A Reliable Resource to Colleagues and Patients With Cancer

From left: ASHLEY MANDRELL, B.S.N., RN, OCN and AMY TOOTLE, M.S., B.S.N., RN, DNP

PHOTOS BY SERENA SHI

It is with pride that I nominate Ashley Mandrell, B.S.N., RN, OCN, for the 2024 CURE Extraordinary Healer Award. I have had the privilege of working alongside Ashley for the past 10 years and am currently her nurse manager.

Ashley joined the blood and marrow transplant (BMT) unit in 2014 as a patient care associate. In 2017, she graduated nursing school and became a BMT nurse. Through Ashley’s tenure in BMT, change has been constant. As nurse manager of the unit, I have witnessed BMT growing as it has added novel cellular therapy treatments, clinical trials have come to fruition and improved treatment plans, and staff members have joined and retired. BMT patient census and operational demands and outcomes were robust throughout the life-changing COVID-19 pandemic. Ashley always remained calm during this multitude of changes. At all times, she is professional, efficient and knowledgeable.

A specific example of Ashley’s extraordinary healing and patient care is demonstrated in the case of Mr. R. His diagnosis was acute myelogenous leukemia (AML), and he received an unrelated donor transplant in the middle of the pandemic. While his transplant was uncomplicated, he spent several of the following months with readmissions for elevated liver enzymes, graft versus host disease and relapse. Ashley got to know Mr. R and his wife well as his primary nurse. Due to COVID-19 restrictions and the hospital’s resulting limited visitor policy, Ashley kept his wife up to date on his plan of care. Ashley advocated in numerous ways for Mr. R, and he and his wife were extremely appreciative.

One morning after interdisciplinary team rounding, Mr. R asked Ashley to stay in his room. He had multiple questions about treatment options, and Ashley answered his questions in detail. He realized that the treatment options were not going be enough for him to achieve remission. After their discussion, Ashley allowed Mr. R time to discuss his treatment options with his family. She was aware of the complex decisions he faced. Ashley began working on a goals-of-care discussion with the care team, patient and his wife and children. She collaborated with nursing leadership and patient experience staff to obtain access for multiple family members to come to the hospital for the meeting. Together, they made the decision for Mr. R to be discharged home with hospice care.

Three weeks later, Mr. R died. The relationship that Ashley developed with Mr. R and his wife helped them to remain strong, fighting until the very end. Ashley does an excellent job communicating and developing therapeutic relationships with patients and their family members. Our BMT patients are lucky to have her on their side.

Ashley provides unit-based orientation for novice and experienced nurses new to the BMT unit. She consistently helps to mentor new employees and unfailingly goes above and beyond to make them feel comfortable. Ashley is passionate about communicating best practices, evidence-based practice and advances in skill competence to provide only the best nursing care. She is constantly engaging in learning opportunities and educational experiences to help her have a better understanding of the ever-changing world of patient care.

Ashley collaborates with a multitude of nurses, advanced practice providers, personal care assistants (PCAs), and physicians and is aware that each group has its own unique scope of practice. She uses critical thinking skills to create new opportunities for nurses and PCAs.

As I reflect on recent experiences in the unit, I am grateful for Ashley’s willingness to assist with her steadfast support and dependability. She is compassionate and caring and always strives to provide the highest-quality, personalized patient care. Ashley leads by example; she demonstrates extraordinary expertise by serving as charge nurse, unit council co-chair and chair; obtaining her clinical ladder IV professional certification; and serving as scheduling liaison to both our RN and PCA units.

Ashley is resourceful, creative and self-motivated. She displays a commitment to getting jobs done. She takes the initiative to create schedules, provide resources and complete assessments. As a nurse manager, it is a relief to know that Ashley collaborates with the unit educator, unit leaders and new staff to facilitate peer training. She establishes specific objectives, methods of implementation, educational resources and ways to evaluate objectives. She takes the initiative to design, implement and assess challenging educational opportunities within our unit. She is organized, trustworthy and dependable. I will forever be grateful for Ashley’s assistance. Ashley also contributed to our organization’s third American Association of Critical-Care Nurses Beacon Award for Excellence in 2019 by being part of the committee that compiled written examples of unit excellence for our submission. She strives to build strong, long-lasting relationships. Ashley cares for her colleagues by demonstrating helpfulness, being the first to jump in to help someone with an assignment. Ashley is well known for picking up additional shifts on the unit when staffing levels are challenging. She serves on the unit’s council and looks for ways to improve staff satisfaction such as organizing events like Secret Santa.

Ashley consistently provides opportunities for the BMT team to help our community. For example, annually, she participates in/volunteers at Pelotonia, which is a large bicycling fund- raiser from which 100% of the proceeds support cancer research. She also volunteers for NMDP, formerly known as the National Marrow Donor Program and Be the Match, and the Leukemia and Lymphoma Society.

A favorite memory of her work in the community is her organization of and participation in the Be the Match Hero Walk in 2022. The yearslong pandemic had been demanding and it was refreshing to see BMT inpatients walk our halls as “heroes.” Ashley created a NASCAR theme for which staff members were the “pit crew” and the patients were the “drivers.” There were decorations galore. Both patients and staff were laughing and smiling — welcome sights in an often serious and busy environment.

Ashley demonstrates compassion in a multitude of ways. She is present, a good listener and strong patient advocate. She provides patients with detailed, personalized care and education plans. As I complete nurse leader rounds with patients, I frequently hear bravos for Ashley. She is recognized as being kind, compassionate and patient.

In addition to providing relationship-based care, Ashley also sits on workgroups to improve patient safety. She was a valued member of the central line-associated bloodstream infection (CLABSI) workgroup in our organization. Her contributions and suggestions led to a new chlorhexidine gluconate (CHG) icon placed on the digital signage outside inpatient hospital rooms. Our unit CLABSI rates have been at an all-time low over the past four years: Since the implementation of the CHG icon, our rates have decreased by 25%.

Ashley is an excellent resource who is committed to increasing her knowledge of the nursing profession, promotes teamwork in the workplace and constantly shows accountability for her care, precepting and her actions. She is friendly and has a positive attitude. Ashley is invested in the success of every new employee. She goes above and beyond to find productive solutions for each challenging dilemma. Ashley has strong interpersonal skills. She is calm, optimistic and confident, and these talents facilitate positive interactions with the team. She is a great listener and often gives employees an outlet to express their fears, frustrations, anxieties and successes. Ashley’s cheerful outlook offers motivation for new employees to excel. She is dedicated to the profession of nursing.

As a busy nurse manager, it is deeply reassuring to have a reliable resource such as Ashley be part of my team. I am grateful for the opportunity to work with her.

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