Removing Barriers to Care: A Talk With Marsha Sinanan-Vasishta, MBA, MSN, RN, NEA-BC, CPXP, Vice President and Chief Nursing Officer of Mount Sinai Morningside and Mount Sinai West

Marsha Sinanan-Vasishta, MBA, MSN, RN, NEA-BC, CPXP

“In challenge there exists possibility” might best describe the leadership pathway and management approach of Marsha Sinanan-Vasishta, MBA, MSN, RN, NEA-BC, CPXP, Vice President and Chief Nursing Officer (CNO) of Mount Sinai Morningside and Mount Sinai West. As a little girl growing up in the Caribbean country of Trinidad and Tobago, Ms. Sinanan-Vasishta dreamed of becoming a veterinarian. It was a serious illness at a very young age that changed her life’s course.

“I got very sick when I was in Trinidad,” she says. “I had a really bad case of rubella—German measles—that required emergency surgery. My infection grew so bad that they had to remove my adenoids, tonsils, and uvula. Care in the Caribbean was completely different than what we know as care in the United States. The wards were all open, and you had to bring in your own sheets and supplies. I was so scared.”

Yet it was this experience that exposed Ms. Sinanan-Vasishta to the world of health care and its various roles, most memorably nursing.

“There was one particular nurse who was able to calm me, and my mother had a high degree of confidence in her care,” she says. “She made us feel safe and well cared for, and that changed everything. The nurses at that time would also do rotations out in the community and visit people in their homes, and I was lucky enough to have this same nurse provide my follow-up care at home. This not only exposed me to the field of nursing itself, but also to the diversity of roles within the profession. The competence and compassion it takes to care for patients in different settings, and how adaptable a nurse has to be, is so impressive. It also showed me how one person can have such an impact on someone else’s life.”

Ms. Sinanan-Vasishta knew then and there that she wanted to become a nurse. She wanted to make a difference in the world. In the years to come, her mother and father would move the whole family to New York, where they had no other family but a few friends. Ms. Sinanan-Vasishta began working as a companion in the Jewish Home and Hospital for the Aged in the Bronx and also started her nursing studies.

Creating Excellence Together

Following nursing school, as a new nurse practicing at the bedside, Ms. Sinanan-Vasishta gained a different perspective on the world of care delivery. “I loved caring for patients and their families. It was incredibly fulfilling,” she says, “but I could see so many inefficiencies, so much waste in the system itself. I had a mentor who used to challenge us by asking, ‘What isn’t working?’ and that stuck with me on the unit. Once I started thinking like that, I wanted to help change things on a broader level. That’s when I had my ‘aha’ moment: In a leadership position, I could significantly influence change and make systematic improvements.”

As she rounds in her CNO role today, Ms. Sinanan-Vasishta continues to look at nursing practice through this lens. “What are the barriers to delivering the best possible care, and how do I help remove them?”

To further prepare her for this work, Ms. Sinanan-Vasishta earned a Lean Six Sigma Green Belt. “I am an avid Lean advocate,” she says, “and I was thrilled to join Mount Sinai Morningside, since it is a Lean organization. Lean Six Sigma as a process improvement approach is focused on eliminating inefficiencies by creating solutions to eliminate waste and redundancy. The staff are my eyes and ears in this process, my patient-facing experts, and rounding provides a direct way of working together to advance practice and make things easier for them. I might be holding the wheel, but really, it’s the staff who are driving.”

Examples of this staff-driven partnership are numerous and have shown tremendous results in improving efficiency and, ultimately, care delivery.

Most recently, staff brought forward the issues of managing the workstation on wheels inventory, broken equipment protocol, and the escalation of clean supply rooms and respiratory equipment. “The medical-surgical units began to find themselves lacking specific respiratory supplies,” says Ms. Sinanan-Vasishta. “In recent years, this patient population has become more acutely ill. Certain equipment that might rarely have been needed is now used much more frequently. Staff pointed out this emerging need for a realignment of readily available supplies to support practice.”

Based upon feedback during CNO rounds, Ms. Sinanan-Vasishta invited members of the respiratory team to her nursing leadership team meeting to further examine the issue and its underlying causes. Soon, a plan emerged and is being rolled out to improve the types of respiratory supplies on these “med-surg” units.

