Nomination Letter

Written by Lynn Berberich, Owner, BrightStar Care of Baltimore/City County

Tynisha Mosley-Bates, RN, BSN is known for her “firsts”.

• She was the valedictorian of her high school class.
• She was the first in her family to get a professional education.
• She obtained her CNA certificate and Geriatric Nursing Assistant certificates while still in high school.
• She paid for herself to go a technical institute and earned a laboratory Associate Certificate 2 years later.  She had two babies while working as a Laboratory Associate and Technician for 7 years at a hospital. 

She was the first in her family to get a college degree. She became a single Mom and put herself through the University of Maryland to earn her BSN in 2009. Her 3^rd baby came along, and she spent 6 years working as an RN in Med-surg and Ortho-Serg at the hospital.

She remarried and moved with her family to a new location and new county. She wanted to spend more time with her kids and in February of 2015, took a part-time job doing homecare for BrightStar Care. She thought this would be ideal for spending more times with her kids before and after school. In our office the Branch Manager described her as the RN that always said “Yes” and found a way to make it work, her “go to nurse”. Her “stick” skills became well-known, and patients always asked for her. Our clients and referral sources asked for her by name as well. She was willing and eager to learn anything new and open to all feedback. This is a quote from the Manager at a local Infusion Company:

"Thank you all again for staffing M. B. for us. I wanted to tell you all how impressed I was with Tynisha and the services she provided. She went above and beyond to assist me. What was most impressive was the fact that she did so even after the office was closed. Because of Tynisha when we have any cases to staff in your area you will be the first call ALWAYS."
 
7 months later our Assistant Director of Nursing (ADON) position became open and after meeting and discussing with her family the changes this would mean she accepted the position of full-time ADON. This was her first Leadership Role. While she was our ADON she became known for her close and trusting relationships with families and family caregivers. One of our clients was a retired RN. The client's daughter lived in New York and worked in a hospital and was very demanding. There were many challenges and issues with this client. Tynisha used her great customer service skills and started having weekly phone meeting with the daughter to fill her in on her mom's progress and address any issues she was having. Tynisha went a couple times a week to check on this client and also offered to pick up groceries several times when the daughter was not able to get to Baltimore. Tynisha put in place a roster for cleaning, shopping and keeping track of food and supplies that were needed. When the client declined, and her skin broke down and a wound developed Tynisha took charge of getting the wound addressed and orders in place to address it immediately. The daughter was so thankful for all the extra attention Tynisha gave her mom. Anna’s daughter wrote a thank you note to the office, thanking Tynisha, stating:

"You have so been much help to us. I truly appreciate your deep involvement, frequent visits, at all hours, and the experience and expertise you provide. It has made a big difference to my Mom’s care. I feel like we are a team."
 
18 months after Tynisha became our Assistant Director of Nursing, our Director of Nursing (DON) resigned, and Tynisha again had a family meeting before she accepted the position of DON. This would mean everyone in the family would have some new responsibilities.
 
She in number ONE in her compassionate care of our clients and their family caregivers. Tynisha continues to be just plain great with families. Recently, one of our client’s spouses was having a really hard time dealing with her husband and his behaviors resulting from his frontal lobe dementia. Tynisha spent some time with the husband and recognized a few of the things that seemed to trigger him and made suggestions to eliminate them. She also recognized some of his wife’s behaviors that were triggering him. She found a way to gently coach the wife on how to respond differently to her husband and achieve different results. She stayed and had the wife practice several times. The wife was incredibly grateful as these changes dramatically improved her interaction with her husband and removed a lot of stress and anxiety and relieved some of her exhaustion as well. The Plan of Care was also adjusted, and our CNAs were coached on how to avoid some of the triggers. 

We had a prospect where the wife had anxiety issues and dementia and her husband of 60 years compensated for her and no one seemed to know. They had no family and when the husband was hospitalized for major heart surgery, their church friends stepped in to help his wife and realized she needed 24x7 care to be safe. On the first meeting, Tynisha could not wear her lab coat because the client absolutely hates doctors. You could not even mention the word doctor without creating anxious behavior. The client really needed medication to help her paranoia and challenging dementia behavior. Tynisha’s strategy was to use the closeness of their 60-year marriage to help the client agree to going to the doctor. Tynisha spoke to the wife and explained to her that going to a doctor’s appointments could be done as a couple. It could be a “date”. She and her husband would go the same day. They could go to the doctor together and get their meds together and take them together. It worked. She agreed to go with her husband which led to her getting the right medication and reducing her paranoia and anxiety to a more reasonable level. This was a huge accomplishment. The church friends wrote to us:

"Here’s the final update regarding [client] - at least, it's final for the moment!  She started on anti-anxiety meds a few days ago and has taken them without too much fuss so far. Her new PCP is on board and is monitoring as we go forward. Her husband is progressing well, and things are now under control. Thank you Tynisha, for all you did. Thank you for the professionalism, knowledge, and concern that you put into our situation. It was invaluable- as was her CNA, Ingrid's knowledge and care. We hope to never need to employ BrightStar again, but we know the situation is what it is and will proceed accordingly and know what a great help and resource you are."
 
Our Salesperson shared another examples of how Tynisha goes above and beyond:

"She is amazing, in her flexibility to accommodate and start new clients and her ability to coach our staff and client family members in the field. She went on a living room visit with me to see a prospective client, who is totally deaf in one ear and almost deaf in the other and has no hearing aids. The client was incredibly anxious about having someone care for her in her home. Tynisha figured out which ear she had some hearing in and repositioned herself to sit on the client's good side and calmly repeated her questions until the client understood. The client's anxiety melted away because Tynisha took the time and made sure the client understood and agreed to everything in the plan. The client's son described Tynisha as amazing, not understanding how she had the patience to communicate all of that to his Mom."
 
We receive feedback from doctors on what an amazing nurse Tynisha is and how thorough she is in problem solving and chasing down the orders that are needed for the very best care. Our local infusion contacts all know Tynisha and call her the “hard stick nurse” and send hard to stick patients our way as they know we can handle them. When a client has a brand-new order, she ensures that the patient was seen even if it means giving up her weekend plans which happened on more than one occasion. Our Branch Manager recalls:

"One of our infusion patients was seen in the morning for PICC line maintenance and care and the patient’s order changed that same day due to side effects the patient was having from her medication. Tynisha was in constant contact with the Doctor to communicate the issues the patient was having and when the new medication arrived Tynisha went back the same day and did a whole new teach and train with the patient until 11:30pm that night. This exceeded her 2-hour window, but the client had a lot of anxiety and Tynisha was patient and understanding which is a recurring theme with her. No matter how pressed for time or how many customers Tynisha has to visit on a given day she never makes them feel rushed or unheard. She always takes the time to explain why she is there and what she is doing, putting them at ease. I have personally seen Tynisha spend hours on the phone with various sources trying to get a doctor’s order so that a patient could be seen, or wound care supplies delivered. I have also heard her on the phone with challenging clients and she never wavers in her calm demeanor as she listens to what they have to say, never raising her own voice. Tynisha exemplifies what it is to be an exceptional nurse daily. There is not a single day that she does not go above and beyond for her clients. For me she wins this award every single day."
 
Tynisha is a poster BrightStar Care RN and DON. Tynisha is our NUMBER ONE RN!