RN Voice

Becoming a nurse at Stanford Hospital & Clinics opens up a world of professional opportunities. RN Voice shares the stories of individual nurses' career paths and nursing experiences. Learn about their career paths, opportunities at SHC they've enjoyed, and where they see their careers at one of the world's leading teaching hospitals going next.

Teri Vidal, RN, CCRN

Nearly four decades of nursing at Stanford continues to bring challenges and rewards.

What began as a summer preceptorship required for nursing school graduation turned out to be the beginning of 37 years (and still counting) of nursing at Stanford Hospital & Clinics (SHC) for Teri Vidal, RN, BSN, CCRN.

As a nursing student in 1975, Vidal couldn't have imagined the changes in health care delivery and the nursing profession that would occur over the course of her nursing career. She is certain, however, that the opportunities she's had as a nurse at SHC enabled her to provide outstanding patient care and to help shape the role of nursing at the hospital.

"From day one, I experienced enormous opportunity as a nurse at Stanford,” Vidal said. "I stayed here because there is so much to learn and our leadership is committed to our success as nurse."

Vidal spent much of her nursing career as a bedside nurse on the E2 Intensive Care Unit (E2ICU). She enjoyed the pace and challenges inherent in caring for patients with complex cases.

"At Stanford, we get the sickest of the sick. Caring for these patients and supporting their families during their time of need is rewarding and challenging as a nurse," Vidal said. "Being a nurse at a world-class teaching hospital like Stanford is exciting because you're exposed to the latest research and innovation in standards of care."

In 2007, Vidal became one of two unit educators for the E2ICU. With 165 nurses on the unit, 17 annual and bi-annual competencies, orientations, equipment training workshops, critical care training, and more, the job keeps her busy.

Vidal was a founding member of the Patient Advisory Council and remains a part of its leadership team. The council includes long-term patients and their family members, nurses, physicians and other team members. Its goal is to gain insight from patients to improve the patient experience across all levels of care.

"The Patient Advisory Council is a fantastic example of how committed Stanford is to the practice of Patient and Family Centered Care," Vidal said.

In part because of recommendations from the council, the E2ICU implemented open visiting hours in 2011. Vidal led this initiative, which required six months of research, planning and strategy.

"I always knew open visiting hours were the right thing to do," she said. "It's so important for patients and their families to be able to be together. However, we faced a lot of operational challenges in implementing this standard."

To learn more about the issue, the hospital sent Vidal and other representatives (WHEN?) to a four-day patient and family-centered care workshop in North Carolina.
"It was a great experience. I attended all of the break-sessions relating to open visiting hours and met colleagues who had faced similar challenges and overcame them."

Over the course of six months, Vidal surveyed her team, reached out to other hospitals and worked with the E2ICU Practice Council in order to develop a successful plan for open visiting hours.

"It was important that our nurses had a venue for expressing their opinions and concerns about open visiting hours,” she said. "They raised important issues which we were able to plan for and address early on, thus easing the transition to open visiting hours, which was successfully launched in September of 2011."

In 2009, Teri earned her CCRN. In June 2012, she went through the PNDP and was promoted to Clinical Nurse IV.

"Shared Governance and the Professional Nurse Development Program are the formal systems for participating in leadership and structuring your career path," Vidal said. "But long before those were in place, the culture at Stanford has always been one that values the contributions of nurses and recognizes our role in quality patient care and good outcomes."

This September, Vidal will celebrate her 38th year as a nurse at Stanford Hospital & Clinics.

Monica Cfarku, RN, MSN

When Monica Cfarku, R.N., MSN joined Stanford Hospital & Clinics (SHC) in October of 2003, she candidly told her manager, "I never stay anywhere longer than two years because I always need a new challenge."

Nearly ten years later, when asked about working at SHC, Monica replies, "I'm never leaving, this is the best organization I've ever worked for!"

She credits her loyalty to SHC to the deep support, both practically and logistically, that she has received from the Nursing administration as she has taken advantage of the many professional growth and development opportunities available to SHC nurses.

In 2012, she graduated with an MSN from SFSU's cohort program with financial support from the Transformation Scholarship, which provides grants to SHC nurses seeking graduate degrees.

