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Wendy Escobedo, R.N., CN IV
Wendy Escobedo, R.N., CN IV, exemplifies all the values of our ministry, especially Service. She has been called an “extraordinary gem” for her servant leadership, made evident through her interactions with patients, the healthcare team and the entire transplant community. When Wendy came to St. Joseph Hospital in 2002 as a new graduate, she felt like she “belonged here.” She began working on the Cardiac Renal Unit (4E/W). Nursing Manager Irma Najera recalls that from the beginning Wendy has been “professional, approachable and always willing to jump in when help has been needed.”
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Recognizing Wendy’s potential and the need to improve processes, in 2003 the then-new Renal Transplant Council approached Wendy about serving as a liaison between the hospital-at-large, Cardiac Renal nursing unit and the Transplant Center. She accepted the challenge, excelled in what she calls an “often intense” role she loves, and has greatly contributed to the enormous success of St. Joseph Hospital’s Kidney Transplant Program. For five years in a row, the program has achieved 100 percent one-year graft survival. Even more impressive, of the half dozen adult kidney transplant centers in the U.S., St. Joseph Hospital’s program has had the highest volume of transplants and has served patients and transplant donors with risk factors that are “statistically higher than expected.” Truly, this program and its Inpatient Care Coordinator Wendy Escobedo epitomize Perfect Care for the St. Joseph Health System and for each and every patient served.
Acknowledges that every person and his/her need is unique and tailors each action and interaction to meet that singular special need.
Service comes naturally to Wendy, who remarks, “I love people and the interactions I have with them. I look at them and think: what a miracle. I’ve been entrusted by God to care for his most precious creation.”
Manager of Transplant Operations Marlene Abe shared an example of how Wendy excels in providing service. “We had a patient who was having difficulties in balancing his needs as a recent post-transplant patient and his life issues. Wendy took on this patient with enthusiasm and in the spirit of a nursing challenge. She patiently reinforced the goals of his transplant care, looked for opportunities to provide care outside of the norm with creativity, and inspired the patient by giving him a challenge with an ultimate ‘prize’ to shoot for. When a new obstacle came, Wendy never lost sight of her purpose to serve her patient well. She elicited the aid of her colleagues, she researched, she had discussions, and she would “tweak” her plans to achieve the best outcomes for her patient. This patient recently achieved a transplant milestone, his first year post-transplant with excellent kidney function. I know without her dedication and true service to this patient, he was at a very high risk for non-compliance and rejection.”
Kidney transplant patients must buy into a strict regimen, without deviation. When this patient became non-compliant, Wendy shares how she took a different approach: “Instead of calling him to say, ‘You’re not complying; you could lose your kidney,’ I asked myself, ‘What’s important to this patient and how can I allow him to achieve what he wants to? What’s causing him to not be compliant? Is he depressed? How can I help him?’ I couldn’t just conclude he didn’t care. We developed a trust relationship of patient and nurse and collaborated on problem solving. Whatever barriers he had, we’d solve them together.”
The patient was a Hispanic single male raising his son, who was about 20 and who was his donor. Wendy described the gentleman as someone who was very independent and didn’t have the control that he was used to. It turned out that his son, who lived with him, and the son’s girlfriend were having a baby, and the patient felt financial pressures. He wasn’t coming to his medical appointments because he didn’t have the money for gas. He felt he needed to return to his job in water delivery, lifting heavy bottles, in spite of the risk of this type of work on his healing incision.
Upon learning this, Wendy offered to get him a note for his employer so that he could get a lighter route, which he did. To convince him to do better, she made a deal with him. A nice picture of the patient and his son had been made into a poster and displayed at the Donate Life run/walk.The patient wanted that picture, and Wendy promised to get it for him if he could do better by following up regularly with the dietitian and endocrinologist who were working with him on his diabetes management. The approach worked. He became consistent in coming for his weekly labs and adhering to his dietary regimen. His blood sugar came down and his depression began to lift as he regained control.
Later, Wendy had expressed an interest in seeing his grand baby, and a year after his transplant he brought the baby by for a visit with her. “I get genuine fulfillment when people (like him) are happy and enjoying life,” she concludes.
Makes every person feel that they are important by actively listening and giving full attention in order to understand the best way to serve them.
