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The art and science of NURSING
Compassion and knowledge work hand in hand when it comes to providing care to patients
Most nurses don't think of nursing as a job. They consider it a calling.
"Nursing has to be your passion. You have to have a desire to develop a rapport with your patients and families as you care for them, to become a part of the healing," said Gabrielle Clouser , a certified pediatric nurse at Children's Healthcare of Atlanta.
After years of management and teaching, she took a job on a surgical floor at Children's at Scottish Rite. She has commuted 110 miles each way for 16 years because she wants to work at the bedside.
"This career can push you to the limits sometimes, but I love the challenge. I really enjoy being able to go home and say I made a difference," Clouser said.
She's seen enormous changes since she began nursing.
"We had no computers. We mixed our own medications and used glass syringes," she said. "When a baby was born at 28 weeks, we wrapped it in a blanket and let the parents hold it until it died. Now we're saving newborns at 22 to 23 weeks," she said.
Expectations have gone up as medicine has advanced, and so has the level of education for nurses. Clouser says working in the intensive care unit is a constant learning experience, but her greatest satisfaction comes from knowing that her skills and compassion are helping a family through a crisis.
"Nursing is about human connections. At the beginning and end there always has to be caring," said Marla Salmon , dean of the 100-year-old Nell Hodgson Woodruff School of Nursing at Emory University. "Nursing practice is undergirded by knowledge, skills and science, but when a nurse evaluates a patient with his or her physical, cognitive, spiritual and emotional needs in mind, she's making sure the person survives, not just the patient. That's what makes it nursing."
If it takes passion to become a nurse, it takes critical thinking and self-development to survive in the career, Salmon said. Nurses must continuously assess, analyze, prioritize and solve problems for their patients. They're also continuously learning new and better ways to deliver care based on new research and technology.
"Nurses work autonomously and collaboratively with other health care professionals. They're not just following doctor's orders. They have to think and be knowledgeable," said Julie Schneider , nurse manager in the neuro-intensive care unit at Emory University Hospital.
"We're the ones taking care of patients 24/7 and looking out for their best interests," Schneider added. "Physicians rely on us for our vigilance and our constant awareness of changes in conditions. They know we're fighting for the best outcomes, and they rely on our insight, knowledge and skills."
'The path to wellness'
St. Joseph's Hospital in Atlanta has the 12th-largest cardiac program in the United States and performs 1,500 open-heart surgeries a year. While it's an everyday event for the nurses, open-heart surgery is a profound experience for patients.
"It's integral to win their trust if you're going to help them get better," said Tina Taylor , staff nurse in the hospital's cardiovascular intensive care unit. "The doctor releases them to our responsibility and it's up to us to put them on the path to wellness."
Today's hospitals are challenging places to work because the acuity level of patients is so much higher than in the past.
"We're seeing patients now who, five to 10 years ago, would not have been saved," Schneider said. "Emory is a referral hospital for the Southeast, so when patients come to us it's a full-court press and we're pulling out all our resources.
"People come in with multiple organ failures and brain injuries, and we have the treatments to turn them around with vigilance and care. We hear about them walking in rehab later and I'm always amazed."
Nurses see miracles happen every day, thanks to technology, education and perseverance.
"When used right, technology supports nursing, extends their reach and frees up time for healing, but nursing research is showing that the healing touch -- what some might call being kind -- has important, positive benefits, and we shouldn't let that fall by the wayside," Salmon said.
"Our job is to enhance life as long as God gives it," said Carol "Zoe" Klingler, a nurse with Hospice Atlanta, a division of Visiting Nurse Health System. "We do nothing to hasten or postpone death, but when a disease can't be cured and someone needs comfort or palliative care, that's when we do our best work."
When Klingler learned about hospice nursing she knew she would be able to give others the support she'd wished she had when her father died. She started working in a pilot program in 1983."You're lucky in life to find the job that gives you energy, the thing you were made to do. I love this job too much not to do it," Klingler said.
A wide-open field
Nursing is the nation's largest health care field, with about 2.7 million registered professionals. They are the primary providers of hospital patient care and deliver most of the nation's long-term care, but nursing has moved far beyond the bedside.
"Nurses can do all sorts of amazing things," said Mark Simmerman, a nurse working jointly for the Centers for Disease Control and Prevention and World Health Organization to research and contain avian flu in Vietnam. "They learn core competencies and skills and can transfer them to a wide variety of opportunities."
The variety of nursing jobs available give those in the profession plenty of options when choosing a career path.
"Nursing is exciting, because no matter what area you're working in, if you're dissatisfied, you can do something else. There are options out there," Clouser said.
Nurses manage hospitals, set public health care policy for state and local agencies, and run wellness, education and rehab programs. They work in law firms as legal nurse consultants.
Advanced practice nurses (nurse practitioners, nurse midwives, clinical nurse specialists) are the primary health care providers in many clinics and work in a variety of specialties.
Nurse researchers are advancing the knowledge of diseases and treatments, while nurse anesthetists administer more than 65 percent of all anesthetics to patients each year. New fields include forensic and space nursing.
"A degree in nursing can open so many doors," Schneider said.
Many people don't realize the scope of opportunities, because too often nursing is thought about in terms of "absence," Salmon said. There is a critical shortage of nurses, which is worsening as baby boomers age and people live longer.
"If we think we need nurses now, it's nothing like what we're going to need in the future. Almost 60 percent of people who need care in their homes don't have a professional to help them," Salmon said.
According to the U.S. Department of Labor, the shortfall of nurses will reach 1 million within six years. Compounding the issue is a shortage of nursing faculty and education facilities.
While fast-track programs, training partnerships between colleges and hospitals, and the Johnson & Johnson nursing campaign have raised awareness and recruited more nurses into the field, many more will be needed.
"This is society's issue. Nursing scholarships were 14 times greater in the late '70s than the '90s, and the commitment to build nursing schools was seven times higher," Salmon said. "It's going to take public awareness and an enormous investment to solve the problem, but nursing is a public good. It's a resource for all of us that we're all going to need."
For Salmon, the career has allowed her to be true to herself professionally and personally. Nursing lets people find their strengths and their passion, she said, "whether it's high-tech or high-touch -- the menu's out there."
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