“All patients, no matter what, deserve the same level of care.”
Wendell Alderson, RN, is retired, but works part time as a recovery room nurse at Alhambra Surgery Center and Fort Sutter Surgery Center in Sacramento.
Why did I become a nurse?
I was a senior in high school and I had no idea what I wanted to do. A friend of mine asked me if I would like to volunteer at a local convalescent home in the afternoons after school. I went through some brief training and began spending my afternoons there feeding patients, writing letters for them, and taking them to the activities. I watched the nurses caring for the patients and became interested in what I was seeing. I asked several nurses about their jobs and began to think this might be something I would like to do. This was in 1969. Very few men were going into nursing, and my family was not too excited about the idea. My grandmother who was a nurse thought it was great. It was difficult as there really was not much support for me becoming a nurse. I went to our school nurse and asked her about it. She was very helpful getting me on the right track and courses to do my pre-nursing when I entered college. That is why and how I became a nurse.
What is the most rewarding experience?
This is a difficult question to answer. The rewards are many. I have been a bedside nurse my entire career. I enjoy patient care. I love teaching patients and family. I like making my patients comfortable. I enjoy listening to and finding out about my patients and their families. I have lifelong friendships with several patients and their families. I love it when someone walks up to me outside the hospital and recognizes me for being their nurse. Most of all I like the intimacy of the nurse patient relationship. Where else can you be with someone about to go to surgery, have a procedure, hear devastating news about themselves or their loved ones, be there for the joy of a new life, or experience a patient transition from life to death? Every day is different and I love that as well.
What advice would you give a new nurse?
All patients, no matter what, deserve the same level of care. It is difficult at times to care for some patients, but be aware they have a history that brought them to where they are today. You are only seeing them at probably one of the worst times in their life. Be patient. Take care of yourself as well. You cannot save everyone. You can only do your best.
What would you like to see changed about nursing?
I have been a nurse for 40 years. The changes I have witnessed are hard for me to even grasp at times. Nurses as a profession have come so far. Men are accepted into nursing now more than when I began. Nurses are regarded more as part of the team of health care providers than ever before. Change is inevitable. It is difficult sometimes, but change is good. Try to adapt to the ongoing changes in your profession.
“The most rewarding experiences occur when you are able to advocate for a patient and help them find their voice to participate in their plan of care.”
Julie Werner, BSN, RN, PCCN is currently working as a nurse manager for the Heart and Vascular Progressive Care Unit, which is a 24 bed integrated unit that cares for floor and IMC level patients.
Why did you become a nurse?
When I graduated from high school, I was undecided about my career path. I floundered for a bit and someone mentioned, “I had the personality and smarts to be a nurse.” I do have an extroverted personality and enjoy helping others, so I decided to enroll in a vocational nursing school to see if this could indeed be my career path. With only a few clinical days under my belt, I knew that nursing was my passion and calling. The amount of satisfaction I felt from making a small difference in someone’s day was the spark I’d been missing when exploring other career options. I finished the vocational nurse program and immediately enrolled into a Registered Nursing program. I’ve been learning ever since and never regretted my decision.
What is the most rewarding experience?
I think the most rewarding experiences occur when you are able to advocate for a patient and help them find their voice to participate in their plan of care. Health care is often a passive experience for patients; and, nothing is more rewarding than having an engaged patient and/or family that makes decisions about their treatment, asks questions, and is actively engaged in learning all they can to optimize their health.
What advice would you give a new nurse?
I think new nurses should learn two very important things. First, never stop learning. Every day for the rest of your career you should be actively seeking learning opportunities. When you stop trying to grow and learn in your career, job dissatisfaction and stagnation make what once was a passion into a chore. Secondly, stop worrying so much about mastering skills such as starting IV’s, inserting an NG tube, or drawing blood the first few weeks of orientation. All these skills can be mastered with time and repetition; much as they were mastered by all the new nurses orienting before you. Inherent qualities such as kindness, empathy, and caring, cannot be taught; so, if you possess those virtues on day one of orientation, you’ve already achieved an important accomplishment.
