Nurse-in-Charge, Shapiro 8, Vascular Surgery/Medical Cardiology
Intermediate Care Unit

Nominated by Gary McNabb, MSN, RN, clinical nurse; with letters of support from Alice O’Brien, MSN, RN, nurse director and Nayla Zreik, BSN, RN, nurse-in-charge, all on Vascular Intermediate Unit, Shapiro 8

In her nomination for the Essence of Nursing Award, Andrea Fonseca, MSN, RN, ANP-C, of the Vascular Intermediate Unit, Shapiro 8, is described by her colleagues as “humble,” “approachable,” “thorough,” “a mentor,” “supportive,” “compassionate,” and “the kind of nurse I aspire to be.”

Her peers praised her ease in dealing with complex clinical situations in her role as night nurse-in-charge. “Andrea resolves complex issues with competence and attention to detail. Her ability to formulate a plan is outstanding,” wrote Nurse Director Alice O’Brien, MS, RN.

In her narrative, Fonseca recalled one such scenario, with one of her most memorable patients. One evening, she came onto the unit to learn that her patient assignment included a patient with complex physical and psychological needs who was also in restraints. She approached this patient with compassion and without judgment and was able to develop a “great rapport” with him.

Her first interactions with the patient were gentle and respectful. “He would not look at or speak to me, and he held back when asked if he wanted something to eat,” she wrote. Still, she made him a sandwich. Slowly, over the course of several days, they developed a trusting relationship. She progressively loosened and eventually removed his restraints. “During my last shift with him, he thanked me and cried,” she wrote. “This experience will forever help me to provide compassionate and sensitive care to patients from every walk of life.”

Fonseca is also known for her astute observational skills. Last year, she was the first to notice when a patient’s monitor changed in rhythm and morphology. She paged the resident on call to voice her concern. They later learned the patient was having a myocardial infarction. “Andrea’s foresight allowed the team to get started on a workup before the patient’s chest pain began,” wrote Nicholas White, MD, the general surgery resident on call. “It would have been extremely easy to miss the early signs of trouble. I believe the patient had the best possible chance at a good outcome primarily because Andrea was operating at a superior level.”

According to colleague Gary McNabb, MSN, RN, clinical nurse on Shapiro 8, this situation demonstrates one of many reasons why Fonseca is an effective nursing leader. “In critical situations, Andrea has an innate ability to calmly direct her team in order to achieve a positive patient outcome,” he wrote.

Added Nayla Zreik, BSN, RN, fellow nurse-in-charge: “Andrea is an expert nurse, a phenomenal teacher and a great support to all.”

Fonseca earned her MSN and BSN from the University of Massachusetts Dartmouth. She is a preceptor to senior nursing students on Shapiro 8.