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UVA Health University Medical Center is marking a milestone. Jessica Alford, RN, MSN, CCRN, manager of the Surgical Intermediate Medical Unit and the Surgical Trauma Intensive Care Unit, reports SIMU is traveler nurse-free, while STICU is expected to follow by the end of 2024.

Life Changing Moves

Alford started as SIMU and STICU assistant nurse manager in summer 2020 as healthcare faced unprecedented challenges during the COVID-19 pandemic. By September 2021, she was promoted to interim manager, then became nurse manager of both units. From late fall into early winter 2020, SIMU experienced a “mass exodus” as 75 percent of that team resigned.

Alford was “a little scared” — but empathetic. “Some of those team members had been with our units for some time, and with all the stress of the pandemic, it probably was the right move for them to make a change in their lives.”

One Door Closes, Another Opens

The recipient of the 2023 DAISY Nurse Leader Award, says there were many new nurses with a lot of anxiety and uncertainty — and very limited resources. “But it gave us the opportunity to rebuild and develop a culture,” Alford recalls. “The units became a great place for new nurses to learn. We were able to keep them, some grew into unit leaders — really focused, excited, engaged, and asking a lot of great questions!”

She worked with Assistant Manager Loucita Hurlbrink RN, BSN, CCRN, to add structure and give more meaning to the work. The units became heavily dependent, and grateful for, traveling nurses. The typical traveler contract is 13 weeks long, but some travelers stayed up to a year. By January 2023, IMU alone had up to 10 travelers, then went almost two years without any core staff resignations.

Since then, both units have become less dependent on travelers hired by external agencies. SIMU was down to four travelers in January 2024. Any remaining ones were hired directly by UVA Health as internal travelers. Up to three travelers converted to core staff. The final traveler’s contract ended in mid-June 2024, making SIMU traveler-free, and fully staffed for bedside RNs.

“We were very lucky with the travelers we had, they were great, many of them served in roles as charge nurses and preceptors,” says Alford. “They really helped us get to where we are.”

She adds, “Now, our SIMU core staff of 27 helps us make a long-term investment, continuing to build on the culture we have in the unit. It’s a very inclusive, supportive, team environment. So dedicated, engaged — amazing to see them flourish!”

Point of View: Experienced Nurses

“The camaraderie working with a solid team makes the hard work much more enjoyable and provides a sense of security in knowing here’s always someone who has your back!” Rachel Dalton, RN, BSN, PCCN, who’s worked in SIMU for a decade. She explains that as management began to hire and train new nurses, they were invested in the unit and its success. “We were able to reestablish our Professional Governance Committee to start making positive changes for the unit and give staff a venue to bring any issues to the table to tackle as a group.”

She raves, "Our manager Jessica has been a rock throughout the rebuilding of the unit — she advocates for staff and always makes sure we feel supported and heard. We’ve had very little turnover since then and I feel it really is a testament to awesome teams!”

Amy Ortiz, RN, BSN, CCRN, TCRN, also has worked in the STICU for 10 years. “The leadership team of Jess, Loucita, and Rachel developed a small group of designated charge nurses that took the lead to make SIMU feel like a team. As this culture grew, it led to several peer nominations among SIMU staff for NPGO [Nursing Professional Governance Organization] awards. This all felt supportive and encouraging in recognizing the unit’s strength!”  

Mel Johnson RN, BSN, CCRN, helped some STICU team members transition to SIMU, while team members who started in SIMU such as Isaiah Norton, RN, decided they wanted a new challenge in STICU.

POV: Newer Nurse

“I felt a lot of anxiety about what the beginning of my nursing career was going to look like with limited core staff within the unit,” remembers Liana Coppola, BSN, RN, PCCN, who joined 5 North just after graduating and found a lot of nurses leaving. “I worked many shifts with travelers, some who ended up becoming staff. Throughout the last three years, I've seen the unit transform!”

She’s gained invaluable experience and clinical skills and now serves the unit as a preceptor, charge nurse, and NPGO chair — working alongside a unit full of core staff. “Being a part of the unit's journey is very fulfilling!”