Nursing at Cheshire Medical Center, 2022

Nursing Report 2022

NURSING at Cheshire Medical Center

Nurses Make a Difference

Cheshire Medical Center Cheshire Medical Center • Nursing Report 2022

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Cheshire nurses focus on all areas of wellness, illness, health, cycles of life and death through their dedication to the timeless work of nursing.

On the cover: Noah Clay, RN Ann Ihekoronye, BSN, RN Els Dignitti, RN-BC Marielle Drew, BSN, RN

Nursing touches the depth of the human experience practice of nursing, present in care, and continually striving to improve the health outcomes for our community.

Cheshire Medical Center’s nursing history goes back 130 years.

In 1892, John Henry Elliot gave his family’s estate to Keene for a public hospital. That same year, a Hospital Aid Society was formed. This organization assisted in furnishing the hospital. And through the donations and labors of the local citizens, the 18-bed hospital was formally opened September 21, 1892.

One year after the hospital opened, a training school for nurses was established.

Cheshire nurses are vital to the organization’s mission. Their ability to positively change patient outcomes is achieved through specialized knowledge that is grounded in science and driven by passion. They serve in key roles within the organizational priorities for our patients, our people, our organization, and our community.

Today, there are more than 500 nurses at Cheshire.. This Nursing Report is a celebration of Cheshire’s nurses—diverse in the specialized 2

Cheshire Medical Center • Nursing Report 2022

Our patients: Nurses provide direct care across the continuum of life and illness. RNs and LPNs provide primary, emergency, peri-operative and surgical ambulatory care as well as oncology, behavioral health, case management and interventional

radiology services. Bedside, they care for patients in our medical-surgical, intensive, labor and delivery, and rehabilitation units. Advanced practice nurses, including CRNAs, RNFAs, CNMs, family medicine and specialty APRNs, provide care in advanced and independently licensed roles.

Our people: Nurses in departments such as Employee Health, Education, Informatics, Infection Prevention, and Leadership support all employees.

Cheshire nurses provide care and compassion with small acts of kindness daily.

Our organization: People are Cheshire’s greatest strength, and nurses are about one-third of our workforce—truly a strong core!

Nourishing and caring for the soul When the Reverend Winnie Skeates, interfaith chaplain at Cheshire, offers the opportunity to pause for a moment of rest and refreshment, she’s always met by a group of grateful staff at the Tea for the Soul cart.

Since 2020, the Tea for the Soul program has offered tea, snacks, and compassion for employees who work directly with patients as well as those who work behind-thescenes. It’s fulfilling and challenging work—and sometimes the challenges lead to stress, anxiety, and burnout.

Through this program, the chaplains remind nurses that it is OK—and very important—for them to take care of their own needs.

Additionally, nurses in risk, quality, utilization review, regulatory compliance, and leadership focus on areas that assure the sustainability of Cheshire Medical Center.

Our community: Diversity of nursing practice at Cheshire assures that nurses will meet our patients wherever they are in need. Collaborative care nurses manage chronic disease for patients at home in our community.

Nurses in ambulatory, acute, and surgical care collaborate across disciplines to improve access to care.

At The Doorway, nurses serve some of our most vulnerable populations and give hope in substance recovery.

Care managers and behavioral health nurses help patients with complex needs navigate community resources.

The Tea for the Soul program is offered at least monthly throughout Cheshire, and is also available when urgent needs exist—like a traumatic event, high census, or when staff are overloaded. It’s also one way to show appreciation for our caregivers while it reminds them to also focus on self-care. 

Cheshire nurses focus on all areas of wellness, illness, health, cycles of life and death through their dedication to the timeless work of nursing. The practice of caring, teaching, comforting, healing, and even grieving touches the depths of human experience. 

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“I wanted to be part of the solution, to be an active part of the COVID prevention task force.”

