There are six Angels in Spain, although you’ll find only five of them in the Meet the Team section of the Angels website. The sixth Angel, so designated by the Spanish team of consultants, is Joaquín García, the nursing supervisor of the stroke unit at Torrecárdenas University Hospital in Almería.
Joaquín’s work, both in and beyond his own hospital and region, exemplifies everything the Angels Initiative stands for. He motivated by excellence in stroke patient care, champions the importance of standardization and helps nursing teams at other hospitals raise the standard of care through training and mentoring. He is not just a vocal advocate for quality monitoring but a practical one, too – he has recorded a video explaining how to register patients in RES-Q and shares his personal phone number with those who may need a little extra help.
“Joaquín also leads by example,” Angels consultant Susana Granados says. His dedication to excellence and data-driven improvement has helped Torrecárdenas University Hospital win six consecutive diamond awards.
“I have always been attracted to data,” Joaquín says. “Data reflects reality. I always liken analysis to a mirror. Numbers are the only way to get a picture of what is happening and what can be improved.”
Empowering nurses
For all his accomplishments, Joaquín García isn’t comfortable in the spotlight but nor can he escape it, as one of this year’s winners of the prestigious ESO Spirit of Excellence Award. “I was very excited, very surprised,” he says of the award that is given annually to five exceptional contributors to stroke care in Europe. “I was deeply honoured.”
Although he shies away from taking credit for his work, preferring to divert our attention to the all-important patients and his “super competent team”, the recognition does serve a further goal, which is to empower the nursing community to embrace new opportunities for leadership in stroke care.
“For a nurse to be nominated, to be recognized along with doctors by a global initiative is a positive thing if it helps other nurses see that it’s possible,” Joaquín says. “It’s still a challenge for society to view nurses as capable, independent and empowered. Even nurses themselves don’t always believe it is possible.”
An empowered nursing corps that is able to influence practice would however make a big difference to stroke care and healthcare, Joaquín believes. “Doctors treat patients, nurses take care of patients. And to give these patients the best quality of care, they need training, knowledge and scientific support.”
His role in changing perceptions of nursing could someday become this bonus Angel’s legacy.
Finding his niche
Joaquín’s own story is rooted in the nursing profession. What he describes as a very lucky childhood played out in Pescadería, a community of fishermen and flamenco dancers in Almería where his family still lives. “I am very proud to come from there,” he says.
His mom was a nursing technician at the local hospital where Joaquín was a frequent visitor. “I spent weekends there too, I loved it,” he recollects. There was never any doubt that he too would become a nurse.
For his initial studies he chose his father’s birthplace Melilla, which through one of the quirks of post-colonial history is an autonomous city of Spain on the North African coast famous for its modernist architecture. After he returned to the mainland Joaquín embarked on specialized studies in nursing management while working in a series of nursing roles in different geographical and healthcare settings – in local and private clinics, in ambulances, transfusion centres and emergency departments. The way he tells it, he continued to exchange one comfort zone for another until he became attracted to neurosurgery during a rotation in critical care and realized that this was where he could, and would, develop as a healthcare professional.
Building a network
“I started in neurosurgery in 2010. I loved the work and learnt so much,” he says. “I loved working with neurosurgery patients. After three-and-a-half years, in 2013, I was offered the position of nursing supervisor in the neurology department. Our hospital started treating ischemic stroke with thrombolysis in 2014. It was a huge change. After treatment these patients would be admitted to the ICU and until the stroke unit opened in 2018 they were hospitalized on the neurology floor. We did the best we could but there was a major improvement after the stroke unit opened.
“When the first patient was admitted to the stroke unit, the whole team gathered around him, we were nervous about what to do. He may be the best patient we’ve treated so far because we wanted to do everything as perfectly as possible. If he didn’t receive the best care, then he certainly received the most personal attention.”
The protocol the Torrecárdenas team applied with so much care had been adapted from the Virgen de las Nieves University Hospital in Granada, and they followed it strictly, also implementing post-acute care processes to manage fever, hyperglycaemia and swallowing
that they only later discovered was the FeSS protocol.
After 2019, the Andalusian Nurses Steering Committee (GENVA), which was founded to promote standardization of stroke nursing care in the region, became a platform for sharing knowledge and experience. Joaquin, who’d played a key role in the group’s creation, says: “We took what was good for the unit, did our research and implemented what worked.”
GENVA having expanded his network, Joaquín helped hospitals in his region develop protocols to take care of stroke patients, and acts as a mentor to hospitals elsewhere in Spain that are developing stroke units.
His approach to this regional outreach is straight out of the Angels playbook. He says, “My job is not to make others do what I did but to tell my story, to share the advantages it has brought me and to spread the word.”
Joaquin’s mother, his first connection with nursing, still lives in Pescadería and yes he guesses she is proud.
“She is a proud mother,” he says drily, “she is proud of my brother too.”
A relaxed life waits outside of work. Joaquin met his wife when they were both working in the same clinic, and they quickly became a family. As well as being in the same profession he and his wife share a love of running and are raising two children together – a 13-year-old daughter and nine-year-old son.
The nine-year-old has already made up his mind about his future career, leaving little doubt that there is to be a third generation of nurses in the García family.
That too, is how you leave your legacy.
