The audio companion to the award winning Nursing Notes email newsletter

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Carolyn Core, Charlotte Wallace, Joan Plisko (l-r)

Nursing Notes Live is an audio extension of the national award-winning monthly e-newsletter, Nursing Notes – which offers the latest industry news, trends and updates in nursing. You can subscribe to the e-newsletter at www.discovernursing.com. Each month’s Nursing Notes issue is accompanied by select few episodes of Nursing Notes Live, which expands on the content and provides you greater insights into the topics presented in the e-newsletter. You can listen to previous podcasts on the Nursing Notes by Johnson & Johnson Facebook page or visit iTunes to subscribe to the podcast!

With your host, Jamie Davis from the Nursing Show and MedicCast online programs.

In the program this month, Nursing Notes Live will be taking a look at sustainability in healthcare and the efforts of nurses to move their facilities toward greener, environmentally sustainable initiatives. Our Get to Know Nurse this month is Charlotte Wallace, RN who recently received the Nursing Leadership in Environmental Health Award from the Maryland Hospitals for a Healthy Environment. I chatted with Charlotte recently about her initiatives and how other nurses can learn how to duplicate what she’s done to reduce waste and environmental impact.

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Make sure you check out the entire April 2013 issue of Nursing Notes, looking at nurses and environmental sustainability. You can read the entire issue online at www.discovernursing.com and don’t miss the other Nursing Notes Live episode this month bringing you two nurses who are very active in supporting initiatives around greener healthcare settings. You’ll find this and other podcast episodes at the Nursing Notes by Johnson & Johnson Facebook page, and in the podcast area in iTunes.

Podcast: Play in new window | Download

Nursing Notes Live is an audio extension of the national award-winning monthly e-newsletter, Nursing Notes – which offers the latest industry news, trends and updates in nursing. You can subscribe to the e-newsletter at www.discovernursing.com.

Each month’s Nursing Notes issue is accompanied by select few episodes of Nursing Notes Live, which expands on the content and provides you greater insights into the topics presented in the e-newsletter. You can listen to previous podcasts on the Nursing Notes by Johnson & Johnson Facebook page or visit iTunes to subscribe to the podcast!

I’m your host, Jamie Davis.

This month, Nursing Notes Live takes a look at nurses who work with and educate our patients with diabetes. With 26 million adults and children struggling with this disease and millions more at risk for developing diabetes, nurses who specialize in diabetes care and education will have their work cut out for them. This month’s featured “Get to Know Nurse” is Lynda Stallwood. Recently, I got the chance to chat with Lynda about her nursing career and her important work with patients living with diabetes.

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Jamie Davis:         Lynda, let’s start off with asking you how you decided to become a nurse. What encouraged you that nursing was a career you wanted to follow?

Lynda Stallwood:     As a very young girl, my sister and I always knew in our hearts, as very young children, nursing was what we wanted to do. We grew up wearing nursing uniforms. I’m not exactly sure why I knew that. I’m not even sure I knew what a nurse was at the time. But it was in my heart to always provide care. We took care of sick animals, dead flies, all kinds of things. It was just that caring gene perhaps that my family has.

I am one of many nurses in my family. So it was just only something that was deep within my heart. I didn’t have the opportunity to go to nursing school until after my children were born. But once I did, I went into it full-fledged. I knew it was just what I needed to be. I think even as my children were born and growing,

I saw that there tended to be a gap sometimes between the medical profession and taking care of your child at home. And I felt like if I could help bridge that gap as a nurse with educating my patients, empowering them to answer my questions, of your healthcare provider, that that’ll be very gratifying. Perhaps as important in their care is providing the correct medication is also providing them the tools that they need to navigate the healthcare system.

Jamie:                   I agree completely. There’s so much about our current healthcare system that requires even more skills and navigating it. So it’s really important. I agree that nurses need to be the pilots for our patients to navigate that system.

Lynda:                   Yes, absolutely.

Jamie:                   So tell me a little bit about how you decided or what drove you into becoming a diabetes care specialist. There’s a lot of things that nurses go through and we come in contact with a lot of different specialties but something in diabetes care keep your interest.

Lynda:                   It is. It was a particular young woman, I was working at a general peds unit at the time. This was over 25 years ago. She came in – she was about 10 years of age – she and her parents came in with a diagnosis of “rule out diabetes.” And they were very calm. They were very attentive. They presented themselves as very confident. That no matter what they will be able to handle the diagnosis which is wonderful. As the care progress and lab tests revealed it was in fact this young woman had Type 1 diabetes.

So we started all the education. She was learning how to draw for insulin, test her blood sugar. She was going on a diet and exercise and lifestyle changes and all of those things that are part of diabetes care and management. Her parents were very active, very supportive. Everybody was just – “We can handle this, everything is fine.” And so I was taking [the cues 0:05:01.5] and trying to just continue to support them but listening very carefully to what they were saying and how they were saying it.

I was working the afternoon shift at the time and before I left for the evening, I wanted to check in on this young woman to make sure she was resting comfortably. I could hear her crying very softly but she was crying. So I just went in and asked her what I could do to help. And she started to open up about how frightened she was and how she didn’t like it and how this was going to affect her the rest of her life and she liked to go out and do things and this would perhaps change her lifestyle and she was worried about her parents.

So she asked if I could actually hold her in my lap, if would sit down on the chair next to her bed and hold her. So I did. I’m only 5”2”. She was very close to my height. She was a tall and lean young lady. I held her in my lap and then just listened to her. And she cried and she talked about things until she settled down and she said she felt better about it.

So I asked her that moment if I could call her parents up just to let them know how she was feeling and that she expressed some concerns. So she agreed to that. So I called her parents. And it was a very important and very precious phone call because her parents then began to see the same things that this young lady did.

They were trying to be strong for her but all the while they were scared to death. They were trying to put on this persona of confidence, that this is no big deal, things will be fine. In essence, they were concerned about her having to check her blood sugar. “What if she had a low – what if she wants to go out, we’re not around? What if she needs medication and it’s not quickly available.”

