Chapters
00:00 Introduction to Mary Tibbe’s Nursing Journey
02:58 Mary’s Transition to Clinical Nurse Specialist
05:43 The Development of the Tibbe Medical Device
08:51 Challenges in Medical Device Innovation
11:33 Advice for Aspiring Nurse Innovators
14:24 The Impact of the Tibbe Device on Patient Care (And a peek at the device itself!)
Ellie Kirkpatrick (00:01)
Hi everyone and welcome back to the non-traditional Nurse! Today I’m joined by a special guest, Mary Tibbe. Mary, thank you for joining us.
Mary is a clinical nurse specialist who actually took an idea for a medical device from concept to reality and worked with her hospital’s innovation team to bring it to the market. So, we’re going to dive into her nursing journey, talk about the challenges she might’ve faced along the way and her advice for any nurses interested in innovation or product development. Let’s get started.
Ellie Kirkpatrick (00:31)
So, Mary, I think we’d love to hear some background on your nursing career and how that has developed over time.
Mary Tibbe (00:38)
Sure, so it all started back when I was a nurse tech at Spectrum Health while I was going to nursing school at Grand Valley State University. Once I finished school, I moved to Traverse City and worked at Munson Medical Center in Traverse City for a couple years in an acuity adaptable ICU. There, we took patients that came in non-responsive after a major event and, hopefully, we were able to take care of them until they walked out of there, which was a really cool experience.
So, I learned both ICU and non-ICU at that point. And then once I had completed my time at Munson, I moved back to the Grand Rapids area where I’m from and worked at Spectrum Health again, where I started. And I actually started in the medical ICU. I oriented in the medical ICU, but at the time they were working on splitting some of the units to create a cardiothoracic ICU.
So, my first day off orientation was the first day of the cardiothoracic ICU. So, since then I have pretty much worked in cardiothoracic or advanced heart failure or something related to the heart. In the cardiothoracic ICU, I worked into a charge nurse role. And at the time they had another role called a critical care nurse rounder. What that was is you worked outside of the ICU responding to patients that were declining or needed help and helped mentor more novice nurses and helped make sure that patients got to the ICU when they needed to. So, after that, I did charge nurse and [nurse rounder] at the same time. And then they had created a temporary night shift nurse educator role. And on the cardiothoracic ICU, the turnover is huge. There’s a lot of nurse burnout, just because of the complexity of the patients on an ongoing basis.
They moved me into the night shift nurse educator role because that’s where all the new nurses go once they graduate is to the night shift. And I, as an experienced ICU nurse, could support them more thoroughly on the night shift and hopefully retain them a little bit more and try to teach them some skills to not become burned out. So, I did that for about a year and they expanded that to also cover the cardiothoracic non-ICU units. So, I was covering both of those units on the night shift as an educator.
Once they ended that position, because it was temporary, they actually created another position that was a grow your own clinical nurse specialist. They needed a clinical nurse specialist for the cardiothoracic surgery area at that time and didn’t have one. And that was a very specialized area to find a clinical nurse specialist in. So, I actually moved into the nurse practice associate role. And part of that was that I had to be getting my master’s and my clinical nurse specialist certification at the same time. So, I functioned in that role, you know, learning the role as a CNS as I go, as I go through classes and also was paired with a CNS mentor. So that was very helpful.
Once I completed my master’s degree and was officially a clinical nurse specialist, my role was expanded to cover the cardiothoracic ICU, the cardiovascular recovery unit, the non-ICU cardiothoracic floor. And then we started opening and shifting to an advanced heart failure ICU as well. So, I helped open the advanced heart failure ICU from a clinical nurse specialist role. Then COVID hit, we all know about that. And we had to stand up some virtual support, especially ICU support for our small community hospitals. I got pulled into that work as the representative clinical nurse specialist and helped design a virtual ICU to cover all of those regional hospitals. And the main purpose of that was to keep patients closer to home and support all of those nurses in the small community hospitals that haven’t taken super high acuity patients with nurses that are very used to taking high acuity patients. So, we took nurses that had at least 10 years experiences is what the team was made of at the time, up to almost 40 year’s experience in a high acuity ICU. So, we were able to implement some technology and support those regional hospitals through the pandemic and caring for those extremely sick patients. We were able to keep a lot of them in their hometown at those small regional hospitals rather than sending them to Grand Rapids where their family and support system was not. So that was a real fun time.
