To the Tune of “Stayin’ Alive”, Nurse Practitioner Saves a Life With CPR—and Urges More to Learn

Leela Gupta, NP

On Sunday, May 18, Leela Gupta, NP, who works at The Mount Sinai Hospital on the Heart Transplant team, took her four-month-old puppy, Otis, out for a walk to McCarren Park, near her home in Brooklyn. She was walking along the track at the perimeter of a playing field when she heard a group of men screaming. They were playing soccer, so at first she thought there might be a fight over a disputed call. However, she looked over and noticed one of the players on the ground—a large man in his mid-60s who appeared lifeless, lying on his side.

She asked a bystander what was going on, and he said the player might be choking. She ran to assess the situation and announced she was a nurse practitioner trained in CPR. She noticed that the man had labored breathing and felt his neck for a carotid pulse, but could not feel one. She asked for help flipping the man from his side to his back, began CPR, and asked someone to call 911.

During compressions, Leela asked if anyone in the crowd knew CPR so she could alternate compressions, but no one responded. One of the players from the opposing team began to sing and clap the Bee Gees song “Staying Alive”, which Leela says was actually helpful. “It was total silence except for that song; the beat of which was perfectly timed to the rhythm of my chest compressions.”

A few minutes into providing CPR, Leela was worried her compressions would become compromised as she grew fatigued. Since no one else was trained in CPR, she instructed one of the man’s teammates to place his hands over the man’s sternum and provide compressions to the beat of the song. She kept her fingers on the victim’s femoral artery to ensure a palpable pulse during these brief breaks, which meant the compressions were effectively circulating blood and adequately performed. She rotated places with him for about ten minutes until Emergency Medical Services arrived.

The paramedics analyzed the man’s heart rate and provided one shock to the man’s heart using a defibrillator, and a heartbeat was restored. He was then transferred to a local hospital for further evaluation. “CPR is a lifesaving technique that helps circulate oxygenated blood until medical help arrives, but defibrillation is often needed to restore the heartbeat,” Leela says. “Without CPR, even if a heartbeat is later restored, the person in cardiac arrest risks brain injury or brain death from lack of oxygen.”

Leela has been in touch with the man’s daughter, who said her father is recovering from coronary artery bypass surgery.

“I am just relieved he is okay. Ironically, I care for very sick heart patients, but this is the first time I have ever had to perform CPR outside of the hospital setting. With no one else trained to do heart compressions on the field, and no automatic external defibrillator (AED) nearby, admittedly I was concerned about the outcome. Thinking about that day is sobering,” Leela says. “There had to be over 100 people at the scene, and not one person knew CPR. That is so scary. This man would have died had I not been at the right place at the right time, and sheds a light on the importance of all adults learning this truly lifesaving skill.”

People and Technology at the Forefront: Jonathan Nover, MBA, RN, System Vice President of Nursing, Emergency Services

Jonathan Nover, MBA, RN

In the fast-paced world of health care, Emergency Services may set the pace. In mid-2024, Jonathan Nover, MBA, RN, assumed the role of Vice President of Nursing, Emergency Services, Mount Sinai Health System, in stride and with a running start.

Mr. Nover entered with an impressive track record of supporting nurses to do their best work, and with significant results. His contributions have led to reductions in hospital-acquired pressure injuries, reduced length of stay, nurse vacancy rates of single digit to zero, increased patient experience ratings, reduced workplace violence, and a strong display of quality improvement and health care legislative advocacy on the national stage.

“Jonathan brings an impressive portfolio of innovation and outcomes to the Health System’s nursing leadership team,” says Beth Oliver, DNP, RN, FAAN, Chief Nurse Executive, Senior Vice President, Cardiac Services, Mount Sinai Health System. “A key ingredient driving his success is his steady focus on doing what’s best for the nurse at the bedside.”

Mr. Nover’s philosophy is seemingly simple and yet highly effective: place people and technology at the forefront.

“I approach my work by striving to be both innovative and servant-minded,” Mr. Nover says. “Innovative in the sense of leveraging technology and best practice to help to guide and accelerate change. I want our nurses and nurse leaders to be at the forefront of novel methods and engaged in this rapidly evolving health care landscape.”

“While I am very tech-forward, I am equally people forward,” he says. “I’m in a terrific position to serve others, to help make the work more aligned, efficient, and value based, and to make the best of every situation for the people around me, from the leaders to the clinical nurses and teams taking care of our patients. I am honored to be at the helm, guiding the collective decisions about nursing practice in the Emergency Medicine specialty. By focusing on serving others, I believe that energy is returned many-fold.”

