On the Move: What It’s Like to be a Critical Care Transport Nurse

On the Move: What It’s Like to be a Critical Care Transport Nurse

When patients need to be moved from one location to another, and they’re in critical condition, every second counts. The transport team caring for them during these moves provide crucial care that can sometimes mean the difference between life and death. Today we celebrate them in honor of Critical Care Transport Nurses Day, held annually on February 18th.

Kristen PonichteraKristen Ponichtera, BSN, RN, CFRN, CTRN, CCRN, is a Critical Care/Emergency Nurse at University of North Carolina at Chapel Hill Medical Center. She knows firsthand the importance of being a critical care transport nurse. “As a transport nurse, no two days are the same. The job entails a lot of planning and preparation, as well as constant maintenance of didactic and clinical proficiencies. The ability to perform at a high level at a moment’s notice is a key element of the field because, for majority of the patient population, minutes matter,” Ponichtera explains.

After she spent years working in critical care and emergency medicine, Ponichtera became a critical care transport nurse because she says, “I was ready to expand my scope of practice and test my knowledge and skills to the fullest. Critical care transport nursing was the appropriate step. I then fell in love with the specialty.”

Like every health care position, critical care transport nursing has both challenges as well as rewards. “The biggest challenge of the job, which doubles as the most exciting, is to expect the unexpected. Every patient assumed under your care during transport is remarkably different from the last, and it is the responsibility of the transport nurse to be able to anticipate the needs of each individual patient,” says Ponichtera.

As for the best parts of the job? “The greatest reward of being a transport nurse is being able to give a patient and their family peace of mind by providing care marked by precision and exactitude when they are in their most vulnerable state,” Ponichtera says. “Practicing with autonomy and earning collegial respect is an additional reward in being a transport nurse. Finally, recognizing the impact made each day on the lives of patients and their families adds value to the career.”

If you are interested in looking into becoming a critical care transport nurse, Ponichtera says that “This is one of the greatest jobs in the field of nursing. Confidence coupled with humility are characteristics every transport nurse must possess, as our patients demand the best in care. But we also must recognize there is always more to learn. Luck is where preparation meets opportunity. Getting the right experience, asking the right questions, and never giving up are the ways I was lucky enough to get into this field, and I suggest you do the same.”

“Although small, the transport nurse community is always willing to lend a hand to those looking to break into the field,” says Ponichtera. “Seek us out and we will be happy to assist our fellow nurses in any way we can.”

What a Knockout: Working as a Perianesthesia Nurse

What a Knockout: Working as a Perianesthesia Nurse

When patients need surgery or any other procedures that require anesthesia, they need a good health care team working with them to ensure their safety. Perianesthesia nurses are a crucial part of this team. And in honor of PeriAnesthesia Nurse Awareness Week, Regina Hoefner-Notz, MS, RN, CPAN, CPN, answers our questions about working as a perianesthesia nurse.

Hoefner-Notz is the Clinical Manager for Phase I & II PACUs (Post-Anesthesia Care Units) at Children’s Hospital Colorado as well as the Vice President/President-Elect for the American Society of PeriAnesthesia Nurses (ASPAN). An edited version of the interview follows.

Regina Hoefner-NotzAs a perianesthesia nurse, what does the job entail on a daily basis?

Perianesthesia nursing encompasses all the care an individual might need around (Peri from the Greek for “around”) the administration of anesthesia—hence the practice name perianesthesia. Most people think in terms of recovery rooms and surgery, but this practice has evolved into so much more.

Nurses in perianesthesia guide and care for individuals through some of the most traumatic times of their lives. Surgery and procedures are nerve-racking for everyone. Anytime a patient receives anesthesia, there are nurses who prepare them, educate them and their family members, vigilantly assess and intervene as they recover from anesthesia, as well as continuing to prepare them for returning home safely. These nurses are specially educated and knowledgeable about many aspects of care, and various surgeries and procedures.

When I discuss this with nurses with whom I work, I acknowledge that they accomplish in 1-2 hours what it may take other nurses an entire shift to figure out. Perianesthesia nurses deal with multiple patients throughout a shift, each requiring care compassion and spot-on assessments.

I have the great fortune of managing our Phase I and II postanesthesia care areas. These nurses specialize in the immediate needs of their patients as well as collaborate with our anesthesia colleagues to determine when a patient is well enough and safe enough to leave the hospital after his surgery or procedure.

Why did you choose this field of nursing?

I was searching for a new nursing venue after 20 years in pediatric critical care. I had heard of the PACU as a great place to work and, in 2000, I took the leap to try this practice area. It has been one of the best career decisions I have ever made. After orienting and learning new skills, I remember thinking, “This is why I went into nursing, to see the whole picture.” It is extremely gratifying to be able to see a patient and family come into a hospital, successfully have surgery, reunite with loved ones, and be comfortable enough to go home to continue their recuperation in familiar surroundings. I love it!

What are the biggest challenges of your job? 

