Celebrated Physician: Pamela Paufler, MD

Who is Dr. Paufler?

Many physicians have pursued other careers before entering medicine, but the path Pamela Paufler, MD took to becoming an attending Critical Care physician at MedStar Washington Hospital Center was, literally and figuratively, somewhat circuitous.

After earning an electrical engineering degree from MIT, the Charlotte, N.C., native began working in semiconductor development for a manufacturer of pacemaker and defibrillator products. Uncertain about making the field her career, Dr. Paufler happened upon a fortuitous opportunity to shadow some physicians, gaining some clarity about her future in the process.  

Why Choose Medicine?

“I decided I liked what they did better than what I was doing,” Dr. Paufler recalls. “As I’d planned to go back to school anyway, I took the prerequisite courses to get into medical school.”

Dr. Paufler earned a medical degree at the University of Minnesota Medical School, followed by a fellowship in Critical Care Medicine at Hennepin County Medical Center in Minneapolis, and another in Cardiovascular Surgery Critical Care at Johns Hopkins Hospital. As she pursued her training, the parallels between her once and future careers were evident.  

“Engineering and medicine are both about solving problems—what’s going on and why, and how to make it work better,” Dr. Paufler says. She adds that the sense of immediacy associated with treating some of the hospital’s sickest patients was likewise appealing.  

“I like the pace of doing a test, getting a result and using that information to make a change if needed,” she says.

But surgical critical care is much more than dealing with black-and-white, if/then outcomes. There’s also the human aspect, working with family members who must often make difficult post-surgery decisions for patients unable to speak for themselves. As such, Dr. Paufler believes maintaining open lines of communication is critical.  

“It’s essential to explain treatment options and outcomes in plain terms, and empowering them to make good decisions with the patient’s best interests in mind,” she says. “We want them to know that whatever they decide, we’re rooting for them.”  

Dr Paufler’s dedication to helping residents and fellows understand the intricacies of surgical critical care was recognized after her first year at the Hospital Center with the Keystone Education Award for resident education. Now, she’s leading several quality and performance improvement initiatives at MedStar Heart & Vascular Institute’s Surgical Intensive Care Unit. 

Life Outside the Hospital

One constant in Dr. Paufler’s life is her love of competitive and offshore sailing, a sport she’s pursued since age 12. She also enjoys swimming and travel, with her most exotic adventure being a visit to the Galapagos Islands. “The wildlife is unbelievable,” she says. “Each island is better than the last.” 

A Shining Example of Devoted and Compassionate Care

Patients often tell us that remarkable care is what sets a healthcare institution apart. Here’s a snapshot of some of the people at our hospital who are providing phenomenal comfort and care to our patients, especially when they need it the most. Above, President John Sullivan presented the President's Award to two nurses, Maite Corbin and Sarah McLaughlin, for remarkable care and compassion to their patient and the patient’s family.  

(Pictured: 2H Nursing Director Maraki Endale, 2H Medical Director Dr. Brian Lee, President John Sullivan, recipient Maite Corbin, recipient Sarah McLaughlin, Chief Nursing Executive Sue Eckert, and 2H nurse Jessica Patterson)

Recognition from Peers

This President’s Award nomination was submitted by Jessica Patterson, RN, BSN, CCRN, 2H Neurosciences Intensive Care Unit, on behalf of her nurse colleagues Maite Corbin and Sarah McLaughlin for their exemplary display of our SPIRIT Values – Service, Patient First, Integrity, Respect, Innovation and Teamwork

Dear President Sullivan,

It is not often that I truly feel the need to recognize outstanding nursing care, but this past weekend I experienced just that. I myself am a Clinical Nurse II at MedStar Washington Hospital Center and work on 2H, the Neurosciences Intensive Care Unit. Recently, our unit received a patient with a devastating diagnosis. A teen girl, walking home from work, was struck by a motor vehicle and brought to MWHC for treatment. Although she underwent extensive surgery, by the time she arrived to our unit, her prognosis was very poor. However, the outstanding team of physicians I work with on both the Surgical Intensive Care Unit and Neurosurgical teams promised her family that they would do everything within their power to medically manage her and give her the best chance possible. To add to the family’s grief, the patient is currently here on a student visa and her mother still resides in El Salvador.

Despite our best efforts, by two weeks after the accident, no significant improvement in her brain functionality had been made. Originally, her mother’s application for a visa to the United States had been denied. This is where the amazing group of nurses I work with come in. Sarah McLaughlin's advocacy for this patient and her mother played a key role in assisting this parent to have the opportunity to see her child while she was still alive. I was the nurse caring for this patient the night her mother arrived. I should also mention that the patient’s mother and many of her family members are Spanish-speaking only. This was her mother’s first time in the United States.

