A Comprehensive Stroke facility needs to meet more than 400 complex requirements from the Joint Commission. As our Stroke Program Manager, Melissa Freeman, RN, MPH, works to make sure Duke University Hospital meets those requirements on a daily basis. In this week’s “Spotlight” interview, Freeman talks to us about the interdepartmental coordination, patient care, protocols, and education involved in her day-to-day work. She also discusses how her backgrounds in nursing and public health inform her work and her hopes for visiting New Orleans and Ireland once travel is safe again.
What are your current responsibilities within the Neurology Department? What does a typical day look like for you?
As the Stroke Program Manager, I am responsible for oversight of the guidelines the Joint Commission has determined we must meet for certification as a Comprehensive Stroke facility. There are over 400 line items in the requirements, each with their own set of criteria. This means my day-to-day work varies.
Daily, I view every new patient record to ensure we’re following evidence-based guidelines for stroke care and update the stroke code log which tracks all activations and the time metrics we are required to collect. I try to go to as many stroke activations as possible to assist the residents in time-sensitive emergencies. I try to help get things done faster, help the staff, look up records for the residents or speak to families/ nursing homes to get as much information possible to help the providers make informed decisions. I coordinate with different departments to improve and make our processes more efficient.
My day could also involve educating EMS, or staff on stroke, writing policies or creating new protocols, reviewing neurosurgical and vascular patient charts for adverse outcomes, educating patients and families, or other data analysis.
In addition to your nursing degree, you also have a master’s of public health. How do each of these degrees inform your current work? My nursing degree helps me understand stroke from an anatomy and physiology perspective and all the medical comorbidities, care continuum, challenges etc that go into caring for patients. It also helps me understand what our nursing staff goes through with every administrative-type change we make. I try really hard to avoid creating documentation redundancy and more work for staff knowing the enormous tasks we ask them to complete daily.
My MPH had a concentration in epidemiology, which I find helps with the data analysis/interpretation I perform and dissecting journal articles. But don’t ask me to complete any complex statistics, SAS was traumatic and I’ve blocked that from my memory.
What’s one thing you wished more patients and their loved ones knew about stroke (or stroke treatment)?
Most strokes are preventable! I wish we (as a country) spent more time focusing on preventing illness. (That’s more of the MPH in me). And of course, time is brain.
What do you enjoy most about your work?
I really like being that point of contact in the emergency setting that sits with the family member(s) and explains everything that we’re doing to try and help their loved one, that coming to the hospital was the right thing, and that they’re in a good place. I don’t think that role exists for a lot of disciplines or facilities. I can’t imagine how scary it is to sit in a waiting room of an ED and not know what’s going on behind the doors. I hope I’m able to help out in that aspect.
What’s the hardest part of your job?
Tough question. I think the hardest part is probably trying to maneuver 18 moving components across multiple departments to accomplish what we need done for the patient/ program, especially when something might be a high priority item for our stroke team, but not anybody else.
What are you most looking forward to doing once the COVID-19 pandemic is over?
Oh so much! I had my heart set on going to Ireland this year for my birthday. I’ve not given up on that trip. I also really want to go back to New Orleans to see friends and enjoy food that I can’t get in North Carolina.
What other passions or hobbies do you have outside of the Department?
When I’m not trying to keep up with my sassy, energetic 4 year old, I read. I probably read 3-4 books a week. I also like hiking, Saints and LSU football, and Villanova basketball (sorry y’all. Go Wildcats!) Now that I live in the suburbs and have a yard, I’m determined to learn gardening.
Freeman poses with her husband Chris, daughter Evangeline, dog Sazerac shortly after they moved to North Carolina last year.