Wendy’s philosophy is that, “Every patient is so unique in the way they deal with the stress of their condition, and in what their support system is. Some have friends and/or family members for support, and some have none. To meet their needs I try to become in tune with them. I ask myself, ‘Where do I best fit? In the role of confidante? Supporter? Do I just observe for awhile and allow them to ask for what they need? I’m blessed to have that nurse’s intuition you hear about. I’m always observing the patient and his or her body language. I’ve learned to assess patients’ environment, their feelings and the people around them. We’re not just here to fix the body – healing is much more. That’s why the Jean Watson Theory of Human Caring we apply is so perfect for our hospital. It’s sacred work connecting us to the human soul.
“Patients enrich me. There can be challenging patients but if you consider what is hurting that person, you can escalate or deescalate conditions based on your interaction with them. I consider myself an advocate for patients.”
Kidney Transplant Program Executive Director Anthony “Tony” Messana is appreciative of Wendy for the “individualized education she provides to transplant patients before, during and after the transplant event.” He continues, “For patients, staff and everyone she encounters she shows her professionalism and more importantly her dedication to service by her warmth and caring nature.”
In training staff to care for the transplant patient, Wendy stresses the importance of reinforcing education in every interaction with the patient to continue achieving a 100 percent success rate long term. For example, she has instructed nurses who are at the patient’s bedside giving them their medication to ask, “Do you know what this medication is for?” She explains, “When the patient is more knowledgeable, he or she is better equipped to succeed.”
“Wendy is available whenever anyone has a question, even if it is on weekends,” says Irma. “She spends time educating the patients and the staff so that they are comfortable with the plan of care. If a new transplant nurse is taking care of a transplant patient, Wendy will be present on the floor to offer support and guidance. She has developed tools that the nurse can use to teach and deliver care to the transplant patients… she did this by asking the nurses what they need and obtaining feedback on the final results. She is a great role model for the nursing profession.”
Recognizes opportunities to serve and facilitates or organizes people or groups to make it happen.
“I remember that when I first worked on the Cardiac Renal unit; I didn’t always know the why of what we did in carrying out orders. I’ve had the privilege of driving processes to better bridge that gap. For example, the discharge process has a direct impact on infection and rejection. Now, patient education begins before the patient is even admitted to the hospital.”
In addition to her work with patients and nurses, Wendy has developed a curriculum that extends to Social Services, Case Management, Pharmacy and Dietary departments, all to ensure the long-term success of the patient. Wendy has even shared her contributions with the transplant community at national transplant conferences. She often gets requests to share with other centers the transplant tools she developed. “By sharing we gain so much insight,” says Wendy. “I go to the conferences to teach, share and learn.”
Tony adds, “The Kidney Transplant Council has grown in effectiveness because of Wendy’s work as a liaison between the transplant program and the hospital staff. She has shown herself to be a role model by being the first certified transplant nurse at St. Joseph Hospital. Subsequently she has been encouraging other nurses who have followed her lead and added to the level of care they provide by being certified as well.”
Responds to change constructively and helps others to remain positive during times of uncertainty.
Wendy’s role involves assuring a smooth transition for the patient from outpatient to inpatient and back into the outpatient setting, allowing continuity of care. The service she provides goes above and beyond in helping patients to “change constructively and remain positive during times of uncertainty.”
Marlene states, “Wendy took on a challenge and risk to pioneer a new role on the St. Joseph Kidney Transplant Team. She is motivated by curiosity and makes the effort to learn more, always posing the question, ‘How can we better serve our patients?’ and not letting barriers and difficult situations sway her from always excelling.”
A woman transplanted over a year ago exemplifies how Wendy has embraced this challenge. She was young woman who had lost her kidney function due to a fetal demise. After many days in a coma, she awoke to learn she had lost her baby, was in kidney failure and on dialysis. After going home, she had a stroke and needed to learn to walk and talk again. “Such adversity really put life into perspective for me,” says Wendy. “She never complained, she only looked at how she was going to get better and was very grateful to the team. Several months after she had her transplant I asked her to come back and speak to nurses in a training class, which she’s done a couple of times. I wanted them to see what’s possible and what came out of excellent care. She came by yesterday for a visit and is doing very well. She has a new life.”