Priscilla Samuel, DNP, FNP-BC, RN

According to a report by the Institute of Medicine, the demand for health care services is increasing significantly. The U.S. patient population continues to grow, age, and become sicker, while a nationwide shortage of primary care physicians is projected to more than double by the year 2030. Fortunately, advanced practice nurses (APNs) represent the largest growing segment of our country’s primary care workforce and a ready solution to ensuring access to high-quality care.

Throughout Mount Sinai Health System, APNs have been successfully integrated into team-based models for the past 30-plus years as part of a continuous effort to enhance quality, safety, and patient satisfaction. They have proven their role as essential to delivering the best of patient care. They help improve access to care, add efficiency to workflows, and provide continuity of care and specialty-based expertise, while minimizing duplication of clinical effort and promoting the appropriate and timely use of the team members.

The Mount Sinai Health System today employs more than 900 advanced practice nurses. Given this large and growing presence, in 2022, Beth Oliver, DNP, RN, FAAN, Chief Nursing Executive for the Health System, appointed Priscilla Samuel, DNP, FNP-BC, RN, as Vice President of Advanced Practice Nursing for the Mount Sinai Health System.

The current health care landscape further highlights the value these providers bring to the communities they serve. “Mount Sinai has seen the number of practicing advanced practice nurses grow from 15 nurse practitioners in the 1990s to 900 advanced practice nurses in 2023,” says Dr. Samuel. “This increase in APNs requires centralized coordination to manage core functions and provide support and resources in the key areas of service, engagement, safety, quality, stewardship, and innovation. My focus is on establishing a framework to help guide advanced practice nurses in prioritizing enterprise-wide initiatives, achieving system and departmental goals and metrics, and furthering their own professional and personal career aspirations.”

In addition to providing strategic direction and developing organizational strategies, Dr. Samuel is responsible for advocating, promoting, and elevating APN practice. “The key is to create a sustainable infrastructure that supports APN excellence,” says Dr. Samuel, “And developing a leadership model is a vital component.” For example, since joining Mount Sinai, she has promoted director-level APN leadership roles at two Health System sites, The Mount Sinai Hospital and Mount Sinai South Nassau, to address the particular needs of these professionals within their respective practice environments.

Mount Sinai continues to recognize the value and impact of integrating advanced practice providers (APPs) into the innovative team-based care models, and in January 2022 established the Center for Advanced Practice. “Both my Physician Assistant (PA) counterpart, Heather Isola, and I are working closely to strategize and provide guidance toward developing an environment in which APNs and PAs are supported, valued, and empowered,” Dr. Samuel says.

“Our overarching goal is to become a center of excellence and a national model for advanced practice provider practice. The Center is designed to provide comprehensive support to all Mount Sinai APPs, while ensuring a systemwide standard of care and practice by blending practice, education, research, and professional growth. The objective is to facilitate pathways for career development, expansion of clinical expertise, and the capturing of productivity,” says Dr. Samuel. “We also support advocacy for these professionals to practice at the top of licensure and leverage the unique versatility of APPs to better meet the needs of our continually evolving health care ecosystems.”

“Mount Sinai advanced practice nurses are poised to be leaders in advancing health care delivery in the United States,” says Dr. Samuel. “I stepped into my role fully recognizing the vital role of a collaborative leadership team.”

She adds, “The Chief Medical Officer, Chief Nursing Officer, advanced practice provider clinical leads, as well as medical and nursing, quality, human resources, and medical staff services leaders play critical roles in supporting and advancing the APN role within our organization. I am humbled by the tremendous support I continue to receive from both nursing and medical leadership in developing a centralized model for advanced practice nursing at Mount Sinai. The future is bright.”

