My Specialty

Med-Surg Telemetry Manager, Rita Calderon, Martin Luther King Jr. Community Hospital

Building a nursing team to care for an underserved community

Tell us about the arc of your nursing career prior to MLKCH.

I began my journey in healthcare at the age of 15, when the L.A. Unified School District offered high school students who wanted to enter the healthcare field an opportunity to take a free LVN nursing program.

I took the boards prior to graduation and received my LVN license at the age of 18. I had to grow up very quickly, working with much older, more experienced colleagues and seeing the reality of life and death outside of textbooks. I tried many things. Maternal/child wasn’t for me, and neither was outpatient. In the ER, I saw lots of gang-related bullet and stab wounds, which was intense and started to make me cold, jaded and hardened — that is just not me!

I later became an educator, which I enjoyed a great deal, and worked 10 years in perioperative acute care. That was exciting because I could see the direct results of my one-on-one work with families and patients.

I only left that position because I fell in love with a surgical tech! He was in the same unit, so one of us had to transfer out so that we could continue to see each other. We’ve been married for 22 years now!

How did you move beyond charge nursing into leadership?

One day, out of the blue, my CNO approached me and asked me to take on the role of director of med-surg telemetry. My first response was, “No!” — I had no formal training in leadership. However, I couldn’t sleep that night because I felt very bad that I had refused this opportunity. Something told me I had to do it.

The next morning, I went back and agreed to take the position, despite my fear. My CNO was thrilled and promised to mentor me until I could fly on my own. But, you know what they say about the best laid plans … As soon as I took the job, my CNO went on a leave of absence. To make matters worse, The Joint Commission was coming within the next 30 to 60 days!

It was a very painful period for me. I had a dysfunctional unit and an unstable staff that relied too much on a revolving circle of registry nurses. I had to turn things around and fast. Whenever I wasn’t at the hospital, I was absorbing every book at Barnes & Noble that had anything to do with leadership. My staff pulled themselves together and we passed the Joint Commission survey with flying colors.

What drew you to MLKCH?

I started my career in East L.A., in a 122-bed community hospital very similar to MLKCH. After working in larger hospitals and more affluent areas, I realized that my skills and knowledge would be best utilized in communities that lacked quality healthcare.

What caught my attention about MLKCH was the community it serves. South L.A. has some of the worst health indicators in the nation. It has been medically underserved for years.

The MLKCH model of high-quality care, innovation, and health beyond the hospital walls is what continues to speak to me to this day. I believe so much in this mission that I’ve commuted 166 miles a day, five days a week, for the past five years!

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What are your responsibilities as med-surg telemetry manager?

I recruit and find talent. I coach, mentor, teach, develop policies and serve as a transformational change facilitator. In addition, I manage my unit’s budget, implement patient experience strategies and promote nursing innovation.

Three and a half years ago, I had only one nurse and a unit secretary. We now have a robust staff of 200. I enjoy putting together teams and creating amazing new processes.

How do you deal with staff resisting change?

When I sense resistance, I have to dig deep to understand what moves people and what they’re afraid of. I ask those who are afraid what the worst-case scenario could be — what they think could possibly happen — and then make them see how supported they are. This can be time-consuming, but the bottom line is the health of the patient, the outcomes and the happiness of the staff.

How do you keep staff happy?

I treat everyone with respect and as a unique individual. I don’t expect them to be like me or anyone else. I value them for who they are and what they bring to the table.  We discover how to get their skills and personalities to mesh so that they can all work together towards our commonly held goals. I like to get to know people and learn what motivates them; I show frequent appreciation for their gifts.

Another critical thing is to ensure that MLKCH nurses feel enriched by their work here, personally and professionally. We have a fully staffed, fulltime health education department to support our nurses. We support online learning; offer tuition reimbursement; and have both a new graduate residency and a Versant experienced nurse transition fellowship.

