Angelle Cooper incorporates the components of transformational leadership in her practice by inspiring positive change through teamwork. Angelle works with her team to identify needed change and creates a common vision to execute the change. She motivates her team by providing them with a sense of being active participants and owners of processes. Daily, she challenges her team's ownership for their work and results.
In 2020, the NCCU was moved and expanded from 12 beds to 20 beds. Angelle brought new staff members on board and consulted her team about decisions related to the new unit, such as the layout, furniture, and equipment. Tasked with getting to know the new members and building a cohesive team among current and new staff, Angelle sought input from her team and developed short- and long-term goals for the unit. She set expectations and created a supportive environment that was open to change.
Angelle has a true understanding of the strengths and weaknesses of her team members and uses these strengths to work with individuals and help them succeed. She has given her staff autonomy over specific jobs, especially her charge nurses; she empowers them with the authority to make decisions and act. Angelle successfully inspired the creation of a shared governance council that reviews patient satisfaction; promotes teamwork and plans team celebrations; and oversees nursing initiatives and adherence. She gave her team a voice to help decide how to implement assignments, projects, schedules, and more. Angelle assists her charge nurses in conflict resolution strategies. She truly inspires the team to find better ways to achieve goals for the unit and for patient care.
Angelle acts as a bridge connecting clinicians with senior leadership. Serving as an ambassador for the NCCU team, she's an active member of our interdisciplinary stroke leadership steering committee. This committee drives stroke best practices at our hospital, which is certified through The Joint Commission as a Primary Stroke Center. Angelle considers the feasibility of each initiative or quality enhancement strategy by questioning:
- Do staff members need further training?
- Do we need to dedicate certain beds for stroke?
- How would the staff feel about the initiative?
- Does the staff have the resources to successfully implement this initiative?
Angelle shares her informed thoughts with the rest of the group to seek collaboration and innovation to maintain a healthy work environment.
Positive practice environment
Angelle inspires others to foster a culture of innovation and creativity by involving her staff in initiatives and improvements. She brings excitement to the team and encourages nurses to be advocates for patients who've had a stroke.
The NCCU takes a multidisciplinary approach to planning patient care. Angelle works closely with the Director of Therapies to establish goals and plan the day-to-day care of patients. Through her efforts, improved communication among therapists, departments, nurses, certified nursing assistants, and physicians has resulted in the delivery of quality, goal-oriented care.
She celebrates her team's successes with them, acknowledging individuals for a job well done. Her team cares for and respects each other as individuals. She has created an environment where everyone can voice their ideas. Her team and therapy staff work together with one focus: the patient. The term “not my job” isn't uttered on Angelle's unit. For example, her team noted that the neuroscience population can be difficult to educate; often there are learning barriers that pose challenges to retaining information. To overcome this barrier, Angelle had direct care RNs collaborate with the pharmacy department to create an information sheet listing the NCCU's most commonly administered medications. This allowed the RN to collaborate with patients and families on their personal medication plans by customizing each handout.
In addition, she collaborated with the neuro unit manager to create a Neuroscience Services brochure that explains the many phases of care. This brochure breaks down the unit specialties, from ED to postacute discharge facilities, explaining the acuity levels and interdisciplinary roles that contribute to the patient's success. With this initiative, she set up expectations for care transitions. These two initiatives increased patient satisfaction scores for nurses and physicians.
Angelle authentically commits to staff involvement and decision-making. She wanted to change the culture of the unit and how the team relates to the other disciplines. One of her initiatives, Coffee and Questions, allows nurses to have open conversations with neurosurgeons and intensivists to discuss past, current, and future recommendations for the care of critically ill neuro patients.
Angelle has a strong faith, and our organization's core values of justice and humility are evident in her leadership. Angelle has bridged the gap in communication among departments in relation to stroke care, working closely with other disciplines to build relationships. She has created a sustainable team that thrives on caring for patients who've had a stroke and patients with neurologic disorders.
Angelle's commitment to high standards for neuroscience care is demonstrated by her mentorship of direct care staff to pursue certification. She planned with the neuroscience service line team to join the the American Board of Neuroscience Nursing's Hospital Registration Program, which allows neuroscience nurses to sit for a certification examination with no out-of-pocket costs. Since pursuing this endeavor, the NCCU grew from zero stroke-certified RNs to seven in just over 1 year. Angelle's initiative supports professionalism within her department and contributes to the organization's overall goal as a Magnet® facility to increase the volume of nurse certifications.
As a result of Angelle's success in her position, she has been assigned as a mentor to others. She works side by side with new supervisors guiding, teaching, and directing them in their new role. Her calm demeanor and ability to work well with others are evident. In the fast-paced critical care environment, she guides new nurses using team-based communication. She is a problem-solver and can translate the who, what, how, why, and when.
Angelle promotes best practice and evidence-based practice. She is well versed on policies and procedures. She promotes our Professional Enhancement Program (PEP) for RNs, and her nurses are very active in PEP. Angelle embodies the core values of our facility and promotes growth and excellence in nursing. She has set this as an expectation as well as obtaining certification in the field. Angelle is seen as a resource for her peers and direct care nurses. She has a strong work ethic and is a role model.
Excellence in patient care
Angelle's team has grown and is more involved in nursing initiatives. She successfully prepared staff for the 2018-2019 stroke recertification survey. Under her leadership, the NCCU has had a significant decrease in falls, catheter-associated urinary tract infections, and pressure injuries. She's also working on an Agency for Healthcare Research and Quality project to reduce the hospital's MRSA (methicillin-resistant Staphylococcus aureus) rates.
Striving to make a difference, Angelle is very involved in our facility's committees, serving on the ICU, Code Team, Neuroscience Leadership, and Stroke Leadership committees. She's a member of the American Association of Critical-Care Nurses and the American Association of Neuroscience Nurses. She's involved with many facility activities involving stroke prevention and our hospital's annual American Heart Association drive.
Angelle and her team piloted a project known as Code FAST that allowed neurocritical care nurses to respond to inpatient stroke alerts to reduce “activation-to-needle” (thrombolytic administration) times. Inpatient stroke alerts can be challenging. The ED is used to triaging patients quickly to make treatment decisions during a stroke alert, so it's common to see faster thrombolytic treatment times in the ED than an inpatient unit or CCU. Angelle's innovation allowed the NCCU RN to become the subject-matter expert and driver during stroke response situations for units outside the ED. From her inspiration and vision, a Code FAST bag was developed that includes: stroke protocols, I.V. start kits, alteplase dosing cards, and syringes to facilitate prompt thrombolytic administration at the patient's bedside or CT (computed tomography) table.
When the project started in August 2019, activation-to-needle times were 55 minutes on average. With continued skill refinement, Angelle led her team to reduce this time to 41 minutes in 2021 (saving an overall median of 14 minutes of brain time).
Angelle's senior director noted, “In her current position, she is dedicated and has built an engaged staff. Angelle influences and mentors team members. She is very passionate about nursing education, neurology, and the care of these complex patients. She takes pride in seeing novice nurses become competent and understands the complexity of the patients.”