The Many Roles of Nursing

Nursing today offers a wide variety of fulfilling opportunities that stretch far beyond the four walls of a hospital and traditional patient care. All nursing roles, however – clinical and nonclinical – involve support, compassion, attention to detail and a desire to make a positive difference in the lives of others.

This rewarding field has a tremendous capacity for anyone passionate about helping people lead their best lives. What follows is a sampling of some of the diverse nursing positions at Salinas Valley Health that uphold our ongoing tradition of excellence for our patients, families, staff and the community we serve.

Protecting Our Workforce

Jill Peralta-Cuellar, BSN, RN, COEE

As Director of Employee Health Services, Jill Peralta-Cuellar, BSN, RN, COEE, leads a team that advocates for staff safety and well-being. Their efforts have a significant impact on the day-to-day operations of Salinas Valley Health. Every one of our 2,000+ staff members has interacted with this team, and they, in turn, have helped and protected our workforce. When she was 17, Jill’s father died due to a job-related accident, making her role today one of personal significance. “I have strong feelings,” she says, “about making sure people work as safely as possible and ensuring we give them the best possible environment to safeguard themselves from harm.” In Jill’s oversight of occupational health for one of Monterey County’s largest employers, she assists and advocates for staff and ultimately affects the safety of the more than a half-million patients who visit Salinas Valley Health annually. Beyond the clinical duties of her team, which were heightened to new levels during the pandemic, Jill’s success also involves building good relationships with administrative leaders, staff and the unions that represent our employees. She credits her achievements to years of experience in a range of nursing areas. Employee Health Services was recognized as 2022 Team STAR, paying tribute to its exemplification of our core values of support, teamwork, accountability and respect.

Maintaining a Safe Environment

Melissa Deen, BSN, PHN, RN

Looking to expand her knowledge and experience, Infection Prevention Manager Melissa Deen, BSN, PHN, RN, took a position as a nurse educator in infection prevention in 2007. She found it both rewarding and challenging, utilizing all her clinical skills and increasing her knowledge in a multitude of areas. Melissa leads Salinas Valley Health in establishing policies and procedures to protect our staff, patients and their families against disease and infection. “Effective infection prevention control,” she says, “requires constant monitoring and action throughout all levels of the organization, including policymakers, facility managers, healthcare employees and those who access health services.” It involves all aspects of health, from hand hygiene, injection safety, antimicrobial resistance and operations during and outside of emergencies. “Paramount in nursing,” Melissa explains, “infection prevention creates a safe environment – for our workforce and those who come to us for care.”

Understanding the Big Picture

Lea Woodrow, RN, BSN, MSN, CPPS

In her service as Director of the Accreditation and Regulatory Department, Lea Woodrow, RN, BSN, MSN, CPPS, has been the driving force in developing, implementing and coordinating protocol to ensure the quality of our service and the safety of our patients. Lea began her career as a bedside nurse in a small rural hospital, working in adult and pediatric surgical units, intensive care, maternity, house supervision and, later, the emergency department. When asked to lead the nursing quality/risk program and later facility-wide quality/risk/safety programs, including regulatory oversight, Lea gained a new perspective on the field of nursing. “I was able to see better why we need to do things the way we do and what the ramifications could be for a patient, a nurse and an organization if not done right,” she explains. It gave her a greater understanding of why the work of nurses is so essential. “I saw the points of view of all nurses instead of those of a single unit and the reality of how one unit can impact another and how that affects our patients, nurse partners and entire health system.” The bottom line,” Lea says, is “all nurses want to do the right thing for their patients.” She is responsible for ensuring that it happens consistently and within designated state and federal guidelines.

Reducing Readmission Rates

Melissa Dausen, BSN, RN, CCM

A desire to ensure successful transitions from a hospital to a home setting inspired Melissa Dausen, BSN, RN, CCM, to shift from pediatric intensive care and emergency department service to a path toward her current role as Continuum of Care Director. First transferring to the inpatient case management team, she discovered a new side of nursing, learning firsthand about the barriers and complexities patients face following discharge. In 2015, administrative leaders asked Melissa to create the Transitional Care Program for Salinas Valley Health, and she embraced the challenge. The program provides an extra dimension of assistance for high-risk patients and, through her direction, has grown tremendously. “We have gone from supporting 1,530 patients with a 21.6% readmission rate in our first year to 4,670 patients with a greatly reduced readmission rate of 14% last year,” Melissa explains. While continuing to lead Transitional Care Management, she also serves as clinical lead for Outpatient Care Management for Salinas Valley Health Clinics, further expanding support for patients in our community.

Balancing Inpatient and Outpatient Needs

Sherri Massey, MSN, RN, HACP

“I truly believe patients will not care how much you know until they know how much you care.”

