nurses experience different days in same occupation€¦ · residency programs that take other...

2 MAY 6, 2020 THE SHERIDAN PRESS NURSES WEEK NURSES WEEK MAY 6, 2020 THE SHERIDAN PRESS 3

BY ASHLEIGH SNOOZY

[email protected]

SHERIDAN — Sheree Cossel left a job de-signing The Sheridan Press to pursue what someone suggested was the perfect career for her — nursing.

She quit with her coworker and best friend, and the two set out to complete Sheridan College nursing degrees.

Three years later, Cossel’s friend continues to manage a strenuous course load while also raising a family. Cossel, however, had to

drop from the program with only one class to complete before finishing her health science degree and continuing on to the nursing pro-gram.

Why? Although she strongly desired to become a nurse and help others, financial obligations and raising a family prevented her from quitting her full-time job to pick up a full-time course schedule during working hours the nursing program demands of its students.

COVID slows nursing shortage, recruiters anticipate continuing issues after

Lois Bass, RN, stands ready at her station at Sheridan Memorial Hospital. COURTESY PHOTO | SHERIDAN MEMORIAL HOSPITAL

SEE SHORTAGE, PAGE 9

BY ALLAYANA DARROW

[email protected]

SHERIDAN — Registered Nurse Linda Schwabauer has spent the past 27 years in health care, mostly as an RN in the labor unit at Sheridan Memorial Hospital.

DAY IN THE LIFE: BABIES, ALPACAS AND LEARNINGNurses experience different

days in same occupation

NURSES WEEK MAY 6, 2020 THE SHERIDAN PRESS 3

BY ALLAYANA DARROW

[email protected]

SHERIDAN — Registered Nurse Linda Schwabauer has spent the past 27 years in health care, mostly as an RN in the labor unit at Sheridan Memorial Hospital.

She loves meeting new moms and babies and taking care of new families. She teaches neonatal resuscitation to colleagues and is a lactation counselor. These days, she spends more time with mothers learning to breast feed without the distraction of crowded deliv-ery rooms.

Limited visitation at the hospital due to COVID-19 restrictions means only one family member can be in the room as support during a birth, which most families are enjoying, Schwabauer said. The privacy families can enjoy without having to choose who is al-lowed to visit is relieving for many new moms and dads. A few have been challenged by visitation limits in cases when the birth sup-port person is also the only child care provider for other children in the family – they can’t all come up together. Prior to the pandemic, transitioning to electronic medical records was one of the most prominent challenges in

health care, Schwabauer said. Losing experi-enced nurses is a constant struggle in many health care environments.

Today, she struggles with complications like ensuring mothers can understand the an-esthesiologist through a mask and frequently apologizing for turning away visitors.

In the early days of the pandemic, fear and uncertainty about equipment availability was a source of panic for many units. She worried what would happen if she had to come to work without supplies.

DAY IN THE LIFE: BABIES, ALPACAS AND LEARNING

COURTESY PHOTO | LINDA SCHWABAUER

Linda Schwabauer greets one of her young alpacas while wearing her scrubs.

Nurses experience different days in same occupation

SEE ALPACAS, PAGE 10


BY CAITLIN ADDLESPERGER

[email protected]

hirty years ago, education, technology and professional oppor-tunities for nurses looked very different from today.

Nursing has undergone numerous major shifts over the past few decades. And yet, local nurses emphasize, the calling has maintained its core value: Caring for patients.

“The bottom line is still very much individualized care — that has not changed at all,” said Martha Newman. Since entering the field in 1985, Newman has worked as a nurse in an emer-gency room, a K-12 school, an office and an ICU. And for the past nine years, she has been the director of nursing at Green House Living, a local long-term care facility.

“That is what nurses do best as advocates for the patient, from the elder to the child,” Newman continued. “Nurses are advocates for those who oftentimes aren’t able to speak.”

Barb Hespen, Sheridan Memorial Hospital chief nursing officer, agreed: “That is what makes you a good nurse: really caring for your patient and knowing your patient.

