The healing touch

Change has been constant in the health care industry, and particularly in the nursing field, since the days of Florence Nightingale.

Denise Kresevic, a member of the faculty at University of Phoenix’s Cleveland Campus and a nurse researcher and geriatric nurse practitioner at the Louis Stokes Cleveland VA Medical Center, has spent 30 years in nursing. Kresevic uses the famous nurse as an example of why nurses have to keep looking for ways to improve their profession.

“Florence Nightingale cut the mortality rate in half during the Crimean War simply by getting surgeons to wash their hands,” Kresevic says. “She was one of those nurses who collected data from the very beginning. Her observations were so astute. She found that something so basic as hand-washing could save people’s lives.”

Smart Business spoke with Kresevic about how continuing education is preparing today’s nurses to adapt to their changing roles and make the next great discovery.

What are the main issues facing nursing and health care industries in Northeast Ohio?

The scope of the nursing practice has increased so quickly. Physicians used to do the kinds of things that nurses now do regularly. In the 1950s, it was the physician that took blood pressure. Now we have nurses not only taking blood pressure, but we also have advanced nurses ordering blood pressure medication.

Even the role of nurse’s aides has changed dramatically. They used to just help a patient eat or bathe, but now they are actually doing things like taking blood pressure. So that function has gone all the way from the physician to the nurse’s aide.

So, one of our challenges is to determine how to adequately prepare nurses to provide this complex care. What educational programs do we need? What should a basic, entry-level education be, and what should be reserved for more advanced courses?

Another major challenge has been to target educational programs that develop competent nurses who are well rounded.

How can nursing and health care professionals address those challenges?

Continuing education is essential. But nurses shouldn’t just focus on clinical education. Yes, you want to keep up to date on the latest drugs and ways to manage pain, but you also have to keep up on the regulatory standards. There are more and more regulatory standards hospitals and nurses must meet in order to demonstrate competency. We really are in an era where we are calling everything ‘evidence-based.’ When it comes to nursing and health care procedures, we’re not doing it because it’s tradition — we’re doing it because there is strong evidence or research to support what we do.

This is particularly important when the population we look at is very diverse. Families have changed. No longer is the majority of health care done in the hospital during the four days patients come in for surgery. Patients need to be able to go home and care for themselves and stay healthy. In this facet, technology has been explosive. People can go online and find information, but they really need coaching and teaching about health.

Nurses’ relationships with patients has changed dramatically over the past 30 years. Patients are much more active partners in their care, and their care needs are far more complex. Certainly overlaying all of that is that the settings have changed and the reimbursement for care has changed. Plus, the regulatory standards are much more stringent.

How have continuing education programs in the nursing field adapted to changing times?

Many people are working, and nursing is their second career. Those students have a broad knowledge base. They’ve seen the world; they aren’t naive. Continuing education programs have to adapt so they fit into people’s schedules. Balancing life while working on your professional education is a stressful task. So, many of the classes have been adapted so people can fit them into their work schedules.

Traditionally, people would do a two-semester program, where they attended classes during the day and worked on individual assignments on their own time. Now, there’s evening and weekend classes and people work in teams on projects they can actually implement. It isn’t an esoteric paper that they’re never going to do anything with. It’s work-related. They are in a situation where they see a problem and they come up with a solution as a group. Then, they can take that back to their work setting and implement it. Continuing education students have too much to learn in too short a time, so their courses have to be work-related, valuable and applicable.

How do you make education more practical?

Continuing education students want to be active learners. They don’t want to come to a class where you’re going to lecture to them. They want to share their life experiences, which is a great way for the whole class to learn. So they learn partly from the instructor but a lot from each other. That’s a valuable learning experience for everyone.

Part of their education is lectures and writing papers, but a big part of nursing education is hands-on. That is where they work with an experienced nurse and get to see what the real world is like.

The partnerships with other people to provide care increase the complexity. Educational programs have to work on not just the clinical skills, but also the communication and collaboration. You are always working with a team. And the nurse is the quarterback — the one who coordinates all the team members and specialists.

Denise Kresevic is a faculty member at University of Phoenix’s Cleveland Campus and a nurse researcher and geriatric nurse practitioner at the Louis Stokes Cleveland VA Medical Center. University of Phoenix, the largest private university in North America, serves a diverse student population, offering associate’s, bachelor’s, master’s, and doctoral degree programs from campuses and learning centers across the U.S. as well as online throughout the world. University of Phoenix’s Cleveland Campus serves students online and at locations in Independence, Beachwood and Westlake/Crocker Park. To learn more, contact University of Phoenix at (216) 447-8807 or (800) MY SUCCESS, or