Staff also shared that it was often challenging to distinguish between pieces of equipment, such as workstations on wheels, that were fully operational and those that were not. Non-working pieces often remained in place on the unit, pushed aside in a rush to bring working equipment to the bedside. Along with colleagues in the Digital and Technology Partners department, the nursing team created a standard protocol for submitting needed repairs and requests for parts and equipment that have since kept operations and care delivery moving without disruption. “The rollout of the new processes and procedures have gone very well at Mount Sinai Morningside,” says Ms. Sinanan-Vasishta. “We are now going to spread this work to Mount Sinai West and are exploring the feasibility of disseminating this throughout the Health System.”

In another effort to foster two-way communications with patient-facing staff, Ms. Sinanan-Vasishta recognized the important role Unit Practice Councils and a Staff Advisory Council that reported directly to the CNO might play. Unit Practice Councils, once only service-line based at Mount Sinai Morningside, are now meeting throughout the hospital and beginning to emerge throughout Mount Sinai West. “These are a terrific forum for advancing practice and relationship-centered care at the local level and throughout the hospital,” she says. “A Staff Advisory Council brings together representatives from the Unit Practice Councils to meet and communicate directly with me as CNO, and to promote the sharing of best practices, exchange of critical information, and brainstorming. This also facilitates the dissemination of their lived work and improvement experiences hospital-wide and has become a very important structure and process for giving voice to nurses. It’s empowering.”

Pathway to Leadership

Ms. Sinanan-Vashista brings both institutional familiarity and solid nursing leadership experience to her Vice President/CNO positions at Mount Sinai Morningside and Mount Sinai West. She continues to be guided in her work and life by a favorite quotation from Nelson Mandela: “It always seems impossible until it’s done.”

In 2021 she was appointed Chief Nursing Officer of Mount Sinai Morningside, having joined the hospital as Deputy Chief Nursing Officer in 2019. Before joining Mount Sinai, she was a Director of Nursing at NewYork-Presbyterian/Allen Hospital, where she provided oversight to the Emergency Department, Behavioral Health, the Dan and Jane Och Spine Hospital, and the Geriatric/Hospitalist Unit. There she helped lead several systemwide quality, patient safety, and patient experience advances. She also previously held clinical nursing leadership positions at Columbia University Irving Medical Center.

Ms. Sinanan-Vasishta is currently enrolled in the Yale Healthcare Leadership, Systems, and Policy Doctor of Nursing Program at the Yale School of Nursing. She earned her Certificate in Lean Six Sigma and Lean Six Sigma Green Belt from Vanderbilt University, and a Master of Business Administration with a concentration in Health Care Management from the University of Phoenix.

A board certified Nurse Executive, Ms. Sinanan-Vasishta was among the first nurses in the country to earn Certified Patient Experience Professional certification. She currently serves as a voluntary adjunct faculty member of the Mount Sinai Phillips School of Nursing and is a member of the Transcultural Nursing Society, the American Nurses Association, the American College of Healthcare Executives, and the International Honor Society for Nursing, and is a Fellow in the New York Academy of Medicine. She co-chairs the Health System’s Nurses Against Racism Committee to help create and sustain an anti-racist and equitable organization and foster equitable patient care within the communities served by Mount Sinai. Ms. Sinanan-Vasishta is a member of the Board of Directors of the OKB Hope Foundation, which provides health care access to rural populations in Ghana, Africa. She is also the nurse lead for Mount Sinai International Advisory Team’s collaboration with the government of Guyana, South America, to help improve health outcomes within the Guyana Public Hospital Corporation health system.

Supporting Nurses: A Talk With Stacey A. Conklin, MSN, RN-BC, MHCDS, NE-BC, Senior Vice President and Chief Nursing Officer, Mount Sinai South Nassau

Stacey A. Conklin, MSN, RN-BC, MHCDS, NE-BC

Each year, Gallup surveys the public opinion of various professions in terms of honesty and ethics. For 21 consecutive years, nurses have come out on top. Nurses are trusted because of their integrity, advocacy, empathy, and compassion. They do whatever it takes to make a difference in the life of another. The work is very rewarding but also fast-paced and demanding, making it critically important for nurses to focus on their personal well-being as well.

“Nurses are dedicated to delivering the best and safest possible care to our patients,” says Stacey Conklin, MSN, RN-BC, MHCDS, NE-BC, Senior Vice President and Chief Nursing Officer (CNO) at Mount Sinai South Nassau. “To deliver this level of care, we have to fully support them, both professionally and as whole people. I see this as one of my top responsibilities as CNO.”

Ms. Conklin, her colleagues, and her leadership team have been conducting focus groups, doing leadership rounds, and working strenuously to better understand the needs of nurses. “My focus is on identifying the most important priorities, bringing these back to our senior leadership team, and fiercely advocating for them,” she says.

