Synapse Spotlight: Rachelle Sey talks Hypoxic Ischemic Encephalopathy (HIE)

Welcome to another installment of Synapse Spotlight where we feature an interview with an inspiring NICU healthcare professional.

Today we interviewed Rachelle Sey, MSN, APRN, CNS, RNC-NIC on her unit’s innovative approach to screening babies for Hypoxic Ischemic Encephalopathy (HIE) in community hospitals using an HIE Assessment App, available for free on the iOS platform.

Tell us who you are, where you work, and your current role in the NICU; and maybe a little bit about your NICN Program and all you’ve accomplished.

I am the Clinical Nurse Specialist at Sharp Mary Birch Hospital for Women & Newborns; I have worked in this role for 11 years. I have been a NICU nurse for 16 years. I oversee our small baby program and our neuro intensive care program. In my role, I spend a lot of time working with nurses and physicians to provide optimal care to our patients to improve outcomes. We have had a NICN program since 2012; we have a core group of 30 nurses between night shift and day shift. We have shown significant improvement in length of stay and reducing overall mortality for our therapeutic hypothermia population since the inception of our NICN program. These results have been published in the Journal of Neonatal and Perinatal Medicine. (Read here!)

Can you tell us more about your HIE Assessment App? 

We have implemented a process of completing serial neuro exams at 1, 3, and 5 hours in order to identify patients that may meet criteria for cooling. Our NICN nurses are responsible for these exams and we have also taught a group of nurses in our community hospitals how to do them. Our neonatal neurologist has developed an App that matches the serial neuro exam steps; It is available on the iOS platform and can be downloaded for free and used in any community setting to help identify infants that meet criteria for cooling. What we have found is that it is difficult to continually provide education to the community NICUs for completion of the serial neuro exam. Access to the App helps these units complete the serial neuro exams in a step by step manner. The goal is for no baby to be missed who may meet the cooling criteria.

The App does not store any data, so it does not provide metrics. However, when serial neuro exams are completed in the EMR, we are able to run reports to determine how many infants who have serial neuro exams meet criteria for cooling, are admitted to NICU for other reasons or are able to return to dyad care following the 6 hours of observation.

What first inspired you to work in the NICU?

I absolutely love working with our tiny patients. They are such a vulnerable population. I also enjoy working with families and impacting their experience in the NICU. While patients in the NICU are often the most vulnerable, there is significant opportunity for improvement. Care is constantly evolving. In the past 16 years that I have been a neonatal nurse, the care trajectory has changed significantly. We are caring for smaller and more acutely ill infants. Knowing that I have even a small part in their success in the NICU, makes everything worth it. 

What is the most rewarding part of your job?

Working with nurses and physicians. Developing and implementing protocols and best practices that really make an impact in patient care. I enjoy challenges and identifying solutions. One of my favorite parts of my job is mentoring nurses and consulting in the unit. I love to share my knowledge with others!

What is your biggest struggle at work and how are you working through it?

Definitely time management. I am constantly prioritizing to get the most critical things done first. I enjoy challenges in the NICU; they keep my job interesting. One of the challenging things in working as a CNS in the NICU is making sure that we are always current with the best evidence based practices to create the best outcomes for our patients. I find many ways to keep current including reading A LOT, attending conferences and maintaining a vast network of colleagues.

What advice would you give to new nurses just starting their career in the NICU?

Stick with it; there are ups and downs with any new career- nursing included. However, nursing is so rewarding. Always maintain a state of inquiry. Take advantage of all the expertise around you and constantly maintain a state of inquiry. Join professional organizations; there are so many benefits. 

How do you continue your education and/or help to educate others?

I definitely am a lifelong learner; besides attending conferences and keeping up with reading the latest journal articles, I just finished my first year in the PhD program at the University of San Diego as a Robert Wood Johnson Foundation Future of Nursing Scholar. The experience of obtaining a doctorate degree is so wonderful. My favorite part of my week is attending my classes on the beautiful campus at University of San Diego. The program has challenged me to view the world differently and to think in a variety of new ways. I am so thankful to Sharp Healthcare and the Robert Wood Johnson Foundation for the amazing opportunity to pursue this doctorate.

Conferences like the One Conference that focus so uniquely on one aspect of care in the NICU, the neonatal brain, have inspired me to be a better nurse. I have applied so much of what I have learned at the One Conference into the care we provide our patients. It has also inspired my further love of the brain and developmental care which is informing my dissertation topic related to neonatal exposure to toxic stress and how it impacts outcomes in our fragile patients.

What is one thing you do every day to keep you sane (in the midst of NICU chaos)?

Maintaining a healthy work life, school, and family balance is so critical. I have a great core group of friends. I have an amazing family (my husband and my 9 yo and 6 yo) that is so supportive of my job and going back to school.

Why should nurses attend the ONE Conference or watch the 2019 recordings?  What makes the ONE Conference unique?

I have participated in the ONE conference for the past 2 years. I can’t say enough about this conference. It is the only conference dedicated to neuro NICU nursing. The speakers are always phenomenal and there is so much to learn from each of them. The conference is innovative in its approach and allows ample opportunity to create networks and make new friends who share similar interests.

Rachelle Sey is the neonatal Clinical Nurse Specialist in the NICU at Sharp Mary Birch Hospital for Women & Newborns in San Diego, CA. She leads both the Extremely Low Gestational Age Newborn and the Neuro Intensive Care Nursery programs. In addition, Rachelle manages a variety of quality improvement projects as well as consults on complex clinical cases in the NICU. She enjoys mentoring clinical nurses through evidence-based practice and nursing research projects.