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Interview with Mary Ellen Bonczek, October 30, 2007
Date:
October 30, 2007
Description:
Interview with Mary Ellen Bonczek, Chief Nurse Executive of New Hanover Regional Medical Center.
Phys. Desc:

Interviewee: Bonczek, Mary Ellen Interviewer: Jones, Carroll / Dail, Jennifer Date of Interview: 10/30/2007 Series: SENC New Hanover Hospital Length 60 minutes

Jones: October 30, 2007. I'm Carroll Jones with Jennifer Dail for the Randall Library Special Collection Oral History Program. And our very special guest today is Mary Ellen Bonczek, RN, NPA, Chief Nurse Executive of New Hanover Regional Medical Center. And she can explain all that in a moment. Ms. Bonczek oversees a workforce of more than 1,700 established Nursing Congress and Nurses Aide Academy to increase professionalism. Provides peer support, improved patient care. She was recently recognized by the YWCA with a Health and Wellness Award. Hello, Ms. Bonczek, we are finally very pleased to see you, and thank you for taking time out from your most busy schedule to come visit.

Bonczek: Thank you. Thank you Carroll and Jennifer. It's an honor to be here.

Jones: Good. Talk about your early years, where you're from, how you got into nursing. First.

Bonczek: I'm originally from Staten Island, New York. It's a small county over the side of Manhattan, and very rural, when in the years I grew up. So my family settled there and I really decided to go into nursing early in my years, probably before high school. Just was very in touch with healing, and it was really a first decision for me was to go into nursing. I also had some experiences with family members where I was able to see the hands and comfort of nursing, and death and dying, and in healing processes. So it really was a first love for me.

Jones: And been since?

Bonczek: And been since. I graduated from a baccalaureate program in 1976. I went to Wagner College, which is on Staten Island, New York. So I grew up there and had my college years there. And left Staten Island in 1984, and my husband and I relocated to New Jersey. And there we stayed for about 18 years and raised our three children, and then moved ourselves to Wilmington, North Carolina in 2001.

Jones: What brought you to Wilmington?

Bonczek: My parents relocated to Ocean Isle Beach permanently in 1996. But prior to that we had a vacation home. My brother relocated to Winston-Salem area about 30 years ago. So we always were familiar with North Carolina and came to visit, and loved the shore, loved the beach, and got a beach house in Ocean Isle for vacationing over the years. And as I said, in 1996 my parents decided to full-time relocate here. And I was left in New Jersey, our children were getting grown and in college, and it was difficult to be so far away from my parents. So I felt the need to get closer. We always wanted to relocate to this part of the country. So just started to look for jobs. When my parents moved here I will say, though, I started to be a little bit concerned about health care for them. They were in their 70s when they moved here and I was worried that I wasn't going to be near should they ever need something. So I really started to study the health care in the region. And it was at that time that I really became familiar with New Hanover Regional Medical Center. And I watched it grow, and I watched it bring services to the community. And I just was enamored by how New Hanover was able to respond to the community at that time. I learned a lot about it, I did a lot of research. And I felt that my parents were in a good place, having New Hanover here. When we decided it was time to consider relocating, I just started looking for a position of a chief nurse. I was a chief nurse in New Jersey and wanted to maintain that position. They are hard to find, especially in southeastern North Carolina. So I waited patiently and saw this position open up and threw my hat in the ring. And lo and behold I was blessed to be honored with the position. And I joined staff March of 2001.

Jones: How have you seen New Hanover Medical Center grow? What areas do you feel are the most important? You mentioned retirement. Since this is a Mecca for a lot of retired people, I'm sure that the diseases, the natural-type things along with everything else, are the large concern. And I can't help but notice in the newspapers, if no place else, the big full-page commercials for testing and that sort of thing showing little grey-haired people, of which I'm one, but I don't have grey hair because I go someplace and have that fixed.

Bonczek: That's taken care of. (laughs) Well, you know, I have been able to watch New Hanover grow even since I've been here in Wilmington since 2001. I can't believe the growth. I really cannot. And the disease processes with the aging population, and we're staying alive longer, we're staying healthier longer, but we also need to cope with chronic diseases such as diabetes, hypertension, cancers that people can survive and recover from. So I'm seeing New Hanover really focus on the cardiac strength of our medical staff and our nursing staff, and the other providers of care. I've seen us grow in our oncology program, and that is one that we'll continue to see grow as we begin to provide deeper and deeper services not only just at the hospital but in various parts of the county, because access is an issue. It's hard to get from one place to the next. The transportation's difficult for some people. So it's important for us to reach out as well in the outreach areas.