Sherri Massey, MSN, RN, HACP, Procedural Nurse Manager

With nearly three decades as a registered nurse, Sherri Massey, MSN, RN, HACP, Procedural Nurse Manager, decided to move from bedside nursing to leadership to help lead staff to impact what they do. “I have always been hands-on, and I strive to set an example for others in being the type of leader they would respect and follow,” says Sherri. “I truly believe patients will not care how much you know until they know how much you care.” Her position, she explains, is multifaceted and involves five different areas: diagnostic imaging, cardiology, the cardiac catheterization holding area, the cardiac catheterization lab, and cardiac rehabilitation. Sherri describes procedural nursing as differing from bedside nursing because these nurses are highly skilled in specific areas of expertise. “While some of the functions are similar,” she notes, “each area has its specialty, and the workflow can be challenging as nurses balance scheduled outpatients with inpatient needs. Procedural nursing brings a lot of value to our organization, and I feel blessed to work with such a great team.”

Ensuring Best Possible Outcomes Following Emergency Care

Maria Dominguez, RN

A dual focus on being available for her four children and making a difference for patients prompted Maria Dominguez, RN, to pursue Emergency Department outpatient advisor service. Communication is critical in her role to ensure the best possible outcomes following patient discharge from the Salinas Valley Health Emergency Department. Maria’s work begins with a brief phone call, relaying recommendations on how patients should move forward with their care plan. She reviews discharge instructions and helps answer inquiries about diagnoses, medications, symptom management and other questions. Maria is the direct liaison between physicians and pharmacies to resolve prescription issues. She also coordinates with Salinas Valley Health Clinics on patient referrals to ensure timely follow-up. Patient experience, Maria says, is also a fundamental part of her endeavors to raise the bar continually. “I listen to how they perceived their treatment in the emergency department,” she explains. “This is particularly important because it helps to improve the quality of our services.”

Development of Specialty Care Areas

Lilia Meraz-Gottfried, MSN, RN

Describing her position as Clinical Development Director, Lilia Meraz-Gottfried, MSN, RN, uses the terms “unique and fascinating.” She values her transition from two decades in bedside nursing – the majority of it in critical care – for “the opportunity to impact decisions affecting the quality of the services we provide and, ultimately, benefit­ting our patients.” Lilia is responsible for a range of medical center programs and growth of specialty areas, including interfacing with Salinas Valley Health Clinics. She oversees the specific programs of stroke, chest pain, joint replacement, diabetes, bariatric, palliative care and spiritual care while also managing quality reporting and teleradiology. Through close collaboration with medical directors and nurse coordinators, Lilia uses her broad nursing experience coupled with knowledge of hospital and clinical workflows to guide staff in improving processes and enhancing patient care.

Combining Administrative and Bedside Skills

Aniko Kukla, DNP, RN, CPNP-PC

“Witnessing the improvements that empowered nurses create refills my batteries. It brings joy to the work environment.”

Aniko Kukla, DNP, RN, CPNP-PC, Director of Quality and Patient Safety

Identifying a way to serve that combined administrative and bedside nursing capacities led Aniko Kukla, DNP, RN, CPNP-PC, to her role as director of Quality and Patient Safety. The transition from an expansive range of clinical experience to that of nurse educator was one that, she says, made her realize she could make a significant difference in the lives of both patients and staff. “Whether having conversations with patients while coaching new graduate nurses or sharing education with more seasoned nurses, these interactions inspire me to keep learning and growing.” Small changes in clinical care, as Aniko has seen, often significantly impact patients, families and staff. One of her favorite aspects of her job is attending meetings run by bedside nurses. “Witnessing the improvements that empowered nurses create refills my batteries,” she explains. “It brings joy to the work environment.”

Analyzing Data and Creative Problem Solving

Ann Buco-Aninzo, MSN, RN, PHN, CPHQ, LSSGB

With an eye to developing better ways to assist our patients, Ann Buco-Aninzo, MSN, RN, PHN, CPHQ, LSSGB, followed a career path of a Performance Improvement Specialist. “I chose this field,” she says, “because I believe that by helping strengthen processes and systems, I can impact more patients through my work.” Ann explains that her brain functions in arrows and boxes and notes that she has a longtime habit of asking herself, “Is there a better or easier way to do this?” With an analytical mind and creative problem-solving skills, she often finds the answer is “Yes.” Ann enjoys the variety of her duties. Some days, she spends hours analyzing information that assists in making data-driven decisions. At other times, she interacts directly with patients to ensure the organization meets their expectations. In each case, Ann’s ultimate objective is to further access and high-quality services that Salinas Valley Health is committed to delivering.

Overcoming Obstacles in Care for Cancer Patients

Jessica Valero, BSN, RN, OCN

A goal of regular hours to balance her professional and family life led Cancer Resource Center Manager Jessica Valero, BSN, RN, OCN, to choose a career in outpatient nursing. With a decade of experience and while looking to further her expertise in oncology, Jessica was introduced to a breast oncology nurse navigator. She became very interested in this specialized area. “I thought it would be a natural progression to continue my service as an oncology nurse, yet in a different way – one that benefits patients by addressing barriers to care, assists with service coordination and provides an opportunity to provide one-on-one support,” she explains. While managing the Cancer Resource Center was not on her radar, Jessica credits a director who saw in her a potential for leadership. She enjoys creating a positive working environment, continuing to educate other nurses about the value that various nursing positions offer and collaborating to overcome obstacles in care for cancer patients. “It is amazing,” she says, “to know the impact a nurse navigator can have on a person’s cancer journey, guiding and holding their hands through it all.”

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