Night Shift Intensive Care

***** ***** **** ***** ********, TEXAS *****

PHONE ***-**-****• E-MAIL **********@*****.***

TIA GRAVES RN, MSN, MSED

OBJECTIVE

To work in an environment that supports best-practice initiatives and encourages the mentoring of new nurses to the emergency and intensive care department setting

SUMMARY OF QUALIFICATIONS

May 2008 University of Nebraska-Lincoln Lincoln, Nebraska

MSN

June 2006 University of Nebraska-Lincoln Lincoln, Nebraska

MS Ed

May 1996 Mt. Scenario College Ladysmith, WI

BSN

June 1983 Western Wisconsin Technical Institute La Crosse, WI

ADN

WORK EXPERIENCE

January 2023-Current HCA Medical Center-Houston

ICU Director

Worked with laboratory services to implement POC testing for ABG’s and TAG studies using state of the art machinery

Collaborated with ancillary service lines to promote improved Metrics with SAT/SBT

Work minimum of 1 shift/2 weeks as bedside role.

Moved employee engagement survey metrics from 76% to 86% within 6 months timeframe

Oversite of 113 employees at present

Promotion of evidence-based practice models

Improving CLABSI/CAUTI metrics to 0.04<1000 ppd

Decreased vent days to less than 0.56 ppd

Pressure ulcer prevention metrics improved to 96% compliance

Continuing to grow ECMO service line

Introduced Ceribell therapy for specific ICU level population, first AI seizure monitor in the entire TMC

Streamlined new RN onboarding process to 12 weeks from 18 weeks, experienced RN from 8 weeks to 5 weeks

Opened a 22 bed CVICU w/ 3 pods, moved old unit to new unit within a 3 hour window.

Chairperson for facility ADA program

Participates in Emergency Operations Committee

Decrease in staff turnover 78% YOY

December 2020-January 2022 HCA Medical Center-Houston

ED Director

Oversite of more than 40 employees

Grew EMS patient volume YOY over 155%

Increased patient volume 22% over budget YOY

Expanded competence of existing staff to improve outcomes. Worked minimum of 1 shift/2weeks bedside role. Actively worked floor when short staff

Assisted in role of interim Director of ICU for 8 months

December 2018-December 2020 HCA Transfer Center

Site Director

Oversite of more than 70 employees

Instituted the work from home program in 24-hour turnaround (COVID)

Increased transfer-in rates by 32% YOY

Worked closely with international transfers to ensure appropriate LOC established

August 2018 December 2018 SignatureCare Emergency Center

RN/Educational Coordinator

Bedside practicing RN

Care for populations neonate to geriatric

Acute emergency nursing practice focus

Coordinator of all education for RN, Tech and Radiology Tech

Teaching ACLS, BLS, PALS and TNCC

February 2017 to current SignatureCare Emergency Center

Facility Director Stafford Location

Opened free standing facility April 2017

Care for populations neonate to geriatric

Worked floor shifts frequently

Acute emergency nursing practice focus

Oversight of radiology, registration, nursing and laboratory

Participate in teaching ACLS, BLS, PALS to staff

Outreach to community concerning medical education

Assist with marketing concepts to prospective physician groups

Initiated best-practice initiatives regarding septic bundling

From opening April to current, overtime managed at <1%

Patient satisfaction scores at >98% consistently

“Zero” turnover since opening when was in position

Deliver on-going education to staff

Operational budget managed below goal on consistent basis

Vision of developing facility into micro-hospital within year

December 2016 to May 2017

HCA Pearland Emergency Department, Pearland Texas

Staff Emergency Nurse/Charge Nurse/Nurse Mentor

Level 3 ED with population from neonate to geriatric

Assisted with clinical competence of all ED nurses

Charge Nurse responsibilities

Active on code blue team, pediatric resuscitation teams

May 2016 to December 2016 OakBend Medical Center, Richmond Texas

Staff Emergency Nurse/Clinical Nurse Mentor

Level 3 ED with population from neonate to geriatric

Only ED within 30 miles of level 1

Assisted with training of new hires to emergency nursing

October 2014 to May 2016 St. Joseph Medical Center, Houston Texas

Director of Emergency Nursing Services

Managed a department supporting 58 FTE’s and 7 PTE’s

Established working rapport with EMS to help bolster volume. In 6 month time increased EMS patient numbers 20% from baseline

Implemented a Geriatric ED for those 65 and older to help speed throughput

Rolled out topical hypothermia protocol and device to make best-practice guidelines

Co-Chair of code blue committee and STEMI committee

Maintained Stroke Certification Status with the Gold Award given for best compliance with core measures

Core measures monitoring of pneumonia, stroke and STEMI key points with 100% compliance in 90 day review of charts

Initiated a student nurse practitioner rotation with goal of hiring select individuals into the Fast Track arena

Opened a 6 bed fast track for high volume days/times and staffed with mid-level providers

Implemented a shared governance role model for ED staff to participate and have active committee attendance

Currently working on ED through-put to help decrease LWOBS and AMA, focus on admit order to discharge time within 30 min.