Jones: Can you tell us-- at this particular time in 2007, what would you consider to be the most prominent diseases that you see at New Hanover that may not have been prominent ten years ago.

Bonczek: Cardiac disease in women has definitely grown exponentially.

Jones: What do you figure is the reason for it?

Bonczek: I think women have taken on more stressful positions in the society. Women are smokers, obesity plays a part in it. And I think we've become exposed to more and more environmental factors and social factors that increase the stress and the risk factors in our lives.

Jones: That's a good point. Can you discuss any particular environmental factors?

Bonczek: Well, I think as we look at the obesity in our society and just the fatty foods, and the racing around and not having time to have a meal at home, and cook your dinner, and eating a lot of fast foods, I think that that has made a big negative impact on women's health. We've seen numbers double in women who have come into our emergency department with chest pain that have ended up in our cardiac cath labs. That used to be a very dominant male disease or male experience, and we're finding more and more women presenting to our emergency department.

Jones: Does this transfer into a higher incidence of diabetes?

Bonczek: That's a factor, the diabetes and the hypertension. Again, because of maybe some of our social factors are causing diabetes to be on the uprise, which then impacts the whole system, your blood pressure as well as cardiac disease.

Jones: Is there a predominant age group for this?

Bonczek: I think we're seeing it younger and younger. We have women in their 40s that are coming in with cardiac disease. It's not the 80-year old necessarily who has just stressed her heart long enough. But we're seeing young women, 40s, 50s, we see an increase in that age population. You see the red-dress luncheons and some of the fundraising that goes on for the American Heart Association, it's really surrounding women and heart disease.

Jones: That is the conundrum, really.

Bonczek: Yeah. But on the other hand, too, we talk about Wilmington being a really popular place for active seniors and retired. We have also seen incredible growth in our births. When I arrived in 2001 we delivered about 3,000 babies at New Hanover Medical Center, and that stayed about the same for a few years. Last year we delivered 4,200 babies.

Jones: Is it a growth in population?

Bonczek: It is. Our population's not just growing in our active seniors and retired, but it's growing in our families, and young families in childbearing years as well as the regional nature that New Hanover has taken on, with our neonatal ICU and some of the other where we have folk from Onslow or outlying counties that come to us for high risk.

Jones: That must be a discipline that would be for a very special person.

Bonczek: It is. It's a very delicate art. It truly is.

Jones: I know that the population growth has been just phenomenal, which is one reason we're doing this particular oral history program, to look back on another ten years. Because we looked back ten years and said, "No. What happened?" And the statistics aren't finite at all, they're continuing. But it does seem like we've become a population of younger retirees. And then some very young people who are in the technology businesses where they can perhaps live at home and then once a week go up to Raleigh, wherever they go. But we're also seeing, from the old Wilmington families that have been generational in businesses, their sons are not taking over the businesses, it's the daughters. So I can't help but wonder, this relates in a way. You've got young women who are taking over a successful business, or a not-so-successful one, making it so. They have all the stresses of competition as the men.

Bonczek: They sure do. Absolutely. And it impacts it in the whole nursing profession. You know, predominately when I was growing up and making decisions about my career, women went into teaching, they went into religious service, into nursing. It wasn't the most commonplace thing to see a woman in the '70s coming out of high school and going into business school or to law school. But today the statistics are incredible for the number of women in medical school.

Jones: I was just going to bring that up.

Bonczek: Mm-hmm, we have a residency program for obstetrics, surgery, medicine. And there are times when more than half of those individuals are females.

Jones: What about dermatology and that sort of thing?

Bonczek: We don't see a residency program at the hospital, but you see in town the number of female physicians and female dermatologists and surgeons is really incredibly high, and lawyers. You see law schools.

Jones: What do you, working in the medical field and obviously successful in that and an expert at this point, attribute to women going into what had always been considered traditionally men's type of positions such as your family physician your minister, priest? And with the exception of the Catholic Church I think they all have women now. But talk about the medical side of it. Do they have patience, do they have a feel for it, do you think, or is it just something that's opened up and they're now accepted?

