1. Carroll, Susan V. MS RN CNE

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The hero of the Pixar(R) film Ratatouille is a skinny, little, blue-gray rat named Remy. One of an enormous family of typical chubby, brown rats, Remy is expected to live and eat like a rat-slinking around under cover of darkness, wallowing in trash, and feasting on garbage. But Remy has a passion for gourmet food and cooking, pursuits that support his life's ambition to do more and to be more. Remy is endowed with keen senses, is educated, and is obsessed with creating his art-food. The film has two underlying themes: (1) the pursuit of excellence over mediocrity, and (2) the conviction put forth by the restaurant critic Anton Ego that "a great artist can come from anywhere."

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Excellence and artistry are part of nursing practice as well. In the description of its Excellence Initiatives, the National League for Nursing (2006) explains that the nurses of today and the future must be able to do the following:


* understand the principles that underlie our practice


* be comfortable with ambiguity and uncertainty


* be agents for continuous change


* think critically and communicate effectively


* function effectively in the face of conflict


* manage technology.



As neuroscience nurses, we must apply these skills in the context of our unique "5-star" environment, and Remy can show us the way.


This passionate rat understands the basic cognitive, as well as the more sophisticated, technical skills of cooking and is able to teach these abilities to his human friend, Linguini, by precepting him at the late chef Auguste Gusteau's restaurant. (Granted, the early preceptive moments make Remy look like a puppet master manipulating Linguini like a marionette.) Remy is comfortable with ambiguity; he is, after all, a rat performing as a human might. When he is separated from his rat family, Remy's future is uncertain but his goals are clear-he has well-thought-out, focused, behavioral objectives to guide him.


Remy is a leader and an agent of change. With Linguini and Colette as his initially reluctant followers, he revolutionizes the nearly moribund kitchen of Gusteau's restaurant. He renews the staff's passion for excellent food, and he changes the culture of the work group. This culture shift is even more apparent when the other rats join the kitchen staff. Remy thinks critically and solves problems, and in doing so, he shows us how we can use critical-thinking skills such as creativity, risk-taking, curiosity, and deductive reasoning in domains other than those in which they were originally learned. He is an effective, albeit unusual, communicator. As he channels the famous chef Gusteau, Linguini, Colette, and the other kitchen staff members listen and learn.


Finally, Remy functions effectively in the face of conflict and constant change. He solves the problems inherent in his little size, and Remy not only manages the technology of the kitchen, but he teaches the other rats to do so as well. He is even able to teach the rats the importance of hand hygiene as they tumble through the wash and rinse cycles of the dishwasher.


Just as the kitchen staff lost their culinary passion and Linguini struggled to discover the artist within, we sometimes lose sight of the passion that brought each of us to nursing. We occasionally forget how much creativity and artistry are a part of the care we provide. Perhaps more important, we don't consciously think about those qualities that make us excellent, artistic practitioners of our craft. Take time to remember the little rat and his passionate pursuit of excellence and art. Like Remy, don't settle for the expected and the mediocre. Aim for rave reviews.




National League for Nursing. (2006). Excellence in nursing education model. Retrieved November 21, 2007, from [Context Link]


Janice M. Buelow, PhD RN, has worked for more than 20 years with people with epilepsy. She started as a staff nurse and worked in the epilepsy monitoring rooms at Rush Hospital, Chicago, IL. After completing her master's degree, Buelow worked as a clinical nurse specialist at the Rush Epilepsy Center. After she finished her PhD at the University of Illinois at Chicago, she spent 2 years as a postdoctoral fellow at the Indiana University School of Nursing (IUSON) under the mentorship of Dr. Joan Austin. She continued her research in epilepsy selfmanagement and began to focus on children with significant learning problems and their families. Buelow joined the faculty at IUSON, and teaches research in both the undergraduate and graduate programs. She has been funded by the Epilepsy Foundation and is currently funded by the National Institutes of Health.


Deborah Downey, MSN RN, has been a nurse for more than 30 years. She received her bachelor of science in nursing (BSN) and master's degree in nursing (MN) from The Pennsylvania State University, and received a postmaster's nurse practitioner certificate from the Uniformed Services University of the Health Sciences. Downey has worked at the Louis Stokes Cleveland Veterans Affairs Medical Center for most of her career in various roles, from nurse manager to clinical nurse specialist. Currently, she is a nurse practitioner on the neurology service where she cares for patients in a primarily outpatient setting. She has served on the JNN Manuscript Review Board and Editorial Board with responsibility for Media Reviews and Continuing Education articles, and is now responsible for the Pharmacology Update section. Downey and her husband are avid cyclists, and she is also a pilot, flight instructor, and a member of the Ninety-Nines International Organization of Women Pilots.


Janice L. Hinkle, PhD RN CNRN, began her nursing education with a BSN from the University of Utah. She completed her master's of science in nursing (MSN) 4 years later with a concentration in neuroscience nursing as a clinical specialist at the University of Virginia. Hinkle is a certified neuroscience registered nurse (CNRN) and has maintained this certification since 1989. In 1999, she earned a PhD from the University of Pennsylvania; the title of her dissertation was "A Descriptive Study of Variables Explaining Functional Recovery Following Stroke." She currently has a 5-year fellowship in Oxford, UK, funded by the Medical Research Council.


Laura Mcilvoy, PhD RN CCRN CNRN, has been active in AANN for more than 13 years, serving on numerous national committees and founding the Kentuckiana Chapter of AANN. As a CNRN for 12 years and a critical care registered nurse (CCRN) for more than 20 years, she has presented and published extensively on various neurotrauma subjects. Mcilvoy completed her PhD in 2005 and is currently pursuing a personal program of research on brain temperature and its impact on intracranial dynamics in the acutely injured neuroscience patient. She is an assistant professor at Indiana University Southeast, and also serves as a consultant and nurse researcher for the University of Louisville Hospital, a level I trauma center. She feeds and clothes a 15-year-old son, six cats, and two dogs.


Jennifer M. Woods, MSN CCNS CNRN, joined the JNN Editorial Board this year. Practicing in northeast Ohio, she has worked for the past 5 years as a clinical nurse specialist in private practice treating patients with a wide variety of neurological conditions in acute and chronic settings. Woods's special interests include critical care, neuromuscular disorders, and headache. She is married and has a 1-year-old daughter who keeps her busy.