosis was poor. Mr. Townsend had complications of his Parkinson’s disease. Faced with the prospect of their own mortality and separation after 39 years together, they asked the doctors to postpone Mr. Beaumont’s chemotherapy until — in a last grand gesture — they could get married.

“When he got sick, it changed everything,” Mr. Townsend said. “We said we must get married. It’s vitally important.”

At the time the couple first met, Mr. Townsend seemed a figure out of Cole Porter, a playwright, slim, insouciant, carefree, chatty. He had a play about women’s liberation produced Off Broadway. “Don’t laugh,” he said as he received guests in his room, but he no longer can remember the name. He taught playwriting for years at the Y.M.C.A. on West 63rd Street.

He had grown up in New York and was a painting student at the famed High School of Music and Art, and later in college, at Tufts. He was close to his mother, a small-boned fashion model, and remembered his father, who was a traveling salesman, as looking like a “gangster,” in tapered suit and hat.

Mr. Beaumont was a French citizen who had traveled the world working with refugees, mainly as the secretary general of Cimade, a French humanitarian organization, from 1956 to 1968. In perhaps his most notorious adventure, in 1961, he put together a team to smuggle 60 African students out of Portugal, where they were being closely watched to prevent them from fomenting revolution in the Portuguese colonies, according to Kimball Jones, a member of the team. They were driven to France, where they were given political asylum. Eventually, several of the students became freedom fighters or attained high political posts in their home countries. Mr. Beaumont later worked with Unicef, traveling to North Vietnam and Cambodia.

"He had done things that I had never dreamed of, and gone places I never dreamed or thought of going," Mr. Townsend recalled. "He was so incisively included in the fate of the world, and I was enthralled with that."

As for Mr. Beaumont, who has the bristly eyebrows and soaring speech of a diplomat, he found Mr. Townsend "étincelant," sparkling "like a star in the sky."

They had dinner at an East Side restaurant, and the next night, Mr. Beaumont called Mr. Townsend, and then kept calling. At the time, Mr. Beaumont was married to a woman, and they divorced in 1974.

"It's the story of many people of my generation who were gay," Mr. Beaumont said. "We took the regular route, which becomes terribly irregular when you leave it."

Over the last few years, they have devoted themselves to caring for each other, and have lost touch with friends. Mr. Beaumont has no American health insurance, his doctor said. When they entered the hospital, Mr. Townsend said, he had not shaved or cut his hair for a year, and he realized that people were staring at him.

"I found the most beautiful black woman you've ever seen working here," Mr. Townsend said. "I asked, 'Who cuts your hair?' She said, 'I do.'" She gave him a spiky cut, which he adores, and he never saw her again.

On the day of the wedding, Aug. 2, they arrived in a patient lounge in separate wheelchairs. There were no tuxedoes. Instead, the hospital provided matching white sweat pants and sweatshirts from its inventory and matching yellow rose boutonnieres.

They had the wedding in the lounge rather than the chapel, which Mr. Townsend said he felt no personal connection to. He did not miss the pomp. "I wanted to have the simplest, most heartfelt situation," he said.

Mr. Beaumont, the more religious of the two, asked his pastor, the Rev. Glenn B. Chalmers, and former pastor, the Rev. Elizabeth Maxwell, of the Church of the Holy Apostles in Chelsea, to officiate. Mr. Beaumont admires the church for its soup kitchen. But priests in the Episcopal Diocese of New York cannot legally perform same-sex marriages, so they called in a colleague, the Rev. John E. Denaro, of the diocese of Long Island, where it is allowed, to join them and to sign the forms. "I'm John Doe — or Jane Doe," Father Denaro said jokingly, getting into the cloak-and-dagger spirit.

As hospital workers in different-colored smocks crammed into the lounge, Mr. Jones, the former colleague of Mr. Beaumont at Cimade, conjured up a cobblestoned Paris street by playing a Charles Trenet song, "I Wish You Love," on his melodica, which sounds like a cross between an accordion and a harmonica. Then, at Mr. Townsend's request, he played "Your Song" — "with apologies to Elton John." Another colleague, Muriel Glasgow, invoked Edith Piaf with her rendition of "Ne me quitte pas" ("Don't Leave Me").

The Martinelli's chilled on ice, next to a two-tiered white wedding cake contributed by a hospital food-service chef.

Mr. Beaumont hailed his doctor, Dr. José Cortés, who was there with his own beaming husband, Mauricio Laffitte-Soler, an art consultant.