What would you like to see change about the image of nursing?
I want nurses to be seen and respected as professionals. I want the public to understand and realize that patients are admitted to the hospital for nursing care. Patients who require hospitalization are not able to visit the doctor, receive a prescribed treatment, and go home and care for themselves. They need 24 hour monitoring and supervision and care provided by the nurse. I won’t be happy until phrases such as; “oh, you’re only the nurse” or “the nurse is the physician’s handmaiden” are never uttered again. The nursing profession is filled with smart, dynamic, innovative, and inspiring individuals who deserve the respect and admiration of all members of the community they serve.
“The ANA is pushing for nurses to be represented on boards of health-related agencies. This is an excellent way for nurses to introduce themselves and the profession to the leaders in the community.”
Dorothy Marsh, BSN, MSN, RN, worked in many positions including Brookhaven Lab, the VA and a Cleveland hospital, and created many start-ups during her career.
The challenges to nursing include the lack of clinical sites for student nurses to learn the ABC’s of direct patient care under the tutelage of a seasoned nurse. As impressive as simulations may be, they’re not a substitute of a real person experiencing pain, dyspnea or other symptoms. Can a simulated patient really display the symptoms associated with mental illness? We’re in danger of producing nurses who are proficient with computers, but never touch a patient on the arm and say, “How are you doing today?” I think the answer is internships, which some hospitals like the Cleveland Clinic are already providing.
The recent outcry over the nurse with the “doctor’s stethoscope” is a good example of the way social media can be used to elevate the perception of nurses. The ANA is pushing for nurses to be represented on boards of health-related agencies. This is an excellent way for nurses to introduce themselves and the profession to the leaders in the community. Network with groups outside of the nursing profession, such as League of Women Voters, “Leadership” groups in cities associated with the Association of Leadership Professionals (ALP), partisan political group, and college alumni.
It’s the duty of all experienced nurses to mentor and nurture those who come behind. This includes not only day-to-day working relationships on the units, but encouraging younger nurses to be a part of their nursing organizations, both ANA and specialty groups. I’ve certainly tried to do this over the course of my career and have been gratified to see some of my young ones go on to become fine nurses and leaders. The old “each one teach one” carried a bit further.
Over the years, I’ve been politically active, working for Civil Rights in the 60’s, on the Health Policy Committee of the Ohio Nurses Association (ONA), working on campaigns. I was Girl Scout leader for many years. After my retirement from the VA, I helped start a Free Clinic here in Akron, which has grown incredibly. I retired from being the administrative nurse when I became 75, but continued as a staff nurse for a few years, and as a board member of the larger institution. I continue to volunteer as a member of the Legislative Committee of the Ohio Association of Free Clinics, and I’m a member of the Environmental Caucus of the ONA.
The profession of nursing, described as healing the bodies, minds and hearts of patients and their families, is accurate. But I always like to remind people that “doctors are cure; nurses are care” because that’s what we do. We care for you when you’re born, when you die and everywhere in between. I also like the quote from Val Sainsbury: “Nurses dispense comfort, compassion and caring without even a prescription.”
One of my most rewarding experiences happened a long time ago. I had a patient with a necrotic bowel who needed very extensive surgery and was one of the first patients in the country to go home with a total parenteral nutrition. He was hospitalized for a long time, and during that period, his wife gave birth to a child who did not survive. I was able to get an order to take him out of the hospital to attend his child’s funeral. I worked closely with his wife on how to care for his line and administer the TPN, and tried to help both of them with their grieving. When he finally was discharged, they gave me an inexpensive little bracelet with a heart on it that says “Thank You.” I’ve never worn it, but I keep it in a little box and take it out at drawer-cleaning time. Some might say my acceptance was unethical, but I think it would have been unconscionable to refuse it. I’ve saved all the nice notes from patients and families, the poems, and the drawings. I like getting a hug from former patients when I run into them at the grocery store or some place. And most of all, I like to get together with my old comrades-in-arms from the VA and my young comrades from the ONA.
