James Camp, MSN, likes to think of himself as the Moriarty of Duke University Hospital’s neuro Intensive Care Unit (ICU), where he works behind the scenes, plotting ways to improve safety, innovation, and daily operations across the unit. For this week’s spotlight interview, the nurse manager talks to us about how he works to handle the information deluge of the COVID-19 pandemic, his joys of patient care and maintaining spreadsheets, and what he wishes more patients knew about visiting the neuro ICU.
What are your current responsibilities at Duke? What does a typical day for you look like?
I serve in the role of Nurse Manager of Operations for the 8E Neuroscience ICU and I have 24/7 accountability for the nursing practice, quality and safety, financial growth, people management, and day-to-day operations of the unit. I am a huge fan of the original Sherlock Holmes series, so I like to tell myself that I am the Moriarty of 8 East. Moriarty was an organizational mastermind that worked in the shadows in a variety of ways to achieve an end goal; and this position is much like that, but with less cloak and dagger. I work behind the scenes in a number of ways that affect our unit’s outcomes and move the unit toward the bigger picture of innovation, growth, and quality.
I don’t think a typical day exists in this role, different things pop up each day that ends up taking a significant portion of my time. I try to keep a balance between working on safety reports and following up on those, reviewing the unit’s finances, people management, recruitment and staffing projections, and rounding on staff and patients and try to get some patient care time in. All the while prioritizing emails, meetings, and project tasks I am currently in progress on.
What’s the biggest way that the COVID-19 pandemic has affected you, personally or professionally? What’s a resource or strategy that’s helped you adapt or cope?
Professionally, I think it has forced me to reassess how I communicate and make adjustments to my communication style. Before COVID-19, I was very conscious about not giving my staff ‘inbox fatigue’ but because changes with how we were dealing with COVID-19 were coming so rapidly, sometimes four to five times a day, I had to figure out how to effectively communicate all of these important changes without exhausting people via email and risk them not reading the information.
At the height of all the changes, I ended up creating a reference book that I updated daily with communication sent out via the command center and they could refer to it for the latest practice. I also was very intentional on when I shared information; if it was critical to operations I made sure to communicate it at that mornings tier 1 huddle and then send a unit email with the operational change. If it was not critical I clustered those updates to a weekly email.
Personally, I’m a bit of a hermit and don’t leave my house too often, so it has had less of an impact for me personally. I spend a lot of time managing a large garden and landscaping, so thankfully I have been able to continue my daily habits. I did give myself a haircut which solidified my assurances I should not be cutting anyone’s hair.
You’re coming to us from Wake Forest University Baptist Medical Center, where you were the assistant nurse manager to Trauma ICU and Neuro ICU. How does that position and health system compare to your current work and Duke, respectively?
In my role at WFUBMC I was kind of a jack of all trades. My primary “home base” was trauma ICU and neuro ICU but I covered all 10 ICUs as the assistant manager since I worked evenings. As the assistant manager I dealt with most of the day-to-day operations and issues, staffing, SRS follow ups and variance reporting for our units budget. I also frequently dropped into staffing as charge nurse and critical care transport when needed. I also responded to all codes on the floor and coordinated their care and transfer to ICU.
At Duke, I have all of those duties plus more. However, I am continually taken aback by the amount of resources and support our teams have here at Duke. I have worked in community hospitals and other academic medical centers, and I can truly say Duke is in a league of its own for resources and support available to staff. I am also incredibly thankful for my three CTL’s, Laura, Ken, and Karen. They have been instrumental in any modicum of success I have had in my time with Duke.
What do you enjoy most about your work?
I have two answers for this, and they are very polarized. I love patient care, and I always look for opportunities to step in and help or to make myself available. I love managing complex critically ill patients. However, I also enjoy the financial aspect of managing the unit. I think that joy stems mostly from my love of spreadsheets.
What’s the hardest part of your job?
As cliché as it is, work/life balance. As the manager, you feel this overwhelming sense of responsibility for everything on the unit. It is difficult to put things aside when doing something outside of work.
What’s one thing you wished more patients (or their caregivers) knew before they came to the Neuro ICU?
Something I wished more families knew before coming to the neuro ICU or any ICU in general, is that even if the patient took the initiative to complete first person consent to be an organ donor, that does not mean that we as health care providers do not give them the same standard of care as a non-organ donor. I think this is a common misconception among the general population, and creates barriers for our organ donation partners that are difficult to overcome because of preconceived notions about organ donation. Unfortunately, families usually only receive that education when they are in a situation that calls for it.
What other passions or hobbies do you have outside of Duke?
I’m a cellist. I have played cello for 25 years now. I am an avid reader; I usually read between 65-70 books a year. I also love gardening and run a gardening blog (@farmgategarden on instagram).
Do you have a headshot-style photo and photo of yourself in a non-work setting that you can share?
I don’t have very many, I usually shy away from cameras. Here is one that might work. I don’t have professional photos – they were scheduled to be in April but got canceled during COVID-19.
In the rare moments when he's not managing our Neuro ICU, Camp enjoys playing the cello.