With a dignity that defied the circumstances, the wedding couple clasped hands on the adjacent armrests of their wheelchairs and said their vows, which Mr. Beaumont tailored slightly to his diplomatic cadences, ending, "until we are parted by death, this I solemnly vow."

Mr. Beaumont's niece, Anne Beaumont, a theater director, had brought a collection of family heirloom rings to the hospital in a box, so they could exchange two of them.

Mr. Townsend got a gold ring set with a tiger's eye; Mr. Beaumont got a basket-weave ring set with a diamond.

Mr. Beaumont's fingers were swollen, but Mr. Townsend managed to push the ring as far as the knuckle.

"I can't get it on," Mr. Townsend said, smiling, "but I like the way it looks."

As enrollment swells, so has demand for adjunct nursing faculty

Ever since starting her nursing career, Carmen Feliciano, RN, MS, has been passionate about mentoring new nurses. A staff nurse in the ICU at Beth Israel Medical Center in Manhattan, she often was the go-to person when nurse managers needed a preceptor.

In 2006, her nurse manager offered to recommend her for an adjunct faculty position at Phillips Beth Israel School of Nursing. As an adjunct, she would continue working full time on the unit and, in addition, take on a part-time role teaching students in the clinical area. Feliciano was thrilled with the opportunity to train the next generation of nurses.

As nursing school enrollments continue to increase, more schools are hiring adjunct faculty to teach, according to the American Association of Colleges of Nursing. In many cases, the greatest need is for adjuncts who can lead clinical groups. Adjunct professors teach part time, generally teaching one or two classes a semester in an area of specialty. Although lecture halls can hold increasing class sizes, the ratio requirements in clinical groups are typically a maximum of 10 students, and lower for certain specialty areas.

For both the schools and the adjuncts, this trend in nursing education seems to be a win-win situation, says Mary Alice Donius, RN, EdD, dean of the school of nursing at The College of New Rochelle (N.Y.).

“In many cases the master’s prepared nurse can’t afford to teach full time due to salary constraints, but they have a desire to mentor younger students and give back,” Donius says. “Working as an adjunct allows them to work and teach. From my perspective as a dean, we could not run the program without committed adjuncts. They make it possible for us to provide an excellent clinical experience at the undergraduate level.”

Swelling Student Enrollment

At Phillips Beth Israel School of Nursing, the number of adjuncts has increased in proportion to the student enrollment increase. In the past five years, both the number of students and adjunct faculty have doubled. The school now has about 270 students and more than 20 adjuncts.

“We needed nurses to teach in [the] clinical [setting], and the beauty of using adjuncts who are already working in a hospital is that their clinical expertise is phenomenal,” says Janet Mackin, RN, EdD, dean of Phillips Beth Israel School of Nursing. “The adjunct faculty know that our students will someday become their co-workers, so there is a huge commitment to making sure the students are clinically competent.”

Adjuncts not only provide up-to-date clinical expertise, but also flexibility for the nursing schools. The number of clinical groups may vary from semester to semester, and adjuncts can be hired on an as-needed basis. Adjuncts are required to have master’s degrees and experience in their areas of specialty. Many have been preceptors and earned certifications in their specialty. Compensation varies, but at Felician College in Lodi, N.J., clinical adjunct faculty are paid $80 an hour. They spend one day a week in a clinical setting supervising 10 students for a 15-week semester and earn $9,600.

Before teaching a clinical group, adjuncts typically meet with a course coordinator to review the class syllabus and coordinate with the professor who is teaching the didactic portion of the course. At Felician College, nursing adjuncts participate in a collegewide adjunct faculty orientation where they hear from the president of the college and learn about support systems available to students, such as the library resources or counseling health services.

“The more engaged the adjuncts are, the more they will feel a part of the college,” says Muriel Shore, RN, EdD, NEA-BC, dean and professor of the division of nursing and health management at Felician. “We do mentoring to touch base and see how they are doing, and we encourage them to have ongoing communication with the full-time faculty. If they are having trouble with a student, for example, then the professor and the adjunct can discuss the situation together.”

One common challenge new clinical adjuncts face is dealing with students who are not meeting expectations, Mackin says. New adjuncts sometimes blame themselves for a student’s poor performance, when in reality students may not have studied, completed homework or spent enough time in the simulation lab, Mackin says.