Bonczek: I think it's all of the above. I think that women entering into the medical field as physicians, they have a different approach to care. You can see sometimes a very different approach on how a female physician deals with a family, deals with a family's death and dying experience, compared to maybe a physician who's a man. You see then taking on some different roles. At New Hanover the dominant surgeon is a male, but we do have some female surgeons that are extremely technical. They're very deliberate, they're excellent clinicians, and they have a wonderful bedside manner, not that our man surgeons do not. But you can see the female surgeons starting to increase. We have our hospice physicians that are some women physicians, and their compassion, their caring, their appreciation for the family dynamics is really incredible. And the women that are now not going into nursing anymore are going into fields of medicine.

Jones: What about the PA program?

Bonczek: We have a strong PA program here at New Hanover now. I just met with a group of ten of them just this other week, and half were women. Again, working with the orthopedic surgeons, being able to spend the time with the patients, times that our surgeons, that our medical staff may not necessarily have to explain procedures. One of our cardiac PAs that works with one of our great cardiology groups in town said, "I do it because I need to spend time with the patients that my physicians don't have time to do anymore." So we've kind of become extenders to help support each other in that total care of the patient, which I think is such a great match with the men and the women both tagging up together to provide care to the patient.

Jones: How much contact do you personally have with the patients? And I ask this in relation to how accepting is the public of a PA overseeing that nice, friendly doctor?

Bonczek: I have close contact with patients. As a routine myself and my colleagues, we make rounds every morning in the hospital. We'll pick a floor, we'll go up, we'll meet with a few patients and ask them how their experience is and talk with them. The majority of the patients that I speak to, they understand the relationship between what we call the physician extender. They appreciate that person kind of coming in and getting things organized up front. There's occasionally times that I hear in the community about someone who went to their doctor's office and didn't get to see the physician. And I try to help allay those anxieties because the physicians have to see anyone with a new problem. It's chronic problems or follow-up that you don't necessarily need to see the physician. We employ nurse practitioners, nurse midwives in our clinics.

Jones: Really, nurse midwives?

Bonczek: We have nurse midwives. Actually through our AHEC, through the Area Health Education Center, our medical staff works with some midwives, some midwifery programs. Yeah. And they're wonderful caregivers, and they just provide such a great service to a certain category of women that seek that out.

Jones: Very interesting. Tell me about the Zimmer Center and the impact that has.

Bonczek: The Zimmer Cancer Center is I think one of our jewels. Years ago when I came to town as I said, I used to hear people driving past New Hanover to go to Duke or Chapel Hill for their cancer care. And there's no need to do that. I mean, the cancer care that we have here at the Zimmer Cancer Center is phenomenal. The people alone are phenomenal. But the technology that we have available, we have the most high-end technology in our PET scanners, which are diagnostic tools. Radiation oncology--

Jones: That's something new, isn't it?

Bonczek: Within the last couple of years, yes, in the last couple of years. Our chemotherapy, we have studies, and trials, and all kinds of research going on. So we're as active a community cancer center. We're accredited by the American College of Surgeons as a cancer-- community cancer teaching center. So our physicians are extremely well-renowned. They're very well published and known across the nation.

Jones: A question on that, cancer, from just a layperson's point of view and as a getting-older senior citizen with a lot of friends who have turned up locally and other places I've lived who have had cancer, have cancer now, all different types of cancer. Is cancer on the rise, or is cancer now being diagnosed properly? I had a doctor tell me, Dr. John Ettonhouse [ph?], he was wonderful...

Bonczek: Yes, I know Dr. Ettonhouse.

Jones: And he said that they always ask you if there is any cancer in your background, any heart problems, blah, blah, blah, and you say "No, no, no." It's probably yes, but it was called something else. Is that true?

Bonczek: Yes, that is very real. I think that is one of the realities that we struggle with is if there was no history in my family maybe that's because my ancestors didn't live long enough to experience that history, or it was diagnosed differently. We see thyroid cancer, and I don't know the numbers, but we see thyroid cancer increasing in our area. And the big question is are we doing a better job of diagnosing and early detection, and we are. As with breast cancer, it's on the rise, but are we doing a better a job?

Jones: Is it still?

Bonczek: I think it's still. And it's early detection. It's getting mammographies, it's doing self-breast exams, it's early detection. That's also, I think, contributing to the fact that we see more cancers.

Jones: I think it also alludes to, for example, two people I'm thinking of right now who waited before going to a doctor thinking, "I don't want to bother him. I'm foolish. I'm okay. I'll be all right when the weather changes," that kind of thing.

Bonczek: Yeah, you hear that very often from stories.

