FIGURE
Name: Ann M. Herbage Busch, MS, RN, CWOCN, APRN-BC
Current Position: Liver Transplant Clinical Nurse Specialist
Current Affiliations: Veterans Affairs Medical Center, Portland, Ore; Instructor, Oregon Health and Sciences University; Assistant Clinical Professor, University of California, San Francisco
Areas of Specialization: Transplant, wound, ostomy, and continence
Professional Education: BSN, University of Portland; MS, University of California-San Francisco
Certifications: CWOCN, APRN-BC in medical surgical nursing; CNS in the state of Oregon
The National Association of Clinical Nurse Specialists (NACNS) is honored to profile Ann Herbage Busch, the first recipient of the Clinical Nurse Specialist of the Year Award presented by NACNS at the annual meeting in Atlanta, Ga, March 2002.
Ann was nominated by Kelly A. Goudreau, DSN, RN, CS-BC, CNS, on behalf of the Oregon Council of Clinical Nurse Specialists (OCCNS), a special-interest group of the Oregon Nurses Association.
As a new registered nurse in 1980, Ann discovered she had a love for patient care, especially in the acute care setting and for clinical teaching. She committed to receiving her master's degree and completed her clinical nurse specialist (CNS) program in 1985. Her earliest experience as a CNS was as a medical surgical CNS in a small community hospital in California. Ann was the first CNS the hospital employed. This first CNS job was a great opportunity to carve out a niche as an advanced practice nurse dedicated to improving the quality of patient care. Her biggest challenge was explaining and then demonstrating just how viable and integral the role can be to the system. She was so successful in showing the worth of the CNS that the hospital administration soon employed another CNS for the rehabilitation unit.
Ann believes this first challenge, demonstrating CNS value to patient care and the delivery system, continues to be a challenge for CNSs today. She believes it is important to succinctly explain the CNS role to lay persons and professionals and that CNSs must always demonstrate the value of their work clinically and financially. Ann uses some simple strategies to increase visibility and understanding of the CNS role. She often shares information, such as journal articles, research, published care guidelines, or professional standards, with colleagues about issues she knows they are addressing. Providing access to information serves as a marketing tool for her services and identifies content areas where she, as a CNS, can make contributions to improving patient outcomes and meeting organizational goals. In addition, she develops "talking points" that target different audiences-patients, nurses, physicians, or administrators.
Besides her daily work to provide seamless care for patients across the continuum, Ann is most proud of her role in the recognition of CNSs in Oregon. She was a member of the Oregon State Board of Nursing CNS Task Force that wrote the rules and regulations for the Oregon State Nurse Practice Act. The act now provides for protection of the CNS title and scope of practice.
Ann feels fortunate to be a CNS. She loves the autonomy, independence, flexibility, and variety of activity in the role. She enjoys the challenges and feels she learns something new every day. She advises CNSs to use any opportunity to educate and demonstrate to other health professionals, including house staff, the benefits of CNS practice. Examples of Ann's practice within each sphere of influence include:
Patient: Provides direct patient care as a provider; consults with nurses and other providers regarding patients' problems requiring advanced clinical expertise, such as self-care management for complex wounds; serves as a case manager for selected inpatients and outpatients; develops patient-educational materials for patients and families before and after liver transplantation; performs procedures; and makes clinical rounds with team.
Nurse: Provides staff education on topics such as wound management and liver transplant; serves as a frequent guest lecturer and preceptor for graduate students at Oregon Health Sciences Center, School of Nursing, where she is an Instructor; frequently sought as a consultant on a variety of enterostomal therapy topics, case management/patient pathways, and liver transplantation; supervises master's students; and facilitates and provides question-and-answer sessions for clinical nurses.
System: Consults with nursing administration and physician staff at her local Veterans Administration and nationally; leads interdisciplinary teams and participates in clinical research; serves in multiple professional organizations; presents at international, national, regional, and local forums and meetings; and regularly contributes to the professional literature through journals and newsletters.
Ann's advice to new CNSs is to find a good CNS mentor, but most of all, take time to listen-discover what your system is all about and discover what patients, nurses, and the system want and expect. Start with their needs. Plan and implement strategies to meet those needs and gradually help to bring new insights that will lead to new needs. In essence, start where the organization is and gradually move it forward, always bringing a critical mass of those who can see the value of new ideas. Outside forces will always create change that affects the clinical work and role of the CNS. The big impact comes from demonstrating what good you can do to meet needs and expectations and provide quality outcomes. Congratulations, Ann! We are proud to recognize you as an exemplary CNS role model and the first recipient of the NACNS Clinical Nurse Specialist of the Year!
Qualifications for this award include nomination by a colleague or supervisor, current membership in NACNS, and 3 years of experience as a CNS. Selection is based on the individual's service as a role model by:
1. maintaining an outstanding level of skill and knowledge in specialty area,
2. demonstrating CNS competencies in all 3 spheres of influence (patient, nursing personnel, system),
3. demonstrating quality patient outcomes,
4. supporting nurses in the delivery of patient care or the advancement of nursing practice,
5. promoting change or collaboration at the system level to impact patient care.
Nominations are now being accepted for the 2003 award. See the announcement in previous issues of the journal or contact the NACNS at http://www.nacns.org.