“...But how you do it is so different (these days),” Hespen added.Sheridan College Assistant Nursing Director Tobie Alsup has noticed a philo-

sophical shift in the field. Alsup started working in obstetrics at a busy, high-risk hospital in downtown Nashville, when women were moved into different rooms for the different stages of giving birth, from delivery to operating to recovery, then separated from their newborns. COURTESY PHOTO | MICHELLE CRAIG/GREEN HOUSE LIVING FOR SHERIDAN

Green House Living’s Director of Nursing Martha Newman, left, shares her pet dog Raven with elder Shirley Powell. SEE NURSING, PAGE 11


12 MAY 6, 2020 THE SHERIDAN PRESS NURSES WEEK NURSES WEEK MAY 6, 2020 THE SHERIDAN PRESS PB


CMYK


MAKING A DIFFERENCEABOVE: Sheridan VA Health Care System nursing staff pose together in celebration of Nurses Week. Pictured, from left, are Daunee’ Kennedy, RN; CynDee Songer, RN; Denise Murdock, RN; Robin Simmons-Black, LPN; and Jean Cox, LPN. RIGHT: Stephanie Rushin, a certified nurses assistant, folds laundry at Greenhouse Living Tues-day, June 18, 2019. BOTTOM RIGHT: Nurse Jerry Hanson mans a triage checkpoint at the emergency entrance of Sheridan Memorial Hospital tasked with checking for symptoms of COVID-19 Thursday, March 12, 2020. BOTTOM LEFT: Stephanie Grasky, a certified nurses assistant at Greenhouse Living, checks in with resident Lommie Kay Tuesday, June 18, 2019.


SHORTAGE : Rapidly aging population, aging nursing staff, shrinking nursing facultyFROM 2

“You’re in a traditional classroom and on top of that they also require you to do clinical hours during the day,” Cossel said. “You can’t have a daytime job and do the nursing pro-gram; it’s impossible just because of the strict requirements they have and they don’t offer an alternative to doing those daytime hours.”

For traditional students freshly graduated from high school or nontraditional students able to go back full time, the current nursing schedule works well and provides ample op-portunities for hands-on experience.

Sheridan Memorial Hospital Chief Nursing Officer Barb Hespen, though, recognizes a continued nationwide nursing shortage caused by three elements: rapidly aging population, aging nursing staff and shrinking nursing faculty to teach those wishing to enter the workforce. Without enough nursing faculty members to teach additional classes, it proves nearly impossible to create alternative options for nontraditional students to complete a nursing degree while working full time.

Sherrill Smith, dean of nursing at the Univer-sity of Wyoming, said the department strug-gles to find adequate faculty, partially because of specific experience required and partially because of the age issue. The university put applications on hold for the master’s degree program for nursing fall 2019 because of a lack of faculty with the right credentials.

“There is a nationwide faculty shortage,” Smith said. “Two of the main reasons nursing schools can’t take on more students is because there are a shortage of faculty, No. 1, and there are only so many clinical sites. Most of the hos-pitals and clinics and public health agencies are already overwhelmed with students.”

The smaller pool of people to pull from hinders the ability to accept more students, as does the lack of available faculty candidates with graduate degrees, doctoral degrees and certification and licensure as a nurse practi-tioner for some classes. Another contributor is salary, as most RNs can make more money working directly in the field rather than teach-ing it.

Cossel recognizes the need for hands-on learning while going through a nursing educa-tion, but she also recognizes the potential of completing those clinicals anytime, as health care remains a 24-hour operation.

“There are lots of opportunities for students in nontraditional roles to be able to go to the hospital and work a night shift or go to the hospital and work different shifts and work around a traditional work schedule while in school,” Cossel said.

With technology and 24-hour options for clinicals, Cossel potentially would have com-

pleted a degree in nursing and been on a differ-ent side of the workforce.

Fortunately for people like Cossel wishing to earn a degree in nursing and eventually become a registered nurse, UW has a few op-tions for nontraditional students to complete degrees in that field.

ReNEW — Revolutionizing Nursing Education in Wyoming — is a statewide collaborative of nurse educators, health care agencies, institutions of higher learning and other stake-holders in a shared baccalaureate nursing curriculum between UW and community col-leges throughout the state. Another program takes students through an online-optional accelerated 15-month program that can be taken from anywhere in the state to receive their bachelor of science in nursing if they have previously received a bachelor degree in some-thing other than nursing.