“As nurses, we have an obligation above all others on the healthcare team to care for the whole patient.”
A nurse for 39 years, Sue Berger, MSN, Ed.D., ANP-BC is currently working as the Executive Vice President/Chief Operating Officer and Director of Health Services at Cazenovia College in New York.
One of the biggest challenges facing nurses is securing the resources necessary to provide quality care in the manner that patients deserve. Another challenge is advocating for resources to compensate nurses at a level that attracts and retains them within the profession. This starts with our nursing educators.
To elevate the professional perception of nurses, nurses can strive to achieve excellent outcomes on a daily basis — provide extraordinary care in their day-to-day interactions. It’s important to remain vigilant and positive in the face of those whose efforts are intended to undermine the authority that nurses have achieved. Nurturing interdisciplinary and collaborative relationships will elevate the perception of nurses. Outside the profession, nurses can utilize their transferable skills to advance initiatives within their communities, serve on boards and municipal committees, and get involved in charitable organizations.
I do see myself as a role model for future nurses, but also for current nurses who I hope will remain in the profession. There’s a work ethic in my generation of nurses that has served the profession exceptionally well. I hope I have passed that ethic along in my mentoring of other nurses throughout my career.
I have used my nursing skills to volunteer in a number of ways. Examples include: serving community organizations, working at large-scale events as part of a medical team; participating or leading health promotion campaigns; and serving on a governing board for a college or nursing.
Yes, I believe healing the bodies, minds and hearts of patients and their families statement is accurate. As nurses, we have an obligation above all others on the healthcare team to care for the whole patient. For those whose bodies and minds cannot be healed due to disease, nursing compassion is essential to help patients find peace and dignity at end of life and to help families and loved ones begin the healing process.
“Nothing compares to sitting by a patient’s bedside and listening to them and acknowledging their fears, or holding their hand in a time of crisis.”
Jackie Rodriguez, MSN, AGACNP-BC (Adult Gerontological acute care nurse practitioner–board certified) is currently working at Holyoke Medical Center in Massachusetts.
In my 11 years of experience as a registered nurse, I have seen the many changes that have happened in the healthcare field that have impacted nurses in many ways. We have entered an unprecedented era of opportunity and transformation in nursing and efforts made on the national level aimed at reducing costs will be the primary drivers of this transformation. A holistic approach to patient care has always been at the forefront of how we care for our patients, but some of those transformations have unfortunately taken the nurse away from the bedside and added additional work that leaves less time for nurses to spend with patients. However, many of the changes have also been positive. Computerized medical records, medication scanning, hourly rounds and bedside rounds have increased patient safety and satisfaction. The biggest challenge that nurses face today is balancing the added demands based on policy and protocol and the human that is on the other side of the medical record.
Nurses have been voted the most honest and ethical profession for 13 years in a row and with that comes great responsibility. In order to continue to provide the best patient care to the more complex patient population we are seeing, we must invest in educational opportunities that increase knowledge as well as elevates the nursing profession. This can include a certification that validates knowledge and experience as well as improving skills. This can also include continuing education, which improves professional competence as well as opening doors to better job opportunities that may require a higher educational degree. More and more healthcare facilities are seeing the benefits of continuing education and are finding realistic ways to help nurses obtain higher degrees while still being part of the workforce.
I think it’s important to give back when you find yourself in a position to do so. Joining a nursing organization that focuses on giving back to the community and mentoring nurses is a great way to do this. Joining the National Association of Hispanic nurses was a great way for me to give back to my community. Our focus is to promote the leadership of nurses through healthcare awareness, advocacy, collaboration and educational advancement. In addition, we focus on delivering competent quality healthcare through community partnerships and pledging to promote health equity within the Hispanic communities in Western Massachusetts. Our hope is to empower nurses to improve the health and well being of individuals, groups, and communities by the use of action-based, culturally sensitive, evidence-based nursing practices. Our chapter is involved in numerous community activities throughout the year, as well as fundraising for nursing scholarships and mentoring nursing students and nurses new to the field.
