Nurse by Nature, Teacher by Example

While two patients were suddenly failing one evening on 14B, Marian Fitzgerald, RN maintained composure and optimism, even as one frightened patient (who would later go into acute distress) left teeth marks in her arm. Fitzgerald's greatest achievement during that shift was not the excellent patient care she provided, but rather the inspirational leadership she showed a nursing student she was orienting her first night at BWH.

As the student, Shiloh Hayward, stood by Fitzgerald's side, she wasn't rattled by the challenging picture of her prospective profession unfolding in front of her. Instead, she was motivated by Fitzgerald's firm handle on the situation. Hayward watched as Fitzgerald performed the Heimlich maneuver on a choking patient, that same patient who had bitten her an hour earlier.

In fact, the series of difficult issues related to the ongoing care of these two patients created uncertainty for Nurse Manager Patty Brita Rossi, RN, MS about whether Hayward would return the next day. Hayward did, citing these lessons she had learned from Fitzgerald: always stay positive and never stop advocating for the patient.

Hayward's return and subsequent hire on the floor are a testament to the strength of Fitzgerald's abilities as a nurse and a teacher. "She makes you feel like nothing is impossible," said Hayward.

Such evenings can be routine on 14AB, which accepts many difficult, multi-system failure patients. "Marian manages them with such ease and clinical expertise; it's second nature to her," said Brita Rossi.

"She has the ability to turn a bad night into a positive teaching experience," added Marcy Gleit Carty, MD, a resident who worked with Fitzgerald and has remained close with her over the years.

With that kind of skill and extensive background in nursing, Fitzgerald, 50, is a natural teacher and role model for her colleagues. She precepts many newly licensed nurses for their first eight weeks and informally for years afterward, helping to develop their skills to her high standards of clinical expertise, said Brita Rossi.

"As nurses, educating is a huge part of our role," said Fitzgerald, of Scituate. "And nursing is a constant learning evolution. I'm always learning and that helps me teach others."

The day after Hayward's first night at BWH, Fitzgerald set aside time for the two to have lunch and discuss the events of the previous evening. "She went above and beyond to make sure I was okay," said Hayward. "No matter how busy she is, she always makes the time to answer everyone's questions."

One of the reasons that Fitzgerald, a mother of three, is so aware of the needs of others is that her own daughter is a newly licensed nurse who entered the profession in January. When Katie was considering nursing as a career, her mother hoped that wherever she worked, experienced nurses would mentor her.

In addition to nurses, Fitzgerald is known for taking residents, interns and others under her wing. In May, she received a Medical Housestaff Nursing Award for acting as a mentor to residents. "When she says something, people listen," said Kathryn Finnerty, MD, who presented Fitzgerald's award. "She is incredibly kind to and patient with new interns. She doesn't attempt to emphasize her own depth of experience over their relative inexperience."

That's because Fitzgerald is a true team player who shies away from taking credit and collaborates with others to provide patients with the best care possible. "She brings a sense of togetherness, a real team feeling, to the floor," said Hayward.

As an intern and later a resident working with Fitzgerald, Tamar Polonsky, MD remembers Fitzgerald's commitment to collaborating with doctors and others on the health care team on behalf of her patients. "I always felt like we were taking care of patients as a team," she said, recalling a time that the two collaborated to overcome delays in the discharge of a patient who was anxious to go home after a lengthy stay on the floor.

Aside from her true love of nursing, Fitzgerald's colleagues say that her keen insight and sense of humor are traits that make her a remarkable teacher, nurse and friend, not to mention a reliable provider of comic relief. "People just gravitate toward her," said Brita Rossi.

Among all the stories shared about Fitzgerald is a recurring theme: she senses when someone is having a challenging day and cheers them up with a funny story or a few compassionate words.

"She makes it her problem if someone else is having a bad day. She truly cares about everyone around her," said Brita Rossi. "Such relationships go a long way in an environment like this, to have someone as a friend, a supporter, and from whom you can seek valuable advice."