BY: JULIE TROCCHIO, M.S., RN
Nursing — my chosen and beloved profession — has been keeping me awake nights. I worry about the school of nursing faculty members I know who are planning to retire with no qualified replacements in sight. I worry when I hear that new graduates aren't finding jobs because we (temporarily) have an adequate supply. I worry about reports of deteriorating physician/nurse relationships. I even worry about TV shows that continue to demean nurses.
But I stopped worrying and got a good night's sleep after reading the articles in this issue by eight extraordinary nurse leaders in Catholic health care. Nursing is more committed and focused on the right things than ever before. What's more, it is building on the foundation created by the pioneering sister -nurses who came before us and their commitment to spirituality, justice and excellence.
"Nursing is poised for a change" says Catholic Health Initiatives' chief nursing officer, Kathleen Sanford, in her article that traces the roots of nursing practice to Mother Catherine McAuley's "careful nursing" system used in the Crimean War and that influenced Florence Nightingale's reforms. She calls on nurse leaders to use as their compass for the future the legacy of the sister-nurses who founded not only our Catholic health systems, but also nursing itself:
"By examining the sisters' charisms, we can help ensure that those historical exhibits on display in so many of our buildings are more than relics from the past. They will continue to remind us of all we can learn from the love, courage and faith they represent. As we plan for the future, we can look to the example of the sisters who believed and then, without fanfare, did 'great things with great love.' Catholic nursing cannot, must not lose this heritage.
"Mother Catherine McAuley's nursing model emphasizes the importance of spirituality in nursing practice, and that is a central theme of Carmella Jones' article on faith community nursing, which, she says, focuses on the connection between spirituality and health. Her team at Holy Cross Hospital in Silver Spring, Md., coaches faith community nurses and their congregations throughout the suburban Washington, D.C. area. "In our mobile society," she says, "people often turn to their faith communities to assist them with coping and maintaining hope in changing life circumstances. Parish nurses remind church members that good health is a gift, and it needs to be preserved and enhanced through wellness behaviors that can be grounded in a holistic spirituality."
Justice and ethical reflection also categorize nursing in Catholic health care today. Sr. Rosemary Donley, professor of nursing and the holder of the Jacques Laval Chair for Justice for Vulnerable Populations at Duquesne University School of Nursing, Pittsburgh, reminds us that social justice teachings challenge us to fill in the gaps separating the "haves" from the "have nots." Sr. Rosemary tells us, "If social justice is to inform nursing practice and education in the future, nursing leaders must do more than name social justice as a value in nursing. Educators, clinicians and administrators must reinvest in and advocate for a health system that manifests and advocates for its principles."
How does this work in Catholic education? Bernadette Curry, former dean of nursing at Molloy College in Rockville Centre, N.Y., describes how Catholic nursing education in the 21st century draws from valuable characteristics of the past, medical science with a holistic perspective that addresses the totality of the persons, including spirituality. She relates how students and professors engage in clinical conferences where ethical implications of care are discussed, including dignity of the patient, the operative belief systems and the respect for life.
Jean Dols, system director of nursing and quality at CHRISTUS Health, tells of the challenge to meet the goals of clinical quality, service excellence, financial health and community value. Her system is conducting pilot nursing care delivery models that put the maximum number of caregivers at the bedside while meeting budgeted targets.
Excellence is at the heart of evidence-based practice, a concept Beth Collins Sharp, from the U.S. Agency for Healthcare Research and Quality, demystifies in her outstanding article on bringing science to the bedside. She explains how nurses routinely contribute to evidence-based practice using "research evidence, thoughtfully and strategically, in order to inform decision making."
Without a doubt, excellence is elusive without a stable nursing staff. Two articles here shed new light on the old issue of turnover. Pamela Duchene, chief nursing executive at St. Joseph Hospital, Nashua, N.H., describes her hospital's 11-year quest for Magnet status, reducing turnover from 24 percent to 5 percent in 2009. She tells us, "The true value in the Magnet Recognition Program is in the journey and the culture it creates, through which nurses realize they can change their world and the world of their patients. A hospital that creates a Magnet environment assures that nurses will remain in nursing practice and that patients will never lack a great nurse at their bedside."
Another kind of recognition related to workforce is Working Mother magazine's "best companies" list. Bon Secours Richmond has been on the list for more than 10 years, making the Top 10 out of 100 in 2009. Francine Barr, the health systems' chief nurse executive, says it accomplished this with a comprehensive strategy of support for first-year nurses; opportunities for professional development; talent acquisition; employee engagement; and keeping experienced nurses in the workforce. For example, it has on-site family centers that offer childcare along with programming that supports concerns of working parents and aging employees.
It is my pleasure to welcome you to this special section of Health Progress on nursing. I think you will feel as I do, that nursing today in Catholic health care is not only on the right track, but continues to lead the profession in the tradition of those who came before us.
JULIE TROCCHIO, M.S., RN, is senior director, community benefit and continuing care ministries, Catholic Health Association, Washington, D.C.