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As many parents can attest, taking a child to get a flu shot or a vaccination of any kind can cause stress, anxiety, and tears. “As children get older, they become more aware and fearful of needles. When this happens, some kids really refuse to get vaccinated or it becomes very stressful, even traumatic,” said Judy Moreno, MSN, RN, CPAN, RN‑BC, Santa Clara perioperative clinical manager. Moreno and colleagues at the Kaiser Permanente Santa Clara Medical Center identified an opportunity to provide the seasonal influenza shot to vulnerable patients between 6 months and 18 years old. They would give them the shot while under anesthesia for planned procedures or surgery, such as gastroenterology diagnostic tests, eye surgery, or dental restoration. Santa Clara is the first Kaiser Permanente facility in Northern California with a flu vaccination program targeting surgical pediatric patients. During this initiative’s inaugural 2023 flu season, 202 patients were inoculated this way. “The impact, so far, has been quite encouraging,” said Greg Neukirchner, MD, pediatric anesthesiologist. He presented the idea to Santa Clara colleagues after learning about perioperative vaccination programs during a Society of Pediatric Anesthesia meeting. Considered a success with young patients at Santa Clara, the program then expanded to offer the vaccine to developmentally challenged adults. The benefits “The benefit of administering the flu shot while under anesthesia is it’s done seamlessly during a planned event,” said Moreno. “It’s really a non‑event for the patient.” During a patient’s pre‑op appointment, the medical team informs the parent or guardian of the option to receive the flu shot during the procedure, and the day of, they can opt‑in to receive the shot. “We have received a lot of positive feedback from many families, with especially positive responses for those patients with either needle phobia or disabilities where interactions in a health care setting is stressful,” said Neukirchner. “It’s a lot less stress on everyone, and they can receive the optimal preventive care they deserve.” The program captures children who are at more at risk for complications associated with flu. “It’s an important opportunity to protect this population, as many of them are at greater risk because of other health concerns,” explained Moreno. “The more children we can vaccinate, the healthier our communities are.” A best practice The Centers for Disease Control and the American Academy of Pediatrics both recommend providing the influenza vaccine to children and teenagers while under anesthesia for a surgery. With preparations underway for the 2024 flu season, the Santa Clara team hopes to exceed last year’s vaccination numbers. They seek to share their learnings and best practices with colleagues at other Kaiser Permanente facilities. Moreno and colleagues will present a poster at the Kaiser Permanente National Nursing Conference in September.

"Dr. Palacios is a national leader in birth equity and an excellent clinician and educator of obstetrics-gynecologist residents," said Neet Arant, PhD, CNM, MS, Certified Nurse Midwife.  Janelle Palacios, PhD, CNM, MSN, RN, is a Certified Nurse Midwife at the Kaiser Permanente Oakland Medical Center, a nurse researcher, and a 13-year Kaiser Permanente employee. Inspiration for Nursing "In my home community, the Flathead Indian Reservation in Montana, I witnessed family members and friends become parents at a young age because of circumstances, limited life opportunities, and oppression inherited from intergenerational trauma. I saw the need to care for families holistically and found nurse midwifery, research, and health policy advocacy to be the path to promote healing and wellness," said Palacios. "My nursing colleagues inspire me with their passion for supporting families during childbirth and beyond. Supporting families during a pivotal time is not limited to the moments of care but includes the work leading to those care moments my treasured colleagues participate in, such as reviewing internal data and fostering multidisciplinary collaboration," said Palacios. Leading with Purpose “Janelle's leadership style is not about individual achievements but our team’s collective strength. She believes in framing her work with the words 'we' and 'us,' ensuring inclusivity and shared responsibility, said Arant. Palacios is deeply committed to improving maternal and child health outcomes in Kaiser Permanente's Oakland Medical Center and all hospitals nationwide. "She regularly engages with high-level government officials, sharing her insights on the experiences of American Indian women in the birthing and women's health space, plus discussing how to enhance maternal health outcomes for all families," said Arant. Delivering Care Excellence Palacios is the East Bay's chair of the supporting vaginal birth team, a team dedicated to improving vaginal delivery rates at the Kaiser Permanente Oakland Medical Center to align with California's standards. “Since becoming chair, the team has implemented multidisciplinary unit culture changes, such as team rounding, warm hand-off meetings with patients and their care team, and messaging campaigns embracing increased nursing skills," said Arant. As a researcher, Palacios mentors obstetrician-gynecologist residents, assisting them in conducting research studies and submitting them for internal review and is currently the primary investigator of the nation’s largest study evaluating morphine rest in early labor. Her role as a nurse midwife influences Janelle’s perspective on labor management. She considers the whole person in relation to their labor status and the baby to identify interventions for optimal delivery outcomes and experiences. "I am honored to be a nurse midwife clinician, educator, and researcher in an environment that embraces and allows me to flourish. I am thankful for my colleagues in the Labor and Delivery Unit at Kaiser Permanente,” declared Palacios.  

