Nursing at the Chaim Sheba Medical Center

The Chaim Sheba Medical Center employs more nurses than any other Medical Center in Israel with approximately 2200 nurses, 78% of who are Registered Nurses (an additional 4% are LPN and 18% are Nurse Aids).

More than 100 nurses begin their professional career at SMC every year as a result of a determined effort to absorb top-notch, highly skilled and motivated nurses in all of our units and departments.  In special units such as the ICUs, Delivery Rooms, Emergency Departments, Oncology and Hematology Departments the SMC employs only registered nurses, most of whom have clinical post graduate studies.

Our vision for nursing is focused on the patients and their families, on maximizing their health and quality of life.  Our goal is to provide patients with excellent care, maintain high treatment standards, and provide our staff with continuing education to uphold their high caliber of professionalism.

While in the Acute Care Hospital registered nurses are approximately 75% (up to 80% in Pediatrics), in the Rehabilitation Hospital there are only 58%, using efficient practical nurses (21%) and Nurse Aids (21%).

The Nursing Management Team includes senior nurses with advanced academic degrees (Masters and PhDs.), who are directly involved in nursing management and coordination of specialty areas dealing with: professional standards; quality assurance; nursing research; nursing informatics; and staff development.  In clinical areas such as Pain Management, Geriatrics, Psychiatry, Oncology, etc., nurse practitioners are utilized to directly administer treatments, offer consultations, coordinate clinical interventions, and engage in teaching missions.

Clinical interventions involve choosing the right nursing methods, based on universal knowledge and international evidence- based literature.  Data on patient- related classification-groups is constantly being gathered to ensure the proper care for each patient.

Making appropriate clinical nursing decisions requires collecting the proper information and correctly evaluating parameters such as the patient's dependency level, stability, or complexity of their condition, taking into account the patient's individual needs.

Extensive knowledge and a high commitment to investigate and develop professional nursing issues related to the care of patients and their families are the foundation for initiating innovative projects.  Our projects have become known for effectiveness and originality and serve as models for imitation by other medical centers in Israel and around the world.  Examples of this can be found in Holistic Care (Bio-Psycho-Social) and in providing continuity of care between levels of treatment. 

Nursing professionals are encouraged to advance their nursing careers in clinical and management areas by continuing their academic studies and nursing education with post graduate courses and by taking part in managerial training and in-house courses.

Nursing students from academic institutions throughout the country apply for their clinical training at SMC because of our excellent reputation and high clinical standards.  Therefore, in 2007, we had 55% of the registered nurses with B.Sc. (compared to 32% in 1999).  With the additional 12% who have a master's degree, 60% of our registered nurses have academic training.

In this era of great technological advances the Chaim Sheba Medical Center is recognized as a pioneer in incorporating new technologies and interventional methods.  Consequently, professional nurses and health managers from all over the country avail themselves of our facilities and pioneering efforts to learn modern clinical methods and management skills.

Due to our location in the center of the country and our close proximity to the Tel Aviv area, the Sheba Medical Center deals almost on a daily basis with the reality of terror.  The clinical and diagnostic skills of our professional medical and paramedical staff puts Sheba at the front line of life-saving treatment for both civilians injured by terrorist activity or soldiers injured in military duty.  Sheba medical teams are constantly on-call to deal with any kind of terror attack, conventional, chemical or biological.  At any given moment, in any kind of attack, all medical and emergency teams arrive at the hospital immediately to administer treatment and aid to the victims and their families.

Research in the nursing field is directed toward a wide spectrum of issues such as health promotion, outcome of care, management and nursing policies, etc. When appropriate the research results are implemented in all relevant units and departments.  Many of our studies have been published in international journals and have been presented at international and local conferences.

The Sheba Academic Nursing School, as an affiliate of the medical center, educates undergraduate students for certification as Registered Nurses, postgraduate students, and offers special courses for new immigrant students who hold foreign diplomas.   All students are exposed to clinical instruction in the various departments and units, as well as to the ambulatory services.

Basic Premises of Nursing Care at the Chaim Sheba Medical Center

The first priority is always well being of the patient (and their families), maintaining a commitment to promoting his or her health, in recognition that each patient has a right to Physical, Social and Mental well-being.

• Patients have a basic right to receive quality health care.

• To aspire to be a spearhead in the field of nursing and a model to other healthcare professionals and organizations.

• Commitment to be active participants and leaders in promoting optimal health in the general population by developing tools, improving healthcare systems, initiating new activities and services and enhancing professional standards.

• Belief in professional autonomy, personal accountability and excellent standards, and the importance of continuing education.

• Belief that human resources must be cultivated and developed to strengthen a sense of commitment to the hospital and the nursing profession.

Nursing Policy

The foundations of our nursing policies are based on the general management policies of the Chaim Sheba Medical Center and Ministry of Health Nursing Division.