The SFSU cohort program holds many classes at SHC, which mostly eliminates the need for a commute into San Francisco. Monica says her managers at the time were extremely supportive of her goals and helped her with scheduling so as to accommodate her class schedule.

Early in her career at SHC, Monica saw a need for greater communication between residents and nurses. In response to this need, and with support from Nancy Lee, Chief Nursing Officer, she started the Interprofessional Education Program at the Stanford School of Medicine.

"I realized I had a potential Master's thesis as I was working on setting up this program and had always wanted to go to graduate school. This was the perfect opening!"

Monica has also completed the Professional Nurse Development Program (PNDP) at SHC. Of that process, she says that writing the exemplars was a challenge because so much of what nurses do in their daily practice is deeply ingrained and "automatic."

In speaking of the support she received, Monica says, "Carole Kulik spent an afternoon helping me talk through my exemplar examples so I could better articulate the reasons behind the clinical decisions in my examples. It was a really good exercise."

Monica encourages all nurses considering going through the PNDP to reach out to the numerous sources of support available, and says that the process itself is very doable if you take it step by step.

In November of 2012, Monica was promoted to Assistant Clinical Nurse Manager in the Infusion Treatment Area of the Bone Marrow Transplant Department. She is enjoying the challenges of her new job, and is grateful for the support she has had from the Nursing Administration throughout her employment at SHC.

"I have had four great mentors behind me every step of the way, including Nancy Lee, R.N, Carole Kulik, Lynn Forsey, and Nina Davis. Most people don't go looking for management positions, but I had these people behind me and I felt very supported as I went through graduate school and the PNDP process, as well as getting into management myself."

Monica feels that SHC is a great place for nurses interested in growing their careers. "Our administration really, really wants nurses to succeed. Nancy Lee has said that people may choose Stanford for the physicians, but they come back for the nursing care. They want us to rise as high as we can and I'm taking advantage of it, because, how can you not?"

Rey Marvin Avelino RN, BSN, CCRN, PCCN

As a child, Rey Alvino's aunt inspired him to become a nurse. "I saw that her job enabled her to help people and also take care of her family." Rey completed his RN degree in the Philippines, which is his home country.

After a one year stint in London, in 2002 his career in nursing brought him to a hospital in St. Louis, Missouri. It was during this time in the Midwest that he first learned of Stanford Hospital & Clinics (SHC). "Stanford Hospital is obviously world renowned and I kept hearing about their focus on patient centered care, research and education, and I became determined to work there!"

Rey succeeded in becoming a SHC team member in June of 2005 and has never looked back. He has taken advantage of the many opportunities available at SHC that enable him to continue to grow as a nurse. He is currently a Charge Nurse on D1, CCUCSU.

Early in his career at SHC, he was asked to be a member of the Stanford Medication Safety Team, a group that conducts monthly audits on each unit to ensure that medications are being safely monitored and dispersed.

Rey has also enjoyed acting as a preceptor to new hires. "Being a preceptor is great for both the newly hired nurse and the nurse who has been at the hospital for a longer time. When you have to articulate why you make the decisions you do, it keeps your knowledge fresh and keeps you examining your own practice, which makes you a better nurse."

Always focused on moving forward in his education and career, Rey decided to go through the Professional Nurse Development Program (PNDP) in October of 2011.

"When you're browsing through the requirements that you have to achieve, you might freak out a little bit! But just take it step by step and it is really reasonable, it isn't overwhelming once you get into it."

He says that the support offered through Stanford Hospital & Clinics' Center for Education and Professional Development and the informal PNDP support lounges were enormously helpful.

"When I was preparing my portfolio there were a lot of classes that were offered that were really helpful. There is a lot of support available to get through the PNDP process. People shouldn't be intimidated, it is doable!"

After completing the PNDP, Rey was promoted to a Clinical Nurse IV.

When asked about his future career plans, Rey says that he plans on completing his MSN.

"Learning for me is a lifelong endeavor. Stanford offers me continuous opportunities to learn and develop myself professionally. There is endless opportunity for growth as a nurse at Stanford Hospital & Clinics."