Mark Adams
May 2016
Coronary Care Unit
University of Virginia Health System
United States




In his role as Manager, Mark may spend most of his time in his office, but is ready at a moment's notice to participate in patient care and demonstrates exemplary nursing practice. Several months ago, I was taking care of two high acuity patients, both were post cardiac arrest patients who were treated with therapeutic hypothermia. They both had completed the protocol and were in a situation where withdrawal of life support was being discussed. One patient was Hispanic with a large, Spanish speaking only family. Recognizing I was going to be challenged when back to back family meetings were held and decision to withdrawal care was being made for both patients - I reached out to Mark for help. It was clear I would be unable to simultaneously care for these two patients and families, so Mark joined me at the second family meeting. Mark sought out a larger room to hold the meeting due to the large number of family members, while I requested multiple interpreters to assist during the meeting. We both participated in a very long complex family meeting where Mark offered his input to the case, as the director of Therapeutic Hypothermia program. He was empathetic and compassionate sharing his experiences of poor survival rate for patients. After the family meeting, Mark assumed nursing care of this patient from me and assisted the family thru the withdrawal of life support process. It is one thing to help out at the bedside for an ordinary low acuity patient, but Mark stepped in and helped with this complex situation. This allowed me to focus on my other patient and family going thru the same heart wrenching experience. In the end, both families got the support and compassion they deserved.
Mark's leadership style is to lead by example- and he empowers all the staff to participate in leadership moments. He updates us thru email which summarizes current events in the CCU. These emails update all staff on a variety of things. Celebrating staff anniversaries/birthdays, new initiatives and projects, updates on Be Safe issues and resolutions that may have occurred. He empowers the shift managers to update MESS boards on a shift to shift basis and participate in the initiatives and seek to resolve issues independently. Mark writes weekly "blurb" which high light important information that needs to be disseminated to all the nursing staff. These blurbs are read, word for word, at every shift change for one week. He encourages staff to participate in blurb writing and it is an outstanding method for saturating staff with information.
Mark makes every attempt to focus on areas of employee engagement- "I have the materials to do my job" is probably one of his most frequent reference points. Whenever we have new equipment or supplies- he is always quick to remind us that we are continuously addressing needs and making sure we have the things we need to care for our patients. He created a "job aid" notebook which contain references for monitors, teletracking, service tracking and other resources- so we have these items at our fingertips. Outside his office are our Standard Work forms- easily accessible to us and he continuously takes feedback and directs this to the important parties.
Mark supports his staff to the highest degree. Recently, I experienced several issues on a nightshift, wrote a Be Safe and sent him an email regarding another issue. Mark called me on my way home to get additional information, and by the time I returned that night one of my Be Safe issues had climbed the Help Chain to administration and corrective measures were already being implemented. Mark has our back and takes our concerns seriously. When he cannot solve an issue, he knows who to call. Marks pride in "the little ICU that could" is evident in everything we do. He graciously served as interim manager twice over the past 2 ½ year. During that time, we had significant staff turnover, a difficult transition with new management, and the highest number of new staff ever for the CCU. He was a leader, and encouraged us to lead as well. While the CCU underwent an earthquake of stress- we also achieved two huge milestones- we have not had a CAUTI since December 2014 and we have not had a CLABSI since March 2015. We also achieved a Silver Beacon award from American Association of Critical-Care Nurses. This was a direct result of his leadership.
It is with great pleasure that I recommend Mark Adams for the DAISY Nurse Leader Award. I have not only been working side by side with Mark at the bedside for many years, but most recently I have had the privilege of being a Coronary Care Unit (CCU) staff RN. This has included while Mark was initially the interim manager twice, then recently Mark was officially selected to be our fearless leader, as our CCU manager.
Mark never fails to send out emails to our entire staff, sharing his congratulations and thanks for a job well done, thereby promoting self-pride in the CCU. One such example is the CCU receiving the Silver Beacon Award from the American Association of Critical Care Nurses (AACN). Not only did Mark place our plaque right outside the Manager's office in a prominent place for all to see including families and visitors, but Mark had a group picture taken and an article in UVA Connect, sharing with the entire UVA Health System, CCU's accomplishment!
CCU is a unique place to work as we have been functioning with the salaried model for many years. This means for the most part, we are solely responsible for staffing our own unit and doing on-call shifts to cover for sick calls or unexpected absences or high patient acuity and one on one patients such as tandem heart or initial therapeutic hypothermia patients. In additions, our unit has undergone some fluxes in RN positions due to various reasons including resignations, 2 RN's who retired, and other RN's out on FMLA and maternity leave. The staff RN's were required to flex-up short shifts and to take additional calls, which placed additional strain on the current staff. There were many months where we experienced a number of very high acuity patient and several deaths. Off and on, the morale of the staff in the CCU was tested, and Mark was the backbone who made sure even through very difficult times, he promoted a positive culture, was resourceful and kept the hardworking and stressful staff upbeat and focused. Mark made sure not only did the entire staff take pride in their work as compassionate care givers to their patients and families, but he made sure we were taking time to foster compassion with one another as well.