A day with horses reminds nurse leaders to breathe and cultivate self-awareness. Pictured, nurse leaders and horse therapy facilitators get in tune with horse energy during a silent meditation at The Pony Express ranch near Santa Rosa, California.

“See one, do one, teach one,” is a philosophy guiding labor and delivery nurse Jenna Ricks‑Cosens, MSN, RN, PHN. Ricks-Cosens was among a group of 5 Kaiser Permanente Roseville Medical Center team members, including another nurse, a midwife and two physicians, who traveled to Sierra Leone in May to train local health care providers. The Kaiser Permanente care team was led by Joanie Seacrist, CNM, a Roseville certified nurse midwife and founder of Hawa’s Hope, an organization created to help promote safe birth in Sierra Leone, which has one of the highest maternal mortality rates in West Africa according to the World Health Organization. The cost of the teaching materials for the trip was sponsored by nurse leaders at the Roseville Medical Center. The team shared their vast knowledge and years of clinical expertise in a series of lectures, and hands‑on skills and simulation trainings at midwifery schools on topics including team communication, how to protect the health of an expectant mom, and complications which can arise during pregnancy and childbirth such as hypertension, sepsis, hemorrhaging, and obstructed labor. “We had them practice as if they were providing real patient care by walking through a scenario that escalated or became emergent,” said Jane Jach, MSN, RN, PHN, RNC‑OB, EBP‑C, nursing professional development specialist. “They were able to practice hands‑on, real‑time responses and develop their muscle memory for critical thinking.” “With each trip we are working towards capacity building,” added Seacrist. “I could go and deliver 100 babies, but I can also go and train 100 midwives.” Empowering care + measuring impact Hands‑on training is their secret sauce, according to Janel Crawford, MD, Roseville OB/GYN, and co‑director for Hawa’s Hope. “People and companies like to donate equipment and other things, but nobody gives them any training on how to use it, or the teachers on how to teach it. And so, it just sits there.” “If you can teach people, then there’s a ripple effect and they teach others,” said Andrea Sherman, MD, OB/GYN. Initially planning to deliver their workshops to about 200 people, they ended up with nearly 300 participants at a handful of midwifery schools, and accommodated a group of physician residents who heard they were in town. To assess how well they were able to reach the goals teaching the midwives, they administered tests before and after each workshop. Overall, they saw a 13.6% increase in knowledge. A rewarding experience “The joy and resilience of midwives there was palpable despite the adversity and the conditions they are working in,” shared Jach. “The experience helped solidify my own nursing knowledge and bettered my practice,” said Ricks‑Cosens. “Going into a different country and having to pull yourself out of your own life and putting your own bias aside, it gave me a whole new perspective.” “I honestly walked away from this experience really knowing in my heart we’ve saved women even though we didn’t directly touch any patients,” added Sherman.

"Rob is a one-of-a-kind human being who is truly dedicated to his work, team, and the department," said Dionne Weadon, MSN, RN, Service Director, Anesthesiology-Inpatient department, Sacramento Medical Center. Robert "Rob" Galli is the senior staff assistant in the Anesthesiology-Inpatient department at the Kaiser Permanente Sacramento Medical Center and is a 26-year Kaiser Permanente employee. Inspiration for Health Care Galli's connection to Kaiser Permanente is deeply rooted. "I grew up in Sacramento as a Kaiser Permanente member, and my brother was born at the Medical Center on Morse Avenue," said Galli. This shared history with Kaiser Permanente as an organization, coupled with the encouragement of a close friend who was a Kaiser Permanente employee, led Robert to apply for a job, beginning his journey with the organization. His colleagues also inspire him: "The professionalism of our nurses and physicians inspires me. Their knowledge of the anesthesia practice and commitment to our patients is commendable. Sacramento Anesthesiology has a fantastic group of providers, and I am proud to be part of the team." Leading with Purpose "Leading with purpose means leading by example. I try to remain true to myself and my core beliefs. I enjoy helping those around me and treating all people with dignity and respect," said Galli. Galli's leadership is evident in his actions. "He often arranges his time off to ensure the department is not left without administrative/staffing support. His reliability, effectiveness, creativity, hard work, and passion for his work and the team are all testaments to his leadership qualities," said Weadon. Delivering Care Excellence "My purpose is to be a high performer at work for the good of the department, for our staff and patients, and to uphold my standards of excellence. I take pride in showing up to work every day and caring for the people I have the privilege to serve," said Galli. Galli's adaptability and willingness to learn are also noteworthy. “When I became department chief, I suggested modifying our daily scheduling to make it easier to access Kaiser Permanente's intranet. Despite this change affecting his workflow, he was 100% onboard. He quickly learned the new system and jumped right in, making our daily work much easier,” said Weadon. “Rob's dedication is also evident in his behind-the-scenes contributions. He assists with all the administrative tasks for our Certified Registered Nurse Anesthetists, including scheduling, approving timecards, and assisting with payroll,” said Weadon. “I appreciate Rob more than words could ever express and he has been there for the team through challenging times. He has a great attitude and is appreciated by everyone in the department,” added Weadon.  

