Q & A: What it takes to work on the front lines of patient care

Paula Miller talks about the challenges and rewards of being a nurse

There to get you settled when you arrive, and there to discharge you when you leave, nurses are an integral part of quality care in the field of medicine. We interviewed Paula Miller, director of quality at Bartow Regional Medical Center, about what it takes to be a nurse today.

Central Florida Health News (CFHN): Why did you choose a career in nursing?
Paula Miller: I wanted to be a nurse since I was six or seven years old. I wanted to take care of my dolls and pets whenever something was wrong! As I continued to grow, I never wavered. As soon as I graduated from high school, I entered nursing school. To this day, I have never once wished I had gone into a different profession. Nothing gives me more satisfaction than being able to make a difference in patients’ and families’ lives.

CFHN: What are the most difficult challenges?
Miller: Each day it changes. Healthcare today is so dynamic. Balancing the business aspect and still making sure the patient and family receive the care they require— and deserve— is one of the biggest challenges. Another challenge is balancing the diversity healthcare has— from patients, the culture of the organization, different issues and concerns, etc. At the end of the day, when you can look back and know you made a difference, then it is all good.

CFHN: What do you find the most rewarding?
Miller: When I first got out of nursing school, my greatest reward was knowing I was making a difference. Now that I do not provide bedside care, I enjoy mentoring staff and managers on how to make a difference in patients’ and staff members’ lives. Happy, fulfilled staffers make great caregivers.

CFHN: What is it like to be on the front lines in customer care for patients today?
Miller: It is awesome. The issues that arise are often due to things out of our control, but we can still make a difference. I believe strongly in a culture of Patient- and Family-Centered Care. The four tenets of this culture are treating all patients and families with dignity and respect, sharing all information, allowing the patient and family to participate in care, and allowing them to collaborate in decision-making. Whenever you have an unhappy patient or family, it is almost always due to a breakdown in one of those four.  Talking to a patient and/or family with a “what can I do to make this better” mentality makes them feel appreciated, and they know you are truly listening to them.

CFHN: Have changes in healthcare altered your duties? If so, in what way?
Miller: I have been nursing for more than 40 years, so I have seen many changes. We are so much safer. With medications, we receive electronic orders from physicians, and have so much access to evidence based practice with the Internet.  Changes can be overwhelming at times. Nurses have to be very mindful not to let technology take the human factor out of care.  They need to remember to make eye contact with patients and not just stare at the computer screen. Healthcare has become more complicated. But the electronic medical record is important, and double verification for giving certain medications is required, because patients have been harmed. These changes help us provide safer, higher quality care.

CFHN: Please discuss how nurses complement physicians in providing healthcare services.
Miller: We get to have more time with our patients. We are there all day with them in the acute care setting. We have the opportunity to make rounds with physicians and hear what he/she is telling the patient. This enables us to clarify what the physician told the patient. We are truly in a position to be the patient’s advocate.

CFHN: What personality traits should nurses have?
Miller: We all should be compassionate, caring, supportive, decisive, creative, rational, persistent, resourceful, courageous, self-motivating, nurturing, and flexible.  It takes all of these traits to meet the daily challenges nurses face to provide the care our patients deserve.

CFHN: Is there a great need for nurses? Is it easy to advance in the field?
Miller: Yes and yes. There is a very great need for nurses. The average age of our nurses currently practicing is late 40s to early 50s. As the baby boomer population ages, the need for nurses will continue to increase. As for advancing in the field, there are so many opportunities. It does take someone who is motivated, creative, and wants to reach out of his or her comfort zone. Those in higher levels of administration did not stay in one position. We took advantage of every opportunity we could, including education and volunteering for committees, projects, etc. We branched out to areas other than bedside nursing and found what felt right. It is a wonderful field to be able to find an area you love and advance in it.

CFHN: Is there anything else someone considering the nursing field should know?
Miller: Whenever I talk to individuals about my profession, I encourage them to become a certified nurse’s aide or volunteer at a hospital. I also talk with them about other healthcare opportunities. There are other careers such as radiology or occupational therapy that involve patient contact. There are so many opportunities in healthcare; to provide a holistic plan of care they all are needed. I also tell them I have never seen a show on television about nurses or hospitals that tells the true story. If that is what has them interested, it’s not a good reason.

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