The next night, prior to the day we were going to withdraw care of the patient, I cared for the young girl again and her mother had not left the hospital. My other coworker and nurse, Maite Corbin, is fluent in Spanish. She suggested a plan of care to me that I had not even thought of which was to ask the mother if she would like to assist in bathing the patient in what would likely be the last time. This was such a personal process that while a translator phone was available, Maite offered to help me and the mother bathe the patient so that the mother would feel comfortable and could easily receive instructions and guidance during the process in her native language from Maite. During the bath, the mother was able to kiss, touch, and be with her child during these final hours. When we were done bathing the patient Maite pulled the side rail of the bed down and pulled a chair next to the patient’s bed to allow the patient and her mother to be as close as possible together. She then proceeded to ask the mother questions about the patient-her hobbies, interests, school performance. The mother was then able to both talk about her daughter, expressing how she always wished for a better life for her in the United States. This also gave her the opportunity to grieve. By time the night was over, all three of us were in tears. The next day, Sarah assumed care for the patient.

Both of these nurses continue to work at the bedside while attending graduate school and being full-time moms themselves. I cannot express enough the gratitude I have to be working with such incredible women. They are advocates for their patients, their patient’s families, and their fellow nurses. They continuously provide the type of courageous and compassionate care I have described in this letter on a daily basis. I am blessed to have the privilege of calling them my coworkers and they deserve to be recognized for the type of care they provided.

Making a Difference

Congratulations, Maite Corbin and Sarah McLaughlin, for being recognized for the outstanding work you do and embodying the guiding principles for patient care we uphold at MedStar Washington Hospital Center. It is an honor to work with people as deserving of the President’s Award as you both.

Know someone going above and beyond?

This is just one of the wonderful stories of our associates who are providing exemplary care to our patients. Do you have others to share? Email them to [email protected]

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Central Line-Associated Bloodstream Infection (CLABSI) FREE

CLABSI Free - A Quality & Safety Milestone 

This week, Unit 2G, a medical intensive care unit at MedStar Washington Hospital Center, achieved a major milestone: reaching two years without a Central Line-Associated Bloodstream Infection (CLABSI).

Central lines (catheters) are tubes that help patients get the medications or fluids they need and allow medical professional to draw blood for testing.  But they also present a particular risk for developing infections, because they are inserted into large veins in the neck, chest or groin.  While these lines are necessary, they must be monitored continuously and carefully.  Medical professionals have been working hard to reduce CLABSI rates in hospitals, and from 2008 to 2013, there was a 46% decrease in CLABSI in hospitals across the U.S., according to the Centers for Disease Control and Prevention (CDC).  Yet, an estimated 30,100 CLABSI cases still occur in U.S. hospitals each year.

How did the physicians and nurses on 2G keep CLABSI at bay for two years (and counting)?  They credit dedicated teamwork for their success. "The most important step is collaboration and communication between all team members,” notes Joshua Wansley, RN, a nurse leader on the unit. “Twice a week, nurse leaders and attending physicians check on every patient and assess if the central lines are still needed for that patient.”

In fact, nurse leaders take the extra step of reviewing central line records every day to verify that the line is needed. “The goal, of course, is that you only have lines in that are absolutely necessary," says Wansley. "That one extra review could show a line ready to be removed.  If it comes out, the risk is gone.”

Resource nurses -- the nurses who manage the workflow on a shift -- keep careful records of patients' central lines. Nurses are tested every year on their skills for changing the dressings around the central lines and other protective steps needed to keep patients safe.  “We also talk about it all the time, so we are all very aware of the current situation with central lines. Our goal is to go that extra mile  to protect the patients," Wansley concluded.

And at the Hospital Center, every patient unit posts its current record in a highly visible place for all to see.  Much like a construction site that records the number of days since its last employee injury, our patient units post the number of days since the last CLABSI.  Keeping it top of mind among every team member -- and among patients and families -- will help 2G and every other unit at the Center prevent these life-threatening infections.   

For Patients:  What You Can Do to Help Prevent CLABSI

Patients can also play a role in preventing CLABSI. The CDC suggests:

  • Speak up about any concerns so that those providing your care are reminded to follow the best prevention practices.
  • Ask your healthcare provider if the central line is absolutely necessary. If so, ask them to help you understand the need for it and how long it will be in place.
  • Pay attention to the bandage and the area around it. If the bandage comes off or if the bandage or area around it is wet or dirty, tell a healthcare providerright away.
  • Don’t get the central line or the central line insertion site wet.
  • Tell a healthcare provider if the area around the catheter is sore or red or if the patient has a fever or chills.
  • Avoid touching the tubing and do not let any visitors touch the catheter or tubing as well.
  • MOST IMPORTANTLY:  The single most important thing that everyone can do is wash their hands.  Everyone who comes into the room to visit or care for a patient with a central line must wash their hands—before and after they visit.  If you are a patient, speak up if you see someone who doesn't follow this very important rule.  If you are a family member or visitor, be mindful of the rule, follow it, and speak up if others don't. It's simple -- and effective.