A Message from SEIU Local 1991 President Vicki Gonzalez, BSN, RN
Women hold more than 75 percent of all healthcare jobs in the United States. Throughout history, women in medicine have broken barriers: they have advocated for compassionate treatment, fought for coeducation of medical students, and forged new paths in public health, all while elevating other women and fighting discrimination.
To close out Women’s History Month, SEIU Local 1991 is spotlighting a few of Jackson Health System’s extraordinary healthcare workers and union leaders. This year’s Women’s History Month theme is “Providing Healing, Promoting Hope.” There is no better time to honor the tireless work of Jackson nurses, doctors, and healthcare professionals who have provided nothing but the best patient care throughout the COVID-19 pandemic.
We stand on the shoulders of women who paved the way for us, and we’re proud to continue their legacy.
B. Vicki Gonzalez, BSN, RN
SEIU Local 1991
Tessie Arellano-Sicam, MSN, APRN, CCRN
Nurse Manager – Coronary Care Unit/Cardiac Cath Lab
Born and raised in the Philippines, Tessie Arellano-Sicam arrived in the United States as a new graduate nurse in 1979. Her only experience at the time came from the clinical areas of her school’s extensive nursing program. Tessie immigrated with 17 other new grad nurses from different schools who had been petitioned to work at Mount Sinai Medical Center in Miami Beach. She joined Jackson in 2000.
Early in her career, Tessie experienced the bullying and hostility that sometimes pervades the nursing profession. Not only had she heard the phrase “Nurses eat their young;” she lived it.
“The experience of incivility shaped me,” Tessie says. “I took it positively and turned it into a challenge. If you are treated like that, you will either develop your confidence, or you will lose it and it will become your downfall. It made me stronger because I wanted to prove that I was capable of doing what others could if I did my best.”
The experience made her tougher. It also informed the kind of nurse manager she would become decades later. Tessie currently manages 48 registered nurses in CCU and the Cardiac Cath Lab. She sets high standards for herself and her team. Tessie expects the very best from the nurses she manages, but she also provides them with the reinforcements they need to be successful. She strives to create a culture that promotes positive relationships among nurses and other healthcare workers because hostility can negatively impact patient care and safety.
“I work not for prestige, but for service to my patients and staff,” Tessie says. “I have a fierce commitment to the values of caring, character, advocacy, collaboration, safety and always seeking what is in the best interest of the people I serve. I feel that being a manager is a support more than anything else.”
Rather than eat her young, Tessie has supported, nurtured, and advocated for them. She helps young nurses build their self-confidence by creating an honest, communicative environment in which they can grow from their mistakes.
“Self-confidence is a very, very strong factor in a person’s development, growth, and success,” Tessie says. “If a person doubts their ability to do a job, of course they’ll feel easily discouraged and become their own critic. As a Nurse Manager, I feel I have a responsibility to provide reassurance and promote learning so that they will perform at a competent level.”
Tessie is committed to developing employee capability and helping others succeed. She says that because of the current multigenerational and culturally diverse workforce, she tries to explore how each person learns, create a learning climate tailored to their individual needs, and validate competencies in a supportive way.
If a nurse experiences difficulties and becomes fearful of losing their job, Tessie comforts them. If the CCU or Coronary Cath Lab is not a good fit for someone, she will help them find a more suitable department.
“I always tell the staff they are here because Jackson hired them,” Tessie says. “We invest to develop people and support them so they will be successful.”
Tessie feels most fulfilled at work when patients, family members, and staff are happy and satisfied. Every day, Tessie strives to ground her team in values.
“I tell them that we should go into the world not just to do well, but we have to do everything with a good heart,” Tessie says. “If you do things with a good heart, you will never fail.”
Regina McDade, EdD, MPH, BSN, CIC, RN
Clinical Care Coordinator, Office of Infection Prevention & Control
TB Control & HIV Surveillance
Regina McDade still remembers the first AIDS patient she ever treated. Regina had just graduated from nursing school in 1986 and began her career at Howard University Hospital. She entered the patient’s room and found the woman lying in the fetal position, a look of hopelessness in her eyes.
