Authors

  1. Baker, Kathy A. PhD, RN, ACNS-BC, CGRN

Article Content

Although I have been a registered nurse for almost 30 years, I am amazed at how my learning never stops. My practice constantly presents me with new opportunities to stretch and grow, even after so many years of rich learning experiences. For example, I have had a career-long desire to be actively involved in shaping healthcare policy, but my connections were quite limited, and I just wasn't sure how to get started.

 

For many years, I simply responded to prompts from my state nursing association to contact my local legislators when a nursing issue presented itself as needing legislative support. These efforts were important, yet didn't really qualify to me as being actively engaged in policy issues the way I longed to be involved. But recently, after these many years, I was appointed by my state specialty nursing organization to represent my colleagues on the Texas Coalition for Nurses in Advanced Practice. A priority of this organization is "to create a legal and regulatory climate in which Advanced Practice Nurses can use their full potential to improve the health and well being of all Texans" (http://www.cnaptexas.org/). As a result of this appointment, I now find myself at the state capitol each month, calling on legislators and advocating for the role Advanced Practice Nurses can play in minimizing the gap Texans face when trying to access healthcare.

 

This "new" area of learning has rejuvenated my spirit and invigorated me to passionately advocate for patient needs through advancing opportunities for nurses to practice fully within the boundaries of their educational preparation and credentials. I am learning so much and growing in areas that are empowering and fulfilling. And even better, I am able to use what I am learning to facilitate opportunities for my advanced practice colleagues at the local level to join me in learning how to actively engage in policy. The Doctor of Nursing Practice (DNP) students in my health policy class are also benefiting from my ability to role model actively the very things I am teaching and encouraging them to pursue as nursing leaders.

 

Another area in which I am growing involves working with a new nursing role, the Clinical Nurse Leader (CNL), that initially was very confusing to me. I am a Clinical Nurse Specialist (CNS), and my focus is on providing specialized care to adult medical surgical patients, particularly patients who have gastroenterology needs. I am also the "go to" person as a CNS when there is a problem that needs a fix: I am prepared as a CNS to gather data, assess a problem (whether at a patient or system level), determine where a process might be inefficient or inadequate, provide a plan for change or improvement, convince others of the need for improvement, and continue to evaluate the effectiveness of any recommended interventions.

 

As this new role was introduced in my area of the country, I learned that a CNL is educated as a generalist to function at a microsystem (unit) level, focusing on many of the things a CNS does at a macrosystem (hospital/ system) level. I struggled with understanding why someone would choose to be prepared as a generalist when they could be prepared as an advanced practice specialist (i.e., CNS). However, as I developed a relationship with a CNL colleague at my hospital and decided to write a manuscript with this colleague to demonstrate how a CNL and a CNS work together to improve patient care, I gained insight into this new role.

 

First, I spent time listening to this colleague discuss why she chose to be a CNL. Then, I did a great deal of reading, looking at several articles and national competency statements that described this new role in depth. Through my investigation, I began to understand more clearly the CNL role and how it interfaces with my CNS role. Thankfully, we all have different passions and gifts. The CNL role is perfect for someone who wants to be influential at the unit level and who finds comfort and reward in working with the same team every day. A CNS role, on the other hand, is designed for someone who enjoys working in a broader sphere of influence, implementing change throughout the hospital or across a system. Different strokes for different folks, as they say!!

 

So after 30 years of learning, I am clearly not done. Nursing is so diverse and the opportunities abundant if we just make ourselves available. I hope as your career advances, you are continuing to learn and grow. Don't be satisfied with "enough" knowledge. Step out in new areas of practice. Expose yourself to things you don't understand. There's a new joy in expanding your knowledge. No matter how long you've been around, remember to never stop learning.