Pathway to Leadership

Dr. Samuel brings vast clinical and leadership experience to her role. She is a board certified Family Nurse Practitioner and holds a Master of Science in Nursing from Columbia University and a Doctor of Nursing Practice from Case Western Reserve University. She previously served as an Associate Dean for Nurse Practitioner Clinical Affairs at the Hofstra Northwell School of Graduate Nursing and Physician Assistant Studies. There, she was one of the founding members and architects of a national model for an innovative graduate nursing education program. Unlike at traditional programs, students improve their critical thinking and clinical skills through a unique curriculum that includes problem-based learning, small group sessions, and experiential hands-on learning. Dr. Samuel also served as the first corporate director for advanced practice nursing at Northwell Health, New York State’s largest health care provider and private employer, with more than 20 hospitals and more than 850 outpatient facilities.

Wendy O’Brien, BSN, MBA

Nurses serve as patient advocates and caregivers, and typically stay far away from the world of business and finances. But Beth Oliver, DNP, RN, FAAN, Chief Nurse Executive at Mount Sinai Health System, has always known nurses are critically connected to an organization’s financial health.

To address this connection, Dr. Oliver developed a first-of-its-kind position to substantiate the financial value of the more than 8,000 nurses at Mount Sinai Health System.

In 2021, Dr. Oliver appointed Wendy O’Brien, BSN, MBA, as Vice President and Chief of Nursing Finance for the Mount Sinai Health System with a goal of shining a light on the financial contribution and value of Mount Sinai nurses.

Ms. O’Brien brings more than two decades of professional front-line nursing and nursing leadership to her role, including serving as Vice President and Chief Nursing Officer at Mount Sinai West. As Chief Nursing Finance Officer, priorities include analyzing staffing practice across Mount Sinai sites, serving as a resource for nursing leadership to manage expenses, and ensuring equitable policies and practices in work assignments and compensation.

One of her priorities is to tie the work of nurses to revenue and illuminate how reduced readmission rates for hospitals can be directly based on education that is driven by nurses. She says, “Hospitals thrive because of nursing.” Nursing leads the initiatives in meeting quality outcomes, including patient experience and the prevention of injuries such as infections, pressure injuries, and falls. She explains, “It is the nurse’s work that is tied to that and therefore the revenue is tied to nursing.”

Ms. O’Brien was born on the island of Trinidad and spent her early years growing up in Brooklyn, where she attended Clara Barton High School for Health Professions. “In high school, the best students were the students in the nursing program. I had to join them,” she says. She graduated from the Practical Nursing Program at Clara Barton and continued her quest for knowledge and understanding. Her unusual career path, more than anything, was driven by her constant curiosity and desire to understand the synergy of people and the work they do.

After her family moved to New Jersey, Ms. O’Brien attended Seton Hall University in South Orange, earning a Bachelor of Science in Biology, all the while working as an LPN. Following her mother’s direction that she “should be a nurse,” she furthered her nursing education, attending Union County College in Union, New Jersey, while doing clinical rotations at Elizabeth General Hospital in Elizabeth, New Jersey, and earning her Associate Degree in Nursing. Ms. O’Brien went on to earn a Master of Business Administration in Health Care/Health Care Administration, Management, from Nova Southeastern University in Fort Lauderdale, Florida, and then returned to complete her Bachelor of Science in Nursing from Chamberlain University. Ms. O’Brien says, “Nursing has afforded me the life I have grown to love. Nursing has allowed me to be in touch with patients and people in need. It brought out the more compassionate side of me, and shapes who I am as a person.”

The COVID-19 pandemic shined a light on hospitals and health care systems and the delivery of front-line care to patients and communities. During this time, health systems faced historic numbers of patients, revenue losses, and unprecedented expenses. It may seem obvious that nursing is an investment towards financial profitability, but oftentimes the work nurses do every day is difficult to directly link to revenue.

“COVID-19 shined a light on the financial aspect; the need to staff appropriately to meet clinical outcomes,” Ms. O’Brien says. “Quality outcomes connect to and lead to fiscal viability.”