Els Dignitti, RN-BC

Els Dignitti, RN-BC

Home away from home

Reassigned Cheshire nurses meet the moment during COVID surge Nurses at Cheshire Medical Center show their resourcefulness each and every day, responding to changing scenarios and adapting to new situations to provide the highest quality care for patients. But the recent surge of COVID-positive inpatients requiring intensive care over the winter demanded even more flexibility, as 30 Cheshire nurses were reassigned to other areas of the hospital to help fill staffing gaps and keep patients safe. These reassigned nurses rose to their new challenges with enthusiasm, and many discovered unexpected benefits in these professional pivots.

“It was a very stressful time for everyone in our organization,” says Marielle Drew, BSN, RN, the nurse manager of Specialty Medicine, who was reassigned to an overflow Intensive Care Unit specifically created for acute COVID surge patients. “Many ambulatory medicine nurses were called upon to help during the surge. I had the opportunity to work with nurses from all around the organization, including Family Medicine, Surgical Services, post-anesthesia care, and other areas. It was truly a very unique opportunity, and I saw many nurses completely change their schedules and responsibilities to help.”

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Cheshire Medical Center • Nursing Report 2022

Els Dignitti, RN-BC, had been a care coordinator at the Family Medicine Clinic in Walpole for two years.

She joined in the team effort by transferring to inpatient rehabilitation for three months as part of a Cheshire “staff match” program in response to COVID-related staffing shortages. She also became part of the Cheshire COVID phone line team, working on Saturdays to answer questions and schedule patients for COVID testing. Els even volunteered to work with the state vaccine effort, both at the New Hampshire Motor Speedway in Loudon and Krif Road in Keene.

“I wanted to be part of the solution, to be an active part of the COVID prevention task force,” says Els. “I volunteered and was sent to Inpatient Rehab, as I did not have the hands-on experience to go to an ICU—my background is in psychiatry. Contrary to my own expectations, I loved it from day one. I learned a lot, and I met many amazing people. After I returned to the Walpole Clinic in February, I realized I missed working bedside and started working at inpatient rehab as an ‘official’ staff nurse starting in March.”

Marielle also made a professional shift after being reassigned during COVID and now works an additional per diem position in the ICU.

Jennifer Kelliher, RN, and Marielle Drew, BSN, RN, in the ICU

“I would most likely have not met some incredible nurses if I was not reallocated,” she says. “I learned more in those eight-plus weeks than I think I have learned in the five years I have been a nurse. The ICU nurses and nurse assistants were more than willing to teach us ‘buddies’ as much as they could.”

Jennifer Kelliher, RN, had barely started working at Cheshire, as a float pool nurse for Family Medicine, when the surge hit last winter. She pivoted right away when she was asked to be a “nurse buddy” in the ICU, thanks to her valuable previous experience on a ventilator unit in a large academic center in Massachusetts.

“I just wanted to help,” says Jenn, who worked the night shift with COVID inpatients. “In any way I could, I wanted to help the staff and patients. I met an incredible group of people.

I am thankful for their kindness and the work they do.”

Center has come out stronger and more resilient than ever, thanks to the flexibility demonstrated by staff.

“The incredible teamwork that was displayed while being reallocated truly provides an example of what it should be like to work in health care,” says Marielle. “I never felt alone and always felt supported—I still do.”

Jenn says that her favorite thing about working at Cheshire is the staff. “ALL of the staff. They truly care about the people in the community.”

Els adds, “I love being part of the local health care community.

I am proud to play an active role in keeping this a healthy place to live, and very much enjoy working here.” 

Whether nursing staff found new professional horizons during their COVID surge reassignments or just gained some new experiences and skills, many found a renewed appreciation for the diverse and dedicated team at Cheshire and the quality of care they provide. Despite workforce shortages and the difficulties of navigating the pandemic over the past two years, the Medical Cheshire Medical Center • Nursing Report 2022

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Growing and thriving at Cheshire A native of Keene, Ashley Copeland, RN, was in the pre-med program at Wheaton College, in Massachusetts, when she volunteered at Cheshire Medical Center over the summer before her senior year. She knew she would work in health care, but it was this volunteer experience in the post-anesthesia recovery room that convinced her she wanted to be a registered nurse (RN).