As a teen mother, I didn’t have many people to look up to or look to for encouragement. As soon as I made the decision to become a nurse I knew that mentoring would be something that I wanted to be involved in. A large part of my nursing organization focuses on mentorship and how we as seasoned nurses can encourage those who are new to the nursing world, and even those who are not sure if becoming a nurse is a goal they can achieve. I hope that I can serve as a role model to those that may have or have had similar circumstances to mine. My statement to those people would be to never give up on your dreams and never give in to those that discourage your dreams.
As nurses, we are entrusted with caring for people at their most vulnerable. Today’s acutely and critically ill patients require sharply tuned alertness and extraordinarily complex care from a team of highly skilled health professionals. Nurses are seeing patients that are sicker than ever. The holistic approach to patient care must go to the next level and include scientific and evidence based knowledge in order for nursing to keep up with the increasing trends in healthcare. However, I still believe that even with all the scientific knowledge we have, nothing compares to sitting by a patient’s bedside and listening to them and acknowledging their fears, or holding their hand in a time of crisis. These are the things that we as nurses are known for, and although with our professional elevation, we at times shy away from these things that remain at the heart of who we are and why we are the most trusted profession.
I have always found that my most memorable experiences have been during a patient’s end of life. It was always an opportunity to get a glimpse into someone’s life and who they were by the love and admiration families had for them. I would hear stories that would make them laugh and cry; and sometimes I would be invited in to share those moments. On the other hand there were those patients that didn’t have families or anyone to come and spend those last precious moments with them. But I was there, and I would always say a prayer for them and let them know that they were not alone. My new journey as a nurse practitioner has taken me to that next level of practice. And although my practice has taken me a little farther from the patients bedside, at the end of the day I’m still a nurse and that experience has been and will always be invaluable to my practice as a nurse practitioner.
“The most rewarding experience as a nurse is the ability to smile to a patient and they smile in return.”
Patience Igwe is currently working as a RN for a specialist Long Term Acute Care Hospital.
My journey to nursing is an interesting one born out of the desire to know. People say that everyone has a story. Below is my story to nursing. My name is Patience Igwe. I am a registered nurse with a bachelor’s degree in nursing and recently completed MSN in Nursing Administration. I reside in Columbus, Ohio, the Buckeye State. I have been a medical-surgical nurse with majority of my nursing experience in the Long Term Care Nursing Facilities for about eight years. Currently, I work as a registered nurse (RN) for a specialist Long Term Acute Care Hospital (LTACH). Prior to becoming a nurse, I had close family members die and had very little understanding of their disease conditions. As a mother myself, I wanted to be quite knowledgeable in health conditions so I can better take care of myself, family members and now the patients that I care for at work. The experience has been challenging, but rewarding.
There are many challenges facing the nursing profession. In my opinion, the biggest challenge facing nurses is the patient-to-nurse ratio especially in the Long Term Care Facilities (nursing homes). In most nursing homes, the ratio is between 20-30 patients depending on whether you are in the long term care or skilled nursing unit. Hospitals have gotten better. The patient-to-nurse ratio in the hospitals is about five patients to one nurse in the general nursing floors and about 2-3 patients to one nurse in intensive care units. Even in these cases, the level of patient acuity can be overwhelming even with the relatively smaller numbers. Other challenges include dynamic nursing environmental changes such as technology, tight government regulations, the fear of law suits and inadequate mentoring programs.
Though nurses face a lot of challenges in the work place, a lot has been done to improve the image of nursing ranging from salary, credentialing, autonomy level, scheduling and nursing uniforms, among others. I am one of the nurses who is happy that nurses are no longer required to wear white-only scrubs and a white hat. The advancement of nursing education up to masters, PhD and Advanced Nurse Practitioners levels are some of the ways stakeholders have tried to improve the image of nursing. Salaries have also increased over the years, making the profession attractive and respectable. In my opinion, the influx of men into the profession is largely due to salary improvement. Prior to salary improvement, it used to be only a woman’s job because the pay was nothing to be proud of. Most hospitals have embarked on programs to encourage their nurses to advance their nursing education from being Licensed Practice Nurses to higher levels of nursing education such as BSN, MSN, APN, among others. Nurses are taking advantage of these programs and my place of work has such program in place.