Jones: And you don't want to be foolish. You know really. But there are various kinds of cancer that people are suffering through right now that you never heard of before. And just like you're telling us, heart disease, cardiac problems, are too.

Bonczek: Absolutely. And we're doing a better job of diagnosing it. We're doing a better job of treating it. We have a cardiac initiative right now, it's called Code STEMI. S-T-E-M-I. And what it stand for is ST elevation. In an echocardiogram, the way your heart rhythm goes there's a segment called a ST interval. And the ST elevated MI, or myocardial infarction. And what we're seeing now is that in the fields and working closely with our EMS, if an EKG is done in the field and identifies an elevated ST segment on the EKG, we have what we call a Code STEMI. And everybody along that line gets paged, shows up, no questions asked, and that patient is in the cath lab, what we call door to balloon time, which is a balloon that goes in to remove that blockage. We are exceeding state averages. Our goals are 90 minutes, we're below 60 minutes. I personally have a friend who was experiencing that, had the chest pain, wife brought him, made the phone call, within 60 minutes he was in the cath lab and his heart was getting the oxygen it needed so that the muscle didn't die. And it's just phenomenal. We see it every single day.

Jones: How about the staff that you oversee? I'm thinking of the nursing staff. I know that there are registered nurses, there are LPNs. Maybe you tell us what an LPN is. And then there are aides. I've been hearing for years that there's a lack of qualified nurses. Why do you think that it so? It's a big multi-faceted question.

Bonczek: It is, but it's so pertinent to where we are today. There are levels of caregivers within the healthcare team. And just talking about the nursing folks right now, there's the nurse aides, there's nurse aide ones and twos, that have various levels of education. There's an LPN who's a licensed practical nurse, and then an RN who's a registered nurse. Various levels of schooling and various licensing or registering exams to get one from one point to the next on that continuum. We are lucky in this region right now with the nursing schools that we have and the growth that we have. And our issue is not necessarily that we don't have enough interested people who want to be nurses, we don't have enough faculty, and we don't have enough space in our schools to teach. We have turned away hundreds of qualified applicants from our schools of nursing over the last couple of years because we don't have enough faculty and there's no room. So albeit, you know, the growth that we're trying to support at all of our area schools of nursing, most specifically Cape Fear Community College and UNCW, but--

Jones: And that's growing.

Bonczek: That's growing dramatically.

Jones: Virginia is doing a fantastic job.

Bonczek: Yes, it is fantastic, and we're supporting that as much as we can. We have received dollars from a Duke endowment for a grant where we are supporting 11 of our New Hanover Regional Medical Center nurses to go to school full time here a UNCW at the Masters for Nursing Education Program, with the commitment that when they graduate they will teach in our schools of nursing, both Cape Fear and UNCW. So our role and job is to open up our doors as much as we can at the hospital to provide the clinical experiences and to provide faculty to help the schools of nursing grow. There are lots of opportunities for women, again, mostly predominantly female. We experience here in our hospital a higher percentage of male nurses than across the nation. We have about ten percent of our nurses are males and the national average runs about eight. And we're seeing that grow with a lot of military, a lot of medics, a lot of second career men and women that are coming into a second career, have had downsizings in other jobs, and look to nursing as a profession of continuity and always guarantee a job.

Jones: I think there's two positions a young lady and man could take now where they could find a job probably anywhere in the country, nursing and teaching.

Bonczek: Yeah. So there are many opportunities to grow nurses from nurse aides, and that's to our Nurse Aide Academy. The Nurse Aide Academy that we have at New Hanover is for our own nurse aides to help them elevate their skills, to increase their awareness of caring for patients and compassion for patients, and patient satisfaction. And it increases their ability to go to the next level which is a nurse aide two. Or if they're a nurse aide two, to help them advance into a LPN program, to just continue to try and power that staff to grow and to grow into--

Jones: You love your job, don't you.

Bonczek: I do. I love it.

Jones: It comes across. That's wonderful.