And then once we kind of got through the midst of the pandemic, we had a chance to kind of take a break and take a deep breath and figure out what this looks like going forward. So, they created a manager role, program manager role. That was kind of a combination of the CNS role and a manager role for the virtual ICU. I had a baby in that time, but stepped into that role after I had a baby and kind of functioned in that role until I left recently. We did some really cool things in that role. We started the virtual ICU and, you know, we tweaked it and got it to where we wanted it. And we’re starting to roll out to the high acuity ICUs when I left. And then also I took on the cardiac monitoring center and the tele-sitting programs as a manager, and then quickly created and added on the virtual nurse program at Corewell Health. So, that’s kind of where I left the healthcare system. And then I transitioned into two fun roles. So, my main role, which you can see on my shirt here is at SBE Medical. And that is I am the director of technical sales for the device that I helped create, which we’ll talk about in a minute.
And then I also have another side job that I work for the Virtual Nurse Academy and I am a virtual nurse program coach. I help other healthcare systems throughout the U.S. start and stand up their virtual nurse programs.
Ellie Kirkpatrick (06:29)
That is great. think you are showing all of the different options for non-traditional nurses. You have done many, many things. And I’m excited to hear.
Mary Tibbe (06:29)
I think it’s a bad case of ADD is what I think it is.
Ellie Kirkpatrick (06:43)
Yeah, and I’m excited for the audience to hear about this medical device and where this idea started; how you first started developing it and what the path was for that.
Mary Tibbe (06:56)
Oh boy. that was almost 11 years ago that we started this journey. That was when I was the nurse practice associate. So I was really trying to figure out what a clinical nurse specialist was as well as lead some major system projects. So, at that time I was assigned reduction of catheter associated urinary tract infections throughout all of the ICUs. If you’re unfamiliar with what is now Corewell Health at the time of spectrum health, there are five
major ICUs within that system. I was leading the catheter-associated urinary tract infection (CAUTI) reduction. We created a team. I don’t know if you’re familiar with Rapid Improvement Events, but we had a whole day where we sat in a room and figured out what the actual problem was so we could sort through that. So, I led through all of that. And then when we got to boots on the ground and we started rounding on these catheters that these ICU patients had, because, you know, the mentality is that every ICU patient needs a catheter when they really don’t. We started getting catheters out of patients, realizing that females unfortunately didn’t have at the time an alternative for collecting urine.
Females either had to have a diaper or brief on, which never feels good, and also traps moisture next to the skin and can really irritate the skin. Or they just had to urinate on the pad that they were laying on and we had to measure it that way. Neither of those [were good options], knowing that I potentially in the future might be in that situation and also have several family members that might also be there. I wanted to make sure that we created something that would allow the patient to maintain some of their dignity, comfort, and ease of use.
As well as being an ICU nurse, I had a whole tick list of things that I needed to meet. But it was collecting accurate outputs so we could do appropriate interventions or watch their kidney function. It had to be able to go with mobility. In the ICU, there’s a huge push with mobility of ICU patients, whether they’re ventilated on ECMO. It doesn’t matter how sick they are, the quicker we get them up and move them, the better the outcomes are for those patients. And so, it had to be able to work with mobility. And then the other thing from a nursing profession is just the amount of time that it takes to do a full bed change on an ICU patient if they’re urinating on the pad. And also, there are injuries that can occur to nurses when they’re doing that. So back injuries and some of those things. I actually had one in my previous life as a nurse tech. I wanted to make sure that I was protecting my colleagues as well. So, I took the idea and at the time we had what was called Spectrum Health Innovation. It was a group of very smart people that do things that nurses do not, such as engineering and business management and those types of things. So, they were able to help make connections with Grand Valley State University engineering classes. And it was really fun because, you know, we went from beginner engineering classes where they had to build models out of everything that was out of their house. So, we had straws and magnets and all kinds of stuff that they would come up with concepts for. And then it worked all the way up to, you know, the more senior level engineering classes and where we really got into what the device was going to look like, you know, drawing a patent, doing all those wonderful things. And, you know, here we are 11 years down the road and we finally have a final product that we’re going to do a finalizing patent on and get on the market here soon.
Ellie Kirkpatrick (10:50)
Yeah. And 11 years in the making obviously shows how much work goes behind every medical device. So that is no small feat. What are some of the biggest challenges you faced along the way when developing the Tibbe? And I forgot to mention that the medical device is actually named after you, which I find so cool.
Mary Tibbe (10:54)
Thank you. Thank you. I didn’t choose that. Actually, the company that licensed it chose that, which I thought was really cool. And so, I know this isn’t one of your questions, but it was just almost an honor to be asked to help with the sales of a device that is named after you. So pretty cool stuff. but some of the biggest challenges I know, the timeframe, I think I, as a nurse thought that it would be a whole lot quicker than it was because I didn’t understand a lot of the stuff that goes on in the background.