“It was like she was put in a corner to die,” Regina recalls.
The patient, Ana, would not speak. She eventually progressed into a vegetative state and died. That experience impacted the trajectory of Regina’s career. She went on to study Public Health at Florida International University because she wanted to help marginalized and underserved communities.
Regina worked at the Florida Department of Health for three years as a Senior Community Health Nurse, first in the Maternal-Child Health Program and later in the Community Health Assessment Team after Hurricane Andrew. Regina, along with a social worker, mental health counselor, and disease intervention specialist, worked in areas of Homestead and Florida City proving health care to low-income and migrant communities. The team would set up mini-health fairs at food pantries, provide chronic disease education and management, HIV/AIDS and STD education, testing, and condom distribution. Regina joined Jackson as a Tuberculosis control nurse in 1993.
“I’ll never forget the director who hired me said I stood out because I came from the streets,” Regina says. “She liked that I came from the Department of Health and that I know where our patients come from, what they go through, and the health and socio-economic barriers they face.”
Regina’s on-the-ground experience helped lay the foundation for her current role as a Registered Nurse and Clinical Care Coordinator with the Department of Infection Prevention & Control. Her role involves helping staff with any issue related to Tuberculosis, such as patient isolation, treatment history, and staff exposure. Every time a patient is diagnosed with TB, Regina is notified. Jackson Health has procedures in place to prevent employee TB exposures, but when they do happen, she investigates every case.
Regina is an adjunct professor at Nova Southeastern University’s College of Nursing, although she isn’t currently teaching courses because of the pandemic. She earned a Bachelor of Science degree in Nursing from Howard University, a Master of Public Health degree from FIU, and a Doctor of Education degree in Adult Education and Human Resource Development from FIU. She has spoken at countless local and national conferences on tuberculosis, case management, infection prevention and control, and the COVID-19 pandemic.
For all her accomplishments, she is most proud of helping vulnerable people access medical attention and manage their care from diagnosis to cure.
“I’ve seen us when we were at our worst, and I don’t want to go back there,” Regina says. “TB used to be a death sentence. Now we can cure patients. I’ve seen miracles happen.”
She recalls one former patient who contracted HIV and Tuberculosis while in jail. After a couple of hospital stints and relapses, he was cured of TB. The patient’s sister, who helped him throughout recovery, kept in touch and informed Regina when he moved to Orlando and became a dad.
“He was so proud to come in and see us when he came back in town,” Regina says. “Having those relationships is gratifying. When they’re under treatment, some people may not appreciate it, but later they come back, and we see how well they’re doing.”
Regina joined SEIU Local 1991 when Jackson hired her. Her father, who was a leader in his own labor union, encouraged her to sign up.
“I think it’s important for healthcare workers to have a union,” Regina says. “I have friends who work in healthcare facilities that do not have union representation, and they feel underappreciated with no support, especially during the COVID pandemic.”
Catherine de la Osa, PsyD
Licensed Clinical Psychologist
Attending, Behavioral Medicine/Consultation-Liaison Psychology Service
Dr. Catherine de la Osa has been an attending psychologist with the Behavioral Medicine/Consultation-Liaison Psychology service at Jackson Memorial Hospital for three years. Every day, she sees patients who are acutely affected by the life-changing incidents that bring them to Jackson Health System — new medical diagnoses, chronic illnesses, transplants, traumatic accidents, amputations, and injuries.
“We get to see patients in the raw,” Catherine says. “On an outpatient basis, the patient has had time to process what’s going on with them and think through how they want to address it with you. But when we see patients on the acute side, we see the raw emotions of shock, anxiety, nervousness, and help them on that level. For me, I like that approach because you’re seeing the emotion and not just somebody who is intellectualizing what’s happening to them. We can dive in and really help these individuals in their moments of need.”