So it really was a bridge-building time. In this instance, it was more building a bridge between the family members, helping them to understand we’re really both on the same page and then it was very appropriate for them to express their innermost feelings. That they were really feeling the same thing. So when they came in the next day to visit her, it was perhaps the most joyful time. Even though the situation didn’t change, they were able to relax, saying, “You know what, we don’t like it but we’re going to do it.”

I just felt like that because that young lady was able to open up to me, she might have done it with someone else somewhere down the line but that particular night, when she needed a nurse, not to give her a shot, not to give her oxygen or anything else but to listen to her and allow her to express those innermost feeling that she needed to which then put her on the path towards the rest of her journey. I felt very privileged. It was a wonderful family to work with and it made me feel as though I did make a difference in their lives.

So that experience then carried on so that I had this burning desire to work with other families of children that were living with diabetes because it is a very pervasive condition. It affects the diet. It affects activity. It affects your freedom. It’s getting better and better as we increase the various types of insulin delivery but still it’s something that you always have to think about, you always have to plan for. So I had such respect for these families and such respect for the children that it just encouraged me to want to work with them and I have had the privilege of doing and talking with parents.

One thing I would like to add when I was doing some dissertation work is that when things that were doing well as far as they were able to keep their child’s hemoglobin A1C levels in normal range or very close to the target, those parents actually felt as so they receive less support from their healthcare providers who were like, “Oh, you’re doing a great job. You don’t need me, ha-ha-ha,” out the door they went. When in essence, those individuals because they were really shooting for these marks, ended up having very high levels of stress and perhaps really would have benefited from additional resources from – we’re talking more with the healthcare provider rather than getting an “Attaboy” and a pat on the back to say, “You’re doing a great job but how is this affecting your life?”

So everybody, regardless of how well or how they might need to improve or be more supported in their efforts of maintaining good diabetes management, everybody deserves that support and that extra look rather than just a pat on the back and saying, “See you in three months.” So that’s about it.

Jamie:                   You know, it’s funny that’s been my experience, I have a daughter with chronic illness and I have – when things are going great, I still need that support system to help us navigate and steer through what we’re dealing with as a family. And it is a family dealing with the illness. It’s not just the child although they have to plan for a lifetime with diabetes. The family itself is really greatly affected and goes through this disease to some extent themselves.

Lynda:                   Absolutely. And there are some children – I know of a child who was 18 months when he was diagnosed with diabetes. These parents have a lot of child care issues. They have to have people who are qualified to watch their child while they were trying to work. There’s issues with skipped schools.

Even though we feel like we’re in this 21^st century, we still have schools that are not prepared and, quite frankly, some don’t welcome students with type 1 diabetes or I would assume maybe other chronic conditions. But because it has something to do with blood. They won’t allow them to have their snack in the classroom because other children are having snacks. As strange as that might sound, that is the reality of what some of these families are dealing with.

So advocacy in every area of their lives but schools were a really big concern. When parents had a school that work with them, they felt like they were on cloud nine but other families that I talked to, they would move their child from one school to the next to the next in an effort to try to find somebody that would help them manage their child’s diabetes when they were in a school setting. So they really deserve a lot of respect and support. That for certain.

Jamie:                   And often they deal with a school nurse in these situations and we’ve interviewed them in the past here on the show talking to them about the various conditions they deal with diabetes being one of them. And just another point where nurses are really having an impact.

Lynda:                   Oh, absolutely. And most of the schools, the families were having concerns with, they had a school nurse but the school nurse would be in charge of 25 schools. So she wouldn’t be able to be there every day. And her workload was so heavy. If they had a school nurse, that would just really empower these families and the kids so that they don’t feel like they’re weird or different but they have a school nurse who’s supporting them, who’s there, who’s able to watch them, check their blood sugar, provide insulin if needed for the very young children that aren’t able to do that for themselves. So absolutely a school nurse.

I have high regard for school nurses and I believe that that is a pivotal place where we can make a difference for families and for kids that are wanting to stay healthy or that have a condition that requires a little assistance. So a big shout out to school nurses. Absolutely.

Jamie:                   Many of the diabetes educators are nurses, why is it that nurses are chosen for that task? Is there something about nursing that you think lends itself to educating about this type of illness?

Lynda:                   I think that nurses inherently have this ability to look at the big picture. With diabetes or any other condition where you’re doing the same thing over and over again, it can become task orientation. “Okay, well this is your blood sugar. This is what you need to do – blah, blah, blah.”

I believe that most nurses that I’ve worked with have the capacity to look at one of the psychosocial impacts that this has on this child and family. Whether the spiritual impacts this child and family might be experiencing as a result of their diagnosis and their chronic condition, what resources are available, what works, what doesn’t work. We recognized that families are also developing.

The concerns that parents might have as their family. The child diagnosed with diabetes might be a toddler or a very young preschooler, as that child grows, that family also grows and develops. We told them when the child was five it’s not going to be appropriate when the child is now 15 and say, “I want to do this on my own.” So knowing what we do about growth and development not only of human beings but of families that puts us in a position to say, “Okay, well, we need to rethink this. We need to relook at our plans.”

And even when the child is pulling back from parents, is that a bad thing? Developmentally, this is what we would anticipate. If we didn’t see that, we would be concerned. So it’s putting all of the pieces together rather than isolated events and being able to get a clear picture of what’s going on.

And I believe nurses are also excellent communicators. They listen well and they also can put things together so that they can communicate clearly. Getting clarification where they need to understand something better from a family member. They know the questions to ask to get the patients or the families to actually express what’s really going on. So I believe that that’s one of the strengths.

Nursing has a lot of strengths but I believe that that’s one of them. When I talk with my students, it is so much about communication. And 99% of an accurate diagnosis is from taking a great history and physical. So history is – we receive that when we’re communicating with our patients. So we want to really emphasize and applaud nurses that take the time to listen, to think and to get the big picture, and then communicate and facilitate parents and kids down the path that they have of managing their diabetes.

