I am a lifelong resident of the Tidewater area of Virginia and began my professional nursing career in 1995.  This was the best decision that I could have made and I find myself wondering where the time has gone!  At this point in my life, I cannot see myself NOT  being committed to nursing. 

I have experience in many areas of healthcare, which are not limited to but do include:  skilled care, telemetry, intermediate care, critical care, emergency medicine, quality management, as well as case management.  I am also an American Heart Association (AHA) Instructor of CPR and First Aid.  As you can see, I am fairly seasoned and well-rounded!  Thus far, my favorite area has been working within critical care.

I was awarded a Master’s degree after completing the rigorous Adult Gerontology Clinical Nurse Specialist/Nursing Educator program at Old Dominion University (ODU) in Norfolk, during the spring of 2016.  This was just after having earned a Bachelor of Science in 2013 from Virginia Commonwealth University (VCU), in Richmond.  I had many wonderful opportunities to interact with various professionals during my practicum experiences while a student at ODU.  Over 600 hours were dedicated to refining my skills as an Advanced Practice Registered Nurse (APRN) and Nurse Educator.  Overall, the time was very well spent and I appreciate the rare privilege of being exposed to so many knowledgeable and caring people. 

Three wonderful rotations were spent within different departments at Sentara Norfolk General Hospital, my area’s level one trauma center.  One of the best and most eye-opening experiences was working with their wonderful Palliative Care Team.  Several patient care conferences were attended daily with the team.  These meetings are designed to assist patients and their families determine the goals of care that are in line with the patients’ expectations.  This was a very valuable experience and one that left a lasting impression upon me.  Essentially, I came to the realization that we need to begin end-of-life care education and discussions long before a crisis situation arises.   

I also had the opportunity to work with an outstanding Gerontology Nurse Practitioner, who is also trained as a Clinical Nurse Specialist.  In addition, she holds a Doctorate degree and serves as a Nurse Educator at ODU.  Primarily, she works with residents of a secure facility that specializes in memory care.  Again, I watched families and caregivers struggle with ethical dilemmas related to care that was being provided to people who no longer remembered who they were or where they were.   

I was able to join the folks at Rappahannock Community College for my teaching practicum in the fall of 2015.  This experience returned me to my roots of a community college’s Associate degree program.  It felt like I had come full circle.  However, many technological advancements have occurred since I attended my first nursing program!  No longer is nursing taught passively; the classrooms are now flipped and learning is more student-centered and active. 

I was allowed to teach their second-year students.  Essentially, I created my own lesson plans and presentations within the cardiac area.  As I mentioned previously, I joined them the summer after graduation as an adjunct faculty member, teaching students nursing excellence in the simulation laboratory, as well as at clinical sites. 

Why Am I Doing This?

Plainly said, I hate to watch people suffer needlessly and I feel guilty for not having spoken up sooner.  Through my vast nursing experiences in critical care and case management, I have developed very strong feelings about working to ensure everyone over the age of 18 has an advance directive in place.  This document speaks for you when you are unable.

You are likely unaware of the unnecessary misery that plays out on a daily basis, in just about every hospital across this country, over and over again.  Trust me–the Palliative Care Teams’ dance cards are booked days in advance, all to discuss care about a person who, in all likelihood, cannot participate in the discussion.  These conversations are extremely difficult and emotionally laden.  The people who attend are usually wholly unprepared for these chats, often due to denial, grief, a lack of sleep, or a basic lack of medical knowledge.

Clearly, we are asking the wrong people at the wrong time!  You cannot take part in the decision-making when critically ill.  Even if you have verbally expressed your wishes to those who love you, please don’t put these people in a place where they have to make decisions upon your behalf.  They often struggle with this burden and second-guess themselves, sometimes suffering from guilt for many years to come, long after you are gone.  Even worse, they make decisions based upon what they want, not what you would want.  I feel like I am being called to try and change this culture.

I, like thousands of other nurses across this great land, have cared for patients when a surprising illness or accident struck.  Some might even say I have been severely traumatized by the countless cases, which I have witnessed unfold, much like slow-motion train wrecks.  The situations are different but the nuances remain essentially the same. 

An advance directive is a gift that eliminates ambiguity and provides some measure of comfort to those you love.  It protects them by literally relieving them of the responsibility for making your life or death decisions.  Folks must understand how imperative it is to have this documentation place, especially if your next-of-kin is not the person who you would want to make your healthcare decisions for you.  I have discovered that all too often people are just plain wrong when they attempt to correctly identify who their legal next-of-kin is.  Many times, learning this information alone will serve as motivation to document their wishes and formally elect agents to speak for them when they are unable. 

It just makes it so much easier for everyone concerned when an advance directive is in place.  Healthcare providers know who to call and at what number.  Your care can proceed with confidence because the team knows which course you would want the team to take on your behalf.  Family members are alleviated of making decisions, like about organ donation, during their time of grief.

Please take the time to document your wishes while you are able.  Life has a way of sneaking up on you, catching you unprepared.  Come talk to me, while we can have a little fun in the process!  I promise I am not selling caskets!  Do not put your family through the wringer, when they are at one of the very lowest points of their lives!

This is my way of giving back and perhaps preventing the necessity for those tough conversations altogether.