Catherine strives to provide hope and healing to patients by reminding them, and herself, that emotions ebb and flow. What a patient feels might be difficult or ugly, but she grounds them in the belief that what they are suffering is not permanent and there is no right or wrong answer for how they feel. One analogy she uses with patients is that they should function like a working pressure cooker.
“The pressure cooker’s got that release valve up top to let the steam out so that the food in there can cook real good,” Catherine says. “If we shut off that valve, that lid is going to blow and end up all over your kitchen. It gets very messy. We have to be patient with ourselves and let that steam out little by little in a controlled way so that we can cook well on the inside and know how to move forward. We may shut off that valve because we want to protect other people from seeing a vulnerable side of us, or because we don’t know how to let it out. That makes it difficult and creates a fester of things inside us.”
Catherine jumps inside the emotional trenches with patients experiencing some of the most difficult times of their lives, but she doesn’t always get closure. A patient may be discharged from one day to the next, leaving her wondering how they are weeks and months down the road.
“One of the challenges is being OK with not knowing,” she says.
Born to a large family, Catherine was raised to be a team player – to be supportive of relatives in difficult times, celebrate happy moments, push family members outside of their comfort zone, and keep them down-to-earth. As such, she thrives on open communication and collaboration in the workplace. She and her fellow psychologists at Jackson work together to provide the best possible patient care and support one another when working on difficult cases. She credits her success to the teams of people who have helped her throughout her career — mentors, family members, her husband, and colleagues.
“I definitely owe those adjectives of ‘spectacular and extraordinary’ to my support system, as they have all taught me something valuable which has helped me get to where I am today,” Catherine says.
In addition to being a caring psychologist and team player, Catherine is a force at the bargaining table. During contract negotiations in October, she helped win a 44 percent salary increase for all clinical psychologists — the greatest increase for any job class. Catherine says she feels grateful to have been involved in recent negotiations. Seeing other women, and in particular union leaders, at the bargaining table left a positive impact on her.
“I was wowed by them,” she says. “They became part of my integration of what it means to be a female go-getter in this world.”
Yahaira Colón, MS, CCC-SLP
Department of Speech-Language Pathology
A speech-language pathologist for six years, Yahaira Colón works with the adult population in acute care. She diagnoses and treats cognitive-communication, speech, language, and swallowing disorders resulting from a neurological event, chronic illness, or trauma.
Yahaira is present for all stages of recovery, from helping her patients regain orientation and awareness to retraining higher-level cognitive-communication skills that will help reduce the burden of care at home.
Her passion is working with the medically complex, tracheostomy, and ventilator-dependent populations to help restore communication and safe swallowing skills. Part of her job requires her to provide counseling to patients who are robbed of their communication skills for extended periods.
“Imagine what that does to patients, not being able to communicate basic wants and needs or talk to loved ones,” Yahaira says. “You have to approach them with compassion.”
One of her recent patients was admitted to Jackson with COVID-19. The woman was placed on a ventilator for more than two months and required a tracheostomy. Because the woman was unable to communicate for so long, one of the first interventions Yahaira implemented was to place an in-line speaking valve so the woman could Facetime with her husband. Just seeing and talking with her husband motivated her and brought hope for recovery. The woman began progressing almost immediately; she tolerated being off the ventilator for a couple of hours a day, ate Jell-O, and drank water.
“This is a patient who was on a ventilator for two months,” Yahaira says. “It was so rewarding to be there when she called her husband and spoke words. She told him, ‘I love you, I miss you.’”
Yahaira’s favorite thing is being present when a patient hears their voice for the first time and helping them reclaim skills they had lost. While on medical ventilation, a tracheostomized patient can only use a speech valve under the supervision of a speech-language pathologist. When not on medical ventilation, the patient can wear the valve for extended periods depending on tolerance. When Yahaira knows that a patient is expecting visitors, she’ll make time to be there so they can use the speaking valve and communicate with loved ones. She knows engaging with family keeps her patients motivated throughout their recovery.
