Leading on the Front Lines
Story by Matt Wing
Cheryl (Wallace) Reinking 鈥�87 oversees more than 2,000 frontline healthcare workers as the chief nursing officer at El Camino Health, a two-hospital Bay Area healthcare system.
Florence Nightingale is widely recognized as the founder of modern nursing. Known as the 鈥淟ady with the Lamp,鈥� who dutifully treated wounded soldiers during the Victorian era, Nightingale founded the world鈥檚 first non-secular nursing school and shaped the healthcare industry in lasting ways.
Cheryl (Wallace) Reinking 鈥�87 can tell you all that. And then some.
鈥淚鈥檓 kind of a big fan,鈥� she says, laughing.
Nightingale has served as an inspiration for Reinking throughout her nursing career. Reinking dresses as the 19th century nurse on Nightingale鈥檚 birthday. She recently penned an article in the medical journal Nursing Management framed by Nightingale鈥檚 innovative approach to nursing.
In celebration of the 200th anniversary of Nightingale鈥檚 birth, and much to Reinking鈥檚 delight, the World Health Organization declared 2020 as the 鈥淚nternational Year of the Nurse and the Midwife.鈥� But that designation was made long before the COVID-19 pandemic elevated the role of nurses who have played essential roles during the global health crisis.
鈥淚 think the general public has seen during this how nurses contribute to the well-being of the whole person, including their mental health and their spiritual health. I think this has been recognized through the pandemic as nurses have served as family members to patients because of the situation we鈥檙e in, with families unable to visit,鈥� Reinking said. 鈥淣urses are caregivers and family members and priests and preachers, all in one, at the bedside of their patients.鈥�
As chief nursing officer for El Camino Health, a two-hospital healthcare system in California鈥檚 Bay Area, Reinking oversees 1,300 registered nurses and more than 700 ancillary workers primarily responsible for direct patient care. She leads them while guided by lessons learned from childhood experiences caring for an ill grandfather, her time at Illinois Wesleyan, and more than 30 years in the healthcare sector. And inspiration, of course, drawn from Nightingale.
They鈥檝e all served her well as she鈥檚 provided critical leadership during the COVID-19 pandemic.
鈥淲ho would have known, or who could have guessed, what would have happened this year as nurses across the world are facing the struggle against COVID-19?鈥� Reinking said. 鈥淏ut El Camino Health nurses have risen to the challenge and taken care of numerous patients with the diagnosis.鈥�
鈥� 鈥� 鈥�
Reinking was raised in a small town with a post office and a general store, but not much else.
The city of Grafton, Illinois, is such a place. A trip to 鈥渢he city鈥� usually meant a 20-minute drive to Alton or Jerseyville, or a trip across the Mississippi River to St. Louis. Grafton is the kind of place where generations of the same family live in close proximity and grandma鈥檚 house is just a short bike ride away.
Reinking was raised on a family farm just outside Grafton. Her grandparents lived next door. Her grandmother was a secretary for the chief nursing officer at nearby Alton Memorial Hospital, who dreamed that her first grandchild would become a nurse. Her grandfather was a talented carpenter and woodworker who fell ill with multiple sclerosis early in Reinking鈥檚 childhood.
鈥淭he whole family was taught to be caregivers. I was quite young, but I participated in his care,鈥� she said. 鈥淎nd that was something that I certainly attribute to my decision to become a nurse.鈥�
Reinking鈥檚 nursing journey continued years later at Illinois Wesleyan, where she gained formal training in the profession that鈥檚 become her life鈥檚 work.
鈥淲hen I came to Illinois Wesleyan, I found what I was looking for,鈥� Reinking said. 鈥淚 felt welcomed and supported from the leaders and peers in my dorm to the professors who supported us through the transition to college.
鈥淚 never felt I was alone. I knew I could reach out for help for whatever I needed.鈥�
Reinking remembers moments when she realized she was becoming a professional nurse. Classroom learning and time spent in the nursing lab prepared her for her first rotations.
鈥淚 felt nervous and anxious about interacting with patients for fear of saying or doing something wrong,鈥� she said. 鈥淏ut as time went on, the skills I obtained through practicing in the nursing lab and just feeling more comfortable in the practice setting made me feel much more confident.鈥�
Reinking was soon a direct care nurse. Not long after, she became a charge nurse with managerial responsibilities. Within five years of her graduation from Illinois Wesleyan, Reinking was managing a large surgical unit.
She鈥檚 been in nursing leadership positions ever since.
