Sheelu Joseph, BSN, RN, CCRN, is the clinical manager of the cardiovascular intensive care unit (ICU) and a central telemetry unit at Houston Methodist Willowbrook Hospital, a Magnet-recognized health care facility that is part of the Houston Methodist Health System. The ICU has four dedicated beds for intensive care patients and 12 stepdown beds with a patient population comprised mainly of open heart surgical patients and stepdown patients who have cardiac diseases. The central telemetry unit monitors cardiac rhythms for patients on telemetry monitors throughout the hospital.
Joining Houston Methodist Willowbrook Hospital shortly after the hospital opened in December 2000, Sheelu worked first in the neurosurgical ICU and then as a charge nurse in critical care before becoming clinical manager. She’s been in this position for almost two years.
Sheelu is involved in everything that goes on in her unit—from staffing to daily nursing activities. On a typical day, she reviews staffing needs in the morning, comparing staff assignments with patient acuity and any nursing challenges that are likely to arise. Then the hospital leadership gathers for what they call a “stand up” meeting where they talk about important issues within the hospital, areas where help may be required, and any special challenges for the day. After the meeting, Sheelu returns to her unit to participate in multidisciplinary rounding. Sheelu represents the nursing staff on several hospital-wide committees, so some days are heavy with meetings. Then there’s a mid-shift huddle at 1 pm. “That’s when we talk about nursing priorities on the unit that day,” she says. All of the nurses get together to review how many patients they have, how many are being admitted, how many are discharging, who is a fall risk, and which nurses have a heavier assignment and may need help, among many other topics. And, of course, a typical day includes a lot of paperwork.
A Model of Motivation and Quality Care
Sheelu’s motivation, devotion to quality patient care, and nursing leadership skills have been noticed by her coworkers. One of them was Anita Farr, the director of the hospital’s Laboratory Department who nominated Sheelu for the Validator Award.
Sheelu worked with Anita on a hospital-wide committee to reduce mislabeled and misidentified specimens. In researching the causes for these errors, Sheelu found that sometimes armbands were not checked properly or extra labels were left inside the specimen bag. She worked with the committee to propose initiatives and create a checklist to prevent future errors. In collaboration with Wendi Froedge, a critical care educator, Sheelu proposed initiatives and developed a checklist to create a heightened awareness among nurses and prevent future errors. This measure was very successful in reducing mislabeled and misidentified errors.
Recognizing Sheelu’s work on this committee and her unique leadership skills, the laboratory director wrote in her nomination: “Sheelu is an outstanding leader as well as a super nurse. She leads her staff and challenges them to be the best. . . . Her unit rarely has an error. She takes the opportunity to use breaks in processes as learning tools for her staff. She holds them accountable for following processes and is always looking for ways to improve the current system. Sheelu does this with an incredibly positive attitude for patients, nurses, and other clinical workers. . . . As a leader, her staff feels that she is approachable and will help them work through all situations. Sheelu is a superhero in all aspects of her job and as a person with high ethical values!”
The nomination reflects the essence of the Validator: Sheelu is a detail-oriented problem solver who is leading the way to quality, excellence, and accreditation. She is, indeed, passionate about quality initiatives. She readily admits that she is a stickler for enforcing nursing protocols, but she believes in a positive, not punitive approach. “I have a very strong team of nurses who really follow the guidelines,” she says. “They take pride in what they do, and they do the right thing.”
She is also a stickler for evidence-based practice. “We need to incorporate research into our nursing care,” she says. The nurses at Houston Methodist Willowbrook Hospital have a Clinical Scholars Club that focuses on evidence-based practices, so there are many research projects underway in the hospital. Sheelu also participates in her unit’s Journal Club to keep up with evidence-based guidelines and how they can be incorporated in nursing interventions. The combination of evidence-based practices and the continuing education opportunities that the hospital provides obviously pays off. Sheelu’s unit has not had a case of ventilator-associated pneumonia in almost 4½ years.
Although Sheelu is grateful to be acknowledged for her work, she believes that every nurse is a hero every day. “We all do so much that is not always recognized,” she says, “and sometimes we go through a lot.”