“When I think what it means to be a nurse, Sherri stands out as a bright star amongst her peers,” said Michelle Braskat, RN, Senior Manager, Appointment and Advice Care Center (AACC), who nominated her colleague for the honor. Sherri Shaw, RN, was named a 2024 Extraordinary Nurse for the Appointment and Advice Care Centers. She is a 26-year Kaiser Permanente employee and staff nurse III based out of the Vallejo AACC. Inspiration for Nursing Shaw recalls a desire to want to help people from a young age. “In kindergarten, I started saying I was going to be a nurse,” shared Shaw. “I've always been inclined to want to do something for somebody whether I know them or not.” Today, Shaw is inspired by the nature of her role as a AACC nurse. “You never know what's going to be on the other line and that's what makes it so fun and keeps you inspired. When you're done with one call, you have no clue what the next call is, what they're going to need and how you're going to help them,” she said. Leading with purpose “My purpose is to make a difference,” said Shaw. “When you make a difference in someone's life, it gives you meaning in your life. You feel like you're on earth or you're present in this moment for that reason.” Shaw believes that even the smallest of things can make a big difference in the lives of Kaiser Permanente members. “As soon as I come into my office and put my headset on to start taking calls, I am looking for a way to help whoever it is on the other line and provide whatever they need the best that I can,” she said. Delivering care excellence “Sherri is an expert OB/GYN nurse, consistently provides high quality exceptional patient care and is a role model to her peers,” said Braskat. “She possesses many leadership characteristics, including courage, respect and self-awareness.” “She makes a positive impact on the lives of the patients she cares for in her daily work as an advice nurse, and indirectly as a leader in the AACC committees and groups she serves,” added Braskat. Her leadership and expertise are valued by the AACC team. Working together as co-chairs of Vallejo AACC Nurse Quality Forum, Braskat called out Shaw’s efforts to update RN protocols.  “Several of the recommendations resulted in beneficial revisions to the protocol, the most used in the Vallejo call center.  Sherri makes sound recommendations in her various committee roles.”

Aron King, MS, RN, says volunteering with the Capitol City Black Nurses Association (CCBNA) gives purpose to his life. “I see the work we are doing is making a difference,” he said. King, an Assistant Nurse Manager on the 2nd-floor telemetry unit of the Roseville Medical Center, and his colleague Carter Todd, MS, MBA, RN, NE‑BC, CCRN, Nurse Manager of the Float Pool, PICC, Transport and Wound Care teams, were presented the Founders Spirit Award at the recent National Black Nurses Association (NBNA) annual conference. While Todd says he doesn’t do this work for the recognition he acknowledges that receiving the award “is validation we are doing the right work.” After founding the chapter in 2018 alongside South Sacramento's Sheree Criner, MS, RN-BC, Todd was part of the NBNA Board of Directors. He now serves as the treasurer while King, who joined in 2019, is the historian. Todd and King were recognized for their outstanding work and leadership of the CCBNA, and their impact in the greater Sacramento area. Their team has helped build the local group from 12 to over 100 nurses and has provided scholarships to Black nurses over the past four years, with $20,000 awarded in 2024, and an additional $30,000 pledged for 2025.  “We want to inform, educate, and empower the Black community so that we see more representation in nursing and leadership positions,” said Todd. To help make that happen, Todd and King have helped lead local programs such as Breaking Down Barriers to Nursing and Barbershop Health Talk to build community among Black nurses and increase diversity in the profession. “I am so proud of Aron and Carter. They are so deserving of the Founders Award for the outstanding work they do with the Capitol City Black Nurses Association,” said Debbie Reitter, DNP, RN, CNS, NEA-BC, Roseville’s Chief Nurse Executive. “They truly live out Kaiser Permanente’s mission to improve the health and well-being of our members and the communities we serve.”