Mark made it a priority to always remind staff that although we faced day in and day out challenges of loss and struggles, there were doing to be brighter times ahead especially during the very rocky patches. Mark reminded us all how appreciative he was in the demanding and very stressful environment of maintaining a culture of "can-do" attitude in our little ICU that could.
Even with all of Mark's responsibilities as our CCU manager, he made himself available as a call RN when needed, and came into work to do bedside nursing! Mark's positive attitude and support of the CCU staff especially during stressful and decreased staffing levels that put additional strain on the staff, contributes to a very healthy work environment in the CCU!
Mark's commitment to making CCU one of the best places to work is evidenced by his priority to having CCU staff an environment where patients receive the best care possible. Families and patients are always treated with professionalism and respect. Mark serves as a role model for professionalism and "grace under fire" as he constantly strives to have the staff provide the ideal patient experience!
I have been an employee as a staff RN at UVA Health System going into my 28th year, most of it spent in the CCU as a staff member. One of the reasons I have stayed so long is due to the fact that Mark has served both as our interim manager and now permanent manger. There are many places within the Health System for me to work, and although I have been approached by others to come and work, besides enjoying working with my entire CCU staff, one of the biggest reasons I chose to stay working in the CCU is because Mark is our manager. He exemplifies professionalism, respect and courtesy. He fosters a positive working and healthy environment in an otherwise very stressful and oftentimes chaotic place to work!!!!
It is with great pride and pleasure that I nominate Mark Adams for DAISY Nurse Leader. Over the last 15 years, I have worked with Mark as a Clinician III, Clinician IV, interim manager and now CCU manager. Over the last several years, the CCU has gone through several periods of staff turnover/resignations, nurse retirement, and multiple staff on FMLA/maternity leave. During this period, the CCU salary model was tested with staff having to flex up hours and be assigned additional calls to cover the unit. This additional strain over several months contributed to staff burn out and low morale. As interim manager, Mark addressed the day to day challenges of staffing and higher patient acuity by promoting a culture of mutual respect and professionalism. His positive "can do" attitude and support of staff during this period of transition contributed to a more stable and healthy work environment. During his time as interim manager, Mark continued as Program Coordinator for Therapeutic Temperature Management educating and coaching TTM champions throughout the hospital. In August 2014, Mark transitioned back into his role as Clinician IV. In 2015, Mark once again readily stepped into the position of CCU interim manager. His priority was to make the CCU the safest place to work and receive care while promoting staff cohesiveness. During monthly staff meetings and weekly emails, Mark's expectations of staff are clear - to promote teamwork among all staff members and provide the ideal patient experience. His weekly "blurbs" keep staff up to date on new initiatives and issues. He also keeps staff informed on clinical practice issues, quality initiatives and hospital operations via email. He encourages thinking "outside the box" and supports staff initiative. One staff member voiced that Mark is "extremely approachable and always understanding of the nurse perspective." Another staff member voiced that as manager "Mark goes the distance for his team and always has our back." His "open door office policy" makes staff feel he is accessible, available and responsive to their concerns and needs. He is somebody whom the CCU staff can look up to and rely on whenever there are any issues, be it personal or work-related. As manager, he exemplifies all the qualities you want in a manager - leadership, compassion, positive attitude, mutual respect and support, excellent communication, humor and a strong commitment to the organization and unit.
Mark is an exemplary role model. He shows genuine concern for his coworkers, patients and the Health System. His compassion for the staff and patients is infectious, his enthusiasm for hospital expansion is unparalleled. Mark exemplified stellar patience and compassion as he was berated by a patient's family member once. He let the family member voice his complaints, giving the gentleman an opportunity to air his grievances. Mark's response was professional and matter of fact which helped the gentleman realize his actions were aggressive and unnecessary. Mark is quick to get involved in facilitating difficult transfers to other units. He is consistently an advocate for our patient's best interest.
Mark will take time from his busy schedule to help provide patient care when the unit becomes overwhelmed. This happened just last week when we were near change of shift and 2 MET calls were emergently transferred into the CCU at once with insufficient time to call in our call nurse. Mark keeps a pair of scrubs in his office for this reason and jumped in to assist at the bedside with these patients in order to ensure the safety of the unit and our patients. He went beyond the call of duty and stayed until 8PM to support us, he is a true team player and leads by example and service.