The Mount Sinai Health System’s Executive Nurse Cabinet members are global leaders in nursing practice. A series of profiles highlights how each member is uniquely advancing the profession.

As part of this work, they are exploring emerging generational differences in the workforce. “For a new nurse, the workplace can be overwhelming at times,” she says. “There’s so much to learn. Yet, those of us who have been nurses for many years can learn some important work-life balance lessons from them.”

Historically, nurses have been known for doing whatever it takes to care for patients and their loved ones, at times to their own detriment. Ms. Conklin senses a subtle shift emerging within nursing, one that has the potential to shape the future of the profession. “As a newer generation of nurses is coming along, it’s clear they’re highly dedicated to their patients,” she says. “But they also understand better than we did that they can only give their patients their best when they are at their best.”

Creating Excellence Together

To this end, Ms. Conklin and her team have been especially focused on supporting the nursing staff in career advancement and by reducing workload.

Career Paths

“The nurses want to know they have a good career path, so we want to work with them to set goals and advance professionally,” she says. “For example, the hospital is currently expanding to add 40 critical care beds and nine operating rooms and launching a cardiac surgery program in 2025. This is an amazing opportunity for staff as they grow and get grounded. If and when they want to go into cardiac surgery, the opportunity is going to be right here.”

The hospital also offers a robust clinical ladder that gives nurses an opportunity to validate their level of expertise and be compensated accordingly. Nurses can apply to participate in a five-level system that works on a point basis. Staff earn points for different aspects of their practice, including patient experience, exemplary practice, community service, research, and others. As they progress, the requirements change to reflect a higher expected level of professional experience and expertise.

Ms. Conklin is also trying to establish pathways to leadership for millennial nurses. “There’s been an unofficial rule in nursing that you have to pay your dues before you can become a leader,” she says. “I’d like us to think differently about fostering young nurses to go into leadership roles and tap into their unique talents earlier in their careers.  We have already begun to do this with the nursing leadership team and everyone is benefitting from the connections with staff and leaders.”

Workload Reduction

Another priority involves reducing the workload of nurses. Ms. Conklin and her team are applying evidence-based models of care to remove tasks that can be time-consuming. “Being innovative is really important to me,” she says, “And that includes listening to the ideas the nurses have and looking to technology as a way to ease their burden and enhance practice.”

“The introduction of the virtual nurse on the Medical-Surgical and Telemetry units is a great example,” says Ms. Conklin. Virtual nursing involves incorporating the support of an experienced nurse into the care of a patient via a real-time telehealth or virtual connection. “The virtual nurse can conduct the majority of an admission or provide a second set of eyes for a skin check, something we would otherwise have to pull another nurse away from the bedside to do. We’re encouraging nurses to identify and delegate other tasks these virtual nurses can perform,” she says. “Like patient education, where they are spending time with the patient, and the patient is reassured that they always have someone there for them.”

Mount Sinai South Nassau is using software to assess patient acuity that accounts for not only how sick the patient is, but for the amount of time it takes to provide care. “The patient is here because they require care, but for Patient A that care may not be as time-consuming as the care necessary for Patient B,” says Ms. Conklin. “Patient B may be admitted for something minor, but their care is time-intensive. We want to understand both the complexity and intensity of the care required, so that we can staff the unit appropriately and objectively. This allows us to tailor the staffing to meet the actual needs of the patients.”

“We also want to help nurses better balance their time at work and at home, and we can do this by thinking differently about scheduling,” says Ms. Conklin. “For example, the nurses on the Behavioral Health Unit wanted to go to 10-hour shifts versus eight-hour shifts. I was all for it, and they proposed a schedule with two shifts going to 10 hours, and the overnight shift staying at eight hours. The nurses who opted for the 10-hour shifts would work only four days a week versus five. Everybody was happy, it worked, and we implemented the change at no cost to the organization. It was a huge win for the staff because they created more work-life balance.”

Pathway to Leadership

“I started school as a married mother of one and pregnant with another,” says Ms. Conklin. “Entering my career a little bit later gave me a very different perspective, and once I started my clinical experiences I never looked back.”

Initially on staff at NYU Langone Medical Center, Ms. Conklin ascended to the role of Assistant Nurse Manager. There, she helped launch a new electronic medical record, learning a lot about the topic before it was even a field. She then accepted a position in nursing education at another hospital, helping to roll out their electronic medical record in tandem with a shared governance council to better engage staff in the work. Later, she took her talents to a systemwide information technology position, all while working on her Master of Science in Health Care Delivery at Dartmouth College.

