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Crit Care Nurse 2003 Feb; 23(1): 88-87
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In Our Unit

Print or Store to Folder? Critical Care Newsletter

Tracy Pasek, RN, MSN, CCRN

Tracy Pasek is the advanced practice RN in the pediatric ICU at Children’s Hospital of Pittsburgh. For more information about this newsletter, contact her at 3705 Fifth Avenue, Pittsburgh, PA 15230; fax, (412) 692-6923; phone, (412) 692-5897; e-mail, Tracy.Pasek{at}chp.edu.

"In Our Unit" highlights unique practices, innovations, research, or resourceful solutions to commonly encountered problems in critical care areas and settings where critically ill patients are cared for. If you have an idea for an upcoming "In Our Unit," send it to CRITICAL CARE NURSE,101 Columbia, Aliso Viejo, CA 92656; fax, (949) 362-2049; e-mail, ccn{at}aacn.org.

The Critical Care Service Center at Children’s Hospital of Pittsburgh includes the pediatric intensive care unit (ICU), the neonatal ICU, respiratory care services, the transport team, and a new cardiac ICU. The number of staff involved—approximately 400 individuals representing medicine, nursing, respiratory care, child life, social work, and ancillary personnel—presents significant communication challenges.

A unique publication that has survived for at least a decade, transcending numerous evolution processes, addresses this issue. This monthly, online critical care newsletter is written and edited by the advanced practice nurse in the pediatric ICU and the director of the critical care and neonatology services. The critical care staff and leadership team consider this to be a highly valuable mechanism for communication.

The newsletter uses a template for the table of contents, column format and pagination. Issues, most of which are no more than 3 pages in length, are numbered and archived, both online and in hard copies.

Clip art is often dispersed throughout the text, along with wrap-around titles, wavy text, and even funky fonts The clip art that is used, such as seasonal shamrocks or "ringing" alarm clocks to accompany "timely" news, may seem "corny" or out of place in such a high-tech setting. The "upbeat" column titles may even seem inappropriate at a time when acuity is skyrocketing, staffing is stretched to the limit, and morale is tense. Nevertheless, the newsletter is well-read, as evidenced by the number of copies lying around the units and the number of return receipts indicating it has been accessed online. In fact, it is not uncommon to overhear, for example, respiratory therapists commenting on write-ups that pertained to nurses in the most recent issue. The newsletter has somewhat of a unifying outcome among disciplines.



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  		Christine Angeletti, RN, and Carrie Lynch, RN, browse through an issue of the Critical Care Newsletter that strengthens communications in the Critical Care Service Center at Children’s Hospital of Pittsburgh.

 
Beneath some of the light-hearted zeal for pediatric critical care that the newsletter conveys is a deep resolve and commitment for the professional development of staff. Gratitude, recognition, and praise permeate its pages.

The critical care newsletter may include anything from remarks patients have made and letters from families expressing appreciation to a Q & A regarding capnography. Highly autonomous groups of nurses, such as the skin care group, competency validators, and charge nurses, frequently request that messages pertaining to their projects be included for information sharing. Sample CCRN questions are added when a core group of nurses are preparing for the certification examination.

Pediatric Pain Awareness Week and Critical Care Awareness and Recognition months are noted in the newsletter, and invitations to attend conferences included. Staff consistently receives public policy updates via the newsletter, which draws on sources from the American Association of Critical-Care Nurses, the news, and political journals purchased for the pediatric ICU staff office. Neonatal content is interspersed with pediatric content. Case reviews and descriptive information that is relevant to both nursing and respiratory therapy are shared.

The director, who sits on the hospital’s institutional review board, passes on information about approved studies to the advanced practice nurse, who summarizes them for the newsletter. The director also assumes responsibility for the administrative update portion of the publication.

Although getting mileage out of a newsletter is simple, its impact should not be taken lightly. For example, in 1 issue, a staff nurse and respiratory therapists were recognized on the front page for their efforts to fulfill the dying wish of a young cardiology patient who wanted a graduation party. In less than 12 hours, graduation attire, balloons, a cake, the guests (including principal and teachers), the real diploma, and even "Pomp and Circumstance" fell into place at the hands of these expert care providers. A photo of the patient in her graduation gown surrounded by the staff who loved her appeared in the newsletter. And, the staff members caring for this patient were highlighted as positive role models. Although this patient died within 2 days of her "graduation," she is memorialized in the issue.

Relying on this issue of the newsletter and the graduation scenario also served as a means to illustrate the Synergy Model for a staff nurse who was preparing to take the CCRN examination. When the advanced practice nurse was helping a nurse study, she stated, "Of course you understand synergy! You’re doing it!" the staff nurse was told. Components of the Model were linked to patient care aspects outlined in the article. This particular nurse went on to pass the CCRN examination.




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T. A. Pasek, A. Geyser, M. Sidoni, P. Harris, J. A. Warner, A. Spence, A. Trent, L. Lazzaro, J. Balach, A. Bakota, et al.
Skin Care Team in the Pediatric Intensive Care Unit: A Model for Excellence
Crit. Care Nurse, April 1, 2008; 28(2): 125 - 135.
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