“The compassion the nurses showed and the care they provided to the patients here at Cheshire impressed me—and motivated me,” says Ashley, who went on to the master’s program in nursing at University of New Hampshire. She felt fortunate to be placed in the Cancer Center at Cheshire for a clinical rotation while in nursing school. “This clinical opportunity was so wonderful that I decided I wanted to work at Cheshire when I graduated.”

Ashley started as a new graduate nurse in the operating room—and has worked at Cheshire for 13 years now in a variety of different roles: operating room nurse, administrative clinical supervisor, professional development nurse educator, and currently nurse manager for the pre-operative department.

“I share an office with the nurse manager who allowed me to volunteer in the post-anesthesia care unit (PACU) as a college student,” she says.

“I find nursing at Cheshire to be an incredibly rewarding profession with many opportunities and paths.”

The number one reason Ashley loves her job is the people she works with.

“So many people are friendly, helpful, genuinely willing to do the right thing for our patients and community.

People greet each other in hallways by name, help each other clean snow off cars in a blizzard, and generally hold a certain kind of integrity that is not often seen in other places.”

When she is not nursing, Ashley likes spending time outside with her family and friends. Her husband and two daughters enjoy being out on their boat in the summers, on the local lakes and river. She also works as an

There are a variety of nursing roles at Cheshire Nurses at Cheshire Medical Center are found in almost every department, from every aspect of patient care to specialized roles outside of patient care, and are leaders at every level of the organization.

Each nurse brings specific strengths, passions, and expertise to health care.

We seek deeply compassionate, highly skilled nursing professionals to join our community.

Licensed Practical Nurse: Clinic, Ambulatory Informatics Procedural Specialist Inpatient Operating Room Scrub Workforce Development Instructor

Advance Practice Registered Nurse: Hospital Medicine Midwifery Clinic, Ambulatory Surgery Inpatient Psych Services

Registered Nurse: Baylor (weekends only) Behavioral Health Specialist Cardiology Procedures Case Manager Childbirth Educator Ambulatory, Clinic Clinical Documentation Specialist Clinical Informatics Critical Care & Emergency Services Device Specialist The Doorway Ear, Nose, & Throat (ENT) Therapy Consultant Employee Health First Assist, Operating Room

Nurses at Cheshire hold positions of leadership in areas such as: Accreditation & Regulation Compliance Leader Administrative Clinical Supervisor Ambulatory Services Nurse Manager

Learn more at www.cheshiremed.org/careers/nursing-cheshire

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Cheshire Medical Center • Nursing Report 2022

‘I matter more here’ Cheshire nurse comes home adjunct professor in the Keene State nursing program.

“I love caring for the people of my community,” she says. “Having surgery can be very anxietyprovoking, and it gives me great joy to be able to comfort community members during the pre-operative phase of care. It makes my day when I can ease the fears of a parent as their child is headed into surgery or reduce the discomfort of a waiting patient. Sometimes the patient is even a familiar face—a friend or family member.” 

Float Health Care Coordinator Infection Preventionist Inpatient Lactation Consultant MOAB RN Instructor Nurse Educator Patient Care Coordinator Quality Assurance Data Abstractor Radiology Risk Management & Quality Assurance Specialist Sexual Assault Nurse Examiner Workforce Development Instructor

Clinical Practice and Education Critical Care & Emergency Services Informatics Inpatient Services Kingsbury Cancer Care Quality Assurance and Safety Surgical Services

“Sometimes patients just need someone to talk to, and I am a very chatty person,” says Darby Demoura. She is an RN who currently works the night shift at Cheshire Medical Center’s Thompson Unit, a progressive care unit where many acutely ill COVID patients received care in recent years. “I actually feel like I am helping people here at Cheshire. I matter more here.”

me boost a patient up and she would look at me like I had seven heads. Here at Cheshire all you have to say is ‘hey can anyone help,’ and four people will jump up and help you out.”

When she is not helping patients at Cheshire, Darby likes spending time with her husband, reading, listening to music, and watching TV, although she avoids medical shows. She has a 1-year-old golden retriever, so fortunately she also likes throwing tennis balls endlessly. She looks forward to moving back to the day shift, so she is not sleeping through all the fine spring and summer weather.

