Ellen Blair, APRN, BC
2014 Award for Excellence in Practice - APRN
“Constant vigilance” is what Ellen Blair, the recipient for the Award for Excellence in Practice – APRN, says has really helped reduce the use of seclusion and restraint on her units. As Director of Nursing for Hartford Hospital’s Institute of Living since 2009, Blair manages the 24/7 nursing care for patients. In this position she sees herself as responsible for keeping “the vision going of ways for nursing to improve practice.” She says that reducing the use of seclusion and restraint has always been something that that they have been conscious of, “but in the last five years we’ve really honed in and drilled down on every episode.” The hospital, consisting of 7 inpatient units, has since seen a significant reduction in seclusion and restraint hours and events. She stresses the importance of always watching what is happening, looking into why it is happening, and exploring what might have been done differently. “It’s about maintaining a therapeutic community on all units and using the milieu to help patients and staff work together as a team to get well.”
For in-depth attention to best practices, she depends on her front-line nursing staff. “I can’t do it alone,” she says. “I have a wonderful staff and we really all work very closely. When someone sees a problem or something that needs to be improved we all meet together.” She is absolutely committed to her team. “I love what I do. I love being able to be there for my staff who are then reaching out to each and every patient.” The support she provides to her staff directly impacts patients – and that is what she values about the position. “I get a lot of fulfillment from giving them the tools and support they need to take care of these very ill patients,” she says. “To listen to them, to make things best for them, and ultimately for the patients.” Her colleagues note her dedication to her team as well. “Ellen is constantly rounding on the inpatient units, greeting patients and meeting with families and visitors,” says Olga Dutka. “She comes in on nights, weekends, and holidays, to ensure that she knows and communicates with all of the nursing staff.” Colleague of 20 years Cynthia Belonick agrees, “For a very busy lady, she always has an open door policy and remains available when needed - a quality that makes her ‘top notch’ among her staff.”
Blair also emphasizes the importance of collaboration – Excellence in practice is “using the state of the art best practices as a baseline, making sure we’re at the top of our game, and collaborating with other places,” she says. “We all have to be very open to looking into what other people are doing.” That means finding the most up-to-date practices in the literature, or, if the literature is not out there, then “doing the research and creating our own.” Blair has done just that, researching and creating a Fall Prevention Protocol which is unique to psychiatry and which includes a patient teaching component. She has also published numerous research articles on the topic in journals such as JAPNA. She was also awarded a hospital grant to research violence on inpatient units, a four-year project involving the use of a tool to prevent potential behavioral dysregulation.
Blair stays up-to-date on best practices by attending “all kinds of psychiatric conferences” through the Ivy League Private Psychiatric Hospital Group. “This group includes some of the oldest asylums in the country,” she says, “places very similar to what my workplace is like.” The institutions all share a common goal, as well. “They are all rooted in the moral treatment of the psychiatric patient. We really work together to keep that treatment going to make sure that each and every patient is treated with dignity and respect and to reduce the stigma associated with psychiatric treatment.” Using any and all networks of knowledge available to you is crucial to keeping your practice current, she believes. “There is so much out there for people with behavioral health problems,” she says.
As for receiving this Award for Excellence in Practice, she says she’s “very honored, very excited!” She emphasizes, though, that what really matters to her is ensuring that patients receive the best possible care: “At the end of the day, it is really about what is best for the patients!”