Making Work More Efficient

In his prior role as Senior Director of Nursing at Mount Sinai Queens, this philosophy proved invaluable. “Jonathan’s decision-making—including the projects he chooses to move forward—centers around improving patient outcomes and the notion of giving time back to both the patient and the clinical nurse,” says Jill Goldstein, RN, MA, MS, Deputy Chief Nursing Officer of Mount Sinai Queens.

“We have an extraordinary opportunity to align goals with our data technology partners and artificial intelligence (AI) experts while ensuring our nurse experts are embedded into decision pathways and workflow processes. The nurse in the loop is critical,” Mr. Nover says. “This may open new doors in the ED clinical operational realm, predicting next steps in throughput with nurses re-engineering new workflows, developing models and tools to help guide nurses to seek out patients at higher risk for specific presentations, or removing manual steps for nurses to improve efficiency. The result should be improved outcomes and giving our patients back time, which in turn gives time back to our clinical staff to help them continuously reprioritize clinical demands and perhaps take a breath, absorb a learning moment, and bond with a colleague.”

Examples abound of Mr. Nover’s technology/person-forward approach and advocacy brought to life. Video patient monitoring is helping to decrease falls and improve safety. Pilots of virtual nursing have shown effective ways to offset the documentation burden on nurses. Electronic reminders of regulatory requirements are improving the efficiency of managers and assistant nurse managers. Text messaging applications are improving patient experience and digital engagement.

“We’re also creating new platforms and workflows that are going to make our work more efficient and more electronic and remove what little paper we still have left,” Mr. Nover says. “As we’re doing this work, it’s important that we commit to finding ways to decrease our footprint, waste less, and become more green.”

Once projects are piloted locally, they are then rolled out systemwide in various ways. In the case of the community-acquired pressure injuries, Mr. Nover’s team created a turnkey quality improvement project. This ensured that each Mount Sinai ED site was ready and able to carry out the specific steps or actionable items to move the project forward.

The One Mount Sinai Vision

“I am proud to note, our ED systemwide community-acquired pressure injury (CAPI) discovery project has captured over 800 CAPIs in the three months since the project has been live,” Mr. Nover says. “That translates to improved patient care and potentially a projected $12 million in-hospital cost avoidance. In another systemwide quality improvement project, we are piloting new workflows to use text messaging to reduce admission delays. We are predicting 50,000+ hours of ED boarding saved in the first year from a simple text message.”

He continues, “This methodology of rolling out projects systemwide is part of the bigger vision to align our emergency departments under the One Mount Sinai vision. Essentially, this vision means that whether you walk into an emergency department on the Upper West Side or in Brooklyn or any other site, the experience will be similar and of the same high quality in terms of care, treatment, policies, clinical practice, and even something granular like offering electronic discharge as an alternative to paper.”

In recognition of their work, four Mount Sinai EDs have received Lantern Awards from the Emergency Nurses Association (ENA) for demonstrating exceptional and innovative leadership, practice, education, advocacy, and research. The ENA is described as the premier professional nursing association dedicated to defining the future of emergency nursing. Mr. Nover says, “I envision all our EDs holding the prestigious Lantern Award by year’s end, because we are hyper-focused on excellence.”

Pathway to Leadership

Mr. Nover brings more than 18 years of progressive and transformational nursing leadership experience in emergency medicine and hospital leadership to his role of Vice President of Nursing, Emergency Services, Mount Sinai Health System. He joined Mount Sinai in 2019 as Senior Director of Nursing, Mount Sinai Queens, where he directed and oversaw the daily operations and performance of the Emergency Department, critical care and medical-surgical services, inpatient dialysis, and evening/night nursing administrator services.

Prior to joining Mount Sinai, he served in several leadership positions at NYC Health + Hospitals from 2010 to 2019, including Associate Executive Director, Emergency Department, and Hospital Patient Experience Officer, South Brooklyn Health; and Associate Director, Nursing Adult and Psychiatric Emergency Department, Lincoln Hospital.

Mr. Nover is the recipient of the New York State 1199 Nurse of Distinction for Leadership Award, and a New York City Proclamation for Community Service from Mayor Eric Adams, a testament to his transformational leadership style and commitment to community health.

He currently serves as Chair of the Government Affairs Committee for the New York State Emergency Nurse Association and is enrolled in the Yale Healthcare Leadership, Systems, and Policy Doctor of Nursing Program at the Yale University School of Nursing.

Nurse Is Inspired to Help Create an AI Tool That Prevents Pressure Injuries

Kim-Anh-Nhi (Nhi) Nyugen (left) and Maria “Vickee” Sevillano

In 2022, Maria “Vickee” Sevillano, BSN, RN, CWCN, COCN, Wound Care Specialist at The Mount Sinai Hospital, attended a virtual informational discussion on artificial intelligence (AI) that clicked like a light bulb in her mind. “Even before attending that lecture I had been wondering if we could create a machine-learning application for pressure injury prevention. I was aware that big strides had been made using AI to interpret radiologic images. But could we use AI to identify patients at risk for pressure injuries? Most likely.” So Vickee reached out to Robbie Freeman, DNP, RN, Chief Digital Transformation Officer at the Mount Sinai Health System, and asked the question.