Darby first started at Cheshire in 2018, just a year after finishing nursing school at Keene State College. She chose Cheshire because she was still living in Keene, so it was closer to home, but there were many other perks. She appreciates the culture of the place.

“I’m so glad to be back with patients.

“I have very much enjoyed my time At the nursing facility I never felt at Cheshire,” she says. “The crew like what I did was important—like here is very good to work with, it affected anyone directly. I make and everyone is very friendly and more of a difference working approachable. There’s a great sense with patients at Cheshire, even of teamwork—always somebody if it is only relieving someone’s there to help, and coworkers will anxiety or loneliness. I try to have go the extra mile to make your shift conversations with people as people, go better.” not patients.”  After about two years at Cheshire, Darby tried working at a nearby nursing facility. Her husband was taking a job there and she accepted a nurse-education position that she thought would offer a good opportunity for advancement. But she didn’t enjoy working at a desk, or other negative aspects that she felt were part of the administration there, so she left after six months.

“I didn’t like being away from bedside,” says Darby. Although she misses commuting with her husband, she does not miss the culture of “petty drama.” “ I would ask a nurse to help

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Ambulatory care coordinators bring it all home The transitional care model at Cheshire Medical Center follows each patient throughout their care continuum to prevent health complications and ensure a comprehensive and safe discharge plan.

But it doesn’t stop there. Cheshire is fortunate to have a small but mighty group of ambulatory care coordinators who ensure tight follow-up appointments, education, and communication for continued care management in the community, decreasing the risk of re-hospitalization.

“Ambulatory care is a vital piece of the continuum of care. We are a patient’s resource once they are discharged,” says Kate Dexter, BSN, RN, ACM-RN, a nurse care coordinator for Family Medicine. Kate works with patients to navigate crucial transitions and help them understand how to manage their symptoms, so they can feel their best and stay as independent as possible in their homes. “Sometimes people don’t know who to turn to once they are home, and it can be overwhelming to no longer have the hospital staff to care for them. Care coordinators provide the follow up and give patients and caregivers a lifeline to call with any questions or concerns.”

Susan Szydlo, RN, another nurse care coordinator for Family Medicine says, “When I was nursing in the 1980s, a patient who had a knee replaced would stay in the hospital for up to seven days.

Now they stay overnight, and are often discharged with drains, complicated wounds and incisions.

They need ongoing testing, physical therapy, and other care coordination. Ambulatory care is vital in supporting a successful recovery, or supporting the ongoing management of chronic disease.”

The transitional care model is a team-based approach to a patient’s care, and at the core of its success are the dedicated, compassionate, and experienced care coordinators who constantly advocate for their

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Cheshire Medical Center • Nursing Report 2022

Susan Szydlo, RN, and Kate Dexter, BSN, RN, ACM-RN

patients. By connecting patients with services in the region, the ambulatory care coordinators daily reinforce the need for Cheshire and other local resources to work together, providing care not as a single entity but as a community.

“I absolutely love that I work for a community hospital, not a huge organization,” says Susan. “It is the intimacy of a small hospital like Cheshire Medical Center, knowing my coworkers throughout the hospital, knowing my patients and the trust they place in me. That is the best part of working at Cheshire—I can make a difference.”

Kate adds, “Each day brings something different and it is so satisfying to know the impact we make on patients’ and families’ lives.” 

Not all heroes wear capes, not all nurses wear scrubs While Cheshire Medical Center does boast scrub-wearing superheroes among our nursing ranks, many nurses report to work wearing “normal” clothes—and all sorts of different hats. Their roles often draw from their clinical background but demand other specializations and nuanced skill sets. While they aren’t bedside like other nurses, they are still integral to ensuring our patients receive quality care at Cheshire.

Angie LeFebvre, MSN, BSN, RN, accreditation and regulatory compliance leader, says her work is foundationally linked to patient safety. “Every regulation, every rule, is grounded in evidence and best practice. By assuring adherence to these rules, we can confidently say that we are giving the best possible care. It’s nice to know that my work is directly tied to patient outcomes.”

