James "Lance" Rounkles
June 2021
James
Rounkles
,
MSN, RN-BC
Joint Inpatient Mental Health Unit
David Grant USAF Medical Center
Fairfield
,
CA
United States

 

 

 

Lance's skillset has helped the unit remain restraint-free since 2018. This is unheard of in a psych inpatient unit.
Lance’s clinical skill and especially his compassionate care exemplify the kind of nurse that our patients need, a role model. Lance has been the VA Nurse Manger on the Inpatient Mental Health Unit for several years now. He constantly strives for excellence and works to improve the quality and safety of the unit. He regularly reads articles and books on how to improve nursing care and shares them with the team so they can improve their knowledge and skills as well.

Lance has been an invaluable mentor, helping me understand the mission of the unit, the nurse’s role, and how to best work with them. Knowing I am an avid reader and student of improvement, he allowed me to borrow one of his nursing leadership books, so I could improve my connection and understanding of the nursing world.

Lance works tirelessly to make sure the patients and staff are taken care of, ensuring adequate staffing, and catching small details that improve safety. Our unit was getting ready to discharge a patient and we were unable to fill a set of prescriptions for him because the pharmacy’s records indicated they were recently filled. Lance remembered the patient had come on the unit with several bags of newly filled prescriptions in his personal property. By remembering this detail, he helped avoid discharging a previously suicidal patient with an excess amount of medications that could have led to an overdose attempt or worse.

I observed Lance engage with a hostile/potentially violent patient without losing his temper, preventing the patient from being needlessly restrained against his will, potentially leading to unintentional injury or harm to him or the staff. A nurse with less experience, confidence, or situational awareness likely would have chosen a different route. His skillset has helped the unit remain restraint-free since 2018. This is unheard of in a psych inpatient unit.

Lance prefers to stay out of the spotlight and regularly gives credit to other staff members; he has nominated 2 other staff for the DAISY Awards.

Although Lance has been here for several years, he constantly looks for ways to improve the quality of care on the unit. When I first got to the unit he showed me how transfer packets could sit for several days waiting for the transferring facility to send the appropriate paperwork. This was a delay in care concern as well as a safety concern. Together we worked with the JRIC office to have the transfer packets sent to their office for initial review for eligibility and our ability to screen packets and disposition improved dramatically.

Lance’s number one priority is quality patient care and safety. Lance regularly works with the JRIC office, house nurse supervisors, emergency department staff, and staff from outside facilities to make sure patients arrive safely and the quality of care we can provide is top-notch.