“These patients go through so much,” Yahaira says. “We sometimes forget how difficult it is to be in their position. It’s important to give them unconditional patience and compassion. I promote hope and healing by shining a light on their strengths so they shift their perspective from what they can’t do to what they can do.”
In addition to being a patient and compassionate speech-language pathologist, Yahaira is co-chair of the union’s Climate Committee. She says being environmentally responsible has become increasingly important to her over the years. She believes that climate change is one of the most important issues of our time and the biggest threat to human health. The Climate Committee provides a platform to encourage her peers to be more sustainable in manageable ways.
“Sustainability looks different for everyone, and that’s OK,” she says. “It doesn’t have to be all or nothing. I think it’s important to give people information so they can decide what’s feasible for them. It would be amazing if all of us played a role in helping Jackson Health System be more sustainable, because all of us medical professionals have a moral responsibility to advocate for health, and there is a very clear connection between climate change and health. I see Jackson being a leader in sustainable healthcare.”
Yahaira is a respected union member and leader. She believes that a union can be a healthcare worker’s right hand.
“SEIU 1991 is our ally; we stand together as a collective voice,” she says. “Membership is crucial so we have strength and unity in our fight for better work lives and quality care for our patients.”
Kelly Medwid, MD
Emergency Medicine Physician, Simulation Director & Core Faculty
You’re a new resident working in the emergency department at Jackson Memorial Hospital. EMS brings in a 46-year-old man complaining of shortness of breath. He is actively coughing, and his breathing is labored. The patient, who is trach-dependent, had been previously admitted to a hospital because of a traumatic brain injury. A surgeon placed the trach about one week before the patient was discharged to a nursing facility.
How would you begin to approach a patient in respiratory distress with a tracheostomy?
The bad news is that if you don’t provide the right support quickly enough, the patient will go into cardiac arrest. The good news is this is just a simulation, and it’s written by Dr. Kelly Medwid.
Kelly has worked at Jackson since 2017 as an Emergency Medicine Physician and Simulation Director for the UM/JHS Emergency Medicine Residency Program. She writes and designs simulation cases based on evidence-based papers to support what medical residents need to learn. Once a month, she runs a 4-hour simulation day for small groups of residents to treat the high-acuity or life-threatening cases of simulated patients. She also teaches an annual six-week course for medical students to learn the basics of being a clinician.
“Working in the ER is just a bit hectic, but I don’t know, I guess all of us in the Emergency Department are a little crazy,” Kelly jokes. “We all like that environment.”
When Kelly is on shift, she is open-minded and approachable. She empathizes with patients no matter what brings them to the ER, even if it’s something that doesn’t fall within the Emergency Department’s purview. Whenever someone on her team has a suggestion, she tries to make them feel heard.
“I definitely do not have all of the answers,” she says. “I try to encourage the whole team to suggest different things. Whenever a nurse, a tech, a resident, or a student has an idea, I try to give praise and incorporate that idea when it makes sense. I like to create an environment of collaboration and listening.”
Kelly loves seeing patients, but the teaching aspect is her favorite part of the job. It keeps her on top of her game with the newest data and the latest evidence-based medicine. Because she teaches, she is constantly learning and improving. Educating keeps Kelly sharp as a clinician and allows her to have fun with residents. She prides herself on creating a dynamic, empowering, and safe learning environment.
“The whole idea is to make mistakes during the simulation days,” Kelly says. “I tell residents that if they do all the simulations perfectly in the four hours we’re together, we’ve just wasted four hours. The goal is to make the simulations difficult enough that they make mistakes and we have things to talk about.”
A debrief follows every simulation. Kelly encourages residents to ask questions and have in-depth discussions so everyone involved becomes a better physician. As far as she is concerned, there is no such thing as a dumb question.
“Any question you have I may have, too,” she says. “Let’s look that up and find the answer. We’re making an environment where you’re free to learn.”