Nurses are often unaware of the costs of care for the settings in which they work, and Ms. O’Brien’s work in this distinctive role strives to quantify the work of the more than 8,000 Mount Sinai nurses and how it directly links to revenue—how nurses can decrease the risk of patient falls, or decrease rates of pressure injuries, and therefore prevent readmissions and impact lengths of stay.

Nurse staffing can provide considerable advantage to hospitals and, as a result, better financial performance. “This role of nursing leading finance is not completely adopted within nursing itself,” Ms. O’Brien says. “We are still tied to the clinical aspect of what we do that sometimes makes it hard to embrace the business side of it.”

Ms. O’Brien’s work underscores the true value of nursing in health care and the impact on society as a whole. She speaks for every nurse working at Mount Sinai Health System when she says, “Whatever happens in that microcosm of a hospital impacts the community. The community relies on us to provide that care.”

Esther Moas Pandey, DNP, MS, RN

A nurse finishing up a busy shift at the end of a long week typically breathes a sigh of relief, knowing the next 24 hours will bring a well-deserved day off. It is gratifying to know that a patient who has been on the unit for several weeks will be discharged the next day. But—and especially if the discharge occurs on the nurse’s day off—that satisfaction is mixed with worry for the patient’s health status at home. Many nurses worry about what happens to their patients after they leave the acute care setting.

The health of many individuals, families, and communities is compromised by social determinants of health. Social determinants of health are conditions that influence health outcomes. They are not medical entities, but rather conditions into which a person is born, grows up, lives, and works. Addressing social determinants is the path to improving a population’s health.

Social determinants of health can influence health equity in positive and negative ways—food insecurity, income, housing, access to affordable health services. Social determinants of health can influence health even more than health care or individual lifestyle choices.

Nurses promote quality health care for all and can have a vital role in addressing social and health inequities by implementing social determinants of health screening.

Mount Sinai Health Partners, a clinically integrated network of Mount Sinai’s full-time faculty and community-based providers that sets the Health System’s strategic population health management goals, builds relationships with the population of Mount Sinai patients. Esther Moas Pandey, DNP, MS, RN, has been at Mount Sinai Health System for more than five years and began her career in the Population Health Division at Mount Sinai Health Partners.

“For purposes of population health, we look at utilization. Putting together clinical teams that manage utilization. We assess how our patients are doing—their goals, the need to remove barriers, make a discharge plan. The focus is to get our patients home,” says Dr. Moas Pandey.

Beth Oliver, DNP, RN, FAAN, Chief Nurse Executive at Mount Sinai Health System, recognized this work on population health across Mount Sinai sites, and said, “You need to be on the nursing team!” Dr. Oliver appointed Dr. Moas  Pandey as Vice President of Care Transitions for Mount Sinai Health System, putting someone with a storied career into the role. “I started as a visiting nurse. I loved home care. I lived and breathed home care for ten years and this was skilled nursing care, private duty, custodial, and administrative.”

Dr. Moas Pandey was previously Senior Director for post-acute care services. She has more than a decade of experience in post-acute care operations, which are a bridge between care services and rehabilitation for patients to return home following hospitalization. Prior to joining Mount Sinai, she was a Corporate Director at ArchCare and served as Regional Director and Administrator for Premier Home Health Care, Inc.’s private duty and certified home health divisions in New York City. Dr. Moas Pandey holds a Doctor of Nursing Practice degree from Yale University, and a Master of Science from New York University.

Under the guidance of Dr. Oliver, Dr. Moas Pandey and her nursing team assumed leadership of Mount Sinai’s Transitions of Care Center. This centralized telephone-based discharge program is staffed by Mount Sinai registered nurses specially trained in hospital discharge protocols. The Transitions of Care Center’s nurses call Mount Sinai Health System patients 24 to 72 hours after they leave the hospital, reviewing and addressing each patient’s discharge plan of care.

