Nurse on the Move: Lisa Górski

During a phone interview, I talked with Górski about why she decided to get into home health care, her time as president of the Infusion Nurse Association, and what advice she has for nurses starting their careers.

Even as a bit of child, I desired to turn into a nurse. When I used to be 5 or 6 years old, I drew an image and wrote a story about how much I desired to be a nurse and help people! This desire never diminished. In highschool, my intense interest in science and a summer volunteering at a hospital as a “candy bagger” solidified my belief that I desired to turn into a nurse.

I knew I desired to work with patients for the long run. I had several college friends who worked in home health care, and on the time, changes in reimbursement led to shorter hospital stays and more transitions to home care. I saw a possible future in home health care.

The challenges and opportunities of this specialty were obvious to me, including working with families in addition to patients and dealing with them for prolonged periods of time to make sure they function well at home. There is an ideal need for effective patient education to assist them manage their very own care. While the assessment and intervention skills I gained during my acute care experience were useful to me, I needed to develop a brand new body of data. While I used to be in a position to manage the blood sugar levels of a critically ailing patient, working with home care patients to oversee diabetes was a special challenge that required not only a clinical concentrate on diabetes, but in addition a concentrate on living with a chronic disease. During my master’s degree, I studied issues related to living with chronic diseases. One of the books I read in college continues to be on my shelf and continues to supply me with recent perspectives – Strauss and Glaser (1975).

One of the challenges is time management. Home care nurses travel and typically see five to 6 patients on the identical day. Depending on patients’ needs, a major period of time can also be spent coordinating care and communicating with other health care professionals involved. As any home care nurse will let you know, documentation is a major burden. You should be accountable to the patient and family. When you permit home, it is advisable take into consideration what is going to or could occur after you permit – have you ever addressed crucial issues to be certain that your patient shall be protected if you are gone, because nobody else shall be there until you come. Think of a patient with an ongoing infusion of chemotherapy drug. Does the patient understand what to do and who to call within the event of an alarm or hostile response? Is there an easily accessible telephone number to call in case of problems?

From a broader perspective, the pressure to make sure positive patient outcomes while meeting reimbursement constraints is difficult. The primary goal of home care is to maintain patients protected of their homes. The home health hospitalization rate is a publicly reported final result, and hospitals are penalized when patients return to the hospital inside 30 days. As a nurse who has worked in home take care of 30 years, the patient’s acuity level has actually increased. I imagine the challenge for home care nurses is to focus less on the tasks at hand, corresponding to wound care or other procedures, and more on recognizing nursing diagnoses and managing outcomes. Keeping patients at home requires that the nurse has exceptional assessment skills, that risk aspects for readmission are identified and mitigated, that continuous monitoring identifies and reports early/subtle changes in condition to enable early intervention, and that close attention is paid to medication management.

I became a house care nurse within the mid-Eighties, during a period of great growth in the house care industry. A growing trend was for patients requiring infusion therapy to be transferred from hospital to home.

During this time, I cared for a lot of patients who required home infusion therapy, starting from easy intravenous antibiotics to complex parenteral nutrition. My critical care skills combined with growing experience in home care have served me well on this area of ​​practice. However, one in all the issues I identified was that exceptional IV therapy skills wouldn’t suffice in home care. Because patients and families are involved in various features of IV self-care, the house care nurse’s patient education skills are equally essential. Patients often feel anxious or can have functional limitations that affect their ability to learn and cope, so these have to be addressed. My first article published in 1987 was about patient education. I actually have since written three books on home infusion therapy and am within the means of writing one other one.

After a few years of working at INS in various local and national roles, it has been an honor to function president for this 12 months. I then continued to serve because the INS Chair for the Standards of Practice in Infusion Nursing for 2011, and I’m currently serving in that role again for the standards that shall be published in 2016. There is a rapidly growing research base on infusion therapy conducted by researchers from around the globe . Working with my amazing infusion therapy colleagues to look and review the literature and develop evidence-based recommendations and educate the infusion community has improved patient outcomes and reduced preventable complications. My involvement with INS has led to many opportunities. I had the pleasure of giving many presentations throughout the country and several other international presentations. I repeatedly speak or have email discussions with nurses, pharmacists and physicians about infusion issues and practices. I recently had the chance to perform in Santiago, Chile and Buenos Aires, Argentina, and shall be presenting in China later this summer. It is obvious that nurses, not only within the US but around the globe, strive to supply best practices to their patients.

Nurses today have so many opportunities in many alternative environments. When you permit a position, you must feel like you’ve got mastered it. Really learn your first job and develop your skills, especially in collaboration with other healthcare providers. Identify where your strengths lie and use them to find out where you must go. Also become involved in nursing organizations related to your practice. I’m also a member of the National Association of Clinical Nurse Practitioners and the American Nurses Association, which have provided me with more information and knowledge and greater exposure to colleagues with similar interests and challenges. I recently attended the International Home Care Nurses Organization (IHCNO), where I used to be inspired by reports of home care research and practices in several countries. Engaging in practice beyond on a regular basis organizational work keeps us fresh and motivated!

It’s really vibrant! Nurses have many opportunities in quite a lot of settings, each clinical and non-clinical. Nurses shape health policy and are increasingly involved in politics. Our critical pondering, expertise and leadership have an incredible impact on patient care. We, healthcare leaders.

*Do you recognize an inspiring nurse who shall be honored in the subsequent edition of “Nurses on the Move”? Send your entries by e-mail
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