Bonczek: Thank you, I do love it. I enjoy being able to create the environment where my nurses can be the best they can be to take care of our patients. You know, when I was in staff nursing, my background's in critical care. And when I started to get into management, my first manager job I still took care of patients and then started to move up the ladder, if you would, and started to become a little guilt-ridden that I had abandoned my profession. I wasn't the nurse anymore. My family would bypass me and go to my sister-in-law who's a nurse because she still practiced and I was a clipboard nurse. You know, and I started to begin to question myself and say, "Well, maybe I should go back to the clinical side," until one time I was, not here at New Hanover but in my past life, in a pretty intense meeting in the boardroom, talking about finances of the hospital. And the first place that was gone to was the nursing workforce. It's a large workforce, it's a high percentage of cost to an organization. And at that moment I realized that I had to develop another expertise besides being a critical care nurse, and that was to be my nurses' advocate in those kinds of meetings and in those kinds of discussions to help support and provide leadership, and be that administrative nurse expert. And it was at that point I had that like "aha" moment that said, "No, it's okay. You've got clinical experts to take care of your patients. You'd better figure out how to do this well." So that bedside to boardroom is something I've always tried to keep. I want to stay close to my nurses so I understand how they take care of patients, but I've got to make decisions for the community and for the overall well-being of New Hanover Regional Medical Center to be financially obligated to move our services forward.

Jones: How is a medical center like this: growing, growing and growing, how is it funded?

Bonczek: New Hanover does not receive any tax dollars for funding. We are a public not-for-profit hospital, but we do not receive any tax dollars. We are really self-funded through the insurers that pay for our patients' care. And it's our obligation to negotiate those contracts to the best of our ability to provide care at really the most efficient way we can to reserve our precious resources, because many of our patients are underinsured or have no insurance at all. There is some money that comes through indigent care through state funds, through federal funds that help to fund our hospital. But really it's supporting the care we're giving, it's not providing a fund that we can work from. It's really just helping to pay for the care that we render.

Jones: So all that is pooled into equipment, and salaries and everything else. I need to tell you this, the library-- Randall Library in special collections was gifted with all the papers having to do with New Hanover Hospital from the time that some bonds were floated to try to build it. The first bonds were negated. From every inch of the way, it took me two months to do this. I never in all my life realized that the builders, the designers, Mr. Alfer [ph?] who was the head of it and a whole group of other people, would even count steps from let's say the doorway to the refrigerator, or the place where you kept medication because you had to be in a hurry without tripping. And I looked at these diagrams, and I thought, "I cannot believe this." The costs kept going up, and changes were made, delays, how doctors are accredited and can practice. And I thought, "How can any one person do that?" And that was in the 1960s.

Bonczek: And it's amazing that today, in this year 2007, we do those same basic fundamentals.

Jones: All the building that's going on, every inch--

Bonczek: Every inch is measured. An now with--

Jones: And for storage, et cetera.

Bonczek: And with an aging workforce, majority of my nurses are in their late 40s, and they work 12-hour shifts and those hallways get long. So we're mapping out where my meds are kept, where my patient is, bringing our things, everything we need, closer to the patient, for the patients care as well as for the nurses and the other health care providers. Just the whole design of our current construction, it is amazing.

Jones: Now let me ask you this. I know, because I was at the benefit of taking part in one of these programs. I know that there are rehab programs going on that are with the hospital, but a little bit separately, I guess, pulmonary, cardiac, whatever.

Bonczek: Actually the pulmonary New Hope Program, pulmonary rehab, cardiac rehab as well as our coastal rehab hospital are all departments of New Hanover Regional Medical Center. They're all part and parcel. Also I don't want to skip over the community who funds New Hanover Medical Center. Our community funds it.

Jones: I was going to tie in to how are these funded, too.

Bonczek: They are funded a lot in part from the generosity of our community, whether it's the Cameron Women's and Children's Center, the Zimmer Cancer Center and all the incredible families that continue to support New Hanover Regional Medical Center. The Care Van, the mobile mammography unit. And I have a personal story to share. My husband, who retires-- he's retired now, he drives the Care Van. And he volunteers at the hospital. So one day a week he drives the Care Van. So I have a personal experience with where that Care Van goes and how it brings early detection for breast cancer to those Rural areas.

Jones: Can you tell us? It all goes out beyond.

Bonczek: Absolutely. It goes out beyond to Onslow. It goes out to the largest frying pan in North Carolina, Rose Hill. I think that's noted for like the largest frying pan. But anyway, that's where the Care Van goes. The outreach that that van has to help women get their mamographies and have early detection. That's funded by the foundation. That's funded by the dollars that the community and New Hanover employees donate back to the hospital. So that's a big part of who we are and what we do.

Jones: One of my questions was going to be how far an area do you service? Even with emergencies you have helicopters who go airlift and bring them in. But where do they come from? Leland or Brunswick County now has a hospital of sorts. I don't know how big it is.

