During her many years of practice, Kate Horner, BSN, RN, CPAN, has had many insights about the profession of nursing. Here she describes a situation where she made an impact on a patient, reflects on how she keeps her passion and enthusiasm for nursing alive, and explains how being an active member of her professional organization influences her practice.
Nurse’s make an impact on a patient’s care every day. Early in my career, while working in the Coronary Intensive Care Unit on the night shift, I admitted a middle-aged man that had a massive MI. He was notably anxious knowing the prognosis of his diagnosis. The patient kept staring at his monitor. I explained how the monitor worked and ended the explanation with “The monitor does not control you. You control the monitor.” He relaxed a bit and laughed at my statement. After spending two successive night shifts in my care without sleeping, he observed, “You are like a mother hen guarding her chicks. I am going to close my eyes and try to sleep. I know that you will watch over me.” To everyone’s amazement, the patient did well enough to leave intensive care and go to an inpatient medical cardiology unit. All had feared that he would go into cardiogenic shock. Approximately a week later, I admitted a patient in acute congestive heart failure. I looked at his face and realized it was the same patient. He was intubated, still awake. He reached out for my hand and I reassured him that I would “watch over him” again. His family soon joined him at the bedside. They relayed how the patient told them this nurse, “was always there watching over him” and were relieved to know that I was that nurse. Despite the patient’s critical status, they felt that they could leave for short periods of time for their self-care. In the end, the patient’s heart was too weak from the massive MI that he had suffered and cardiogenic shock prevailed. I watched over him and his family during this last phase of his care.
Nursing is a team sport, but the lineup of your teammates as well as the rules of the game are ever changing. Therefore, in this climate, keeping your passion and enthusiasm for what we do as nurses is essential. I always tell people that happiness is a choice. I have never had a dull day as a nurse; I have experienced the busy, crazy, unbelievable, and thought- provoking days that nurses do. I always remind the team that I supervise that we have a chance every day to make a difference in the lives of the patients for whom we care. Often, it is the small things we do that patients and their families remember. Finding your niche in the vast field of nursing is key to finding meaning and purpose in your work. Once you have found your home base, keep growing. Step out of your comfort zone and implement a practice change based on the best evidence. Become certified in your specialty. If you maintain an attitude that there is always something to learn, it will keep you coming back to work each day seeking that next challenge.
I had been a PACU nurse for over two decades before I became active in the local professional chapter of my specialty field of practice, the Greater Cleveland PeriAnesthesia Nurses Association (GCPANA). Nurses who attend meetings learn about legislation at the state and national levels that can affect our nursing practice. Educational offerings by the GCPANA highlight current practice and potential issues patients may encounter and offer strategies to mitigate patient harm. Seeing the many benefits of being involved in a professional association, I then joined the state level board of the Ohio PeriAnesthesia Nurses Association (OPANA). In this role, I traveled across the state meeting nurses working in small and large institutions. Many of my peers were dealing with similar issues and had similar needs. These experiences encouraged me to submit abstracts for poster presentation to the American Society of PeriAnesthesia Nurses Association (ASPAN) for their annual conference. I was surprised to learn my posters were accepted for presentation at the national organization’s conference.
An education session at the first conference I attended had a profound impact on me. I learned that patients across the country were experiencing postoperative urinary retention (POUR) and that just one incidence of POUR could cause permanent damage. As nurses, we have the responsibility to “do no harm” just as physicians do. I went back to my unit and started working on this issue. I am now the principal investigator of a research study on the incidence of POUR on our orthopedic patient population. As I reflect, it all started by attending a local meeting of my professional organization. Now I am working toward influencing change in practice by researching a problem that is common in our daily practice.
Kate Horner, BSN, RN, CPAN
Assistant Nurse Manager, PACU, Cleveland Clinic