“Our program support chair, Lynn Rubenstein (RN-BC, MA), does a great job guiding and supporting new faculty,” Mackin says. “She matches them with course coordinators, includes them on faculty development activities and they can reach her 24/7.”

In the spring, Phillips Beth Israel plans to start offering a formal mentoring program for adjuncts in which they will be paired with a full-time faculty member. The mentors will provide guidance about everything including career goals and how to handle a disruptive student.

Rewards of Teaching

At Phillips Beth Israel, many of the adjuncts have come through referrals from nurses who are working in one of the hospitals partnering with the school. Mackin acknowledges that although taking on a clinical group for 15 weeks may seem fairly easy, it is not. Adjuncts are expected to arrive about an hour before the shift to prepare for the clinical group, and it can be challenging to monitor all of the students as they work on the unit. Adjuncts also are expected to complete a large amount of paperwork, such as grading student care plans.

Although working as an adjunct is demanding, Feliciano finds deep satisfaction in helping students connect what they learn in the classroom with experience in the hospital. “In my regular day job, it is rewarding when I see the patients get better, but when I adjunct I am being a role model and shaping the future of nursing,” she says. “I know these students will be taking care of me when I am older, and this clinical experience is going to shape their careers for the rest of their lives.”

On March 29th, Cathy Binck, RN, MSN Nursing Informatics Administrator at Beth Israel Medical Center presented at the Nursing and Health Information Technology conference co-sponsored by the Greater New York Hospital Association and the New York State Chapter of HIMSS. Her topic was Staff Training Strategy, Curriculum Development and Implementation of an EHR. Ms. Binck shared Continuum Health Partner’s experiences in bringing electronic nursing documentation and provider order entry to 5 hospitals.

Beth Israel Brooklyn nurses celebrated Beth Israel's cultural diversity by hosting a St Patrick's Day celebration. Nursing provided decorations, baked Irish soda bread, and coordinated with our Nutrition department to serve corned beef and cabbage. The highlight of the event was a demonstration of traditional Irish step dancing courtesy O'Malley Irish Step Dance Academy.

On January 12th of this year, an earthquake struck Haiti, my home country. Immediately I felt compelled to travel there and do whatever I could to help. Upon arrival, I was stationed at the University Hospital in the center of Port-Au-Prince. The realization that I was born there, in that place, made the moment all the more profound.

The conditions were devastating. Without any running water, the medical staff had to walk around with bottles of hand sanitizer clipped around their waists. Something as simple as an IV Pole was nonexistent. To make do, we hung IV bags by nails and used gloves by a string.

One morning, I heard a loud scream. When I looked down the street, I saw a pregnant woman in active labor. As her pain intensified and the birth became more unavoidable, I suddenly found myself gloved, gowned and kneeling beside her. I asked her to push, and within 15 minutes, I opened the cervix and delivered a baby boy. He was breathing fine and crying.

It’s a good thing I paid attention during my Clinical OB/GYN rotation! I thank God for the knowledge and calm attitude I provided the unexpected patient; it allowed me to think critically with unclouded judgment during that special emergency.

After the earthquake struck Haiti, a team from Beth Israel flew down to offer their help. When we arrived, we were told there were 1000 people waiting for surgery at the General Hospital! Patients were afraid to stay in the building after experiencing a 6.1 magnitude aftershock, so we used the building as a surgical area and moved the patients out to tents that we set up in the hospital yard.

There was no running water or electricity and medical supplies were very limited. Lack of pain medication and anesthesia was a big concern. Motrin was the best drug they had for pain, but we’d brought pain medication and antibiotics, which we had to replenish every two days.

We cared for patients with gunshot wounds, back surgeries, hip fractures, severe burns -- many devastating problems. Most of our patients showed signs of sepsis and many of them were in renal failure. Our team needed to improvise for all the challenging situations: we used door hinges and nails for IV poles; we kept our flashlights handy since there was no electricity; we borrowed one oxygen tank from the OR area for the PACU area, and we used it on a patient who needed it most.

During our course of work in Haiti, we did see signs of slow improvement, but this is not a short-term endeavor. There are still many homeless people, along with those who have no food or water, and many who need medical attention. There is a great need for follow-up care for many months and years to come. As healthcare professionals, we must use our talents and skills to help these earthquake victims.

Most marriages don’t last 25 years, so Beth Israel Medical Center’s Kings Highway Division must be doing something right – because 41 of the hospital’s nurses have been there for a quarter century or more!