Bonczek: Well, our primary service area is Pender, Brunswick and New Hanover Counties. Those are our primary areas that we service. And most of our patients come from those areas. But there's what's called the seven-county region which includes Bladen, and Columbus, and Onslow, and patients that come to us for regional care, whether it be prenatal care, high risk OB, cancer care or cardiac care. And then there's the extended region, if you would, which is the trauma, depending on where a trauma occurs and where our helicopter may go to get patients. So we do extend out a little bit further than a seven-county region, but predominantly it's New Hanover, Pender and Brunswick, and then a little bit more from the area surrounding that. With both of the counties' growth, the growth that is happening in Leland is just phenomenal. It is. And Dosher's there, and Dosher's a wonderful hospital in Southport that we really are blessed to have a good relationship with. We're able to help support some of the higher-tech needs that that hospital has. And now with Brunswick County Hospital growing, there's plenty of people and plenty of patients to serve. So I think it's going to really help enhance the health care in the region.

Jones: Can you tell us about what's happening now in advanced medical care detection, machines or whatever, that will become commonplace, hopefully, down the road? What are we looking in the future of medicine?

Bonczek: The technological advances that we are experiencing now but we're going to see even more and more is what we call non-invasive surgery, where you can have surgery now through a small incision that's done through microscopically, almost robotically. And there's robotics surgery that's done external where the surgeon's using and manipulating with his or her hands the instruments that are inside in the organ at the vessel.

Jones: I read a paper on this recently having to do with colon cancer detection.

Bonczek: Colon cancer, kidney or renal diseases. The vascular surgery that's being done by vascular surgeons here at our community and our hospital, these patients are going home in a day.

Jones: I was going to say that cuts down on a lot of your problems.

Bonczek: And, you know, when I was nursing or out of school, I mean my open heart patients were there for a good solid two weeks. Our patients are up out of bed the next day. Some of our vascular patients go home that night. It's just amazing. So that technology is going to continue to advance, and I think we're going to see more and more non-invasive or minimally-invasive work done. The detection pieces are going to continue to get stronger and stronger with blood tests and screening, with tissue sampling, with a PET scanner or high fast MRIs and CT scans.

Jones: Can you tell us what a PET scan is? I know what it is but--

Bonczek: What a PET scan can do is identify certain levels of agents in your body. It helps detect cardiac disease. It could help detect cancer when those certain levels are elevated in your body. And those technologies are going to zero in on early detection and more focused to treatment. Radiation oncology, what we are doing with radiation oncology and the advances in mapping where cancers are and being able to zero in and address that individual tumor are so technically detailed. It's just amazing to watch and see. And I think that's just going to get more and more advanced, and it's going to go out of the hospital into more and more access-- easier accessed place for our patients.

Jones: I see in various area, occurs all up and down the 17th Street Corridor and off there, some of the medical practices, the larger ones, seem to have their own testing laboratories, chemotherapy, radiation rooms. And I have been following with interest tests that have been done on various types of medications that either is by pill or through a vein for cancer patients, as an example. And there must be a lot of medications and types of treatments. Do you wait for the FDA to approve everything?

Bonczek: Yes, we are involved in some trials, some research trials, whether they're stents for ceratoid arteries or drugs for cancer, some chemotherapy agents. But then, yeah, waiting for the FDA to approve is what we do before we go into the mainstream, if you would, with it. But--

Jones: Tell us about the YWCA Health and Wellness Award.

Bonczek: That was quite an honor.

Jones: What is health and wellness with them? Explain that.

Bonczek: Well, the YWCA's mission is eliminating diversity and empowering women. And I was honored with the nomination from my organization who nominated me and put me forward for consideration for that award. And it's women across our region that are involved in health and wellness programs that have contributed to empowerment of women and to help eliminate-- or improve the diversity of our-- respect for diversity. And I think that the work that the hospital has allowed me to do has been able to empower the nurses to give them autonomy in their practice so that they can make decisions about the patient at the bedside. It doesn't have to go up a hierarchy to get to me or another director to make a decision. I empower my nurses to make those decisions at the bedside for the betterment of the patient. And I think that was a piece in part. The Nurse Aide Academy, to empower those ladies that are nurse aides that want to progress but don't have the means to progress, we try to provide opportunities for that growth and development, and really to respect the cultural diversity that we do have in our community and to make sure that those advancements are there for everyone and not just the select few was part of some of the work that we've done at the hospital that I've had the opportunity to lead that I think put me in the position to be nominated for that honor.