Jamie:                   I’m glad you mentioned your students because one of the things that I saw recently in the news mentioned the misunderstanding that much of the public has about that they might be experiencing condition of pre-diabetes, heading towards an adult diabetes, type 2 diabetes problem. And we see so many people developing diabetes that’s preventable. How does this change how we approach talking to our patients about their wellness in the future and we got new students coming out all the time? This is going to be one of the problems, the premiere issues they deal with in their nursing career moving forward.

Lynda:                   Well, that’s a great question. I just included that in a discussion that I have with some students the other day when we are talking about modifiable and non-modifiable factors in all of our lives. Things that we can’t change are our gender, our age, our genes that we’re born with. But the modifiable things that can be changed: our diet, habits, exercise, other lifestyle choices that we make whether it be smoking or drinking alcohol or taking other kinds of substances into our body or even where we live, our natural environment affects our health.

So with students, I try to encourage them to think about those things that the patient cannot change and those things that the patients can change and helping their patients to understand that they do have the ability to change. Find out what their thoughts are about why they’re continuing a certain lifestyle. If they actually are happy with their lifestyle and they have no desire to change, then supporting them, telling that there are things that they can do to improve their health but you will certainly not going to force anybody. That doesn’t work. But finding out what his thoughts are about it. What are their thoughts and feelings?

If someone will say, “Well, she’ll never change.” They’ll claim that over somebody and after a while you start to believe it. “I’ll never be healthy. I’ll never be the appropriate weight for my frame. My mother told me that for a number of years.” So we have to figure out what is it that people have heard. What is it they believe and if those things are not true, then we can say, “Well, wait a minute, I know that you’ve heard that all your life, but let’s stop and think about it. Have you tried this? What are your thoughts about this?” and providing them with examples or getting them in touch with peers that were in the same boat or something very similar to what they’re in and say, “Look, I was able to better understand. I’ll be able to break out of that mold.” Many times we believe what people have told us about ourselves.

I think one of the most important things that we can do is say, “Yes, but that’s what someone’s told you. What do you believe? What do you really think about? What is it that you really want? What did you imagine yourself being? Five years is going to go by, do you want to be different in five years? Maybe even one year. But start talking about five years. Start talking about ten years down the road. What are your goals and aspirations? If you don’t have a goal, you’ll never achieve it. So if we’re setting a goal, helping them to set up reasonable steps towards that goal, encouraging them that if you fall, you fall forward and you keep getting up, that everybody does. You keep getting up and you keep moving on.

But it’s important that there’s a lot of people in this world that are hopeless. They figured they’re situation will never change. They believe that. They’ve been told that. So I’m thinking if you been hoping to people, we’re not pushing ideals upon them but we’re giving them hope. That there are ways if they can change their lifestyle. That they can have improved health. That they can have better longevity. That they can have joy along the journey. That is powerful. That’s not a pie-in-the-sky.

There are things that we can do to help patients and families to receive hope. Looking at statistics or getting on the internet so, “Oh, boy, I’m in that category and I’ll never change.” That can be problematic. Information, if it’s not balanced with hope and with the human experience can be more damaging I believe than helpful. As much as we enjoy technology, we can use it and it’s great and wonderful. There’s nothing really in my estimation that can substitute for that human context, that human connection where we’re listening and communicating with other individuals and being patient with them and empowering them to be the very best that they can be.

Jamie:                   Well, Lynda, I want to thank you for taking some time and sharing with us. Before we wrap up and close out this interview, would you like to share a final thought about diabetes care for the nurses and students that are listening to this program perhaps? Because we’re all going to experience or come in contact with patients who are dealing with diabetes. The numbers point to the fact that we’re going to be hard-pressed to avoid handling a patient with the problem with diabetes. Is there some wisdom or some encouragement you’d like to offer to the nurses listening?

Lynda:                   First of all, for those that are already providing diabetes care, I applaud you. I thank you for the work that you’re doing. It’s worthy work. For those nurses or students that have yet to make a decision, I would encourage you to investigate, become connected with someone that has something to do with diabetes care because it is a very fulfilling position. You have the opportunity with [them] – as difficult as it is to do to have a chronic condition.

When you’re caring for someone with a chronic condition you have an opportunity to accompany them on a journey that they’re on. You see them grow and develop. It is a very gratifying experience and it makes a difference. It impacts these families. It encourages them. It helps them to be their own advocates which is what we want. And then we can encourage them to be advocates for other families.

I know of families that start their own peer support groups because they know that they needed it so badly, they needed to be connected with someone and they have helped other families. This child has been diagnosed for five years, they’re connected with someone who is newly diagnosed when their child was about the same age. That connection, it’s what we’re made to do as human beings. It’s to reach out and to assist one another in a powerful and meaningful way. So I just applaud all nurses and all healthcare providers that have anything to do with assisting children and families and adults with type 1 diabetes.

Jamie:                   Lynda, thank you very much for coming on Nursing Notes Live and sharing a little bit of your nursing story with us. It’s encouraging to hear how passionate you are about the care you provide for your patients.

Lynda:                   Well, thank you.

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Don’t forget to check out the March 2013 issue of Nursing Notes, highlighting the work of nurses in caring for and educating people with diabetes. You can read the entire issue online at www.discovernursing.com and don’t miss the other Nursing Notes Live episode this month featuring a panel of nurse leaders involved with diabetes care sharing their insights into the challenges facing us from this worldwide epidemic. You’ll find this and other podcast episodes at the Nursing Notes by Johnson & Johnson Facebook page, and in the podcast area in iTunes.

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The latest nursing news and information brought to you by the Johnson & Johnson Campaign for Nursing’s Future – This is Nursing Notes Live.

Nursing Notes Live is an audio extension of the national award-winning monthly e-newsletter, Nursing Notes – which offers the latest industry news, trends and updates in nursing. You can subscribe to the e-newsletter at www.discovernursing.com. Each month’s Nursing Notes issue will be accompanied by a couple of episodes of Nursing Notes Live, which will expand on the content and provide you greater insights into the topics presented in the e-newsletter. You can listen to previous podcasts on the Nursing Notes by Johnson & Johnson Facebook page or NursingNotesLive.com; or visit iTunes to subscribe to the podcast!

