Connecticut Nurses Adapt to New Roles and Challenges
Compassion has always been a requirement for nurses. Today, with so many reaching elderly status, it often involves the complex health issues of seniors. Above, Alison Lucibello gently reassures a patient at Yale-New Haven Hospital.
All images by Keyvan Behpour
In medieval Europe, nuns and monks often served as primitive nurses, caring for the sick and injured in makeshift monastery hospitals. Florence Nightingale became a pioneering legend centuries later while tending to soldiers wounded in the Crimean War, and in 1860 she founded a nursing school at St. Thomas Hospital in London. While today’s highly trained, extremely specialized and knowledgeable nurses are a far cry from their trailblazing predecessors, one constant trait they share is compassion.
‘‘Nurses have to be compassionate,” says Peter Cordeau, chief nursing officer at Sharon Hospital. “They have to really want to be with people and care for people, that’s number one in nursing. There are people that are very book smart but do not have that complete compassion to deliver care at the bedside.”
In a modern setting, hospital nurses need to effectively combine compassion with a variety of advanced skills, including management ability, medical knowledge and technical expertise.
“Technology has truly changed the face of how nurses operate in today’s world,” Cordeau says. Medication is now only administered after barcodes have been scanned, and hospital records are kept digitally. This digitization of hospital data provides increased patient safety and the ability to track the performances of nurses and other hospital staff. Patients can even compare hospital performance statistics on websites like medicare.gov/hospitalcompare.
In addition to a need for more technical expertise, the nursing field has seen increasing demand for advanced practice registered nurses.
“There’s a big focus on continuing to grow and develop in your professional role as a nurse,” says Beverly Lyon, chief nursing officer and vice president of nursing administration at Milford Hospital. “You see a lot of nurses looking to continue to advance their careers and we’re seeing more advanced practice nurses.”
Patricia Fitzsimons, senior vice president of patient services and chief nursing officer at Yale-New Haven Hospital, also says Yale has increased the number of advanced practice nurses it employs. “In this institution we have about 400 advanced practice nurses. Some are nurse anesthetists, some are midwives, some work in the clinic as nurse practitioners,” she says. “They have a greater scope than the registered nurse. They can prescribe, and they can diagnose and manage the plan of care in a different way.”
In keeping with a larger trend in medicine, nurses have been divided into a sometimes dizzying array of specialties and subspecialties. “Caring for cancer patients is a specialty and caring for adults is a specialty, and caring for adults with cancer is a specialty,” says Fitzsimons.
Specialization helps achieve more positive patient results, says Karen Buck, assistant chief nursing officer and patient care services director at Lawrence + Memorial Hospital in New London. “Evidence has demonstrated that positive outcomes are more consistent and higher when nurses with a Bachelor of Science in Nursing or higher degree are involved with direct patient care,” Buck says.
The growing specialization in the nursing field also can increase a hospital’s ability to provide care. Nurse anesthetists are able to administer anesthesia to patients and "they extend the ability of the institution to deliver anesthesia,” Fitzsimons says.
|Registered nurse Lynda Miguel of Danbury Hospital tracks a patient's progress.|
Transitioning patients from an acute-care hospital setting back into their home has increasingly become a focus for many nurses. “There’s only about a three-day stay now for a hip replacement or a knee replacement,” says Lyon, of Milford Hospital. “So we’re really trying to equip patients and their families to manage once they leave the hospital, really preparing them for home, with a lot of focus on home planning.”
Lyon expects that with the nation’s aging population, there will be a growing need for nurses who specialize in working with elderly patients. “I believe that we’re going to see more and more of the advanced practice geriatric nurses helping to transition our patients back into the community,” she says.
Moreen Donahue, senior vice president of patient care services and chief nursing officer at Western Connecticut Health Network, which includes Danbury Hospital and New Milford Hospital, agrees the role of nurses outside the hospital continues to expand. “Nurses are becoming part of the continuum of care, meaning that more health care services are moving from the inpatient to the outpatient setting,” she says.
In today’s hospitals, nurses also need to be efficiency experts.
“While the essential component of the role of the nurse—namely the provision of safe, high-quality care—remains relevant today, the financial and economic pressures require that nurses practice in the most efficient manner possible,” Donahue says. “Nurse specialists need to have highly developed critical thinking and prioritization skills. For example, emergency room nurses need to constantly reprioritize their work based on patient volume, acuity or both. Nurses in the emergency department are time-management experts. No day is typical; sometimes there are multiple trauma patients needing attention and the ED nurses are experts at moving appropriate resources to meet the patient’s needs.”
In the early 2000s there was talk of nursing shortages, but more nurses have since entered the field.
|Milford Hospital’s Marie Parker assists a doctor in a post-surgical review.|
“There are a number of factors that have helped,” Donahue says. “More universities opened schools of nursing, and other schools expanded their nursing programs. For example, many universities now offer ‘nursing as a second degree’ programs for people who have bachelor degrees in another discipline. Also, nurses are choosing to remain in the work force past the usual age of retirement.”
Nursing demographics also have shifted; the traditionally female-dominated profession is drawing more and more men. “In recent years, the number of male nurses has doubled from approximately 5 percent to 10 percent, especially in critical care areas,” Donahue says.
Cordeau, from Sharon Hospital, has been a nurse for more than two decades. He says while there were always other male nurses, there is no longer a stigma about men who choose the profession. “I think the male nurse vs. female nurse thing is a thing of the past,” he says.
Nurses manage each patient’s overall care and often have much more interaction with patients and their family members than any other hospital staff member. As a result, despite advances in the field, a prime component of nursing has remained unchanged throughout history. No matter their specialty, nurses must be able to quickly form a connection with those in their care.
“Nurses must connect on a very deep level within minutes of meeting their patient,” says Buck, from Lawrence + Memorial Hospital. “Patients are faced with trusting their lives with a stranger. It is not always an easy give on the patients’ side. Our patients are here in very stressful situations. Nurses’ primary focus is to do what is needed to return that patient to their level of wellness, and developing a trusting relationship is an important component of that.”
Connecticut Nurses Adapt to New Roles and Challenges