Jones: Congratulations. That's marvelous.

Bonczek: Thank you. It was wonderful.

Jones: How are the nurses, male or female chosen-- my understanding is that nurses have these shifts round the clock on the floor, and there's a team leader. Are they watched by other nurses with experience and have fitness reports written? How are they chosen?

Bonczek: We call them coordinators, and those are our lead charge folks around the clock on the off-shifts. And there's coordinators for almost every unit. And they're chosen really with a couple of different eyes. One, it's usually someone who has a desire and a natural ability to lead, someone who wants to be a little bit in control and take responsibility for how that shift is managed and how those patients flow, and how the staff is assigned. And then there's obviously some education that we provide to see if we have nurses that are interested in learning about the skills of leadership. And from there it really does build our succession planning where we have coordinators then move into a higher level management position with more responsibility get further education and training, and that's where we partner a lot with our school of nursing, to be able to provide our nurse leaders with leadership training, budgeting, financing, how to run a little business, because that's basically what you're doing is managing a business.

Jones: What would you like to see happen? When you do leave, whenever that is, what would you like to leave behind that you really accomplished, or have you accomplished it? You don't strike me as the kind of person who's ready to say, "I'm through."

Bonczek: Yeah. No, I'm not done yet. I think my legacy, if I can at New Hanover Regional Medical Center, is that there's a succession plan for leaders, that we mentor and grow each other, and that that philosophy is imbedded in my nursing staff. I want the legacy to be that the staff feel they can make the decision and contribute with the medical staff and contribute with the other health care providers about their patients. And if I'm not there, that that won't go away. That will stay there. Because I think that will bring our patients satisfaction, our outcomes for the quality of care, that is what will make those things skyrocket and improve, and continue to improve. The further away the decisions about our care get from the bedside, I think the poorer the decision we make. I'm very much a supporter for information technology and its use in the hospital. And I think the other think I want when I'm gone, I don't want anyone to say, "What silly decision did Mary Ellen make about this information technology?"

Jones: You are human though.

Bonczek: I do, but I work really closely with Avery Cloud, our Chief Information Officer, and we have finished. Today was actually the last unit that went life with our barcoded medication administration. We go to the food store and we can barcode everything and scan our way through, but we've just finished implementing that for medication administration to our patients. So patient safety is the other piece that I want to leave with New Hanover, and that is a safer place for our patients to get care. Because we are human, we have processes that are complex, and we have very, very intricate medications that need to be given to our patients. So now I can scan the medication, I can scan the patient barcode, and I know you're getting the right drug at the right time. And so that's another piece that patient safety is very important.

Jones: I have one last question, and perhaps it could be in some quarters considered to be a touchy-type thing. There are so many people, allegedly from reading the newspapers and listening to the news, who have no health insurance. And I've always been told, and I've been a believer, that really sick people are never turned away.

Bonczek: That's right.

Jones: And there seems to be in this political world of ours a huge accent on health insurance and so forth. At New Hanover Medical Center how do you absorb these costs of people who are indigent, and I hate to use that word, mothers who can't afford to take care of their children properly? Are they really cared for?

Bonczek: It's not just on paper that New Hanover cares for anyone who presents themselves no matter what their race, religion or ability to pay. That's a true statement and I fully believe that with my heart.

Jones: I believe it.

Bonczek: The impact of the underinsured and uninsured patients is dramatic on our ability to be financially healthy. Yes, some federal funds. Yes, some state funds, some grant dollars. But it really is inherent upon the leadership team of New Hanover and the staff that we work with to be respectful of every resource we have. We can't waste tape. We can't waste sponges or dressings. We can't waste nurses' time. We can't waste respiratory therapists. Everything we do is a valuable resource that needs to be used efficiently and effectively. We can do that with the help of automation. We can reduce steps in processes that cause waste. We could work with our medical staff to develop protocols and pathways that help us be consistent in the delivery of care that is shown to have best practice outcomes but also can be a little bit more-less expensive. We group buy with other hospitals to get best prices. We negotiate to reduce the cost of care. It's a constant initiative on the part of leadership and every employee at New Hanover to utilize our resources as best as we can so that we keep the cost down, so we can continue to provide care. Behavioral health is a perfect example right now with the North Carolina mental health reform that's happening around us and to us, which has now created in our community an incredible need for stronger behavioral health programs. And New Hanover is--

Jones: What are the programs?