“As a general rule, these students are finding across the state, or across other states, nurse residency programs that take other graduates over a 6- to 12-month period of time, they give them the additional support that allows them to transition smoothly from a student role to

the RN role,” Smith said. Hespen said while the nursing shortage has

certainly been at the forefront of conversa-tions for a while, the COVID-19 pandemic has decreased the need quite a bit, as elective sur-geries and operations were canceled for a time to account for a potential influx of virus-ridden patients.

“The shortage has gotten less because our volume of patients is less,” Hespen said.

COVID locally has brought less strain on the nursing workforce at SMH at this point. When business returns functioning as it did before the pandemic, nursing jobs in all areas — hos-pitals, long-term care and the Sheridan Veter-ans Affairs Health Care System campus — will still be needed and sought after by recruiting staff, especially specialty nursing positions. Specialty, surgery, long-term care and inten-sive care unit nursing staff are extremely rare to come by, Hespen said, and something SMH continually seeks.

“I don’t know why there’s such a shortage (in specialty nursing positions),” Hespen said. “It’s really surprising in surgery to me, but I would say it’s a shortage here and it’s a

shortage from the last place I worked. It just seems to be a nationwide shortage; it’s a very specialty position. You either love surgery or you don’t.”

The National Center for Biotechnology Information also cites shortages due to lack of potential educators, high turnover and inequitable distribution of the workforce. The Bureau of Labor Statistics’ Employment Pro-jections from 2016-2026 projects the need for an additional 203,700 new registered nurses through 2026 to fill newly-created positions and to replace retired nurses. It also projects the RN workforce growing from 2.9 million in 2016 to 3.4 million in 2026 — only 15%. According to the American Association of Colleges of Nursing, 84.5% of the 3.8 million registered nurses in the nation are employed as such in 2017, remaining fairly on track for the BLS needs predictions.

When government agencies lift COVID-19 restrictions and businesses agree to again allow a full patient flow, recruiters will be seeking those who have responded to their call to health care, ready to serve despite chal-lenges that come with the job.

COURTESY PHOTO |

The Bureau of Labor Statistics’ Employment Projections from 2016-2026 projects the need for an additional 203,700 new registered nurses through 2026 to fill newly-created positions and to replace retired nurses. It also projects the RN workforce growing from 2.9 million in 2016 to 3.4 million in 2026 — only 15%. According to the American Association of Colleges of Nursing, 84.5% of the 3.8 million registered nurses in the nation are employed as such in 2017, remaining fairly on track for the BLS needs predictions. Pictured, Victoria Milne, RN, speaks with a patient.


FROM 3

Still, the new “surreal” environment has changed some systems for the better, even as the day-to-day panic settles down.

“I can really see our staff coming together,” Schwabauer said. “Between doctors and nurses there is very good communication…we are there to support each other really well.”

With more time at home, she completes more projects. She and her husband of nearly 40 years spend more time together.

She gives more time to relaxing activities, like learning to spin and process fiber from her six alpacas — time that allows her to be more productive when she’s back at work.

Support through meals, gifts and words of gratitude from the community is felt throughout the hospital, Schwabauer said. Having few COVID patients and adequate staff puts her mind at ease.

Still, she worries some rural Wyoming residents are taking the state’s light COVID impact for granted, as businesses begin to reopen and a coronavirus case surge is still possible.

While she has never encountered a situa-tion like today’s public health environment before, Schwabauer is armed with more than two decades of experience with pa-tients, doctors, hospital work schedules and personal care – enough to balance a hectic 12-hour day with an unexpected pandemic, a 40-year marriage and six alpacas.

For nursing students, the pandemic is a brazen part of their introduction into a career in health care. As the world contemplates, criticizes and appreciates the role of the health care worker in 2020, Sheridan College is no exception.

The nursing department pushes students to consider today’s health care environment through the lens of a COVID-19 case study, including background, pathology, patient

scenarios, nursing care, prognosis, home care management and more.

“What I tell them is, historically, they’re liv-

ing in a time that hopefully they’ll never see again in their career,” Assistant Director of Nursing Tobie Alsup said. “I’m not sure that’s true but I hope it’s true.”

Armed with the appropriate knowledge and experience, students can become forces for leadership and change, she said. Now that they have studied during an unprece-dented time in health care, these students will contribute significantly to their profes-sional spheres -- with not only technical skill but also intrinsic qualities that support a healthy and long career.

