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3 Wishes Project

A teddy bear being held.

Nurses on 6SA and 5E have seen growth in compassionate end-of-life care as part of the implementation of the 3 Wishes Project that we began in the Fall of 2022. This program has also grown into a powerful tool to support wellness of all the healthcare team members on these units.

Since beginning at UWMC-ML in Oct 2022, we have had 344 unique healthcare team members participate in this humanizing work, including 242 RNs, 19 PCTs and MAs, 6 Spiritual Care Providers, 6 Social Workers, 46 Physicians and APPs, and 39 volunteers and hospital administrators.

We have fulfilled 1,188 wishes for 460 patients. This includes 2,808 individual keepsakes or tangible remembrances.

The 3 Wishes Project (3WP) is a palliative care intervention that started in Ontario, Canada in 2013 that aims to improve the end-of-life experience for patients, families, and healthcare team members by eliciting and attempting to fulfill a set of wishes for a dying patient and their loved ones. With the 3WP, healthcare team members can foster humanizing experiences for patients, loved ones, and themselves. The 3WP is a unique approach to infuse humanity, celebrate a patient’s life and their legacy, and support families and healthcare team members alike.

Being a patient in the hospital can be a dehumanizing experience and dying in the hospital can have profound, long lasting consequences for everyone attendant to the death including the patient’s loved ones and those on the healthcare team. Clinicians who care for dying patients and their family report compassion fatigue, symptoms of depression, and posttraumatic stress disorder. Palliative interventions hold great potential to improve the experience of healthcare team members providing end-of-life care.

Framed keepsakes on a bedside table.

The 3WP at UW Medicine began in October 2022 at UWMC-Montlake in the Medical ICU and Oncology/Bone Marrow Transplant ICU (6SA unit) and has since expanded to the Surgical ICU (5E unit).

The goals of the program are:

The 3WP is intended to be inclusive for all of those at the EOL, thus patients are able to participate if it is thought by the healthcare team that they have a >95% chance of dying in the hospital, if a decision has been made to withhold or withdraw life sustaining treatments, if the patient is already receiving exclusively comfort focused treatments, or if the patient is enrolling in Hospice.

Here are some reflections about our program:

"His nurse involved us, as we faced the sad, unreal process of watching my son’s life slowly decline. The plaster hands, fingerprints, and recorded heartbeat in a stuffed animal were all novel. We all loved these meaningful ways to preserve tender memories of my son as we faced our grief and difficult decisions."
- Family Member

"This wonderful program changes so many lives and really helps connect with patients."
- ICU Nurse

"This music helps our patients and infuses so much humanity into the hospital. My tension has melted away and I feel at peace. I feel so fortunate to have been able to be present for this experience and wish there was more of this across our hospital."
- ICU Physician

"There is no easy way to approach the topic of death, but the [3WP] provides a tangible and meaningful way to navigate the grieving process for both family members and clinicians."
- ICU Nurse

Read the 2024 3 Wishes Project program summaries:

Sepsis Awareness Month: Nursing-Led Excellence in Action

Sepsis awareness personnel smiling and holding up a sepsis awareness t-shirt

During Sepsis Awareness Month in September 2024, our nursing teams demonstrated unwavering commitment to improving outcomes for patients with sepsis through innovation, collaboration, and education. Led by evidence-based nurse-driven protocols, we proudly celebrated a month of impactful initiatives designed to enhance sepsis recognition and response enterprise wide: University of Washington Medical Center Montlake and Northwest campus along with Harborview Medical Center.

Key successes included:

a nurse holding up a sepsis awareness poster

These achievements reflect the strength of our multidisciplinary approach, which mirrors how we care for our patients with sepsis—collaboratively, decisively, and with heart. Together, we are saving lives through education, empowerment, and excellence in care.