Mentoring of new nurses is very important if a company wants to maintain high retention level of its new nurse hires. I experienced the problems associated with lack or poor mentoring of brand new nurse out of school. The challenges are overwhelming and can be intimidating. Mentoring requires more experienced nurses training new hires. The mentors are nurses with more experiences, patient and like to teach. The mentors should minimize their level of judgment and realize that these new nurses are fresh and want to learn. As a novice, the least thing a new nurse wants to feel is the sense of stupidity from a trainer/mentor especially as people have different ways of learning. I also like to model to a new nurse. For instance, if a new nurse observes that I practice hand washing and use my protective equipments per protocol, he or she will be encouraged to do so. This way, the nurse becomes a better nurse.
Volunteering in areas of need in society is good for everyone, not just for nurses. As a nurse, I find time to volunteer as much as I can. I volunteer in some soup kitchens, in my church and deliver Meals-on-Wheels. Volunteering helps us to step out of our comfort zones to help others in need. It is a great feeling.
Yes, nursing is about healing the body, minds and hearts of patients and their families. Having gone through formal nursing education and gained nursing care experience, this description of nursing as a profession is very true. A simple illustration is that a sick or ill patient is not a happy person. May be there are a few able bodied persons out there who want to depend on somebody else to take complete care of them in all aspects of life. If not, I believe that a healthy, active and independent person is a happy person. A person who has been used to being in control of his or her life will, obviously, not be happy when he or she has to completely depend on somebody else. That is why a lot of patients go into depression. This becomes an important part of nursing to be able to tune-in to patients’ feelings, engage them into communicating their feelings and doing even the simplest thing as rubbing their cold feet to put a smile on their faces. Sometimes, the high patient-nurse ratio and all the demands of nursing make it difficult for us to do those simple things that can put a smile on a patient’s face. We still have to try.
The most rewarding experience as a nurse is the ability to smile to a patient and they smile in return. I know that most patients are not happy when they are in the hospitals or nursing homes. Which sick person will be? It is difficult to be happy when you think of all the thousand things you could be doing outside and here you are stuck in the hospital bed. That is why it is important to show gratitude and help a sick person know that even though we cannot control all things that happen to us, nurses can help put a smile to their not-so-happy faces and place a soft touch to their achy bodies.
This is my story. What is yours? Let us share.
“All it takes is one patient, one family member, or a fellow staff member to make us smile and remember why we do this rewarding job.”
Glenn Buck, RN, is currently an ER travel nurse working in Seattle at Swedish Cherry Hill.
The biggest challenge I see in the nursing profession is probably the shortage which affects not only the nursing staff, but also the operating ability of the facilities, the ability of the physician’s to give complete care to the patients and of course the care given to the patient’s themselves. When units are working short staffed, the care given to each individual patient is diminished and not due to the dedication or skills of the nurse, but just because of the sheer number of patient’s that they are required to take care of. It is also more difficult as the Baby Boomer generation continues to age and health problems become more complex requiring higher levels of care. The longer nurses work short staffed and are working harder, the shorter amount of time nurses will spend in high stress areas of nursing, therefore leaving less experienced nurses to take care of the sickest most complex patients. This will eventually deplete the amount of nurses overall as many more will leave the profession earlier than they had originally planned. It’s also possible that facilities could be sued more as our society is becoming more and more adept and willing to take anyone or any business to litigation if they feel they’ve been wronged. As nurses work short staffed, even the most skilled and experienced nurses are more prone to make mistakes. This opens the nurse, the physician and the facility up for litigation. Facilities need to treat nurses better, pay us better and staff the units more safely, and if this is the culture that is fostered, I foresee more people entering the nursing profession. Another thing that I think hinders the ability of nurses to take care of their patients is the idea that we are more customer service driven with surveys and handling tasks that are more concerned with patient satisfaction. Many times, it is impossible to make patients and their families happy with their care even though the care has been up to the standard of care. This goes along with the shortage of nurses within the profession.