I tell my team, “Whatever your dream is, we’ll make it happen.” Already, 20 nurses on my team have gone back to school and completed their BSN, MSN or NP. In addition, we have now our first progressive care certified nurse.

As a leader, how do you keep bullying and incivility from taking hold?

We make sure that we hold people accountable to our core values and let them know that everyone is important and needs to be treated with respect. You have to care.  Disrespect doesn’t work for me. You treat everyone on the team as well as you treat patients and families.

When interviewing potential new hires, what characteristics do you seek in candidates for your unit?

I seek nurses who are humble; have integrity; demonstrate assertiveness, courage and honesty; are willing to be vulnerable; and strive for excellence.

When we have new grads come into our organization, it’s actually hard for me to choose who to hire, since they’re all so amazing, passionate and skilled. They want to be of service and ask, “What can I do to make a difference?”  That’s how nurses come out of school today: wanting to make a difference for the next generation. With nurses like that, we’ll continue to make a difference.

In your opinion, what should these novice nurses do to become the nurses they seek to be?

Stay true to who you are and your values. Never compromise patient safety or your integrity. Always validate procedures and what you’re doing.  Finally, as my mentor once said, believe everyone and trust no one. If someone recommends a certain course of action and you’re not sure, review your policies and procedures to make sure you understand what’s most prudent for the situation. In the end, you must only trust yourself.

What are the most exciting technological changes that have come along for the nurses on your team?

We are a state-of-the-art facility that’s reached Stage 7 of the Healthcare Information and Management Systems Society’s Electronic Medical Record Adoption Model; just 6 percent of hospitals in the nation have achieved that.

Instant communication via our care phones is wonderful. We also do real-time documentation of vital signs and medication administration and use barcoding for safer medication administration.

MLKCH has Cerner’s CareAware myStation technology, which is an interactive TV interface that incorporates the patient’s chart, their personal preferences and movies and entertainment, in the language that the patient prefers.

We can assign educational videos for the patient and family to watch and then use that as an impetus for discussion and teaching. When they complete a video, it’s automatically recorded in the EMR, which helps us document our teaching process.

Additionally, we have a “physician on wheels” telehealth system that allows geographically distant physicians to meet at the patient bedside via video interface.

Tell us about MLKCH’s community outreach efforts.

MLKCH does a great job of working with patients who are less fortunate. The challenge is ensuring that when they leave our care they’re going somewhere good. We are committed to that, even if it means a longer wait time for placement.

South L.A. has an acute need for health education and resources beyond the hospital doors. For that reason, we’ve created a free screening program called “Know Your Basics,” which offers blood pressure, blood glucose and other screenings at neighborhood events and festivals. These screenings are often how we start what may be long-overdue conversations about health.

Our “Man Up!” program takes prostate and other men’s health topics into community barbershops. We provide clinical staff for screenings and also train the barbers — who are a trusted source for many men — on how to have those conversations with their clients and refer them to appropriate services.

We also reach out to young people and elementary students to encourage them to pursue careers in healthcare. We’re a very culturally diverse staff, so the kids get to see successful and happy professional people who look like them. That is so important.

What are the greatest rewards of being a nurse manager? What feeds your spirit?

My joy is seeing the growth of the individuals on my team and watching them achieve things they thought they would never be able to accomplish. I like seeing nurses transform into amazing nurse leaders.

I also enjoy having the ability to ensure patients receive the best possible care from our amazing and dedicated clinicians.

At this point in your career, what are the things you still want to learn? How would you like to grow as a nursing professional?

I’d like to understand how to incorporate and balance the financial and the clinical aspects of healthcare. One of my greatest frustrations is when insurance companies deny care for which we’ve advocated. There are so many roadblocks in just making sure our homeless and vulnerable population get what they need.


Keith Carlson, RN, BSN, CPC, NC-BC, has worked as a nurse since 1996 and has maintained the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students at www.nursekeith.com.


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