The Campaign also encourages you to check out the recently launched Short Takes: Narratives by Nurses video series! A group of nurses and one nursing student – people just like you – each filmed their very own videos, where they share their thoughts on their nursing careers. To watch the videos, visit the YouTube section of the Nursing Notes by Johnson & Johnson Facebook page or www.youtube.com/JNJHealth.

I’m your host, Jamie Davis.

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Jamie: I’m here with Lynn Erdman, our Get-to-Know Nurse this month and, Lynn, thank you so much for being on Nursing Notes Live.

Lynn Erdman: Well, thank you for inviting me.

Jamie: So why don’t you take a few minutes and tell us, first of all, what encouraged you to become a nurse?

Lynn Erdman: My encouragement started during my college years. I actually served as an intern at a local hospital and wasn’t really sure what I wanted to do. I thought I would enjoy the health field like the sciences and my college education. By doing that, ended up working as a nursing aide or nursing assistant and really, really enjoyed and was in awe of what the nurses did with patients on the floor and how they interacted. That’s really what piqued my interest and caused me really to move in that direction.

Jamie: So where did you go to nursing school? Did you start off in a diploma program or did you move right in to a BSN program?

Lynn Erdman: I was in a BSN program. The first two years, obviously, I was looking – “What do I wish to do?” And so the way it was set up is the – you apply during your second year, your sophomore year, to be in the BSN program starting in your junior year. So that’s what I did. Taking all the preparatory courses. So I finished with a BSN the first time out.

Jamie: And then after you got your nursing degree and passed your boards, what was your career path from then on out? I know you’re an oncology nurse by profession now but did you start out in oncology care?

Lynn Erdman: I did not. I thought I wanted to be a NICU nurse or a Neonatal Intensive Care nurse and started in that area with working on the night shift as many young nurses do and actually really liked working with the small babies and working with their parents. But about six months into my stint there in the Neonatal Intensive Care Unit, I got a call from the chief nursing officer, the Director of Nursing there at the large hospital where I was working and got a call to her office and I thought, “What have I done wrong?” As a novice nurse I thought it has to be – it can’t be something good.

But anyway I showed up in her office and she said, “I’m getting ready to start an Adult Oncology Unit at the hospital and I need a few energetic bright young nurses to help me start that area because there’s a lot of learning to do. If you will go work on that unit for six months, then you can choose anywhere in the hospital and any shift you wish to work. So being the young, naïve nurse that I was I thought, “Well, I can do anything for six months.” So I actually took the offer. I always credit her believing that she was wiser than I was and thought that I would have a passion for that area. I never looked back and I have continued in oncology since that time. So it’s been an amazing career and I really thank her for seeing the path more clearly than I could at that point in time.

Jamie: It’s amazing how the nursing leaders in our lives have really influenced our paths and that wisdom become so important as we look back and see where we are today.

Lynn Erdman: Oh, it is. It is. And I’m so grateful for them and try to share some of what I learned from many mentors in my life with the nurses that I encounter. Anytime a nurse calls me and says, “Can I come and spend some time with you? I want to see what it is you do.” That’s been in varying parts of my career. I’m always eager to say, “Oh, yes, absolutely. Come spend some time with me and let’s talk and let’s look at what options might be out there for you and how you could even grow what it is that you’re doing.”

Jamie: Now we talked before we got started recording that this month we’re focusing on Philanthropy and Nurse Volunteerism. I know that you became very active through, I guess, your processes as oncology nurse and learning about these things. There are a lot of opportunities for volunteering associated with fund-raising for cancer projects and things. Tell us a little bit about how you got steered in that direction.

Lynn Erdman: Sure. I was fortunate enough to be the founding director of Presbyterian Cancer Center in Charlotte, North Carolina. I was one of the first nurses in the country that had ever been given the opportunity to create a cancer center from the ground up. So that started me looking outside the walls of the hospital to see what organizations could we tap into and could we utilize or what volunteer groups could we utilize to help us not only in the fundraising and building that cancer center but also in putting the pieces together from everything from psychosocial support for the patient to support for the family and everything in-between.

So as I started reaching out, I realized that not only where there lots of groups willing to help but there were lots of places I could make a difference as well. And so that really started early on my volunteer opportunities. And so I volunteered with numerous organizations: the American Cancer Society, Leukemia and Lymphoma Society, the American Lung Association – just numerous different organizations that were related to cancer. I also found out that there were lots of opportunities that nurses really had not taken a role in with many of those. I was able to move in and actually encourage other nurses to come onboard and volunteer for many of the organizations.

I then ended up being able to, in a volunteer role, serve on many of the boards at the national level including the Oncology Nursing Society but also many cancer-related boards such as the American Cancer Society and the Association of Community Cancer Centers and that type of thing. And as I was doing a lot of that. Again, I did not see a lot of nurses in those same role so began encouraging nurses to put their toe in the water and really volunteer and then step up and offer to be on committees and to take positions that needed leadership in a particular way that nurses really could fill that niche.

Jamie: What is it about nurses that makes it vital for them to become involved at these organizational levels rather than just as an individual volunteer

Lynn Erdman: I think it’s our desire to give back or certainly that was the crux for me developing that interest. I certainly think nursing has a huge component of that giving back and wanting to help others as part of the make-up of what a nurse really is. This enabled me to take that beyond the nursing profession and out into the community as well.

Jamie: And it has given you opportunities to advance professionally because you are now the vice-president of Community Health for the Susan G. Komen Global headquarters. Tell us a little bit about how you led in that direction.

Lynn Erdman: Certainly. Well, I worked in a hospital setting and I work as a clinical nurse specialist and then as a hospital administrator and a hospital senior-level vice-president but then during my volunteer work with, actually, several organizations, I was recruited to the American Cancer Society about seven years ago and to actually start a new position that they had created there. And so I went to the American Cancer Society first and was able to use lots of my skill sets and a broader population of patients.

