In her job as a pediatric clinical nurse specialist, Rena Pearson-Shaver, RN, MSN, emphasizes communication and flexibility.
During a typical day at the Children's Medical Center in Augusta, Pearson-Shaver might need to spend hours explaining a home-care procedure to a family, or it might take only minutes. She's learned to tailor her teaching style to fit a family's needs.
Clinical nurse specialists like Pearson-Shaver are licensed registered nurses who have graduate preparation in nursing. These specialists practice in a wide variety of health care settings and are expert clinicians in areas such as pediatrics, critical care, diabetes, rehab or psychiatric/mental health.
"CNSs are mostly specialty-oriented, and they need to have a strong background in that specialty, with least several years in experience in that area with good hands-on skills," Pearson-Shaver said.
While all nurses on staff at Children's Medical Center teach different portions of what parents and caregivers need to know before a child goes home, it is Pearson-Shaver who coordinates that information.
"Communication is the key to the whole thing, and that starts not just with the nurse and the family, but [with] the entire interdisciplinary team," she said. "If there's something the physician wants the nurse to teach, if we can be apprised of that, then we can educate the patient all along the patient's stay, instead of [just on] the day of discharge."
For example, she said, the families of patients who have open-heart surgery should not be taught how to perform CPR on the day of the surgery. "You have to plan when to do it, and work with whatever is going on with that family.
"We need to understand the family's capabilities for learning, and how they actually learn best," she said. "Some people can take written directions, read them once, and they're fine. Others need pictures, and still others need to do the procedure three or four times before they're comfortable with something."
One of Pearson-Shaver's biggest teaching challenges involved an Hispanic family that had a child with a congenital heart defect. The family could only be present at the hospital for two days to learn how to take care of the child.
"We knew the daddy spoke English, and so I went armed with Spanish medical sheets and a Spanish video to talk to them," she said. "But when we got to the room, the daddy needed to leave ... and I found out that the mom didn't read at all."
Pearson-Shaver called in a translator, used the Spanish videos and drew pictures to illustrate the proper care.
"That's where the value of having the day to dedicate to education comes in. The typical nurse is not going to have the type of time," she said.
While not every hospital has clinical nurse specialists, "we have proven that CNSs have helped decrease repeat visits," she said. "We need people who can focus on meeting all the discharge needs of the patient."