“I learned a lot about technology, workflow, and hospital operations and was able to use my clinical knowledge to really enhance workflows across the organization,” says Ms. Conklin. “But, I was feeling very disconnected from patient care. I wanted to go back into nursing and become a CNO, and I was fortunate to have a great mentor who helped me do just that. And, as a CNO at the height of the pandemic, when we had to open virtual units, my IT background became instrumental in helping operationalize units and technology in non-traditional patient care areas.”

Ms. Conklin has more than 20 years of experience in nursing administration and patient care. She was Director of Patient Care Services at Mount Sinai Beth Israel and Chief Information Officer at North Shore University Hospital in Manhasset, New York. She later served as Senior Director of Patient Care Services at New York Eye and Ear Infirmary of Mount Sinai before being named Vice President of Patient Care Services and Chief Nursing Officer there. Today, Ms. Conklin oversees all nursing activities at Mount Sinai South Nassau, and the more than 900 registered nurses who ensure the delivery of consistent high-quality care to their community. A testimony to the hospital’s Nursing Service, the American Nurses Credentialing Center (ANCC) recently designated Mount Sinai South Nassau a Magnet hospital for the third time, the highest available recognition of excellence in nursing care.

Ms. Conklin served as an adjunct professor of Graduate Nursing at Molloy College, where she received her Bachelor of Science in Nursing. She earned her Master of Science in Nursing from Walden University in Baltimore, and her Master of Science in Health Care Delivery from Dartmouth College. Ms. Conklin is board certified by the ANCC in both Nursing Informatics and as a Nurse Executive. She is a member of the American Nurses Association and a Fellow of The New York Academy of Medicine.

Rehabilitation Therapist Rises to the Occasion and Delivers a Baby Outside The Mount Sinai Hospital

Aura Weltman, a senior clinical specialist in the Department of Rehabilitation and Human Performance at The Mount Sinai Hospital

On Thursday, December 28, shortly before 8:30 am, Aura Weltman, OTR/L, SCLV, was walking on Fifth Avenue toward The Mount Sinai Hospital and heard a woman scream. Aura, a senior clinical specialist in the Department of Rehabilitation and Human Performance at the hospital, looked around and noticed that the street seemed unusually deserted. The only people she could see were a couple walking about half a block ahead of her.

She was unsure who was in distress, but a second scream was clearly coming from the woman, who seemed to be losing her balance as she walked up the ramp to the hospital. Aura ran to her as she started to fall, caught her, and helped her to the ground.

The woman said “baby,” and Aura instinctively dropped to the ground to assist.

“I noticed someone standing close to the hospital entrance, and I called for him get help. I could tell that there was no time to wait,” she says, adding that the delivery took only a few minutes. “It was miraculous to have a perfect, beautiful baby boy crying in my arms. The mom was so brave and strong—her only concern was that the baby be wrapped and warm.”

Although Aura had never delivered a baby before, she had trained as an emergency medical technician through a summer program at UCLA after graduating from high school. She explains, “When I was 16, I was a passenger in a near-death car accident. As a result of this, I wanted to know what to do to help others in case of an emergency.”

Aura remained with the baby and his mom, reassuring her and caring for the baby until a team from the hospital arrived. “One of the security guards came out and took off his coat to wrap the baby. He also removed and unlocked my phone so I could advise my manager that I had a ‘minor emergency’ and would be a little late!”

She continues: “Once the teams arrived, they cut the umbilical cord. One team took the baby, and I began to help the mom to a stretcher. After entering the hospital and checking that both were okay (and checking on dad, who clearly did not expect this), I wished them well. By the time I turned around, the baby and mother were being wheeled away, and the team of medical professionals dissipated.”

Debra Zeitlin, who is Aura’s manager in the Department of Rehabilitation and Human Performance, was not surprised to learn about her efforts to help someone in need. “Aura’s actions and calm demeanor are no surprise to me or her colleagues,” she says. “Aura is an excellent, dedicated clinician who goes above and beyond for her patients on a daily basis.”

Aura was also recognized for her courage and compassion in the Mount Sinai Health System’s daily leadership huddle.

When asked about her courageous actions, Aura speaks about the influence of others. “I am so grateful to my parents and my community—they have always placed an emphasis on seeking knowledge and helping others. I am grateful for learning so much about compassionate care and excellence from many of my Mount Sinai colleagues,” she says. “The members of the Department of Rehabilitation and Human Performance, including doctors, nurses, therapists, and staff are hard-working, devoted, and creative; they honestly would have done the same. Our department is constantly involved in rebirth—working to aid those recovering from brain injuries, spinal cord injuries, and a host of other challenges—it may be a bit less dramatic but it is every bit as miraculous.”