So that really intrigued what I was doing and then was recruited about – within the last, a little over a year, to Susan G. Komen. What that’s allowed me to do is really take my interests in working with women with cancer and really specialize and hone my skills and my expertise in the area of breast cancer in particular. So allowing me to work at Susan G. Komen, I get to oversee all of our community grants that are given out and around the country. So those are the grants that impact patients directly.

We have about 2,000 of them that are given out and it’s close to $100 million. So to be able to have a nursing impact on that and therefore a patient impact has really been one of the greatest gift that I’ve been given. It’s remarkable to see the difference that we’re able to make from a particular standpoint of being in a voluntary organization that has large-scale impact not only in this country but really around the world.

Jamie: And you really even though you’ve moved away from bedside direct care, you still have a very real impact on patient outcomes.

Lynn Erdman: Correct. I do. I have a measurable input and outcome for what happen to patients because everything is measured and evidence-based and that makes me truly excited. But the other thing that is extremely interesting within this is I’m also responsible for all the educational materials that are created at Susan G. Komen as well as our Breast Helpline. So if patients call in to our helpline, if there are really challenging situations on the other end of the phone, a lot of times I’ll get call. We talk to this patient and I have to admit that brightens my day every time that happens. And it happens pretty routinely and I love the connection with tying in with the patient and just helping them in a crisis situation really think through what their options are. Not telling them what to do but really helping them realize they’re in control of what happens and here are several things that they can think through and ask their physician or their nurse practitioner or whoever maybe caring for them as they go back. So it’s helping put them in the driver’s seat and I like that aspect of it too.

Jamie: Yes, still applying these core tenets of basic nursing care even in a tele-health setting like that. It must be very gratifying.

Lynn Erdman: Correct. It is extremely gratifying.

Jamie: So tell us a little bit about how you see nurses in the future becoming more involved as more volunteer opportunities present themselves. I see nurses involved in everything from their local churches as parish nurses volunteering their time with their communities there. All the way up through organizing large fundraising efforts for things like Susan G. Komen. What is it that you see are opportunities that nurses should be on the lookout for moving forward?

Lynn Erdman: I think that our healthcare system is going to be burgeoning in the future. We know that baby boomers are certainly hitting that age when indeed not only are they aging but more diseases are going to hit that population. And I’m not sure we’re even going to have enough of a healthcare system, nurses included, to be able to take care of what’s getting ready to be kind of avalanche in healthcare in the next 20 to 25 years.

And so what I see is nurses have a real opportunity to help not only volunteer in certain areas that are needed within the community but even creating new opportunities for volunteerism that might be needed, that nobody can see yet. But the nurse that’s at the bedside or that’s in the healthcare clinic sees with her lens or his lens – “Oh, my goodness, I can see the train wreck ahead of us.” And if we start this now in the community, then we’ll be prepared by the time it hits. So I think that nurses have a unique ability to see what’s happening often before others do because of the place and the role they hold in healthcare. So if they use that to the proper ability, then we can help make a change for what’s happening in this country going forward.

Jamie: As we wrap up here, Lynn, just tell us a little bit about what you’d like your volunteer efforts to leave as a legacy. Because volunteerism often is about going above and beyond and doing that little bit extra. Do you see yourself as leaving that kind of footsteps behind you that others can follow in?

Lynn Erdman: I would love to leave footsteps that others can follow in. I think that would be a great, indeed, a great legacy and I do think that nurses have the ability to do that whether you do it outside of your time that you are working or whether it’s part of even the philanthropy work that you do for your profession. You have the opportunity to do that. And, yes, I think that creating something that truly allows us in the volunteer area to be not only evidence-based which is a new world for the volunteer community but also have the ability to track and trend what is done so that we know the impact that’s being made also makes a huge difference.

I encourage nurses to volunteer any and everywhere they can whether it’s their church or – I’m a volunteer at my church as the nurse once a month. So I run kind of health/sick room and that’s a simple way to give back. But then I also volunteer with the Charlotte Rescue Mission in Charlotte, North Carolina that helps both men and women get a new start in life when they’ve had problems with drug and alcohol abuse which is totally outside of the realm of oncology but it’s an incredible way to be able to give back and to make an impact in people’s lives that are truly struggling and also use our healthcare system as well.

Jamie: So really volunteering can even be an opportunity for you to explore other passions in nursing and healthcare.

Lynn Erdman: Actually, it can, and it may turn nurses on to something that they didn’t realize they had a passion for or even a skill set for. I have found that everything that I have done in my volunteer career throughout my professional career has led to opportunities for me to grow in certain areas and to add new skills and to really quench that hunger and thirst for learning that I think all nurses share.

Jamie: Well, Lynn, I want to thank you again for taking these few minutes to sit down with me and talk about your experiences as a volunteer and share those experiences with our audience here on Nursing Notes Live.

Lynn Erdman: You are very welcome and I certainly wish you the best and thank you for having me as a guest.

Podcast: Play in new window | Download

Nursing Notes Live is an audio extension of the national award-winning monthly e-newsletter, Nursing Notes – which offers the latest industry news, trends and updates in nursing. You can subscribe to the e-newsletter at www.discovernursing.com. Each month’s Nursing Notes issue will be accompanied by a couple of episodes of Nursing Notes Live, which will expand on the content and provide you greater insights into the topics presented in the e-newsletter. You can listen to previous podcasts on the Nursing Notes by Johnson & Johnson Facebook page or NursingNotesLive.com; or visit iTunes to subscribe to the podcast! Student nurses – now you too can submit your photo to be included in the Campaign’s Portrait of Thanks Mosaic Project! For every photo uploaded by February 1, 2012, the Campaign will donate one dollar to the Foundation of the National Student Nurses Association to help fund nursing student scholarships. Submit your photo today at www.campaignfornursing.com/portraitofthanks.