UWMC Northwest Campus Medical/Surgical/Orthopaedic Nursing Certification

Karen Paulsen MSN, ARNP-CNS, ACNS-BC, NPD-BC, PMGT-BC, CMSRN, ONC
Clinical Nurse Specialist- Medical/Surgical

Each fall I work with nursing leadership to determine resource availability and the number of nurses we can support with an online nursing medical/surgical certification program. Nurses apply for a sponsored position with an application (showing that they meet exam requirements) and are willing to sit for the exam within 6 months of completing the course. In January we start the online program with encouragement to attend an additional zoom session reviewing the content of the week and practicing multiple choice questions. During National Certification week, I encourage nurses to complete their CE applications and Success pay applications, so they are ready to apply for their national certification upon completion of the course. At the end of the course, we have a 3-hour mock exam to assist them with their readiness. I complete rounds of participants assisting them by filling out applications and encouraging the completion of the online course. I also encourage those from previous years who have not received their certification that they can still do it, and we have confidence in their ability to succeed.

As a certified nurse (5 certifications) it is important to me to mentor and encourage other nurses to earn their first certification or maintain their certification through renewal. I have been a site facilitator for UWMC/NW campus since 2019 assisting with UWCNE Medical-Surgical Review and Update course and now ANA Medical-Surgical Nursing Certification Test Prep Essential course. The first year I was in this role I recruited fifty-four nurses with enthusiasm and forty-three nurses became med/surg certified that year. My current recruitment lists are now smaller for the NW campus with twenty-three nurses due to resource availability, but I still encourage all nurses to come study with us as I refer to myself as their study buddy for their exam. One recently certified nurse sent me an email:” Thank you so much. We appreciate your leadership and continuing support in our education. More power to you, Karen.” It is statements like these that continue to encourage me and fill me with gratitude in my role as a nurse. On a smaller note, the NW campus had an Orthopaedic Nurse certification group start in 2023 with 75% completing their national ONC certification, which was the first for the Ortho/Neuro floor. This year we had another group completed their class and are now waiting to take the certification exam.

two nurses standing in the hallway of 1E

1E Oncology Unit Opens at UWMC Northwest

On September 24, 2024, the UWMC–Northwest Campus opened its new oncology unit: 1E.

For both staff and patients, this launch marked the beginning of an entirely new journey—a new specialty, on a new unit, within a new (for many of us) institution. While the transition has not been without its challenges, it has been defined by tremendous growth and outstanding care. At the heart of this success lies one driving force: teamwork.

From nurses and nursing assistants to providers, pharmacists, and countless others (the list is long!), every team member has come together with a shared mission to promote patient safety and well-being. Amid all the “newness,” the unit staff have shown incredible adaptability, a sense of humor, and above all, deep compassion.

Highlights from the First Three Months (9/24–12/31/24):

Staff trained to 1E:

Chemotherapy-trained nurses: 29

Chemotherapy administered: 100 intravenous chemotherapy doses (composed of 163 individual chemotherapy agents)

the brass bell hanging in the 1E concology unit. This is the bell patients ring when they are cancer-free.

During this time, we saw our first patients begin—and complete—their initial cycles of chemotherapy. New-to-specialty oncology nurses were able to witness their influence on their patients' progress throughout treatment. One especially meaningful moment: our first bell ringing, which is a well-known oncology tradition that celebrates the completion of a patient’s treatment and the start of a hopeful new chapter.

Looking ahead to 2025 and becoming one year old, we’re excited about the continued growth and evolution of 1E. While challenges are inevitable, the experience of launching a new unit has equipped this team with the resilience, collaboration, and determination needed to face whatever comes. The nurses and staff here embody what it means to put patients first, to advocate fiercely, and to advance clinical practice through dedication and teamwork.

We are deeply grateful for the continued support from all corners of UWMC, which have been instrumental in helping us become successful and provide excellent oncology care.

EBP Workshop – Building Knowledge to Improve Patient Care

To provide world-class nursing, it is essential to employ Evidence-Based Practice (EBP) to ensure that our care is up to date and backed by research. In January 2024, we had the last EBP workshop with our now retired Nurse Researcher, Liz Bridges. 47 UWMC nurses attended.

EBP is a systematic, evidence-driven problem-solving approach that translates new knowledge into clinical practice. Nursing Professional Development has partnered with the UWMC Nurse Researcher and the UW Health Sciences librarian to offer an EBP workshop one to two times a year since 2015.

What is covered in the EBP Workshop?

The primary goal of the workshop is to provide tools and knowledge related to bedside nursing research, ultimately boosting patient outcomes by integrating the best available evidence into everyday nursing practices. It also strengthens our professional practice environment by empowering RNs to contribute to nursing knowledge and best practice.