My challenges are a little different right now as a nursing manager and leader. I want every nurse to see this as an amazing practice area and to reach their greatest potentials through education and participation. I try to encourage ongoing professional education and involvement. It has been extremely rewarding to see nurses reach professional places they never thought possible, knowing I have a small hand in some of that. Other challenges evolve around the changing face of health care and trying to determine how we continue to give exceptional care to our patients, while always being mindful and good stewards of our financial resources.

What are the greatest rewards?

I have been a pediatric nurse for 37 years. The greatest reward of this job is to see families breathe that sigh of relief as we reunite children with their parents after surgery. The reward is seeing a child well cared for, and not as afraid as they might have been if they had not been in a pediatric hospital with perianesthesia nurses providing very specific care for them. My practice area combines two great loves—perianesthesia nursing and pediatrics.

What would you say to someone considering this type of nursing work?

This is an incredible practice area with something for everyone. Some nurses want to be front and center, always part of the action, and there is a place for them in PACU. Some nurses want to educate patients and spend meaningful time making sure everyone knows what to expect and what to do—there is a place for them in the pre-op areas and Phase II discharging areas. Some nurses want a little bit of everything, and they can do that too. Perianesthesia nursing can be found in hospital settings, surgery centers, outpatient centers, GI clinics, dental clinics, and anywhere there is a need for anesthesia and excellent nursing care.

Is there anything I haven’t asked you about being a perianesthesia nurse that is important for people to know?

Perianesthesia nursing is so privileged to have a professional organization exclusively dedicated to this practice area. ASPAN is the organization whose core purpose is to “Advance and promote the unique specialty of perianesthesia nursing.” ASPAN sets standards of care by promoting evidence-based practice for all nurses practicing in this area. This organization encourages networking, as well as professional growth and development, for all its members and I am a perfect example of someone who has been able to expand my professional horizons by being actively engaged in ASPAN. I would encourage every nurse to seek out his or her specialty organization and get involved.

Looking Back: What Retired Nurses Want You to Know

Looking Back: What Retired Nurses Want You to Know

Whenever we finish an experience, we tend to look back on it for many reasons. For example, we may look back after graduating from college to remember what classes we liked or friends we made. We revisit childhood in our minds to think of the really good times we had and what it was like growing up. And, when we retire, we will probably think back to what we learned, loved, and liked about our careers.

At Friendship Village Tempe, a retirement community in Arizona, there are forty-five retired nurses. They took some time to tell us what they would love for everyone—from new nurses to experienced ones—to know.

“Everyone today must acquire knowledge regarding their own health in order to make wise decisions.”
—Mary Lou Adler, RN, BSN

“Being a nurse uses all the knowledge and skills that you have. Deciding to be a nurse means you have not decided anything yet, because there are so many opportunities in the field.”
—Nancy Dolphin, PhD, BSN

“Problem solving skills can be transferred from bedside care to international leadership in addressing and advocating for health and human rights.”
—Joan A. Newth, RN, BSN

“Nurses can be advocates for family and friends when they are hospitalized to ensure safe, appropriate, compassionate, and ethical care.”
—Rosemary Kessler, RN, BSN, MED

“Since Florence Nightingale established the foundation for nursing, our profession has continued and continues to evolve as an art and a science.”
—Joan A. Newth, RN, BSN

“The number one thing that I would want you to know is that laughter is the best medicine. The number two thing is—that laughter is the best medicine!”
—Marilyn Lehwalder, RN, BSN

The following are from retired nurses who preferred to be anonymous:

“It will never get well if you pick it.”

“Marry a doctor.”

“Old nurses never die, they just lose their—patients—patience.”

What advice would you share with your nursing colleagues? Let us know in the comments!

Everything You Ever Wanted to Know About a CNA (But Were Afraid to Ask)

Everything You Ever Wanted to Know About a CNA (But Were Afraid to Ask)

In health care, as in a number of professions, if it’s not your job focus, you may not know what other people do in theirs. For example, if you’re not a Certified Nursing Assistant (CNA), you may not be aware of what is in their scope of practice.

Kim Warren, RN, BSN, nursing assistant program director at Dawn Career Institute, a private, post-secondary school preparing students to pursue a new career in the health care and wellness fields, took some time to answer questions about what tasks a CNA is responsible for, what kind of training they need, and what someone considering this type of position needs to do.

An edited version of our interview follows.

Kim WarrenFor those who don’t know, what is a CNA and what kind of tasks does he/she perform?

A CNA assists nurses in the care of patients of all ages. Care includes bathing, dressing, grooming, feeding, and personal care.

What kind of training does a CNA need? From what kind of school? Do students usually attend part-time or full-time? Do they go through clinicals like other health care professionals do?

To become a CNA, a candidate must take a state required training and competency evaluation program and pass a certification exam. These programs are offered in every state in a career training school, some high schools, and some community colleges. Programs are usually 6 to 8 weeks in length, which includes classroom and clinical, depending on individual state requirements. Students usually attend full-time.

What changes, if any, have occurred lately with regard to being a CNA?

Over the last year, some post-secondary schools have required that students who are pursuing a nursing degree take a CNA course before entering the clinical portion of the nursing program. I think this is a good idea because it gives the student more clinical, hands-on experience and also allows them to get this experience early on in their education path.