The Campaign also encourages you to check out the recently launched Short Takes: Narratives by Nurses video series! A group of nurses and one nursing student – people just like you – each filmed their very own videos, where they share their thoughts on their nursing careers. To watch the videos, visit the YouTube section of the Nursing Notes by Johnson & Johnson Facebook page or www.youtube.com/JNJHealth. And congratulations to the Campaign’s Amazing Nurses contest winner Lillian Shockney! Find out more about Lillian and the contest finalists at the Nursing Notes by Johnson & Johnson Facebook page.

I’m your host, Jamie Davis.

This month’s featured “Get to Know Nurse” is Lillian Shockney, winner of the 2011 Amazing Nurses contest and Administrative Director, Johns Hopkins Breast Clinical Program. Lillie expressed her excitement of being named the 2011 Amazing Nurse and also talked about the importance of finding ways to expand beyond the basic nursing job description.

Don’t forget to check out the entire December 2011 issue of Nursing Notes, featuring inspirational stories about nurses like you giving back to patients and their communities. You can read the entire issue online at www.discovernursing.com and don’t miss this month’s other episode featuring a look back at highlights of some of the great nursing discussions we had this year on Nursing Notes Live. You’ll find this and other podcast episodes at www.NursingNotesLive.com, the Nursing Notes by Johnson & Johnson Facebook page, and in the podcast area in iTunes.

Podcast: Play in new window | Download

Nursing Notes Live is an audio extension of the national award-winning monthly e-newsletter, Nursing Notes – which offers the latest industry news, trends and updates in nursing. You can subscribe to the e-newsletter at www.discovernursing.com. Each month’s Nursing Notes issue will be accompanied by a couple of episodes of Nursing Notes Live, which will expand on the content and provide you greater insights into the topics presented in the e-newsletter. You can listen to previous podcasts on the Nursing Notes by Johnson & Johnson Facebook page or NursingNotesLive.com; or visit iTunes to subscribe to the podcast!

Be sure to check out the Campaign’s recently launched Short Takes: Narratives by Nurses video series at the Nursing Notes by Johnson & Johnson Facebook page or www.youtube.com/JNJHealth! A group of nurses and one nursing student – people just like you – each filmed their very own videos, where they share their thoughts on their nursing careers. The Campaign also encourages you to upload your photo for the Portrait of Thanks Mosaic Project. For every photo of a nurse uploaded between now and February 1, 2012, the Campaign will donate one dollar to the Foundation of the National Student Nurses Association to help fund nursing student scholarships. Submit your photo today at www.campaignfornursing.com/portraitofthanks. And check out the five finalists of the Amazing Nurses Contest at the Nursing Notes by Johnson & Johnson Facebook page!  The Grand Prize Winner will be announced during the CNN Heroes: All-Star Tribute Show on December 11.

I’m your host, Jamie Davis.

This month we kick off our second season of Nursing Notes Live with a look into the lives and careers of medical-surgical nurses. This month’s featured “Get to Know Nurse” is Kelly Hyde, a certified med-surg nurse at Oregon Health and Science University medical center. I got the chance recently to chat with Kelly about how she got started in her nursing career.

INTERVIEW

Jamie:                         Kelly, welcome to Nursing Notes Live. First off, I’d like to ask our Get-to-Know nurses what drew them to nursing. Why did you become a nurse, Kelly?

Kelly:                          Well, I was a civil engineer for about twelve years and really enjoyed that profession as I was kind of engineering storm water and drinking water systems to promote public health. But I really wanted to kind of pull back from that and do something that it was a lot more personable, working more closely with people and their lives and their individual stories. So I decided to go into nursing to kind of implement my critical thinking skills and those sorts of things with a more tangible effect, really, one-on-one.

Jamie:                         So you really were doing something that was really a public health role but not necessarily a healthcare role but just something that was affecting public health. That’s interesting. Had you known someone else that was a nurse or was this just something that just intrigued you when you moved into it?

Kelly:                          Actually, I kind of grew up in a healthcare-related family. My mom and my grandmother are both nurses. My father is a hospital administrator. So I kind of grew up hearing about healthcare around the dinner table kind of thing. It was something I was always exposed to growing up. Yes.

Jamie:                         Kind of the insider’s view you have with the administrator and everything else. That’s interesting. What drew you into Med-Surg nursing?  A lot of nurses traditionally start in Med-Surg and then move into other specialties. But Med-Surg is a specialty unto itself, what kept you there?

Kelly:                          As a student nurse, actually, I did most of my clinical nursing in Med-Surg and I guess I just got lucky as I enjoyed my clinical placement so much that I decided to go with that as my specialty. I work on a surgical specialty floor for gastrointestinal surgeries and I’ve always been fascinated with the GI system and wound care. The unit that I landed on happened to be really doing some interesting in-depth kind of on the front end of things work with wound care and GI specialties. I just really enjoyed. I thought it was fascinating and decided to stay there. So that’s where I’ve been ever since I was a student.

Jamie:                         I hear that time and again from nurses who say there was a section or a segment of their clinical rotations in nursing school that resonated with them and that’s what got them into a specific specialty. I use that as a way to say, “Look, keep your mind open because you just know what area of your clinical might click with you.” Certainly, it seems like Med-Surg and, specifically, surgical and GI seemed to really click with you. What is it about wound care? Certainly we’re seeing a lot of more wound care issues with a lot of patients. Is there something in particular that you really enjoy?

Kelly:                          Well, I think there’s a lot of dynamics behind and around the wound care that are fascinating about how the wound came to be and how you get it to heal in terms of looking not just the wound itself but other things that are going on with the patient. Whether it’s pain or whether it’s diabetes like blood sugar control or nutrition or just kind of a multi-dynamic system that goes into healing wounds. There’s also a lot of technology involved. You have your basic dressing changes but you’ve also got Wound Vac therapy as well. So there’s a lot of different ways to treat and manage wound. I think it’s just the on-going and ever-evolving kind of subspecialty of Med-Surg nursing.