"Rachel led our facility's Magnet journey, giving nurses the voice to contribute to shared decision-making, empowering us to create change, supporting our academic advancements, and helping us become leaders who will influence quality patient care," said Assistant Nurse Manager Kacee Clyne, MSN, RN, CNML, NE-BC, CNL, GERO-BC, CCRN, PHN. A 6-year Kaiser Permanente employee, Rachel Wyatt, DNP, MHA, RN, NEA-BC, was named a 2024 Extraordinary Nurse, Kaiser Foundation Hospitals Leader of the Year and is widely recognized for her leadership as the Chief Nurse Executive at the South Sacramento Medical Center. Additionally, she serves as Interim Chief Operating Officer at the medical center. Inspiration for Nursing "As a teenager, I worked as an office assistant for a hospitalist. I was curious and wanted to do more than manage the doctor's schedule. After seeing my desire to be an active part of the care team, the office manager tapped me on the shoulder and said she saw me as a nurse. I am forever grateful for this moment, which steered me to where I am today," explained Wyatt. "The best part of my day is seeing our nurses and teams in action. Our nurses are leading with purpose, and their dedication to advancing the practice of nursing despite external challenges, such as a national nursing shortage, is truly inspiring," said Wyatt. “The inspiration drawn from my team keeps me going. My team’s accomplishments and how they support each other are the heart and soul of their success,” said Wyatt. Leading with Purpose "Rachel has shown tremendous support to our nurses during the last four years of being the center of COVID-19 care in South Sacramento. She embraced the challenge of having 50 extra surge beds in partnership with the state to care for our sick community," said Staff Nurse Milanelle R. Guiao-Tranchina, BSN, RN, PCCN, CMSRN. It was her unwavering belief in the ability of her nurses rising to the challenge and creating a culture of nursing excellence that helped the South Sacramento Medical Center achieve the American Nurses Credentialing Center (ANCC) Magnet Recognition® with Distinction for nursing excellence — the only hospital in the world to receive the honor with distinction on the initial designation in December 2023. "She provided nurses with opportunities for wellness, such as regular mental health check-ins, access to counseling services, and flexible work schedules to counteract the trauma from burnout, fatigue, and social isolation. She celebrated her staff through DAISY awards, BEE awards, and mindfulness classes, including HeartMath," added Guiao-Tranchina. Delivering Care Excellence "Despite her busy schedule, Rachel rounds with patients and families and performs caring tasks like fluffing pillows to place behind a patient's back, granting a young patient's wish to see her best friend, or helping expedite a complicated inter-facility transfer so the patient can start rehab sooner," said Guiao-Tranchina. “Great or small, all truly appreciate her work and dedication to nurses, nursing, and Kaiser Permanente patients,” said Guiao-Tranchina.  

“Irma is an exemplary example of what it means to be a motivated, driven, humble and supportive mentor. She continuously goes out of her way to help others, peers and patients alike,” said Elizabeth Scriven, BSN, RN, GERO-BC. “She was my mentor and has pushed our entire department towards success and stability. I am so grateful for her endless encouragement and support that has allowed me to become a better nurse, educator and individual.” Irma Gomez, RN MSN-Ed, NPD-BC, is the Nursing Professional Development Specialist for Kaiser Permanente East Bay and a 9-year Kaiser Permanente employee. She was named a 2024 Northern California Extraordinary Nurse for Nursing Professional Development. Inspiration for Nursing When Irma was a young adult, her father was diagnosed with pancreatic cancer, and was in and out of the hospital for cancer treatment. “It was during one of those visits that I met this amazing nurse,” shared Gomez. That nurse recognized how stressed her family was because of the illness, and the financial burden that it was causing. “She was amazing and found us resources was able to help get a lot of those medical bills waived,” added Gomez. “It had a huge impact on my family, and I thought, I want to be like her. I want to be able to help people and not just at the bedside, but in all these other aspects as well,” she said. Leading with Purpose In her role as an NPD specialist, Gomez gets to impact nursing in different ways and is intentional in her communication. “Working with nurse colleagues, teaching, mentoring, and guiding them, I see the impact flow over into the care that they provide for their patients,” she said. “I always thought I’d be at bedside, as it was so rewarding seeing patients get better or being there with them in their final moments,” Gomez said. “When I first started in the Nursing Professional Development Department, I was fresh from bedside nursing and was struggling to find my place in the education world,” said Scriven, who nominated Irma for the Extraordinary Nurse honor. “With Irma’s help, I began to grasp my intention in this new role.” Delivering Care Excellence Gomez reflected on a Code Blue program her team created to assist care teams in their response to the code. “They were complimentary of how well the nurses responded and managed a code overnight,” said Gomez regarding a call she received from a Patient Care Services director. “It was that moment that made me realize that what I do really does have an impact.” “I'm not at the bedside anymore, but the work that I do, and all of us educators do, has such a profound impact on our patients. What we do touches the hands of the nurses delivering bedside care.”