I loved our collaboration with Grand Valley State University. And there’s a timing thing with that too, because you have to time it with the semesters. We had to delay, you know, some of the progression as the semesters transitioned. I think we had a couple design challenges. As you can imagine, this is a very sensitive area on females. And so we wanted to make sure that it was the most comfortable and fit the best, would stay adhered so you didn’t lose urine and you didn’t need a bed change and all of those things. So, some of the design complexity I think was the biggest challenge and we went through several iterations to get to where we are. I think finally we’re at a point that it’s everything that I wanted it to be.
Ellie Kirkpatrick (12:25)
I think process improvement is so ingrained in nurses, whether we are thinking about it or not, we’re constantly finding ways to do things better. So, what advice would you give to a nurse who might have an idea for an innovation or product but doesn’t even know where to begin?
Mary Tibbe (12:30)
Yeah, I mean, I was fortunate enough that we had an innovation department so I could, you know, put my idea on a piece of paper and everything about it and hand it to somebody to help develop it. But not every nurse is that fortunate. I do know just from my own personal experience in working with a company that we have now, we have venues where you can bring your idea to us. We can, you know, have some non-disclosure agreements and we can work through whether that’s something that we can help you with or give you some feedback on what’s going on. And I imagine other companies do too but, that’s kind of the biggest thing. And I mean, reach out to some senior nurses. They might have some good ideas as well. I have, some friends that actually developed their own product too. So, they were very helpful in helping me navigate from a clinical side, because I didn’t understand half the stuff that they were talking about through the patents and the intellectual property and all of that stuff. So, it’s been a very big learning curve when they start talking about some of the business management stuff and all of those other topics.
Ellie Kirkpatrick (13:48)
Yes, and that’s been a theme throughout all of our interviews is reach out and network with people and people are so happy to help, especially nurses. So, looking back on your journey, what has been the most rewarding part of this process? And then what’s next for you and the Tibbe.
Mary Tibbe (13:55)
I think the most rewarding part of this process is when we were able to do volunteer trials and actually try it on patients because that was the first time I got to see my device actually work and how much it helped patients. I had someone that volunteered to wear it and it allowed her to be mobile. In her personal she life couldn’t go out to the grocery store, couldn’t do any of that. She’s completely independent other than she had some urinary issues. And so, this allowed her to go to the grocery store without worrying about having any wetness or leakage. Just hearing the stories from the patients that the device is doing, what I actually wanted it to do by supporting the comfort and dignity of patients is just super rewarding. And I can’t wait for it to get on the market and start hearing some of those wins as well.
And then what’s next for the Tibbe, so we will have final product ready to go on patients. Right now, we have samples that we can show and I can actually show that in a minute. I have it sitting here on the table, but we’ll have final product in March and we’re actually kicking off our sales debut at the National Association for Clinical Nurse Specialist Conference in Boston in the middle of March. So, it’s kind of cool because I am a CNS and the theme of the NA-CNS conference is innovation. And so, I am taking this device as an innovative CNS to make its debut to the whole US. So, kind of fun. But that’s our next step.
Ellie Kirkpatrick (15:43)
That’s awesome. We’d love to see the device if you have it there.
Mary Tibbe (15:54)
Yeah, this is our device. So, it’s an adhesive device. There is a little bit of prep, but it should, make up for itself after the prep. It’s a two-piece design. And one of the things, so you can see it’s a closed system so you’re going to collect accurate output. It’s not going to leak everywhere. If the patient stools, it’s not going to get mixed in with the urine. and it’s a two piece design so you can leave the ring adhered to the patient and you can inspect, can clean, can straight cath for patients with some urinary retention. So, you should be able to straight cath through this as well. And then you can replace it. Since it is adhered, you can be mobile with it. And I’m sure we’ll have other things that will spiral out of this to help support that. But you can be mobile with it. And so it’s super flexible, super soft. We designed it so even if it got pinched, it would still drain. It can hook to suction. It can hook to gravity. So if you have any questions about the actual device, I know it’s kind of hard to see the camera, but they just look great.
Ellie Kirkpatrick (17:11)
That’s great. It’s very cool to see it in person after we hear about your journey. And I think it’s such an inspiring example of how nurses can really be leaders in this innovation space within healthcare, because we’re on the ground floor seeing the problems. Why can’t we solve them also? So, thank you so much for sharing your experience and insights with us. For anyone watching, if you found this conversation valuable, be sure to subscribe to the non-traditional nurse monthly newsletter and you’ll be the first to get these exclusive interviews with some amazing nurses. You can sign up through the link in the description to stay connected. And thanks again, Mary, and for everyone tuning in, we will see you next time. Thank you.
Mary Tibbe (17:51)
Thanks, Ellie. Bye, everybody.