鈥淲hile I didn鈥檛 realize it at the time, 麻豆直播鈥檚 nursing program prepared me to step into a professional nursing role very quickly,鈥� she said. 鈥淭he leadership courses required in the nursing curriculum allowed me to see processes and systems in nursing and healthcare more broadly, which served me well as I have moved into nursing leadership roles throughout my career. The nursing faculty was second to none in promoting a broader view, always incorporating innovation and evidence in making clinical decisions and solving problems.
鈥淚 feel so fortunate to have chosen 麻豆直播 for my baccalaureate program in nursing.鈥�
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El Camino Health treated the first known COVID-19 positive patient in Santa Clara County, and the second overall in California, on Feb. 28, 2020.
Reinking hasn鈥檛 had a normal day since.
鈥淭here hasn鈥檛 been anything we have experienced that has been quite like this,鈥� she said. 鈥淚鈥檝e never seen something quite as impactful on the healthcare system.鈥�
A command center was quickly established. Contact tracing was conducted. El Camino Health dusted off its pandemic plan and put it in action.
But plans and practices have frequently changed as health officials learned more about the novel virus. Reinking has kept nurses apprised of changes, such as recommended personal protective equipment (PPE), through a variety of mediums: sessions with nurse educators, written materials, daily e-newsletters and mobile technology nurses can access bedside.
鈥淲e have had to change our practices, and I would have to say that鈥檚 been the most difficult thing we鈥檝e had to endure,鈥� Reinking said. 鈥淚t鈥檚 been especially challenging with the staff because one day it鈥檚 this kind of PPE, but tomorrow is another type of PPE, and that鈥檚 been based on availability in some instances. So that鈥檚 been frustrating to have to administer because it鈥檚 presented a lot of confusion.鈥�
Testing has also been a challenge for El Camino Health, but it has improved, both in terms of availability and turnaround time for results, since the outset of COVID-19. Hospitals have additionally faced issues with patients who have delayed seeking treatment in fear of being at a hospital during the pandemic. There鈥檚 also the financial struggles hospitals endured when elective procedures were suspended, though Reinking is thankful the lost revenue has not impacted staffing at her hospital.
But many nurses will tell you the most difficult part of the COVID-19 pandemic has been caring for patients unable to see loved ones due to closed visitation. Nurses have arranged video conferencing between patients and their families, but it isn鈥檛 quite the same. As a result, nurses have increasingly been required to play supportive, compassionate roles for patients isolated from their family and friends.
Reinking is able to make exceptions to the rule when patients are facing dire prognoses.
鈥淚 can never say no to that,鈥� she says. 鈥淚 look at the chart and make sure that the situation is appropriate and it鈥檚 the right thing to do. But this is the end of the patient鈥檚 story, the end of their life, and I can鈥檛 deny that request.鈥�
Nurses have encountered countless heartbreaking moments during the COVID-19 pandemic, but there have been small victories and moments of hope along the way.
Reinking triumphantly recalls the story of a 65-year-old man who was treated for COVID-19 at her hospital. The previously healthy man was placed on a ventilator and given the antiviral medication remdesivir, but his condition did not improve the way doctors had hoped. He was eventually prescribed extracorporeal membrane oxygenation (ECMO), a treatment using a pump to circulate blood through an artificial lung and back into the bloodstream, but that required a transfer to a larger hospital in San Francisco.
The survival rate for COVID-19 patients on ECMO was very low 鈥� only 14% at the time, Reinking says 鈥� but the man responded to the treatment and his condition slowly improved. Though he was still very weak and unable to walk or swallow, he was eventually transferred back to El Camino Health, where the staff helped rehabilitate him.
After more than two months in the hospital he was finally discharged.
鈥淲e had a little celebration for him when he left and surprised him when he came off the elevator with signs and a little parade for him,鈥� Reinking said. 鈥淚t was something our staff really needed, and I think it was good for him, too.鈥�
The remarkable recovery wouldn鈥檛 have been possible without the dedication of hospital staff, and Reinking takes great pride in the work being done by frontline healthcare workers under her charge during what may be the greatest healthcare crisis of our time.
鈥淓l Camino Health nurses have demonstrated exemplary practice standards and extraordinary compassionate care when caring for COVID-19 patients,鈥� Reinking said. 鈥淭he community has reached out to show its gratitude by donating meals, displaying signs of gratitude throughout the community, and we鈥檝e received literally hundreds of handwritten cards.
鈥淚 couldn鈥檛 be prouder of our staff and the generous community it serves.鈥