Jamie:                         What do you see the future in that role for nurses? I just read an article recently that talked about nurses fulfilling more and more roles as there are gaps in where physicians are covering parts of healthcare. Do you see nurses having a more active role in wound care as a primary care resource for that?

Kelly:                          I think so. I think not only in wound care but a lot of different elements within the healthcare field. I think that the notion like the definition of what it means to be a med-surg nurse is expanding because of budget cuts, because of nurses taking over almost more of practitioner roles. So you’re looking at more issues about like chronic illness, diabetes, pain management, even psych issues, and all of those come up so frequently in our med-surg patients that maybe prior in history may have been a little bit less complex. So there’s a lot more factors weighing in to how you practice nursing on a day-to-day basis.

Jamie:                         You have that civil engineering background. Do you bring some of that to your nursing practice? Is there something that you – as you look in how you practice nursing, you say, “Wow, this is a skill I picked up as a civil engineer that I’m transferring into nursing care.”

Kelly:                          Yes. Actually, I do. It’s funny because, as a civil engineer, I did a lot of project management, a lot of multi-tasking and managing various projects that varied in complexity. Each project have their own unique issues and I kind of mirror that, reflect that over to having a certain patient load and having to critically think for patients and advocate for them and work with their families just as I would have worked with contractors or other consultants kind of thing. So there are some parallels – sort of a stretch but in my mind it was sort of a good phase as I go lead in to nursing for me, so, yes.

Jamie:                         It makes perfect sense to me. There are many stakeholders in any public works project and there are certainly many stakeholders in the care of patients both from the healthcare side of things with our collaborative care approach that we’re seeing more and more but also in the patient themselves – their patients, their family members, the caregivers, the visitors, and just the dynamics of sending someone home. We were sending sicker patients home than we did ten or fifteen years ago because they don’t stay in the hospital as long. So you need to involve so many more people.

Kelly:                          Yes. [It’s] becoming a very multi-disciplinary approach to patient care – a lot of different players in the hospital that are involved in getting a patient ready to go home or on to their next level of care so, yes.

Jamie:                         What do you see as one of the biggest challenges facing medical-surgical nurses? I know there are sub-specialties in there but it is, I think, one of the largest areas of nursing care as a whole. What most people that are not around the healthcare setting all the time think of, when they think of nurses in the hospital, they think of med-surg nurse. So there’s a lot of history and maybe a lot of stereotypes that go along with that. There’s a bright future here. Certainly, it’s going to be a very busy field but are there some specific challenges that you’re looking at that may be coming down the road that you are paying attention to?

Kelly:                          I think there are a couple of issues that come to my mind. (1) You sort of touched on that, is that sort of the image of nursing. I think it’s something that a challenge and something that’s exciting at the same time. I think that nurses are kind of redefining themselves in their profession and their practice. They are becoming more leadership-oriented, more science-based than I think that they were in the past and so that they’re redefining what it means to be a professional nurse and defining their practice. So I think that’s kind of something that’s starting to evolve and it is becoming bigger, which is very exciting. And I also see issues coming down the road with healthcare reform and affecting a lot of what we do at the bedside in terms of promoting public health and nutrition and trying to get people off on the right foot so that they can be advocates for themselves out there in the world where healthcare and exposures to healthcare is limited. And I also see technology will have a big impact on nurses in the future too. Technology is always constantly changing with medical records, imaging, and even some kind of point-of-care bedside technology that’s coming up on the forefront. So you have to keep up with stuff all the time. [Laughter] So not only for med-surg nurses but I think all nursing specialties have to face all these issues.

Jamie:                         There’s a lot of things going on that have to do with, like you said, healthcare reform and the fact that the way that reimbursement occurs for patient care especially in things like med-surg where you are sending patients home and they can’t be readmitted for the same problem or the reimbursement for hospital-acquired problems. Certainly it’s going to change our focus and we’ve always – I think, nurses have always been at the forefront of improving patient conditions and stopping healthcare infections. That’s the basis of Florence Nightingale’s early work. There’s a problem there as well because I see a lot of nurses having less and less bedside time with their patients or at least saying they’re having less and less bedside time with their patients and we want to send these patients with more information and yet we’re also asking them to spend – the nurses to spend more time with them to do that and yet they don’t have the time to spend is what I’m trying to say. Do you see that as well or do you think that this is something that will get resolved through technology or through other educational resources?

Kelly:                          I would love to think that technology would make it easier but sometimes I think it adds more time than taking away from patients unfortunately. But there’s – it’s kind of an interesting question because I’m involved in a leadership project where I work here at OSHU. It’s based off the National Health Service out of the UK. It’s a product called “Productive Ward: Releasing Time To Care.” It’s a program that’s the staff-led initiative within a hospital to enable the nurse to spend more time at the bedside with patients and the program allows you to do that by streamlining workflow processes and reducing steps that it takes to get from A to B, streamlining procedures and equipment rooms and those kind of things. So I see those kind of initiatives sort of trickling into hospitals perhaps to try to meet that gap between healthcare reform and still wanting to provide good safe patient care to get us back to the bedside where we all want be truly.

Jamie:                         What about mobile devices? I really – of course, I’m a technology guy, it’s based upon what kind of work I do in nursing but I see a lot of possibilities from mobile devices like tablets – like the iPad – or the mobile phones and devices. I have to think – and this, of course, is something that I didn’t get the chance to do when I was in nursing school a few years back. But it seems to me that there’s an opportunity for the nurse to carry every chart in their pocket and not necessarily have to go back out to the station and do your charting like we do now or like I did in the past. Do you see that? I could see that being a really great tool to enable the nurse to spend more time in the room with the patient, just having that one-on-one time.

Kelly:                          I absolutely agree. I think that would be great. I think that, in that respect, technology has something to perhaps offer us to get us back to the bedside. Yes, definitely. Something more integrated so that you’re not having to waste time, like you said, going back to the nursing station to log in to the computer, checking on something that you can sort of have the information that you need at your fingertips to use it immediately when you need it. Yes, that will be great.