Trained in lean Six Sigma concept management

January 2014 to October 2014 St. Joseph Medical Center, Houston Texas

ICU and ED Clinical Nurse Educational Manager

Assisting with mentoring and training of new hires to both service lines blending bedside practice and didactic concepts of adult learning theory

Assisting with instituting evidence-based guidelines to include the sepsis campaign, malignant hyperthermia learning modules, etc.

Developed curriculum orientation concepts for the novice nurse for both the ED and ICU service lines, to include the recovery of post open heart patients

Wrote and maintain educational budget alignment for ED/ICU educational purposes

Assisted with the on-boarding of new hires to the hospital

August 2012 to December 2013 Riverside County Regional Medical Center

ED Clinical Nurse Mentor

Assisted with bedside cares of emergency level patients ranging from neonate to geriatric in a level 1 setting

Proctor of new hires and travel nurses to department protocols

Assist with the educational development of the new graduate nurse

Assisted with maintenance of best-practice models of care

August 2004 to August 2012 University of CA-San Diego

Director of ED/Clinical Education/Flight RN

Developed and implemented existing new hire and new graduate orientation program for the Emergency Department to maintain budgetary goals

Participated in process improvement committees with patient-centered outcomes, including implementation of initiatives as hypothermia post cardiac arrest and field care hypothermic protocols.

Based on evidence-based materials, implemented the battery-driven ventilator and Bi-PAP machines for ED transport, and implemented EtCO2 management protocols for closed head injured patients which drastically reduced the LOS and improved clinical outcomes

Active on the Code Blue committee, chaired from 2010-2012

Participated on committee for acquiring Magnet Status for UCSD, obtained in May 2012.

Developed and instructed courses for AACN Critical Care lecture series; systemic approach/lecture based protocols

Developed budget response plans for ED Educational plans and new hire projections to include new graduate programs and assisted with writing and implemented the EPIC-ASAP Charting system

Partnered with the OB Department to teach staff about basic ECG recognition and interventions

Worked collaboratively with the Bio-Medical Department for roll-out of new defibrillators for the entire UCSD Campus facilities, to include off site departments. This included a needs analysis and budgetary guideline development and implementation prior to roll-out.

Active with the Toxicology Department for their research into venomous snake and black widow research projects

Assisted with orientation of new physician residents to the department and partnered with their various mentors to ensure educational needs were met

Participated in the designing, planning and roll-out of a new 36 bed level II emergency department to include staffing matrix and new equipment training modules and Studor Principles for Success

Trainer and educator for the moulage for various training exercises to include "Operation Shake-Up" and "Lights out."

Authored and implemented Evidence-Based Standard Protocols for the ED, which significantly decreased ED LOS and increased RN autonomy and was certified by the State of California

Drove the change from level 3 triage to the 5 tier ESI triage process

Developed and implemented annual skills for both ED nurses and techs emphasizing high acuity/low use skills and equipment

Implemented the iSTAT device for ED bedside usage, including set-up and management of the CLEA protocols for competence

07-2004 to 09-2005 Boswell Memorial Hospital Surprise, AZ

Manager of Clinical Nurse Education for CVICU/ICU

Recruited to develop and implement the education program for the CVICU and ICU

Worked side by side new and seasoned staff to develop and fine tune existing bedside competence and implemented training courses for new hires — speeding profitability.

Taught IABP classes for Datascope throughout U.S.

Responsible for the education budget for all CVICU new hires and new nursing employees

08-2001 to 07-2004 St. Anthony's Hospital St. Petersburg, FL

Staff RN/Charge RN

Worked on ICU and ED teams as bedside RN or charge RN.

Precept of new hires and mentoring experienced staff

Wrote many of the existing competencies based on evidence best practice styles

10-1996 to 08-2001 US Army Frankfurt, Germany

Staff RN/Charge RN/Flight RN

Worked on fixed and rotor transport teams

Rotated through ICU, Shock Trauma and ED based on needs

Worked as rotor transport nurse for US Army Frankfurt, Germany

1983-1996 Kenosha Memorial Hospital Kenosha, WI

STAFF RN

* Began RN profession in ICU and ED nursing departments

EXTRACURRICULAR ACTIVITIES

Speaker for Zoll Medical at NTI 2008, 2009, 2010 and 2011, 2013

Clinical instructor for Datascope IABP

Field instructor for EZ-IO

Author of courses Basic and Advanced 12-Lead ECG courses for the ED

Red Cross Disaster relief volunteer (Haiti, New Orleans, Raleigh)

Moulage Coordinator UCSD Disaster Relief Team

Flight Physiology Instructor Fixed/Rotor Transportation Team

BLS teacher for community outreach

ENA member

EZ IO representative/training coordinator

Per Diem Fixed/Rotor Transports while in Florida

VOLUNTEER EXPERIENCE

2010 DMAT member for Haiti earthquake response team

2007 San Diego canyon fire first responder team member to Qualcomm

2005 DMAT member for hurricane Katrina response team

1999 DMAT responder Landstuhl Airplane crash

2023 Treasurer of POA Palm Crest

PUBLICATIONS

ED Nursing Monthly contributing writer April 2009 to 2016

AACN September 2010 contributing writer

LANGUAGES

German and medical Spanish

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