HL20: Roxana Reyna, RN—Finding a Way to Heal

Roxana Reyna, RN, has learned that sometimes the best way to treat a serious injury is to improvise. Reyna's creative skills as a skin and wound care specialist earned her an invitation to a White House event honoring healthcare professionals who look beyond textbooks and develop their own solutions.

In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. They are making a difference in healthcare. This is the story of Roxana Reyna, RN.

This profile was published in the December, 2014 issue of HealthLeaders magazine.

"We can't wait for a company to come up with something that will help our patients heal faster, so I have to think of it and create it there on the spot at the bedside with what I have."

Neonatal medicine has vastly improved the chances of survival for infants. But when dealing with wounds, burns, and other skin issues, nurses can face challenges because medical supply companies often don't make standardized dressings and bandages that are small enough to fit infant bodies. This was a common vexation for Roxana Reyna, RN, a skin and wound care specialist at Driscoll Children's Hospital in Corpus Christi, Texas. So, she learned to improvise.

"I got interested in wound care and I noticed that there weren't any dressings or bandages made for kids that provide the same pathway to healing," she says. "I had to take the dressings and design them, cut them up, and make them so I could get the full effect of the wound healing that I needed for the babies and the kids."

In one burst of creativity, Reyna's proudest moment came when she devised a dressing for babies born with omphalocele, a birth defect that leaves intestines protruding from the body and covered only by a thin layer of tissue. Surgery repairs the defect, but in the interim, the infant is at risk of infection. Pressed to improvise, Reyna fashioned a Hydrofiber dressing made from antimicrobial materials.

"I am there to get those kids to heal using the materials on hand," she says. "We can't wait for a company to come up with something that will help our patients heal faster, so I have to think of it and create it there on the spot at the bedside with what I have."

Reyna's skill at improvising has not gone unnoticed. "I became a resource for the entire hospital. I was being called upon where the wounds were worst," she says. And in June, Reyna was invited to the White House to take part in an event honoring the MakerNurse program and its innovative clinicians who use their brains, pragmatism, and creative energy to solve problems that aren't in the playbook.

"Sometimes we are standing there with our hands crossed because we have nothing available. When we make these things, we provide something even better than the standard of care," she says. "We are helping kids survive who had never survived before, who would have a higher risk of infection or mortality. We are helping kids get home quicker and helping them stay out of the hospital."

Reyna's eclectic career path before nursing shaped her confidence to create solutions. "I have a background as a cosmetologist and also as a florist, so I have a creative side in me. I can see things in the way they need to be shaped. It is not difficult for me. It is fun," she says.

Equally important, she says, is working with other clinicians, managers, and administrators who respect, understand, and support colleagues who have the courage to create solutions. "They are very supportive at Driscoll. We collaborate," she says. "We are encouraged to be innovative when we need to be. If the standard that has been carried on for years is not helping kids and we see that there can be something better to help them, then we are going to take a leap forward in doing things that are going to be safe and cost-effective and following those steps where we are still helping the patients reach better outcomes."

As the healthcare industry moves toward best practices and standardized care, Reyna says it's important that hospitals and health systems continue to spark the creative energies of bedside care providers.

"That is what the nursing profession is: being able to assess a situation and maybe create something, evaluate it, and revamp it if you need to," she says. "It is an ongoing process. Some things will work. They are going to become standardized.

"We are always having to customize things for the patients because their needs are all different," Reyna concludes. "In the works now is building a community of nurses who bring forward their ideas so we can collaborate. They can feel supported and empowered to do these kinds of things. That is my focus: building a wound care team; having people empowered to be the resource on their units and floors. We will come together to share ideas."