Patient outcomes are also directly tied to the work of Ellen Loughney, BSN, RN,

Angie LeFebvre, MSN, BSN, RN

who specializes in quality and patient safety. “Nurses in this specialty help make care safer for our patients, and our work helps prevent errors and harm,” says Ellen. “My favorite part of my work is working together with staff to identify and implement changes that have made care safer and helped prevent patient harm.

I have the ability to be part of positive change and make things better.”

Deb Chamberlain, MSN, RN, works in Nursing Informatics, which she says combines the knowledge and wisdom of nurses with computers, technology, and health information. “Informatics supports our frontline clinicians in the use of our electronic tools, bridging the gap between clinicians and IT,” she says. “It improves communication among health care professionals by providing accurate information about their patients, which lets them make the best decisions for treatment.”

Deb Chamberlain, MSN, RN

Like all nurses, those in “scrubless” specialties have found a special place for their important work at Cheshire.

Ellen says, “The best part of working at Cheshire is the staff in other areas, who don’t have ‘patient safety’ in their job title, yet believe that patient safety is a core part of their job. I also appreciate the amazing, supportive co-workers in my department—every day, I am grateful to work alongside them.”

Angie agrees that Cheshire’s strength is the people. “Cheshire Medical Center is small enough that we know each other and understand how each of our roles contributes to the bigger picture and how our work affects our patients,” she says. 

Ellen Loughney, BSN, RN Cheshire Medical Center • Nursing Report 2022

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Our Circle of Gratitude program gives patients and their families a special way to share their heartfelt appreciation for exceptional and compassionate care. Not only is it inspiring for staff to be honored, it is also healing for our patients. This past year, over 40% of honorees were nursing staff—thank you for all that you do!

Scott Aldrich, RN Alicia Bedard, RN Christa Bond, RN Joan Brown, RN Kristen Burnett, RN Currier Carter, APRN Erin Ciancetta, LNA Jenna Clark, APRN Marissa Cyganiewicz, RN Cathy Dailey, RN Laura Eno-Kennell, LPN Allison Etzweiler, RN Brooke Garger, APRN (2) Lisa Hanamoto, RN Miles Harris, RN Deborah Jacques, RN Margaret Kelly, APRN Katrina Masure, APRN (2) Jodi Mattson, LPN Alison Poulin, RN Kin Rilling, RN Gabrielle Schuerman, APRN Calvin Seppala, RN Adrienne Simpson, RN Ellen Slocum, LPN John Starkey, RN Michelle Stockton, RN Kelsey Trombley, RN Sherrie Tyler, RN Teagan Valeski, RN Stephanie Vose, RN Kristen Walker, RN Teresa Woodside, APRN Victoria Zimmerman, RN *Please note that this list is accurate to the best of our knowledge. We apologize if your name was accidentally omitted from the list of honorees.

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Cheshire Medical Center • Nursing Report 2022

Scott Aldrich, RN

Administrative Clinical Supervisor, used to work in the Float Pool. At times, he’ll still step in when there is a need for coverage on the floor.

For one of his patients, it was the small things that made all the difference:

“I appreciate Scott’s

Katrina Masure, APRN

Family Medicine – Walpole, has been honored twice in the past year through the Circle of Gratitude. One of those grateful patients wrote:

helpfulness in giving

“Katrina is a very

me caring attention,

kind and wonderful

promptly responding

health care provider.

to my requests, and

My 90-year old

locating glasses for

mother loves her…we

me to use. I’ll never

need more Katrinas in

forget his kindness.”

the health system!”

To view the full list of Circle of Gratitude honorees please visit: www.cheshirehealthfoundation.org/circle-of-gratitude-honorees

THANK YOU TO ALL OUR NURSES,

YOU MAKE A DIFFERENCE Cheshire Medical Center • Nursing Report 2022

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Nursing Report 2022

580 Court Street, Keene, NH 03431 | 603-354-5400 | cheshiremed.org

Cheshire Medical Center 12

Cheshire Medical Center • Nursing Report 2022