Jamie:                         Yes. We’ll have to just keep pushing for that. I think med-surg nurses really uniquely – because there are just so many med-surg nurses that seemed to be the one of the primary nursing specialties in numbers. I could see those nurses really being at the forefront of saying, “This innovation is needed.” Hopefully, that will continue to change.

Kelly:                          Yes, I agree.

Jamie:                         Talking about public health earlier and some of the things you were looking at in your engineering career. But certainly there’s a need to really focus on public health ever more as a nurse now. We’re sending these patients home faster. We need to really bring that holistic nursing view that we are supposed to have all the time. But I think we’re really focusing in on all of these different aspects because there’s so many things about patients now, all the co-morbid factors, that we are sending patients home that have all these chronic illnesses and they also have surgical problems, wounds that are still in the mode healing, so they are at risk for infection because of decreased blood flow from diabetes or obesity or whatever. The med-surg nurses pay attention to all of that.

Kelly:                          Yes. You’re absolutely [true]. There are so many factors that you have to look at before you send the patient out the door and along with that is assessing their level of education and their understanding of how much – you can teach them but you have to really assess how much they’re actually absorbing and that they have the resources to implement when they do go home. And it might, I guess, cause a resurgence in home health too to also bridge that gap to give patients a lot more support when they go home. So it seems like we kind of send people out the door and expect the best and then we seemed to be surprise when they are coming back through our doors as well – “We told you what to do. Why didn’t you do it?” So I think there are a lot of strides to gain in patient education and follow through when people go home and how to give them more support when they’re in their home environment.

Jamie:                         I see a lot of studies that I’ve seen over the last few years looking at this tele-nursing aspect of discharge patient care. The research that seems to point to the fact that just having a phone call a day or so after discharge and talking with the patient and the caregivers has a great positive effect on outcomes and on readmissions. Because, first of all, I think, we forget we’ve all been patients or had family members that have been patients before too and we all know how hard it is to pay attention to all those details and all those instructions right before you’re thinking about – “All right, I got to go get the car in the parking lot. I got to have money because I got to pay the parking garage.” All these little details that are going through your brain and the nurses talking to you about, “When you get home, do this. You need to go to the pharmacy and do this.” It’s no wonder that more patients still come back.

Kelly:                          Right. It’s just overwhelming. Definitely.

Jamie:                         It’s great to hear that you are proactive about assessing your patient’s understanding of things. That’s one of my pet peeves when I look at nurses in handling discharge and I know everyone’s busy but we’ve all seen that situation where – “Here’s your discharge instructions. It’s all written down write here. Sign here and we’ll get you on your way. I’m going to call transport.” And that’s discharge. [Laughter]

Kelly:              Right. That’s not quite discharge.

Jamie:                         Well, that’s what passes for discharge in some places and it’s so frustrating because it doesn’t take that long to just take a few extra minutes and make sure the patient education is there.

Kelly:                          And so many patients are going home with a new list of medications they’ve never seen before. They don’t know what they’re for. They don’t know what side-effects are going to happen. They don’t know how to take them safely. There’s so much education to go home not only for self-care but for medication education as well.

Jamie:                         It sounds like you’ve been doing the right things. Now OHSU stands for?

Kelly:                          Oregon Health and Science University.

Jamie:                         Yes. It looks like a great program. I was checking out their website here before we got on the call and they seem like that’s a great program. You got your BSN there and you continue to work there. It’s fascinating to see all these great organizations for healthcare around the country and some of the initiatives they’re involved with. I love the project you’re working on that’s trying to model some of the things that the NHS is doing over in the UK.

Kelly:                          Yes. It’s fascinating to be part of that project. I believe that Oregon is one of the first state to implement that project and hopefully if it’s successful it will spread throughout the country. It would be a good avenue for increasing the patient care and increasing the job satisfaction that nurses have in general. It will be great.

Jamie:                         Kelly, I want to thank you for taking a moment to catch up with us. I know we kind of put this interview together on-the-fly in just a few days and I really appreciate you’re clearing up sometime to speak with the Nursing Notes Live audience and to share with them. Could you just maybe leave us with a final thought for that nursing student or that person thinking about a nursing career that is saying, “I might be interested in the nursing career as a med-surg nurse.” Would you like to share some thoughts on what they might want to pay attention to or things they might want to think about as they go through school?

Kelly:                          Yes, absolutely. I would encourage nursing students out there to at least do one clinical rotation in med-surg nursing even if it’s something you think you might not want to do because you may be surprised by what you come across. I think it’s a great arena to not only learn a lot of great bedside skills and to learn how to work in a multi-disciplinary setting but you are – I think you get a unique opportunity to become a really strong patient advocate that you might not get in another setting because of all of the on-going multi-sectorial issues that are going on with your patients. I would just really highly recommend someone to just check it out because I think there’s a lot under the surface that might not be immediately apparent that can offer a lot of opportunities for growth and leadership and experience and just be a great growth opportunity for anyone interested. I guess it kind of an honor to be a med-surg bedside nurse and be such a strong advocate for your patients and just see people go through their experience in the hospital and walk to that experience with them, be their advocate, be their educator, be a listener, just to encourage them and see their progress and kind of hopefully send them out the door with a new start on life and to have watched that patient go through that journey is humbling and inspiring and I think that a lot of people should just try to see if that’s a good fit for them especially when they’re in the nursing school.

END INTERVIEW

Don’t forget to check out the entire November 2011 issue of Nursing Notes, featuring med-surg nursing careers. This month’s Nursing Notes newsletter highlights the growing recognition of the med-surg specialty, the necessary skills of a med-surg nurse and provides information on nursing scholarship opportunities. You can read the entire issue online at www.discovernursing.com and don’t miss the other Nursing Notes Live episode this month featuring a panel of med-surg nurse leaders and their insights into this nursing specialty. You’ll find this and other podcast episodes at www.NursingNotesLive.com, the Nursing Notes by Johnson & Johnson Facebook page, and in the podcast area in iTunes.