Mount Sinai Health System is one of the few places in the country with a dedicated team of nurses whose full-time work is to call patients to prevent avoidable readmissions. A milestone was reached in April 2022, focusing on transportation and food insecurity. Transitions of Care Center nurses ask patients: “How will you get to your follow-up appointment? Do you need assistance with that?” Nurses ask about food insecurity and access to healthy foods. Registered nurses have the clinical knowledge to discuss specific foods such as a heart-healthy diet and other nutritionally sound meals.

Dr. Oliver has continued to push for a more comprehensive and widespread strategy and says, “We need to do more. We need to put together a social determinants strategy for all nurses across the whole Health System.” Consequently, efforts continue to incorporate social determinants into the daily work of all nurses across every Mount Sinai site.

Dr. Moas Pandey works with nurses to bridge nursing care on the acute side to a patient’s care after they leave the hospital—to make sure patients are successful with their health plan after they leave acute care. “Population health can really speak to the ‘why’ of nursing—to the social justice piece. We know we cannot keep patients at home without addressing their barriers to care and social determinants of health. This is the new rule of nursing.”

Sujin Kwon, RN

Sujin Kwon, RN, Mount Sinai Queens, recently received a STAR recognition from a colleague for her help during a challenging time caring for patients with COVID-19. Her colleague said, “I had the pleasure and honor of working with Ms. Kwon on two occasions, and she showed exemplary nursing leadership behavior both times. She lifts you up when you are down; I will be forever grateful.”

According to her supervisor, KyeongHwa “Kimmy” Kim, RN, going above and beyond for her team is typical of Sujin, who has worked on 2 East, a Medical Surgical Unit at Mount Sinai Queens, since 2001.  “Whenever we need anything,” says Kimmy, “Sujin comes to help out; she is so dedicated, so committed to her colleagues and her patients. And she does it all, so quietly and so humbly.”

Sujin loves nursing, specifically, bedside nursing. “I love what I do, and although upgrading our skills is important—I am a certified infusion nurse—I never want to be far from patient care. It is so rewarding and makes me feel fulfilled.”

Patient Stephanie Zile with daughter

Stephanie Zile and her husband were at The Mount Sinai Hospital in the Labor and Delivery Unit and were anxious. Their first child was born by a caesarean section, and it was a difficult experience. But this time around, two nurses, and other staff, made the journey a smooth one. “Beila Edelman, my OR nurse, is a rock star,” she says. “In the hours before I was ready to deliver, she immediately perceived that we were tense, Beila wanted to understand what we were going through; how we felt emotionally, and even encouraged us to cry. As soon as I gave birth and my daughter was deemed to be OK, Beila brought her close to me and then took a photo of my husband, me, and my daughter. It was wonderful how she made a sterile operating room feel warm and comfortable. And she did her best to expedite the recovery so I could be transferred to a postpartum room, also coming with me to make sure I was settled.”

Stephanie has equal praise for her daytime nurse, Shanaaz Begum, RN. “Shanaaz really listened to me and sometimes could just read my body language and know what to say or do. She was totally attuned to my needs. One night, my husband and I were tired, so Shanaaz took my daughter to the nursery so we could get some rest. Importantly, she made me feel totally comfortable with having some respite time while also trying to nurse. Although this was my second birth, she made suggestions to reorient me to new motherhood—for example about breastfeeding—that were so helpful.

Shanaaz is fully engaged with her role. “Being a perinatal nurse is truly an empowering experience. Educating and comforting new mothers during this transformative time gives me great pleasure. I do my best to listen to my patients and help them achieve what they envisioned for their delivery experience.”

Beila says she feels blessed to care for her patients. “From coaching women through their labor experience with encouragement and positive affirmations, and supporting them through their cesarean section experience, to bringing their newborns to them for their first kiss, I do my best to create a joyful and positive experience,” she explains. “Meeting each patient where they are and finding out what they might require allows me as the nurse, together with the Labor and Delivery team, to create the best experience possible. Being in service to moms and their families in their sacred birthing experiences is an honor and privilege, and I am blessed to be able to serve this community with love and joy.”