Schwabauer is an expert in the early days of life, when infants and mothers first learn to nurse. She knows how to help an infant struggling during their first hours.

Some nurses spend their careers assisting surgeons, responding to trauma calls in the emergency department or getting to know

patients over years of dialysis treatments. Karen Steir worked as a nurse at SMH for

44 years before “retiring” to become a hos-pital volunteer. Her volunteer time spreads from the Kozy Korner gift shop to the surgical waiting room, to decorating for the annual 5-year-old birthday party.

The cardiac rehabilitation team helps pa-tients learn to adapt their diet, exercise rou-tine and daily schedule after experiencing a heart attack or undergoing a serious surgical procedure.

These days, employers and employees, teachers and students, parents and children ask each other for flexibility, patience and adaptability when plans fall through, tech-nology doesn’t work and emotions run high. For any day of the year, these qualities are strengths nurses bring to their health care environment.

COURTESY PHOTO | LINDA SCHWABAUER

With the current public health situation, Linda Schwabauer spends more time at home caring for her six alpacas and processing their fibers.

ALPACAS : With more time at home, she completes more projects


NURSING : Modern technology aids in care of complex cases“Now, it’s very much more focused on the women’s expe-

rience and making her feel safer,” Alsup said, explaining that mothers now typically stay in one room for the entire experi-ence and are able to spend more immediate time with their babies.

This change extends beyond obstetrics.“It’s more personal, patient-focused, family-centered, pa-

tient-centered — more holistic, not just providing physical care but also psychological and family support,” Alsup said.

In another notable shift, today, people tend not to be ad-mitted to the hospital unless their situation is serious, accord-ing to Hespen. As a result, the patient-to-nurse ratio in most hospitals tends to be lower than in years past, but individual patient care is more complex.

Modern technology aids in the care of these more complex cases, from remote monitoring to ultrasound capabilities to telecommunications.

“Technology — not just in nursing but overall — has just been a game changer for health care,” Alsup said. “Think of technology in ‘84. We didn’t have cellphones, we didn’t have desktop computers, we didn’t have laptops. Now...the same progression has happened in health care.”

While useful, Hespen noted, these advancements cannot replace the human element of nursing.

“People are monitored a lot better (with technology), and we have different capabilities for caring for patients — you can tell sooner when people are deteriorating — but the negative side is you can lose the hands-on approach,” Hespen said. “If

we get too technology-based, sometimes we lose that caring touch with people.”

Newman also worries about the technological focus in health care.

“In some ways, (nursing) has become much more managing machines,” she said.

To counteract this, Newman trains the nursing staff at Green House Living to look at the person before their stats and encourages them to get to know their patients.

Nursing education in the classroom has also shifted, Alsup said, following “a much more interactive approach in a lot of

different ways” than it used to, she said.“We have a lot more of a flipped classroom style, where

students are expected to come prepared and they’ve read ahead of time,” Alsup explained. “There are a lot more activi-ties in class that foster that interaction, rather than someone lecturing.”

Nurses also have more and more opportunities to further their education, moving beyond associates and bachelors de-grees to masters and doctorates.

Through these advancements, the nursing profession is continuing to diversify, offering nurses a variety of job oppor-tunities beyond the hospital.

“I just love the diversity we have in nursing,” Alsup said. “If you don’t want to work in a hospital, you don’t have to.”

“I don’t know of any other job that you can go from being a school nurse to taking care of people at the end of their life to taking care of women in OB/GYN to emergency,” Newman agreed. “There are so many opportunities that you could never be bored as a nurse. I don’t know any other field, honestly, that has that ability to have a huge change in your job without changing fields.”

As health care continues to evolve, Alsup expects more complex and diverse nursing roles to grow over the next 30 years. And when Hespen considers the future of nursing, she looks forward to growth in participation in public policy — shaping legislation — and leadership.

“I hope to see nurses continue to be a very pivotal part of the health care team,” she said. “They provide a valuable and sometimes understated part in patients’ care and wellness.”

FROM 4

COURTESY PHOTO | SHERIDAN MEMORIAL HOSPITAL

Jazz Scott, RN, remains with a young patient at Sheridan Memorial Hospital.

12 MAY 6, 2020 THE SHERIDAN PRESS NURSES WEEK NURSES WEEK MAY 6, 2020 THE SHERIDAN PRESS PB

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