Jo Barratt, RN, BSN
Acute Care for Elders Unit

Background

I received my degree from SUNY Brockport, NY, in 1977. After college, I worked in a supervisory position in long-term care and rehab facility. I came to Highland because I wanted more variety and more day-to-day contact with patients. I am considering going for my Master’s degree. 

Time at Highland Hospital

I’ve been here since 2001.

Career Path at Highland Hospital

I started on the ACE unit. It’s a great place to work. Highland’s small enough that you get to meet people from all areas but large enough that you can get to where you want to be. There are lots of opportunities here, one of which was the help to become certified in geriatrics.

My Dominant Personality Traits

I think my main virtue is patience. I really like older people—the feistier the better! I put my all into my work and try to give 110 percent. Geriatrics is challenging and intellectually rigorous. Being somewhat stubborn serves me well. I don’t jump ship when the going gets tough. I love variety, too. My job gives me the opportunity to teach nursing students and help newer staff with professional development. That, combined with patient care, makes my job so satisfying. It makes my heart feel good to go home and know I did everything I could.    

About the Acute Care for Elders Unit

Our patients can be very vulnerable. Many are frail and some are confused. Most of them have a complex combination of acute and chronic conditions. We have to keep track of multiple diagnoses, a litany of test results and combinations of several medications for each patient. Also, with older patients, the key is to prevent functional decline. Older patients who stay in bed rapidly lose muscle mass and function. We have to get them moving quickly and enable them to resume as many activities of daily living as possible. This means we’re a very busy unit.

The ACE model of care focuses on identifying geriatric syndromes and treating them early. We have to be ready to take remedial action before a crisis requires it. Special emphasis is placed on assessment of the presence of pain, mental status, skin integrity, elimination, diet, and mobility. Treating pain appropriately is a fine art for us. We need to keep our patients comfortable enough to encourage mobility and, at the same time, make sure a painkiller doesn’t trigger delirium. Older adults often don’t have the typical signs and symptoms that a younger person would so we have to be thoroughly familiar with atypical presentations. More and more surgical interventions are being done on an increasingly elder population so our post-op skills have to be top notch. 

We have a very respectful workplace. Our team works together to help ensure that everyone is coordinating their efforts. There’s tremendous staff loyalty to the unit’s mission and that builds team cohesiveness. We put the needs of our clients at the top of our agenda. The physicians are very, very approachable and listen to us. They ask for our opinions. I think we have more say in patient care than is typical in many hospitals.

My passion for geriatric nursing continues to deepen here. My patients help me define my own attitudes and expectations about aging. They help me appreciate what a gift life is.

Jericho Banker, RN, BSN
Nurse Leader, Unit Educator

Background

I received my Associates in Applied Science degree from Finger Lakes Community College, Canandaigua, NY, in 2000, and my BSN from St. John Fisher, Rochester, NY, in 2007. I'm currently working on my MSN in the FNP program at St. John Fisher.

I started my career in Cardiopulmonary stepdown. I worked in sub-acute rehab in a long-term care facility for several years and was a nurse manager for a year. I returned to Highland to work in acute medicine with a geriatric focus.

Time at Highland Hospital

I've been at Highland since 2004. I chose to come here because I wanted to work towards my Master's degree and I knew they offered tuition reimbursement. I'm staying because I love Highland. They have good benefits and a nice clinical ladder program. It's small so everyone knows each other and it's easy to see how the entire organization runs. Last, but not least, I wanted to work with the elderly and Highland is a NICHE hospital (Nurses Improving Care for Health System Elders). It is in my opinion that it's the best hospital in Rochester for elder care. My goal for the future is to be a Family Nurse Practitioner, but I still hope to work in Geriatrics.

Career Path at Highland Hospital

I started on the W5 Cardiac Unit. I've been with the ACE Unit since 2004.

My Dominant Personality Traits

I like people and I'm calm. Patients pick up on both and I think it makes them feel better. I also take on a leadership role when I'm not doing education and feel I have the ability to prioritize and see "the big picture." There's lots of competition for my time, but I think my patients know they're my top priority because, when I'm with them, they get my undivided attention. I have a lot of patience so I'm well suited to being an educator and a motivator. I believe that working as a nurse allows us to learn something new every day. That's why I enjoy being the staff educator. It's important to me to encourage the staff to embrace learning opportunities and change. I go in with the attitude that my job is never boring.

About the ACE Unit

Most of our patients are geriatric with a multitude of medical problems and co-morbidities. We occasionally have a younger patient but our staff is trained to understand the complex needs of an elderly patient. We see a lot of respiratory illness, some cardiac since we have telemetry, GI problems, and even some not-so-common disease processes. What makes our unit so unique is that our population has special needs. In addition to having an acute illness, elderly patients often have an extensive medical history, and may experience delirium when they are hospitalized. What happens to a geriatric patient when they are sick is very different than what happens to a young person. Geriatric patients can decompensate very quickly when they are hospitalized with an illness. The staff here recognize this, and we do our very best to take steps in getting them back to their baseline. 

We have a wonderful staff of geriatricians and work closely with Physical and Occupational Therapy as well as Social Work, Dietary, and Case Management. It truly requires a multi-disciplinary approach. We often find that there is not just one disease process but many. The patients are often complex, making this a wonderful place to learn. This unit is also unique because there are no other hospitals in Rochester that have an acute unit specifically for the elderly. We have several nurses that are GRN's (geriatric resource nurses) and have completed a program to become credentialed as GRNs. The ACE unit is very challenging, but very enjoyable and rewarding at the same time.