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This guest post was written by Karen Hardin, MSN, RN, NE-BC, CNE, the director of the bachelor of science in nursing programs at Marian University, Indianapolis, IN. In 2012 she attended Telling Stories, Discovering Voice: A Writing Weekend for Nurses, offered by the CHMP’s program in Narrative Writing for Health Care Professionals

Forty years ago this summer I graduated from a diploma nursing program at a large city hospital. I agreed to stay on as a nurse and was assigned to the female surgical unit. I was pulled, on my first day, to the male unit across the hall, which became my home for the next three years. I progressed from new graduate to charge nurse to head nurse within a year. Now, that hospital is moving to a state-of-the art facility, and that move, along with my 40th anniversary, have put me in mind of 1973, a year of many firsts for me: first job, first paycheck, first white uniform, first patient death.

First death: I knew James (not his real name) for only the last hour of his life. I’ve never forgotten him or the events of that day.

The day started with morning report from the night-shift charge nurse, Mac. We all called each other by last name, but we called her Mac. She sat at the head of the table in the nurses’ station at 7 AM. I, the only RN at the table, sat next to her. She’d started working there the year I was born.

Immediately after assignments were posted, I made my first set of rounds. James was in the second bed by the window in 16B, one of two four-bed rooms. He had been in the ICU until the night before. I took the clipboard from the foot of the bed and looked through his records: temperature, pulse, blood pressure, intake, and output. I introduced myself as the day-shift charge nurse. I did a quick head to toe. I checked his nasal canal. I checked the IV rate, solution, and site. I made sure that his abdominal dressing was dry and intact, his pedal pulses were present, and he was alert and oriented times three. I assessed the other three patients in the room and as I left, James asked me, “What do they call you around here, Little Mac?”

This is a reposted from Primary Care Progress. CHMP and Primary Care Progress are celebrating Nurses Week together modeling collaboration and team. That’s the way we like it!

Shocked by a tense interaction she witnessed between a nurse and a resident, this nursing student saw the urgent need for nursing and medical students to learn to work together and communicate with each other.

karrah-hurdBy Karrah Hurd

After six weeks in the accelerated bachelor of science in nursing program at the University of Rochester, I was already on clinical rotations in the hospital. I was learning clinical functions that my second-year medical school friends had no idea how to perform: catheterizations, wound dressing changes, how to calculate and administer medications.  There’s just not enough time in the first two years.

On the other hand, in the nursing program, our heavy clinical schedule doesn’t provide us much time to perfect writing SOAP notes (or subjective/objective assessment and plan), for example, which medical students practice every day.  It was clear that we were each acquiring distinct knowledge and skills that we could share with each other — if given the chance.

I was living with several medical students, so we had what I learned would be a rare opportunity to share our knowledge with each other.  I taught them how to administer different medications for their voluntary flu clinics and calculate medications.  They taught me how to write an awesome SOAP note, how to perform more specific subjective and objective assessments, and ways to remember complex pathology and physiology concepts.  Working together, we learned from each other and came to appreciate the unique skills that each of us could bring to patient care.  However, I quickly learned that this type of cooperation didn’t always carry over to the hospital.

This is a repost from today’s Primary Care Progress. HealthCetera and Primary Care Progress are modeling that interprofessional exchange matters to advance the public’s health.  We’re celebrating Nurses Week together. 

The IOM’s 2010 report The Future of Nursing: Leading Change, Advancing Health called for “nurses [to] be full partners, with physicians and other health care professionals, in redesigning health care in the United States.”  We need a culture of collaboration and interprofessionalism in education and practice. Here, an R.N. makes the case for interprofessionalism in family medicine in this post that originally ran in 2012 on STFM’s blog.

courtney-kasunBy Courtney Kasun, R.N., M.N.Sc.

One year ago, I began teaching in an interprofessional student clinic.  The student clinic itself had been around for decades, staffed by students in our family medicine clerkship.  However, after a recent campus-wide push for more interprofessional education across health care disciplines, we began adding nursing and pharmacy students to our clinic and having all the students see patients as an interprofessional team.

This is a repost from Primary Care Progress and the first of our celebrating Nurses Week 2013.

photocredit: Primary Care Progress

photocredit: Primary Care Progress

The future of nursing in primary care
An interview with Virginia P. Tilden, Ph.D., R.N., F.A.A.N.

By Sonya Collins

Thank you for giving us an interview for National Nurses Week.

I’m very pleased to know that PCP is honoring National Nurses Week.  And I hope in the future that it’s joined by a Team-Based Care Week that is all about doing the right thing for patients.

I love that idea.  And how do you see the role of nurses in primary care evolving in the coming years? How do you see this role in ten years?

I see nurses in both staff and provider positions having a vital and expanding role and a responsibility for reinventing primary care now and in the years ahead.

In the staff role in traditional primary care practices, the RN typically does patient triage, telephone advice, and prescription management, sometimes including case management and chronic care management. Overall job satisfaction in this role typically is low, and burnout and turnover are high, such that medical assistants have tended to step into this staff role.

However, important reinvention of the RN staff role is happening now with exciting results. A recent ABIM Foundation study of innovative primary care practices found many RNs playing a different role. Care in these practices is typically team-based with RNs working at the top of their licenses as care coordinators, case managers, and systems specialists, resulting in much better patient care and higher morale for everyone, including physicians.