Earlier this year, Nikki Marks, Nurse Practitioner within the Ajmera Transplant Centre at University Health Network (UHN) was awarded a Hospital News’ Nursing Heroes Award for her work supporting high-risk patients with COVID-19 and ensuring an exceptional continuity of care. (Photo: UHN)
Name: Nikki Marks
Title: Nurse Practitioner, Ajmera Transplant Centre
Number of years working in health care: 26
I was born and raised in: Toronto
In my role as a Nurse Practitioner, I help transplant patients move through the healthcare system with the best possible continuity of care. As nurse practitioners, we are there taking care of patients, day in and day out. We don’t rotate off like the other team members do, so we are there to ensure the best quality and consistency of care. We look at how we can improve patient outcomes by focusing our efforts on certain kinds of interventions and ways to improve patient outcomes and the patient experience.
Just before the COVID-19 pandemic was declared, in January 2020, we had just launched a pilot program looking at using an app to remotely monitor lung transplant recipients after their transplant. The app allowed us to use texting and video visits to check in with patients and we had developed a library of educational tools. As the pandemic became a reality, we decided to change from a pilot and enroll as many patients as possible so that we could continue to provide care and keep in touch with them without them having to come into the hospital for their visit.
Because of that experience, I volunteered to participate with the Connected COVID Care team. This program was launched so that patients who tested positive for COVID-19 – or were suspected to be positive – and didn’t need immediate admission to the hospital could be monitored and cared for remotely. I got to work with that group, such as setting up models of care for managing patients who had COVID and were discharged from the hospital. I helped support the close monitoring of patients – particularly those who were high risk – such as sending oxygen saturation monitors to them.
By December 2021, when therapeutic treatments became available for COVID-19, we were positioned very well to be able to assess and support our high risk patients as part of the Connected care and Ajmera Transplant team, including administrative staff, nurses and physicians. We created a process so that high-risk patients with COVID can have access to early treatments that help to avoid hospitalization and severe complications as much as possible. Transplant recipients – who are at higher risk from a COVID-19 infection – have such a close connection with their nurses and their physician team already, so that helped us support them. I think that the staff at UHN make these strong connections and really reinforce it with patients that if something is going wrong, we want to hear from them or their local health care teams. We want to ensure that they have access to treatments and care based on the best evidence. The Connected COVID continues to do this and links with other health organizations so people can get care closest to home. We definitely can’t do this alone, without communication with our patients, connection with other hospitals and health care teams and the province organizing with us.
I decided to get into health care because I enjoyed sciences in school and I have a lot of nurses in my family. My aunt is a nurse, and she was one of Canada’s first OR assistants, which is an advanced practice role in the operating room. My grandmother was a nurse in World War II in the Navy. She was in nursing school before the war, and she had a lot of stories about being a nurse on the Navy ships.
I knew that it was a career that I could do a lot of different things, and have the flexibility to keep learning. In nursing, you can continue to grow and develop as a professional and there are many different roles. It really felt like a career that you could continue for your whole life.
The thing I love most about my job is that I get to work with amazing people every day across UHN. I really value these relationships and getting to work with all kinds of different people; including patients and healthcare providers from different specialties and different experiences. Being a part of the team, there’s a real commitment to doing the best that we can do for patients and we can always ask one another for help. I think being able to help to improve outcomes and to help people who are experiencing serious illness to move through that and adapt and even thrive is really amazing. And that is an important part of how I see UHN – a group of people who all have this same motivation.
The most incredible thing I have seen at work was when we had a patient who was so sick, and whose lungs were so badly infected. The team removed her lungs and sustained her for several days before she got a lung transplant, and that had never been done before. Just working through that – it sounds so amazing in retrospect but even more so knowing how complicated it was for the bedside staff. None of us had ever even thought that this was possible. It was so difficult to work through and the ICU nurses, staff, respiratory therapists, surgeons and medical team were like, “How can we do this?” It is just so amazing that we all worked through it and were able to contribute in all kinds of small ways to that happening.
Just being able to trust each other and work through that, it’s a big example of what we do every day, because there are always these situations that are complicated, and we work through them as a team.
I’m inspired by anything related to sports, especially cycling and triathlon. When I see people who have overcome illness and injury – which most people have – it just helps me remain grounded in the fact that all the work that we do in health care helps contribute to people being able to do amazing things in their own lives. I’ve been in an Ironman race with someone who had a heart transplant, and lots of races with people who have faced other kinds of challenges.
When I may feel things are hard, I get really inspired by my patients, that they go through so much, and that they can keep moving through challenges. I just feel like we’re all trying to succeed, have amazing experiences and live the best life possible. With sports, this ideal really comes out for me; I love seeing people striving to do their best.
My biggest worries are the pandemic and the environment. I worry about the environment and the impacts of how we live, how we travel and things like that. I think some of what we have learned in the pandemic – such as about reducing travel – could be a good thing for the environment, and I’m thinking a lot about ways that I can change my behavior to be more environmentally responsible.
The pandemic is still on my mind in the context of my kids. I’m worried about how the pandemic will impact their ability to live the kind of life I’ve known. I also worry about the impact of all these variants on people who have chronic illnesses. We can’t just forget about higher-risk people and leave them isolated at home.
I found joy recently by taking a cycling trip with my triathlon team. They are all friends and people who I have cycled with for years. Being able to get away with them and go on a trip away from work and my family for the first time in two years was really amazing.
My favourite movies are comedies, like old Mel Brooks or Monty Python movies.