Samantha Pagliara, RN, is all about doing her best. What makes her exceptional is her extraordinary desire to give back and make a difference. Known on her unit as Nurse Sam, her coworkers see her as their go-to person. When something needs to be done, they often turn to her. She’s flattered by the faith they have in her. Sam’s goal is always to go above and beyond. “The day that I settle for mediocrity,” she says “is the day that I need to find another job.”
Sam has been a pediatric nurse for 15 years. She has been at the University of Florida Health Shands Children’s Hospital in Gainesville, Fla., for almost nine years. Because of her experience, she is frequently called on to help orient other nurses and students to the floor. One aspect of nursing that she always stresses is compassion. She experienced a lack of compassion when her young son had to have eye surgeries every five weeks for more than a year, and she doesn’t want other parents to ever endure such negative experiences. “You have to understand that every patient has a story, and every patient means something to someone else,” she says. “You can’t just be task-oriented.”
Sam was just a child herself when she began to think about nursing as a career. When she was nine years old, her youngest sister became ill just after she was born. Sam wanted to help care for her. “I’ve always been a nurturer,” she says. Later, she worked as a nursing assistant and also provided home health care. She has been committed to nursing ever since.
Sam was also influenced by her mother, a school teacher and single mother. Despite tight finances, Sam’s mother always found a way to put a little money aside so she could bring snacks, pencils, and other small necessities to school for students who needed them. “She taught me how to give back and to always go the extra mile,” Sam reflects. “It’s not just about doing the job. It’s about making a difference.”
Sam earned an associate degree in nursing, graduating in 1992. For the next two years, she worked in the neonatal intensive care unit. Then, after a year off when her son was born, she returned to nursing as a pediatric nurse. From the start, Sam fell in love with the pediatric patient population. “Children are amazing,” she says. “They are so resilient, and they love you no matter what.”
Rallying the Nursing Staff
In caring for her patients, Sam was aware that the hospital needed a pediatric sedation team. Children on the pediatric units often require invasive procedures that are painful and anxiety producing, resulting in an experience that can be extremely traumatic for toddlers and young children. If a child could undergo the procedure under sedation, he would be spared a great deal of stress. Without a sedation team, however, the child would have to be transported to the operating room or interventional radiology, which meant significant added cost and more emotional trauma. With a sedation team, many of these procedures could be performed on the unit—in many cases, in the patient’s own bed with the parents present— in a more cost-effective, comforting way. Research supports procedural sedation. It offers less chance of injury, and the procedure is more effective if it is performed when the child is comfortable.
Sam knew that this was the best practice for minimizing anxiety and improving outcomes. Moreover, she was willing to do something about it. She rallied the nursing staff, nurse educators and managers, clinical coordinators, and physicians to develop tools and schedules. Together, they put together a formula for light sedation that allows a quick recovery. She enlisted nurses who were willing to take call to cover the interventions and lined up physicians who were licensed to administer the medications. A nurse to monitor the patient along with a physician who could perform the procedure had to be available at the same time, so scheduling was a challenge. Sam also wrote an entirely new protocol for procedural sedation. When nursing management reviewed her plan, it was clear that there could be only one response: they approved a pilot. The protocol has worked so well that it is now being used on all of the pediatric floors throughout the hospital.
What’s Best for the Patient
Writing this new protocol is just one example of what Sam does for her patients. That’s why her nurse managers, Laura Bratcher and John Stephens, nominated her for the Superheroes of Nursing Achiever Award. The Achiever is the talented multi-tasker with seemingly endless knowledge and skills who always keeps an eye on what’s most important: patient care. In the nomination, Laura and John wrote: “When Sam sees something that is important, she rallies her coworkers at the bedside, does the literature searches, develops the procedures, and educates the staff. Her number one goal is to do what is best for the patient. If she can ease any pain or make any hospital stay less stressful, she will. She does this all the time.”
Sam learned that she had won the award on her birthday. “It was a wonderful gift,” she says, but she seems to get the greatest reward from knowing that she did the best she could. “When I put my head on my pillow at night, I know that the child I cared for knows that I will come back the next day and make sure that he is all right,” she says. “I’m grateful for that.”