We recently had a very difficult patient situation on our unit that involved an early termination of a pregnancy to save the mother's life. Due to the mother's instability, the birth and recovery had to happen in our unit with OB and L&D involvement. This caused an ethical and emotional strain on all nurses and doctors involved, especially because these situations are not common place to a cardiac ICU's scope of care. He made sure that ethics was involved and that staff had the support and emotional assistance we needed.
These were Mark's words to us once the situation stabilized: "It is not a sign of weakness and a person should bear no shame to admit when a situation exceeds our current capabilities to handle things - rather, it is a sign of maturity and strength. I have been humbled and grateful to talk with a number of you about your feelings surrounding these events. This has been a taxing time and I want you all to know there are a number of avenues to address personal needs for any of the situations we have encountered. Support from our chaplains, Moral Distress Team, and FEAP are available; all three have been notified of the recent events. I encourage you to continue to take care of yourselves and of each other, and to let me know how I can facilitate your connection with these and other resources."
When our beloved Marian Lawson left the CCU after twenty years of service as our previous nurse manager, there was a void. As an already respected CCU colleague and Clinician IV, Mark Adams was able to fill that void with the complete support of the unit personnel as interim manager. The CCU continued to run smoothly. Then, after the CCU had a brief stint with another nurse manager, the CCU once again was left leaderless. For the second time, and during a time of personal loss in his life, he filled that void by once again becoming interim manager ("part 2") and now has officially been promoted to CCU Nurse Manager! (Do know that the staff in the CCU begged him to return as nurse manager?). Hence, Mark twice showed extreme selfless dedication to the CCU. His personal example had a trickle-down effect. Other nurses began stepping up and became Clinician IVs, other nurses took on leadership positions; things started an upward trajectory. The CCU continues to prosper.
Mark is enthusiastic about the goals and vision of the healthcare system. Mark and the Clinician's and 4's of the unit motivated our staff to work towards our silver level beacon award. He is our cheerleader for our current 1 year+ of being CLABI and CAUTI free! He sends us weekly "State of the Union" emails to keep us up to date on current happenings, expectations, new staff, announcements, etc. He also started shift blurbs at the beginning of each shift to reinforce important new standard work and practice updates. All nurses are welcome to contribute a blurb for the week. He is a champion for standard work initiatives and keeps our standard work documents right outside his office for easy use.
Mark has empowered our PCA liaison, Jess. She writes: "He mentors me when I need to have difficult conversations with the PCAs and is my backup when my own strategies are unsuccessful. He includes me in our interview process, giving me a voice in the hiring process of our PCAs." As a new Clinician 4, Lauren writes: "His mentorship has been critical to me as I acclimate to my new role. Mark gives me both positive and constructive feedback, clearly and in the moment, which has greatly assisted me in my professional development and communication skills. Some days his mentorship just means letting me vent and other days this means laying the path down for me to move forward when I get stuck on a unit initiative."
Andrew, a CCU nurse writes: "Mark has always been someone I looked up to, and aspire to be more like. He is available anytime I need to ‘vent' and acts as a sounding board for situations and problems that arise."
Mark's many years at UVA have provided him with unique insight into the nursing profession. He is a tremendous resource to staff on and off the unit, especially on the topic of therapeutic hypothermia as a tool post cardiac arrest. Mark is always willing to import his wisdom to those who seek it.
Mark has an "open door" policy which keeps him very engaged with staff and invites staff to come to him comfortably with concerns or questions. When a situation becomes overwhelming Mark is there to support staff either by leading or guiding the way. He makes himself available when needed, even when he is leading Boy Scouts through the woods on weekends.
Mark does an excellent job at using and integrating our visual management board. He and our medical director review the board daily and apply A-3 thinking to solve problems that arise. Their most recent A3 is our OR Handoff Report for our critical direct load patients in order to ensure a safe and quick handoff of care to the appropriate personnel. This stemmed from a situation when a Tandem Heart patient was direct loaded into the cardiac catheterization lab and some large gaps in care and communication occurred.
Mark has been the catalyst for nurse driven protocols especially the therapeutic hypothermia protocol. He is the TTM program lead for UVA and continues to be involved closely with all of our hypothermia patients in order to ensure the best patient outcomes possible. He and a team have formulated the "CGRAF" as a guide for inclusion or exclusion criteria to pursue therapeutic hypothermia treatment based on 5 clinical indicators on admission. We are close to enacting this new protocol in our program here at UVA based on nursing research that he spearheaded. (Latest update is it goes live in 3 months)
Mark promotes a positive image of what a nurse should be. He provides motivation for the clinicians under his supervision to advance their careers. Mark's personality and dedication attracted positive, high-minded workaholics who not only enjoy coming to work, they really like the people with whom they work! They thrive. They achieve. And they stay for years in the CCU.