As a leading medical center in Israel and as an academic hospital affiliated with the Tel Aviv University, the Chaim Sheba Medical Center remains focused on providing quality services and excellence in all aspects of care, therapeutic treatment, technology, and expanding our knowledge.

We Are Committed to:

• Respecting our client's rights, beliefs, religion, and culture.

• Performing quality medical interventions based on the highest professional standards.

• Promoting multidisciplinary teamwork designed to meet the patient's and their family's complex needs.

• Investing in nursing human resources, both as individuals and as teams.

• Enriching the role of nursing and broadening intervention and autonomy, in concordance with changes in the healthcare systems in Israel and abroad.

• Developing new professional roles to meet the patient's needs in an era of new epidemiological phenomena and changes in the healthcare system.

• Promoting nursing research that will create a clinical evidence base to serve as a tool for care and management policy.

• Managing the system in accordance with the economical, professional and political changes taking place in the State of Israel.

The Nurse's Role at the Chaim Sheba Medical Center

The role of the registered nurse at Sheba is to manage and implement the clinical care necessary to achieve the physical, mental and social well being of patients and their families.  The nurse ensures continuity in all aspects of treatment within and between hospital units and the community.  

The nurse utilizes her professional, managerial and ethical skills to provide total first-rate nursing care.  In addition, the nurse's role includes education, guidance, and support, not only for patients and families, but also for students and professionals. 

Special emphasis is given to achieving the psychosocial and mental welfare of patients and their families.  Activities are based on special expertise, gained through continued graduate and post-graduate nursing education.

Group interventions by nurses and hospital social workers functioning as a team are designed to promote health related behavior by means of various techniques.  Patients and their families face difficulties related to physical ailments and disease, requiring help with coping skills or social support systems. 

Interventions are aimed at improving quality of life, decreasing anxiety levels and increasing health awareness.  Increased demand from all over the country to participate in these support groups is the best evidence of their importance.

Professional Development

Our nurses contribute greatly to the quality of care the patients receive and their satisfaction by virtue of their professional abilities which have been gained through two central areas:

• Clinical Axis - nursing specialization in various fields is achieved by theoretical and practical training (post-graduate education) in areas such as Nephrology, Oncology, Intensive Care, Emergency Medicine, Mental Health, Pediatrics, Midwifery etc.

• Their authority and autonomy is broadened on the basis of their extended knowledge and high-level technical skills.  Additional clinical expertise is gained through "in service" continuing education in various topics such as Pain Control, Wound Care, Diabetes prevention and treatment, and case management, to name but a few. 

• Managerial Axis - nursing managers and nurses who choose the managerial career track acquire their managerial skills through specific academic studies and in special workshop training sessions, which focus on management in the health care environment.
  These two areas complement each other to create professional nurses and nursing managers focused on the needs of both the patient and the institution. 

Work Methods

Clinical care that focuses on the patient's special needs can be expressed in many ways.  Choosing the appropriate work method is the crucial first step to ensuring quality treatment and improving outcome.  All of our work methods are based on a holistic approach that uses valid structured assessments and interventions.  Audits are performed regularly to monitor processes at all levels of care and identify specific gaps, which are then attended to by applying the proper intervention. 

Current Nursing Research

The performance of nursing duties is evaluated and moderated on the basis of specific data gathered from a broad spectrum of research projects.  Among the various studies that are presently being conducted are the correlation between patient education, patient compliance and quality of life; evaluating the effect of different nursing work methods on health outcomes; identifying efficient techniques to decrease anxiety among patients and their families; and the decrease of pain among different patient populations.

Many of these studies have won grants from leading academic health policy and national institutes and have been published in Israel and abroad for international conferences and professional journals.

Sample of Specific Projects

Several projects are being implemented at the SMC to improve nursing intervention and performance, elevate quality, and improve patient safety. Some of these activities include; nursing intervention in a pre-surgical clinic; sedation service for children to reduce pain; Clinical Call Center - health triage and health information service; implementing automated computerized medication dispensing systems; special care for mothers and infants using a "Rooming In" method ( birthing in a natural setting); and Symptom-Balanced Therapy, incorporating computerized clinical files with medical and nursing intervention.

New Roles in Nursing

Nurse practitioners and nurse coordinators are at the hub of the treatment network, each in his or her specific field.  Experts advise, teach, and develop projects to promote treatment in specific areas, and audit nursing activities in the wards.

Clinical nursing specialists and coordinators focus on organizing treatments for complex patient cases as part of their responsibility for maintaining continuity of care.  Geriatrics, Oncology, Psychiatry, Trauma, Pain Service, Bone Marrow Transplantation, Breast Cancer and Diabetes are some of the specialties practiced at the SMC. 

In addition to the above, and because we are a designated a Trauma Center to receive and treat wounded civilians and soldiers, we emphasize on the nurse's role in rehabilitation.  The utilization of the nurses' unique knowledge and skills in rehabilitation units such as neurological, geriatric and pediatric rehabilitation is essential to achieving a patient's rehabilitation goals.