Bonczek: Well, we have the Oaks, which is our psychiatric hospital, and we're committed to continue to provide that level of care. Our emergency departments, our psychiatric patients present to our emergency department. The state hospital beds that are closing are putting really the onus of managing this very critical patient population at the hospital level. And our legislators. You know, our legislators, we work with them, we lobby with them, we help them understand the realities of the decisions that are made so that we can look to our hospital associations for support and for some, you know, potential dollars from there. So it's a group effort. It's something that we do every day, we're conscious of.

Jones: Along with that, I want to ask you personally because I don't want to get into a political arena, but have any of you talked about the way that we might be heading towards socialized medicine?

Bonczek: We talk about it just in conversations at work with--

Jones: Not seriously.

Bonczek: But not seriously. We talk about and look at other health care systems in other states, in other countries. We compare, we contrast. But in the end, I mean, we have incredible health care in this country.

Jones: We absolutely do.

Bonczek: It's magical. I watch every day and I see magic happen. I see miracles happen every day. I see opportunities to improve, I see ways we could do it better, but there are miracles happening every single day.

Jones: Can this start, by some miracle, getting into the classrooms and talking to children or teachers about the necessity of physical exercise and health related issues?

Bonczek: Yes. And we do that at New Hanover. We're involved with outreach programs in the communities and partnering with the schools. Matter of fact, just next week there's a school summit almost, if you would, with some of the area schools and the hospital and other health care providers to sit down and talk about obesity in children. Our cardiac rehab program has done tremendous work in working on obesity in children and have gotten some grant dollars to work on exercise programs, to work on diets with the school system. So there's always more opportunity, but those wheels have started.

Jones: Mary Ellen, it's been a pleasure to talk to you.

Bonczek: Thank you, Carroll. It's been a pleasure.

Jones: It's always a pleasure to talk to somebody who loves what they're doing and it shows through. You can't help but become enthusiastic.

Bonczek: Well, thank you. I do love what I do. I'll grant that.

Jones: And what you're doing, this is probably one of the most important pieces of real estate we have in the county, if not the most.

Bonczek: I would agree.

Jones: And not just New Hanover county. I see pictures and some history of James Walker and Babies Hospital and think, "Did they have any idea what would happen?"

Bonczek: It's interesting. Some of our medical staff that I speak with frequently were on the ambulances that were moving the patients into that building, day one. And to live and feel the history that's there and meet with some of the people that have worked at James Walker that worked at community and now work at New Hanover Regional Medical Center, the amazing thing about some people that I work with-- I saw a woman today, she works in environmental services in the Oaks. And I said, "So, how long have you been here?" She said, "32 years." Thirty-five years, 40 years people have worked at New Hanover Medical Center in some way shape--

Jones: As volunteers, because I know you've got a great volunteer force.

Bonczek: And we've got an incredible volunteer workforce. And that's one of the beauties of Wilmington, and one of the reasons why I think my husband and I were drawn here from the very beginning was the culture, and the people, the heart of Wilmington. And the respect that people have for each other is just amazingly wonderful. And as we continue to grow what, you know, I hope never becomes a reality is that we lose that. And you hope that people that relocate here and gravitate here do it for the reasons of the heart and soul of Wilmington and New Hanover County.

Jones: You can just get on television and talk to people.

Bonczek: (laughs) I do feel it. You know, a funny story, I don't know if it's appropriate, but coming from Staten Island, New York and then in New Jersey, spent a lot of time in Brooklyn and Manhattan. And then in the northeast a lot of horn-blowing when you're driving. You know, if you miss a light or you're--

Jones: It's too congested. You're in a hurry.

Bonczek: Yeah, you're waiting a second that that light changes and you don't go. And it's one thing I still say a year to my husband, "You know, I still love it. I don't hear horns blowing."

Jones: They don't drive well, but they don't blow horns.

Bonczek: That's okay. But if I'm at the light and I'm waiting for it, and I take a nanosecond to get there, you know, that's the little things that make a difference in how people respect each other and are patient. And it's okay to wait a second or two. I don't mind standing in line waiting for good service, you know. So anyway, thank you.

Jones: That's terrific. It's a good philosophy. Thank you so much.

Bonczek: Oh, thank you. I'm sorry I was so late in getting here, but--

Jones: That's all right. It was worth waiting for.

Bonczek: I appreciate being a part of this. I really do.

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