Vickee quickly became deeply involved in exploring how AI could be used in wound care as a member of a workgroup with Kim-Anh-Nhi (Nhi) Nyugen, MSc, Senior Clinical Data Scientist, Icahn School of Medicine at Mount Sinai. “Nhi needed to know our workflow, from placing the consult to chart review and completing a consults. Shadowing the nurses at The Mount Sinai Hospital to understand how wound care prevention, assessment, and treatment currently existed, we identified more than 300 clinical data points that would indicate a profile of patients at risk,” Vickee says. “From there, we created a model called the Pressure Injury Prevention Artificial Intelligence (PIPAI) Tool that would align best with our workflow. I validated the model every day for four months on two pilot units, and after some finetuning, we scaled to five additional units. I did unit-to-unit in-service with the staff to increase tool utilization. We deployed the tool to additional units, and currently the PIPAI tool is in use in 15 units.”

The initial results from the pilot units were overwhelmingly positive. There was a nine percent increase in patients discharged without pressure injuries, compared with before the pilot started. And the model was 50 percent more accurate in identifying patients at risk compared to the current risk assessment tool, the Braden Score.

“Pressure injuries are a global issue, and a heavy financial burden for hospitals, in addition to contributing to complications for patients,” Nhi says. “Traditional methods miss more than half of patients who will develop pressure injuries. “We need to create a tool to be more proactive in prevention rather than reactive after a pressure injury happens. The tool runs independently and continuously, thus at-risk patients are identified as soon as they arrive in the unit, even before the nurses see the patients.”

The model will be rolled out to Mount Sinai Morningside later in 2025 and likely to the rest of the Health System over time.

Vickee’s face lights up with a big smile when she speaks about the impact of this AI tool. “I am so excited and happy when a patient goes home with a healed pressure injury or no injury,” she says. “With this tool, maybe we can reduce pressure injuries around the world!”

Mount Sinai’s Nurse Residency Program Helps Graduates Transition to Professional Practice

The Mount Sinai Health System Nurse Residency Program (NRP), which started in 2019, is designed to facilitate new graduate nurses’ transition into their professional practice positions in the Health System. NRP provides education and support for what can be a daunting change from the student experience. Each year, six cohorts of new graduate nurses participate in this program, attending one eight-hour seminar each month for twelve months.

James Gold, DNP, RN, MedSurg-BC, NPD-BC, was recruited to Mount Sinai in 2024 to be the systemwide Nurse Education Manager lead for the program. In this role, Dr. Gold collaborates with site-specific NRP educators: Latia Lee, RN, MA, CPN, The Mount Sinai Hospital; Evelyn Navarro, RN, MA, MS, Mount Sinai West; Kingsley Nurse, MBA, MS, M.ED, RN, Mount Sinai Morningside; and Elissa Orbon, MS, RN-BC, Mount Sinai Queens. Together, they work to enhance curriculum topics, engage new graduates, and introduce simulation strategies with a system focus. “Efforts to standardize the program is a strategic goal of the Health System,” he explains. “The program provides new graduate nurses with many diverse teaching, learning, and coaching experiences.”

James Gold, DNP, RN, MedSurg-BC, NPD-BC

Recently, in-person sessions throughout the Health System introduced a multitude of experts, in subject areas including hospice and palliative care, pain management, medication safety, and conflict resolution. Residents also plan to meet with legal/risk management experts from the Health System to understand the importance of accurate patient care planning and clinical documentation. Other teams already in progress include experts representing rapid response, infection prevention, quality, and equity, among others.

The residents consistently participate in clinical reflections, a forum where they can confidentially share their successes and challenges with fellow new graduate nurses and a facilitator. The facilitators include senior clinical nurses, preceptors, and nurse educators. In these sessions, facilitators mentor the residents and discuss ways to promote the critical thinking skills required for them to succeed in their clinical nurse roles. Peter Ehiebolo, BSN, RN, a nurse at The Mount Sinai Hospital, completed the program last month. “The monthly sessions helped create a safe space for me to vent my feelings, share my challenges, and ask for workable recommendations to surmount them. Through the program, I realized I was not alone as I navigated my transition from student to professional nurse.”

Dr. Gold and the coordinators say their NRP interactions with new graduate nurses are highly gratifying. “When new graduate nurses arrive at the Mount Sinai Health System, they are naturally unsure of their new role,“ Dr. Gold says. “After twelve months, they are significantly more confident and competent. It is incredibly rewarding to contribute to the professional development of new graduates and shape the evolution of this program, and strive to be the best NRP in New York City.”

