Nurses: Greatest Advocates For Patients
This article was first published in Health View, June 2002.
She comforts a distraught parent in the Emergency Department when a rush-hour car crash has shattered a family. He provides relief in the wee hours of the morning after pain has awoken an elderly woman in the Surgical Intensive Care Unit. She brings a warm smile at lunchtime to encourage a little boy in pediatrics whose homesickness has taken away his appetite.
Day and night, around the clock, nurses care for the physical, emotional and spiritual needs of patients at Carolinas Hospital System. Their specific roles throughout the hospital are as varied as the women and men who fill them. Yet, whether they work in the operating room or oncology or labor and delivery, they all have a common focus: providing quality, compassionate care for the adults, children, and infants in their charge. "Physicians make decisions to admit patients because of the nursing care that is needed. Nurses are an integral part of the health care team, 24 hours a day / 7 days a week," said Costa Cockfield, Chief Nursing Officer. Cockfield is proud of the approximately 500 registered nurses and licensed practical nurses that comprise Carolinas' nursing staff. "We have one of the most dedicated groups of people that I have ever had the pleasure of working with. I have been personally enriched by this staff and they go far beyond what is needed. I see it on a daily basis," she said.
The outstanding quality of nursing care provided at Carolinas Hospital System is reflected in the fact that six Carolinas employees were among 100 nurses statewide who were recognized in May for excellence in their profession. The six women, who represent a total of more than 90 years of experience, were honored with the Palmetto Gold Award. The award is given by a coalition of key South Carolina nursing organizations and is designed to salute individuals for outstanding job performance and a demonstrated commitment to nursing.
"These exceptional nurses epitomize the true spirit of the professional nurse," said Cockfield of Carolinas' award recipients. "I have a lot of respect and admiration for each of them, and those who know them would not be surprised that they were chosen for this prestigious award. God has blessed them all with qualities that make them exemplary nurses," she added
While the Palmetto Gold Awards recognize nurses who excel in their field, the very traits that make these nurses successful can be witnessed every day at Carolinas Hospital System. "It really takes an intelligent, compassionate, dedicated, highly skilled individual to be a nurse. The list of qualities I'd equate with a good nurse is very, very long," Cockfield said. She added, "People have misconceptions about the actual work of a nurse; it truly is hard work. Nursing tests you - it often asks more of you than you ever thought you could give. You're juggling the needs of the patient, which may be different from the needs of the family member, which may be different from the needs of the very busy physician." In addition, nurses are working in a health care environment in which they are treating very sick patients who are spending fewer days in the hospital. "Patients are in and out so rapidly. Nurses begin discharge instructions on day one so patients will be properly prepared when they are discharged home," Cockfield said.
Yet despite the inherent challenges, the profession offers innumerable rewards. Nursing is unique in that it offers a variety of job opportunities. "There are so many different kinds of things you can be involved in, from a flight nurse to a school nurse to a staff nurse in an acute care setting," said Donna Sullivan, Director of Women's Services and the hospital's nurse recruiter. "There are always opportunities for you to do something else, and the field is constantly changing and evolving," Sullivan said.
Harriett Fore, a staff nurse on the gynecology and urology unit, appreciates the flexibility that nursing has afforded her for more than 20 years. "It's a very sound profession for women in terms of having a family. I didn't work Monday through Friday from nine to five. It's a real benefit to family life when you are rearing children," she said. Though Shanon Collier is a relative newcomer to nursing, her three years at Carolinas Hospital System have convinced her that she made the right career choice. "It's the look you get when you give someone pain medication after they've been hurting. It's being there for a patient's family in a time of need," said the staff nurse on the orthopedics and neurology unit. Sullivan agreed, "The emotional rewards are tremendous. To comfort someone who has just been given bad news, to hold a newborn's hands - those times are truly the heart and soul of nursing."
It's the nature of a nurse's job to give - to patients, to family members of patients, and to other professionals who work side by side at the hospital. Carolinas Hospital System's administration recognized that nurses needed someone to listen to them, to their needs, their frustrations. So in January, the Nursing Leadership Group was created. Comprised of 23 nursing employees selected from departments throughout the hospital, the group provides nurses with a forum to share their ideas, complaints and suggestions. "What better way to constantly improve our nursing department than having our staff share their ideas?" Cockfield said.