What kind of career paths can CNAs have? Where can they work?

Many CNAs go on to become RNs and work in a variety of health care settings. Some choose to work as a CNA, and they find jobs in hospitals, nursing homes, hospice facilities, and home health care settings.

What are the biggest challenges?

There is often a lot expected of a CNA! The positive side is that there are always CNA jobs available and the flexibility to work in multiple places is convenient.

What are the greatest rewards?

A CNA position is very rewarding in many ways. You have daily one-on-one contact with patients and clients of all ages and ethnic backgrounds. A CNA spends more time with the patient than any other health care professional and therefore is able to meet their changing needs.

What would you say to someone considering this type of nursing work?

I would recommend CNA to anyone looking to pursue a career in nursing, as it really provides insight into the health care profession and also allows students to gain experience that they don’t get until later in nursing school. For those who may be unsure if the medical field is the right fit for them, a CNA program provides the opportunity to get this experience early in order to make an informed decision. I believe that CNAs are valuable and such an important part of the nursing team. I have worked with many CNAs throughout my career, and I have the utmost respect for them. I truly believe that I would not be the nurse I am today without the great team of CNAs that I have worked with.

Hit Me with Your Best Shot—A Different Kind of Infusion Nurse

Hit Me with Your Best Shot—A Different Kind of Infusion Nurse

When you think about an infusion nurse, the first thing that pops into your mind is one who works with patients in everything from cancer treatment to skilled nursing care. But Kristopher Hunter, BSN, RN, CRNI, VA-BC, shows that there are so many other paths an IV nurse’s career can take. Hunter works as a Senior Technical Service Engineer for 3M.

“My current infusion therapy job is unusual in that I spend a significant amount of my time in meetings discussing infusion therapy needs and trends, on the phone answering clinical questions from nurses from around the world, in the lab tinkering, or in my office working on projects like educational modules,” Hunter explains. “I occasionally travel to speak from a podium to infusion therapy or vascular access professional organizations.”

Hunter took time to answer our questions to help us celebrate IV Nurse Day. What follows is an edited version of our interview.

Kristopher HunterWhat does your job entail? What do you do on a daily basis?

My expertise is in care and maintenance of vascular access devices in various care settings such as acute care, long-term care, and home infusion. In my role as a senior technical service engineer at 3M, I educate and consult on infusion therapy-related topics with both nurses working clinically as well as 3M scientists, to help develop innovative solutions that keep the patient and the nurse at the forefront. One of the particular tasks I am charged with is what is known as usability engineering, a fancy term for “Can someone use this?”

I love the challenge of identifying not just how we would want nurses to use something, but how the nurses in the real world actually use tools in their day to day jobs. Little things like how one peels the liner from the dressing, or whether the antimicrobial is attached to the dressing or a separate piece, makes a huge difference in how usable a product is and how easy it is for nurses to comply with best practices.

Why did you choose this field of nursing?

Infusion therapy chose me. I started my career looking to work in cardiac critical care, but fell into a minor infusion therapy role in a skilled nursing facility when I first started out. From there I moved into acute care, and home infusion, vascular access, and outpatient infusion/oncology. I found the specialty to be extremely rewarding, as it offers a near perfect mix of technical procedural excellence—that other procedural nurses know such as in the cath lab or OR—but also retains that personal 1:1 patient care that I value. Some of my best memories from this role are the conversations with some amazing people.

What changes, if any, have occurred lately (last year or so) in being an infusion nurse?

I believe there has been an overall growing trend within infusion therapy surrounding the awareness of PIVs. As the research continues to mount we are finding that they play a much more significant role than we imagined. For many nurses the humble PIV is seen as disposable, but I have seen growing awareness around the country of changing the practice from scheduled PIV exchanges to maintaining functioning and healthy PIVs until clinically indicated.

What are the biggest challenges of your job?

Clinical practice varies greatly between hospitals, states, and regions of the country, not to mention internationally. It can be a challenge keeping on top of all the diverse needs of infusion nurses.

What are the greatest rewards?

I often hear stories from nurses, and our staff in the field, about solutions that I personally worked on that made a positive impact for patients. For example, I recently provided information about adhesives and skin-saving interventions to a nurse at a children’s hospital so she could make an educated decision on what products to use. I love how my very small contributions can help nurses improve patient’s lives.

What would you say to someone considering this type of nursing work?

Infusion therapy is a diverse specialty that affords any nurse many opportunities to explore and expand their career. If you are technically and procedurally inclined, you can focus more on vascular access. If you love the personal 1:1 connection with patients, then outpatient infusion is amazing. Infusion therapy touches nearly every other nursing specialty and offers a fantastic way to explore your nursing career.

Certification is so important—not just for your career, but the profession. It is important that we all take measures to study and improve our practice so that our patients are receiving the best possible care. I believe that certifications are a great way of showing that you are willing to go the next step. If you give IV medications or insert IVs, you are practicing infusion therapy, and I would urge nurses to look into the CRNI and VA-BC.

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