Aura believes she was not alone during this experience. “I genuinely felt that I was being guided from above—all the training that I had received years ago flooded back. I feel lucky to have been placed there at the right time and fortunate to have been a part of such a miracle.”

Nurse Says He Is One of a Team, Performing “Small, Meaningful Gestures Every Day”

Joseph Long, licensed practical nurse

Joseph Long, a licensed practical nurse, joined the Mount Sinai Doctors Internal Medicine Associates practice seven months ago as a new graduate. According to Sandra Casey, MSN, Associate Nursing Director of the practice, he is a dedicated and compassionate team member. Joseph was recognized recently for going above and beyond in his care of a patient who was returning home after an office visit with Sara Towne, MD.

Dr. Towne recounts, “A few weeks ago, Joseph, my resident, and I were the last people in the evening session, and we had a patient who was determined to go home, despite having an unsteady gait. The patient did not have a rolling walker or any assistive device. Joseph walked the patient out of the practice and to the bus stop on Madison Avenue before going home. This was almost 9 pm.”

Joseph does not consider his action extraordinary. “Walking this patient to the bus wasn’t an effort to be a better nurse or offer a better patient experience—I was just treating another person with the courtesy they deserved,” he says. “And while I’m grateful for being recognized, I am not a unique example. I see members of my team perform these sorts of small, meaningful gestures every day. They step out of the role of caregiver and see their patients as human beings, treating them with compassion and respect. “

Patient Thanks a Nurse Committed to “Making a Genuine Connection”

Alipio Esguerra, BSN, RN

Alipio Esguerra, BSN, RN, is a nurse at the Mount Sinai Therapeutic Infusion Center at The Mount Sinai Hospital. His supervisor, Nurse Manager Monica Reiter-Wong, BSN BC, received a letter from a patient, expressing appreciation for the outstanding care provided by Alipio.

“Alipio was so distinctively conscientious, informative, and polite, that I wanted to let you know how impressed I was. He explained the purpose of all the pre-medications; explained every procedure as he was doing; inserted the IV needle perfectly the first time, with not a hint of pain; took special care to help me in and out of the room when I had to visit the bathroom; and followed up himself every time the titration rate had to change, instead of leaving it to another nurse. There seemed to be extra dedication to detail in Alipio’s approach, a very earnest courtesy and helpfulness, that I thought deserved special commendation.”

Alipio is humble when asked to reflect on being recognized for his commitment to patient care. He shared his approach to his chosen profession in a thoughtful message:

“I am honored to receive recognition for my contributions to direct patient care and empathy. This recognition means more to me than words can express.

In our noble profession, the heart of our commitment lies in putting patients first. Every day, we encounter individuals and families facing challenges, and it is our duty to provide not just medical care but also a compassionate touch that can make a significant difference in their healing journey.

I firmly believe that empathy is the cornerstone of effective health care. It’s about listening, understanding, and making a genuine connection with our patients. It’s about acknowledging their fears, celebrating their victories, and standing by them in their moments of vulnerability.

I am proud to be part of a team that values these principles and strives to create an environment where patients feel heard, respected, and cared for in every aspect.

My manager, colleagues, mentors, family, and the entire health care community inspire me every day.”

Physician Assistant Provides Warm and Empathetic Care to Breast Cancer Patients

Yelena Bernstein, PA

Physician assistant Yelena Bernstein, PA, has worked at Mount Sinai West with the Chief of Breast Surgery, Stephanie Bernik, MD, FACS, since 2018.Yelena consistently goes the extra mile for patients and is truly an integral part of the Breast Surgery team, says Toby Bressler, PhD, RN, Senior Director of Nursing for Oncology and Clinical Quality.

“Yelena is warm, helpful, and empathetic with her colleagues and patients,“ she says. “She volunteers to provide coverage for colleagues, always offers assistance to the team, and helps orient new physician assistants joining breast surgery departments throughout the system. We are grateful to have Yelena on our team.”

A patient letter praised Yelena for her compassionate care, reflecting Yelena’s commitment to the patient experience: “I am so grateful to Yelena for escorting me to the OR. Her hand-holding me to sleep was so comforting, and so above and beyond any efforts I would have ever expected, considering your incredibly busy schedule. Honestly, your kind attention moves me, even as I write this. I want to thank you again for getting me through this year with care and dignity.”

Yelena‘s approach to her work is simply stated: “As a breast oncology physician assistant, I strive to make every patient feel comfortable, understood, and supported during their challenging journey.”

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