BCEN's 2020 Distinguished CPEN Award winner discusses why certified nurses are suited to lead during a pandemic and how investment from hospital and nurse leadership can foster professional growth.
Certified nurses have long been champions for innovation and improvement at CHOC Children’s Hospital in Orange, California, says Lisa J. Chambers, MSN, MPS, RN, CEN, CPEN, TCRN, emergency services/trauma clinical educator, so when the COVID-19 pandemic struck, they stepped up to transform emergency department processes.
Chambers, who was recently named the Board of Certification for Emergency Nursing's (BCEN) 2020 Distinguished Certified Pediatric Emergency Nurse (CPEN) Award winner, recently discussed the role certified nurses have played in the country's responses to COVID-19 with HealthLeaders.
The following has been lightly edited for brevity and clarity.
HealthLeaders: How have you seen certified nurses innovating during this pandemic?
Lisa J. Chambers: Certified emergency nurses are confident in innovating improvements in emergency department flow, depending on the day-to-day needs. Our department has certified nurses making decisions on every level of department function and care provision. Creating a COVID-19 workflow in the emergency department occurred, in part, through collaborative discussions with certified nurses and the emergency physicians that work in our department.
Identifying patients and parents with potential exposures and those who also were arriving solely for a COVID-19 test was helpful early in the pandemic. Then, once the virus became community-acquired, almost every symptom that a patient presented with meant they may be a COVID-19 positive patient. We have a COVID waiting room for patients and families who arrive only wanting a COVID-19 test. They sit in family units socially-distanced and then are tested in a negative pressure area to avoid any cross-contamination.
Sick patients are processed through the department in a socially-distanced manner with increased vigilance over surface disinfection and isolation precautions. The reality is that anyone may be positive and without a negative test, everyone must be considered either positive and symptomatic or positive and asymptomatic until their COVID test is processed and reveals the results.
HealthLeaders: What characteristics do certified nurses embody that makes them suited to lead during the pandemic?
Chambers: Certified nurses have been found to be more confident in their care delivery and have a stronger knowledge base. This is because they have a deeper depth of understanding of the concepts around care.
There is a bit of risk involved with paying for the certification exam and the overarching concern that one might not pass. Finally deciding to test is a leap of faith. Studying and preparing to take the exam does take a bit of commitment … but [certification is] the seal of confidence that nurses recognize that they have indeed attained what they hoped for, and then they are able to perform at an even higher level because they themselves feel the weight of their knowledge and responsibility.
HealthLeaders: The current situation in the world has caused many to rise to the occasion, but do you have any examples of how certified nurses were innovating before the pandemic?
Chambers: All the leaders in our department have at least one certification. Our pediatric base station coordinator Kim Zaky, MSN FNP-c, MICN, CEN, CPEN, TCRN, helped our hospital establish the first pediatric base station on the West Coast.
And there are several [CPENs] on our Clinical Practice Council, which is a shared governance group. The CPENs champion many improvement processes in our department. Some examples are bedside report audits and a metabolic patient care improvement process.
HealthLeaders: What lessons can nurse leadership and/or hospital leadership take away from your experience?
Chambers: At CHOC Children’s Hospital, because we are a Magnet [Recognition Program®] hospital, we take nursing certification seriously. Nursing excellence helps us to promote excellence in care delivery and improve patient safety. Having a reimbursement and reward program in place helps the nurses know that the hospital is committed to the nurses' growth and the quality of care delivery. Up until a year ago, the cap for all reimbursement for education was kept at a one-time reimbursement of $10,000. Then last year it went to $10,000 per year. This is a very generous and helpful benefit to all of our staff.
The hospital also offers classes and many opportunities to grow and expand knowledge, experience, and leadership skills. They have invested in the infrastructure and the support standards that allow for professional and personal growth.
HealthLeaders: Post-pandemic, do you think hospitals will seek out more nurses with certification?
Chambers: That is difficult to say. There is still a nursing shortage and not all hospitals can wait for better qualified candidates to fill positions. A hospital like CHOC that truly demonstrates a commitment to help nurses grow while improving the level of care for the patients is a rare and wonderful treasure. Many hospitals want the nurses to be certified, but do not want to help the nurses afford the honor. Nurses do not tend to invest in themselves, as they are really focused on benefiting others. When nurses feel invested in, it helps to grow a sense of commitment and loyalty.
With a strong knowledge base and high level of confidence, certified nurses are essential to innovating patient care during the pandemic.
Investing in programs that promote nurse growth and professional development improves care delivery and patient safety.