Alert to Signs of a Stroke, Mount Sinai Queens Nurse Helps Save a Colleague

From left: Vanessa Rose Jayme, MS, RN; Daniella Stephen, MPH, MSN, RN; Anne Pisciotta, RN; Asha Cox, RN; Connie Vargas, Director of Nursing Systems; Riskarlyn Figuereo; and Sharon Kurian, MSN, RN, CMSRN, Assistant nurse manager, 3 East

Asha Cox, RN, Nurse Manager on 4 East at Mount Sinai Queens, started her day recently by checking on a nurse in her unit who had experienced an injury earlier in the week. Calling the nurse at home, Asha immediately detected that something was wrong. She said to her colleague, “Your voice has changed, are you okay?”  Within moments, Asha knew this nurse was not well.  “It was also clear she was alone in her home.  I told her to call 911, but she could not.  I asked for her address, but it was hard to understand her, so the next step was to look through the Mount Sinai database to find where she lived and how to reach her emergency contact.  I also told her to unlock the door for emergency services, if she could do so safely. And to lie on the floor to avoid falling.“

Thankfully, colleagues were in the office, and it became a team effort. Daniella Stephen, MPH, MSN, RN, Senior Director, was by Asha’s side, offering guidance. Riskarlyn Figuereo, Administrative Office Coordinator, searched through the database for the emergency contact information and home address. Anne Pisciotta, Clinical Nurse Manager, 3 West, was a calming presence with her frequent nods of support.  And Vanessa Rose Jayme, MS, RN, Assistant Nurse Manager, came just in time to offer her telephone for multitasking while Asha spoke to her colleague and the 911 operator simultaneously. “I was feeling in control, but when 911 called back to say they could not find the entrance to her building, admittedly I had to work a little harder to calm my nerves,” Asha says.

Safiya Alozie, RN, Nurse Manager, 3 East, was in the office as well. “As we listened, the voice over the phone gradually became more slurred and disoriented,” Safiya says. “Asha remained calm, soothing her colleague and reassuring her that help was on the way. We heard the cries and the fear through the phone, and the anxiety among us all was palpable. The 15-minute phone call seemed liked an hour. But Asha never showed any fear, reminding this nurse that she would not hang up until the ambulance arrived. When we all heard the medical team burst through the door, there was a sense of relief for everyone. We could finally exhale!”

Asha, who has worked as a nurse at the Mount Sinai Health System for 18 years, says her experience was key in helping her navigate this “somewhat surreal” situation. “As nurses, we learn how to pay attention to seemingly little things, the details, an unusual symptom,” Asha explains. “In this case, I picked up on her voice, and the longer she was on the phone, I recognized the signs of stroke.”  She adds, “You cannot be sure how you will respond in times like these, but I am a person of faith. I am also am so thankful that my colleagues were close by. I felt supported.”

Jill Goldstein, MA, MS, RN, Vice President, Patient Services, and Deputy Chief Nurse Officer, Mount Sinai Queens, says: “Asha exceeded the definition of hero this day. She followed her intuition and her heart, which led to the successful 911 intervention. This is emblematic of Asha’s leadership style, authentic, transformational and dedicated to her staff and colleagues. We are blessed to work with Asha.”

Patient Is Grateful for a Secretary’s Compassion and Concern

Daniel Figueroa, Secretary lll

A patient recently shared her heartfelt appreciation for the outstanding service of Daniel Figueroa, Secretary lll, Department of Medicine, Center for Post COVID Care at Mount Sinai-Union Square.

Due to challenges with her insurance, the patient travels from Albany to receive care at Mount Sinai. She described how stressful this situation has been for her and recounted how Daniel went above and beyond to assist her when she arrived late to an appointment. She stated that she was grateful for his empathy as he ensured she felt heard and cared for. Daniel immediately advocated for her to be seen, and his kindness and genuine concern deeply touched her heart. She explained, “You never know what someone is going through, and Daniel’s compassion made all the difference.”

Arlene Rodriguez, Administrative Manager, Department of Medicine, says, “Daniel’s ability to listen attentively and show genuine compassion made a significant difference in this patient’s experience. Daniel’s dedication, empathy, and exceptional service set a shining example for us all. You are truly remarkable, Daniel, and we are grateful to have you as part of our team.”

The patient experience is clearly Daniel’s No. 1 priority. “As I speak to patients, I am committed to listen carefully and allow them to express themselves without judgement. Each patient has a story to share, and I want to ensure that each one has a safe space to discuss their health. My approach is to value each patient with respect, integrity, professionalism, perseverance, and accountability,” he says, adding, “In the words of Mother Teresa, it is not how much we do, but how much love we put in the doing. It is not how much we give, but how much love we put in the giving.”

Pin It on Pinterest