As far as things that nurses and others can do to elevate the perception of professionalism of nurse’s would be to teach physicians that we are invaluable in the care of the patient’s that physicians are also taking care of. So many nurses feel slighted, unappreciated, disrespected by physicians that treat them like less than a person and often times in front of a patient. This defeats the culture of professionalism both of the nurse and actually the physician and makes the patient feel that the care they are receiving is substandard. Most of the time, physicians are just ordering tests to investigate and then diagnose. Nurses are the professionals that carry out and monitor those interventions and then sometimes suggest a different course of action that may be more beneficial to the patient. Good physicians will take this under advisement, maybe change the direction they are taking towards caring for the patient, or educate the nurse in a professional manner why the original path was taken. Another way maybe that I think is doing a disservice to nurses’ professionalism in the eyes of the public is this idea that a Bachelor RN is a better nurse or better prepared than either an Associate degree nurse or an LPN. I am probably going to upset a lot of nurses, but I disagree with this opinion. In most programs there really isn’t any more intensive clinical instruction for bachelor-prepared nurses. Ethics and leadership are the main focus. In my humble opinion, neither leadership nor ethics can be taught. Requiring nurses to have a BSN and using marketing to the public that touts that all of their nurses are bachelor-prepared nurses gives the public the false perception that any nurse that has less education are somehow less qualified to take care of them. As far as I am concerned, as we continue to work on the job and learn from fellow colleagues, physicians and continuing education is far more valuable than any learning from textbooks. This is by no means a comprehensive list of things that could be done.
I really don’t see myself as a mentor to other nurses. I do, however, aim to help other nurses as much as possible, as well as learn from other nurses every day while taking care of patients. I am always striving to learn more to be able to better take care of my patients. I think that giving back to our local community and to the world at large is the best way to help other’s having a better quality of life through more healthy living. Telling my story about volunteering to other nurses can get them excited about doing something that may have more meaning in their lives. This allows an increased number of people without the ability to have access to good healthcare, to at least be seen by a healthcare professional, get education and hopefully live a healthier life.
I have used my skills in a volunteering capacity. I have been on two volunteer medical missions. I went with an organization called One Nurse At A Time to Belize for a short five day mission taking care of members of three different villages. I performed triage on many patients with many different complaints. I was able to make judgments based on my clinical assessment whether or not patients needed to be seen by a physician or if they could be sent to the pharmacy and get over the counter medication that we brought that was donated by the members of the mission and by other organizations. I was able to, with direction of a physician, suture a 15 year old boy who came in with a machete injury to his hand for harvesting bananas. I recently returned from a two week mission in Guatemala with my 17 year old son, Nicholas with a Seattle based organization called Guatemala Village Health. This organization was started by two physicians in 2007 and they have been taking volunteers, nurses, physicians, physician assistants, dental hygienists and dental assistants at least twice a year since then. They have Guatemalan nationals running programs when they are not there. They have started educational programs in fluoride, composting toilets, planting gardens and healthy eating as well as maternal and baby health. It was very rewarding to see the progress they have achieved, as well as humbling to see how much is still left to be done. The conditions are never good, but it is humbling and rewarding to give of your clinical and compassionate skills to those that do appreciate everything that you do for them. The other overseas work I have done was work for Partners In Health as an Ebola Clinician in Port Loko, Sierra Leone for a month. Traveling overseas and seeing the conditions that people live in every day definitely opens up your eyes to the world around you. I find that returning home from a mission is almost harder than going on the mission. Unless others have gone to similar places and done similar things it’s difficult for friends and family to really understand what you have encountered and the impact that volunteering has on one’s psyche. It recharges you, it changes you and when you return, it’s not long before you are thinking about when and where you can go on your next mission. I recommend that every nurse go on at least one mission. There are many, many opportunities and organizations that travel to many different locations. One Nurse At A Time has a database of organizations, locations, amount of time and cost of missions. A reason that nurses may hesitate to go on a mission is that the cost can be somewhat prohibitive at times. There are many ways that money can be raised to pay for a mission. Many organizations have scholarships available and they just need to be applied for. I have heard of nurses doing a letter writing campaign or talking to local physicians and/or businesses to sponsor them. I did a GoFund me campaign that funded part of my trip. Please don’t let the cost of a trip deter you from going. There are many ways to make it happen.
