National Nurses Week
Looking Out for Others, on the Unit and on Her Team
Brenda Demeritt improves outcomes and experiences for patients, families and her staff.
Long before Brenda Demeritt, MHA, RN, became a nurse, she knew she wanted to help others. When she was 13, her great-grandmother was diagnosed with cancer. That summer she took turns with her sister staying with their great-grandmother so she wouldn’t have to be alone, and it was that experience that made her realize she would make a career out of caring for people.
Fast forward and Brenda has been a pediatric nurse for 31 years and is the clinical director of A6NS Medical/General Pediatrics at Cincinnati Children’s. She continues to care for others—in her leadership on quality improvement projects, her dedication to population health, and her commitment to building connectedness within her team.
One initiative she helped lead recently was the implementation of safe handoff at the bedside, a nurse handoff format that engages patients and families and that is featured in the document that was submitted for Magnet® redesignation this year. In this practice, at the change of shift, the nurse who is going home briefs the oncoming nurse on their patient and provides updates from their shift while inside the patient’s room. Brenda got the idea while attending a poster presentation at a Cincinnati Children’s nurse residency completion ceremony. The presentation was evidenced-based and supported many positive outcomes around patient safety, the patient and family experience, and providing high-quality care. Brenda decided to make it happen on her unit, where nurses were used to giving reports at the nurse’s station. She invited the nurse residents to present at the A6NS Point of Care Interprofessional Council within Shared Governance, where all council members agreed to implement this new way of giving and receiving safe handoffs.
She consistently gathered data from individual families and patients and supported staff through individual challenges and comforts in performing handoff at the bedside.
“Our feedback from our families was nothing but positive,” Brenda said. “They said it makes them feel a part of the team.”
An average of 82% of patients and families responded positively to the Patient Family Experience survey question, “Were you comfortable talking with nurses about your child’s worries or concerns?” post implementation. This was a 7% increase from pre-RN handoff at the bedside implementation. Additionally, as the compliance rate with RN handoff at the bedside rose, so did the percentage of 9 and 10 ratings of the facility on the survey.
Caring for Community
Brenda’s impact on our community is significant. Baseline hunger was reported as high as 93% among families whose children are insured by Medicaid. She collaborated with physician lead Kathy Auger, MD, MSC, Hospital Medicine, and a multidisciplinary team for a grant to provide meals to families who are on Medicaid or self-pay. These caregivers receive two meal cards per day per caregiver for up to four total meal cards per day.
“Hunger came up a lot of times through surveys,” she said. “Early in the project we did a survey of families, having them answer questions like how often they were hungry while here. And it was astonishing.”
The current rate of reported hunger post intervention is 18%, which is below the goal of 25% and has been sustained for several months.
“A lot of the patients that we see on our unit are local kids,” Brenda said. “Other units sometimes attract more out-of-state patients, but because we’re [a] general medical [unit], most of our patients and families we see are local.”
Brenda is also the nurse lead on the implementation of a core screener tool to assess social risk and needs among our patients and families, implemented by a hospital-wide Social Determinants of Health (SDOH) screening taskforce. The SDOH taskforce promotes screening standardization with the goal of improving needs such as caregiver education, food security, financial resources, caregiver health, housing, firearm storage safety, and transportation. A6NS was the first inpatient unit to test and go live with an electronic screening tool automatically delivered to each patient’s MyChart Bedside account upon admission and activation. This project was a collaboration with Kenna Sheak, MD, Hospital Medicine, and Anita Shah, DO, MPH, Hospital Medicine. She is also working on additional screenings for mental health with DeAnna Hawkins, DNP, RN, assistant vice president, Patient Services; Mona Mansour, MD, MS, associate division director, Population Health; and Mary Greiner, MD, MS, medical director, CHECK Foster Care.
She is quick to credit her partners. “In some ways, I don’t feel like I should take credit for some of this. I was just in the right place at the right time and said ‘Yes, I will help you do that.’”
She also understands that when we take care of each other, we take better care of our patients and families. Around five years ago she created a “tap out” basket for her unit. The basket contains coloring sheets, aromatherapy, stress relieving squeeze balls and candy, and is used when someone on the unit is having a rough or bad day. Someone from the team taps the staff member out, getting a safe hand off, and takes over their assignment for 15 minutes, allowing them to take a break and rejuvenate themselves.
“I was recognizing that sometimes some shifts are really hard,” she said. “And people feel like they can’t say, ‘I need a break.’ And they should be able to say that. Sometimes I think it's better for them and the patient and family if they take that break.”
She is currently working with her chaplain to offer monthly “wellness debriefs,” sessions for clinical staff to chat with each other, their resident chaplain Patrick Duffy and a SpringHealth counselor, without the presence of management. Brenda updates Patrick beforehand of the events that have happened on the unit within the last month, such as a patient death or staff celebration, to give them some background on the vibe of the unit.
“I just think that if we can connect as human beings that we make a better work environment,” Brenda said. “So I’ve always been very passionate about retention activities and providing opportunities for people to connect.”
When asked what she herself does to “tap out,” she explained that she is cared for each day by her team. Brenda’s dedication to them came back to her in manifold expressions of support in her own time of need when her husband passed unexpectedly from COVID-19 two years ago.
“I cannot tell you how amazing the staff was. They rallied around me,” she said. “I would just walk in, and some days, there’d be something on my desk or something on this table, and it was just amazing. I honestly get taken care of every day when I come in here, because they’re so amazing.
“And I don't take it for granted. Because I don’t think everybody works in an environment like that.”