The Nursing Leadership Group meets on a monthly basis, and all members are encouraged to add their input. What's working well on their unit? What isn't? What changes could make an inefficient process run smoother? Collier recalled that one of their first tasks was to ask staff in their respective departments to name five things that would help improve the care they provide. "One simple thing that came out was that we needed more wheelchairs in the hospital. Administration immediately ordered more wheelchairs," she said.
Through the monthly sessions and smaller subcommittee meetings, the nurses work on issues that come to light through frank discussion. "We can discuss anything in there without judgment from anyone," said Collier. Fore appreciates the opportunity to have a direct link to hospital administration and is thrilled with their responsiveness to the group's suggestions. She plans to continue to honor the commitment she made to participate in the group. "I felt like a lot of trust and confidence was put in me by the invitation to be in the Nursing Leadership Group. This isn't something to be taken lightly," Fore said.
Some of the issues brought up at the meetings are easily resolved, like adding sugar-free ice cream for diabetic employees at hospital functions and relocating equipment to more convenient places on nursing units. In other instances, finding a solution requires additional study and communication with other departments, such as an issue concerning the ordering of narcotics. "Because of suggestions from the Nursing Leadership Group, the process of ordering narcotics has been simplified, and the feedback is that the new process is so much better. This has saved the nurse a significant amount of time, and time is a valuable commodity to a busy nurse," Cockfield said.
The Nursing Leadership Group also took on the task of planning the observance of National Nurses Week in May. "They came up with wonderful ways to recognize our staff as well as to celebrate the profession," Cockfield said. Fore's suggestion was that nurses in uniform greet the public as they walked in the lobby doors during National Nurses Week. "It went over beautifully," she said. "People were just so pleased that a nurse was there to greet them. I underestimated the impact of this simple exercise," Fore added. Other suggestions that were implemented included inviting legislators to spend a day shadowing a nurse and the sale of T-shirts to raise money for a nursing scholarship. "It was heartwarming to see the nurses carry out activities that truly gave back to the community and the profession," Cockfield said.
While National Nurses Week was a time to celebrate the joy of nursing, the profession is well aware of the challenges it faces. A nationwide nursing shortage continues to plague hospitals, and Carolinas Hospital System is no exception. "For the last year and a half it has gotten progressively worse," said Sullivan. "There are just so many more opportunities for women now, and that has really impacted our profession," she said. In light of the ongoing need, the hospital's continuous recruitment activity is enhanced by efforts to encourage the entry of more people into the nursing profession. High school students, and more recently, even elementary school children, come to the hospital to shadow nurses to learn about nursing careers. Carolinas Hospital System provides a number of scholarships each year to full-time nursing students and offers tuition reimbursement to employees who choose to pursue a nursing degree.
The hospital is attuned to the special needs that accompany a nurse just starting a career. "It is a difficult transition, and we are very sensitive to that," said Sullivan. The hospital's Partners in Care Program provides a host of information and hands-on training through weekly sessions. Each new nurse is then paired up with an experienced nurse through the hospital's preceptor program. "We put a lot of time and training into our new nurses. We want to give them a sense of comfort so that they will be successful. It is so easy to feel completely overwhelmed in the first few weeks of practice, but we are committed as a hospital that whatever resources are needed to help a new nurse succeed we will be there to support them," Sullivan said.
A nurse's education doesn't stop when he or she is oriented to the hospital. Continuing education opportunities through in house in-services and outside conferences serve to update nurses on the latest in technology, techniques, new medications and equipment. "In today's health care environment, changes take place so rapidly. Nurses must place a lot of importance on the need for continuing education. The good nurse seeks out educational opportunities and has a thirst for knowledge," Cockfield said.
As nurses face the future, the shortage in their ranks is unfortunately expected to worsen. "We are going to have to be smarter and more creative in how we utilize our nurses," Cockfield said. While she anticipates that advances in technology will continue to change the way nurses care for their patients, Cockfield hopes that other aspects of nursing will remain unchanged. "One thing should remain constant…that the nurse will always be the patient's greatest advocate."
by Diane J. Epperly, Contributing Writer
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