Going along with the mantra of nursing healing the bodies, hearts and minds of those we take care of and their families, it can definitely be seen in all areas of nursing and particularly in volunteering. When you give of yourself outside of your normal FTE, those lives that you touch and those people that you hold their hand or give them a hug and a smile are so very grateful that you have taken the time out of your own life to help them live a healthier life. I believe that despite the long hours, the missed bathroom breaks, the missed food, the missed time with our family, nurses enter this profession to give of themselves and help to make other’s lives healthier, happier and more fulfilling. All it takes is one patient, one family member, a fellow staff member to make us smile and remember why we do this rewarding job. Volunteering takes this to a whole new level. I challenge nurses who are feeling burnt out, unappreciated and ready to leave the profession or even switch their focus, to go on a mission. They will come back renewed and with a vigor that they can transfer to their patient’s, the families and their fellow staff. To further expand on the above mantra, I feel that as nurses we are the ones who see people at their worst. We are charged with fostering trust in such a short amount of time and in such an intimate way that we must take care of the heart and minds of everyone we come into contact with. I feel that you can heal the body, but unless you touch their heart and mind, they are not whole. Education of patients and their loved ones is a huge part of our everyday life as nurses. It is important that we leave a patient in a better state, physically, mentally and emotionally than they arrived.
“Nursing is such a diverse and fabulous career with multiple clinical settings and opportunities to specialize.”
Linda Sarna, PhD, RN, FAAN, AOCN, is the Interim Dean at the UCLA School of Nursing, and the Lulu Wolf-Hassenplug Endowed Chair in Nursing.
How did you get involved in a career in nursing?
Initially, my college major was geology. However, after my first field trip breaking up rocks I realized that I would much prefer dealing with people. I had taken the science courses that were prerequisites for the nursing program at UCLA so the switch was not too challenging. Once in the program, I found that I loved what nurses did and had a particular affinity for patients suffering from cancer. I felt that my nursing care could make a difference.
How did you become interested in Oncology and Tobacco Control?
As an oncology nurse, one of my earliest memories was taking care of a young man with end stage lung cancer and it had a profound impact on me. My Master’s Thesis focused on the hopes of terminally ill patients, and I encountered many patients with lung cancer, including women, which was a surprise to me. It would be a decade before lung cancer became the leading cause of cancer death among women. After my doctoral dissertation which focused on older people with lung cancer, I focused my research on the quality of life and symptoms of women with lung cancer. Lung cancer, the leading cause of cancer death among American men and women, and worldwide, still receives inadequate attention in the nursing literature. This early work identified the influence of tobacco use and exposure to secondhand smoke on cancer-related symptoms, comorbidity, and quality of life. As a result, I focused more directly on tobacco use and to the role that nurses could play in treating tobacco dependence, especially in the oncology setting.
Although over 30% of cancer deaths are due to tobacco use, there was little attention to preventing tobacco use or helping people quit smoking when I was in nursing school. Even though it was recognized as the leading cause of preventable death in the world, accounting for more deaths than HIV/AIDs, tuberculosis, and malaria combined, there was limited nursing research in the area. Evidenced-based interventions and effective policies to reduce tobacco-related disease were identified in 1996, but the implementation is lacking in the US and in many countries in the world. The ultimate goal of my work is to reduce tobacco-related diseases and suffering, especially tobacco-related cancers worldwide, and to enhance the critical but underdeveloped and unrecognized role that nurses can play in tobacco control (prevention, treatment, and reduction of exposure to second-hand smoke). I have had the opportunity to be involved in this work nationally and internationally in Asia, specifically China, and Eastern Europe. In collaboration with the International Society of Nurses in Cancer Care (ISNCC), I have been involved in studies in Poland, the Czech Republic, Romania, Slovenia, Slovakia, and Hungary to help prepare nurses to help smokers quit. I have had the great fortune to have worked on policy and position statements on tobacco control for nursing organizations, including the Oncology Nursing Society (ONS). This work endorsed by the American Nurses Association and the ISNCC, among others, and has helped to shape the profession.
Smoking among nurses is an important barrier to effective nursing intervention for tobacco dependence among patients. As the Principal Investigator for Tobacco Free Nurses (TFN, www.tobaccofreenurses.org), which provided the first ever US program focused on smoking as an issue for the nursing profession, we tested the use of an online program to support quit efforts. TFN was selected as an exemplar by the WHO as the type of program that health professionals could initiate to address factors influencing tobacco control.
I have many publications, including books and book chapters in this area. I was a co-editor of a monograph, produced in collaboration with the World Health Organization, which integrates policy and research efforts of nurses in response to the United Nation’s Summit on Non-Communicable Diseases (NCDs), the second ever UN meeting focused on a public health issue. The monograph addresses policy implications that support nurses’ ability to address NCDs in clinical practice, and it provides direction for spearheading and monitoring changes in practice.
What has been the most memorable experience of your Nursing Career?
There are so many. I will list the top three. I think that the ultimate experience which continues to be ongoing is my work my colleague, Dr. Stella Bialous, Associate Professor at UCSF, on the Tobacco Free Nurses initiative which began in 2003 www.tobaccofreenurses.org
Also right up there was the opportunity to analyze data from the Nurses’ Health Study, the largest prospective study of factors influencing women’s health. Going to Harvard was very exciting and our study revealed the extraordinary impact of smoking on female nurses’ survival and quality of life.
Lastly, I would include my opportunity to lead UCLA’s efforts to implement a tobacco-free policy on campus http://healthy.ucla.edu/pod/breathe_well This policy impacted over 37,000 people and I was very excited that as a nurse, I was able to educate my UCLA colleagues about the health dangers about tobacco use as well as the benefits of quitting.
What is the greatest difference between the clinical and administrative side of nursing? How was that transition for you?
In academics, my focus is on preparing new nurses to be caring and competent. The rewards come from students achieving their goals as compared to patients. As an administrator, my focus is on promoting and supporting my faculty rather than my own scholarship. I have many competing priorities but the students and faculty come first.
What are two or three Changes would you like to see in how Nurses are trained today?
1. Every nurse should receive adequate education during their nursing program so that they will feel confident and comfortable in helping patients quit smoking and in reducing exposure to secondhand smoke. This should be part of basic nursing education but we found that many nurses as well as graduates in other professions are not adequately prepared.
2. Every School of Nursing should address the health behaviors of student nurses, especially smoking. Healthcare professionals who smoke are less likely to intervene with smokers. I don’t want to lose any more nurses to tobacco-related illness so it is imperative that we support student nurses’ quit efforts.
3. Every nurse should receive their education on a tobacco-free campus. This policy will denormalize tobacco use making it easier for smokers to quit and preventing uptake by the next generations. Nurse educators are in a perfect position to lead this effort.
What advice do you give for students thinking about pursuing a career in nursing?
Nursing is such a diverse and fabulous career with multiple clinical settings and opportunities to specialize. If you do specialize, pick a field that you love and join a nursing organization in that area. For me, oncology nursing and the Oncology Nursing Society have provided so may opportunities to be involved in meaningful work with wonderful people in a variety of disciplines. I would definitely encourage any person entering nursing to seriously consider going on with their education and become an academic. We desperately need PhD prepared faculty to educate future nurses.