By PRISCILLA GREEAR, Staff Writer | Published October 13, 2005
Through the decades, nurses have worked from the bedside to the boardroom and the classroom to stay in touch with and ahead of the changing times and to assure Saint Joseph Hospital’s leadership position in health care. At the same time, they’ve followed the hospital’s Mercy mission—compassionate health care in a Catholic environment. And now Saint Joseph nurses will have even greater opportunity to contribute to research and raising standards in their profession, with the establishment this spring of The Kenneth E. Thomas Center for Nursing Excellence.
While Saint Joseph’s School of Nursing graduated its last class in 1973 as the Georgia State University nursing program was established, the hospital continues into the 21st century to show the world the ever increasing value of the trained nurse with its pioneering tradition of nursing excellence. This nursing leadership is critically important today as hospitals and doctor’s offices face shortages of nurses around the nation. The Atlanta Business Chronicle reported last year that Georgia is one of 30 states facing a nursing shortage, which experts say is especially severe in the Southeast. According to a 2002 U.S. Department of Health and Human Services study, there are projected to be more than 32,000 unfilled nursing jobs by the year 2020 in Georgia. In an article on the Georgia Nurses Association Web site entitled “Eight Things To Do for the Nursing Shortage,” the director of The Center for the Health Professions at the University of California, San Francisco, Edward O’Neil, Ph.D., reported the top need is to “first leverage the strategic value of nursing to the core missions of the hospital—quality, safety and efficiency. Without the understanding that nursing is at the core of each of these values, there will be no progress made.”
Affirmation of the strength of Saint Joseph’s nurses came in 1995 when it became only the third hospital in the nation, and the first in Georgia, to receive the Magnet Recognition for Nursing Excellence from the American Nurses Credentialing Center of the American Nurses Association, ranking it among the top 1 percent of nursing programs nationwide. Its nurses have won the award twice more since 1995, an achievement shared by only two other hospitals in the United States. Nurses in only one other hospital in Georgia have also earned the Magnet recognition. And the Center for Nursing Excellence, named for the late cardiothoracic surgeon who was one of the pioneers of Saint Joseph’s cardiovascular program, will focus on nursing research, including studies of the differences in patient outcomes related to the environment in which a nurse works.
“Our Center for Nursing Excellence is gong to have a very strong focus on research, not only about nursing and the profession, but about the differences in patient outcomes related to the environment in which a nurse practices and the adequacy of nursing care,” said Vickie Moore, RN, chief nursing officer and senior vice president of operations at Saint Joseph’s.
A 1963 graduate of the hospital’s former nursing school who has worked there since, Sandy Shupe reflected on the joy of her career there, which keeps her coming back across town from Tucker year after year. A Baptist who is now the manager of pre- and post-operative care, she believes the hospital has stayed true to the vision of the sagacious Mercy Sisters, and that dedication to human life still permeates the medical mission.
In 1980 nurses launched the Shared Governance Professional Practice Model, an operational method that lets nurses working on the front line—that is, at the bedside—make decisions about nursing policy, procedure, education and standards for patient care. Traditionally, nursing policies and procedures are set by chief nursing officers or departmental directors. The model allows bedside nurses to create their own environment, making them happier and resulting in better patient outcomes. Saint Joseph’s nurses began taking leadership positions in every specialty and at every level within the hospital, including the board of directors. When the hospital began its open-heart surgery program, nurses took the lead in making sure they themselves were trained and obtained the appropriate credentials, and they developed standards and procedures for best practices in transplant patient care.
Shupe added that staff nurses lead and are members of councils focusing on leadership, performance improvement, professional development and nurse practice.
“We write our own policies. We do our own performance improvement. We watch issues that are current and do a lot of research,” she said. “Instead of being a top-down hierarchical managerial style, it’s from the bottom up so nurses at the bedside decide what practice is and how to make changes that benefit the patients from their knowledge and background.”
She too has always had a position to grow into. “They’ve always met my needs … They support our education, growth and development as professionals.”
The Kenneth E. Thomas Center for Nursing Excellence will include a professional development component—helping nurses gain clinical expertise and training. Furthermore, it will contribute research and work to develop health policy on a national level and will advocate for nurses to ensure that their work environment includes professional practice and autonomy. The center is named after Dr. Thomas because he sought opportunities to test and educate nurses, inspiring a passion for learning at the hospital.
“The continued professional development of nurses is fundamental to maintaining high quality patient care,” said Moore. The research program will foster tighter relationships with researchers nationally and “because of its Magnet designation and expertise, Saint Joseph’s is in a unique position to make significant contributions to the nursing profession.”
The center will continue the work already begun by Saint Joseph’s nurses to help colleagues in the Caribbean bring Magnet principles into their practices and will continue collaboration with the Lillian Carter Center for International Nursing, sponsoring conferences in conjunction with the American Nurses Credentialing Center.
“It is so much more valuable for patient care for the nurses who are actually at the bedside every day to be involved in policy development,” said Moore.
And as the nurses develop professionally, Moore also stressed how customer-oriented attention to both the vulnerable patients and their families is an integral part of its standards of excellence.
“We do things to them that they would prefer not happen, all in the name of getting them well,” she said. And so, “it’s important to Saint Joseph’s that patients and their families feel comfortable with the care they receive and the compassionate way it’s delivered.”
To pass on that philosophy of care, Shupe, with a comforting gentleness one would appreciate before surgery, said that Saint Joseph’s feels a sense of responsibility to remain affiliated with various area nursing schools for which it provides mentoring and training, sharing those clinical and ethical standards of excellence. While most of her nursing staff is not Catholic, she has never found anyone to have difficulty working in the faith-based hospital. Rather, the philosophy unites people of faith and good will as they give of themselves as caregivers. As for this Protestant, she cheerfully added that one sister “told me I could come in as a lay nun.”
In the rare case that a patient dies in surgery, family members often call a chaplain in for prayer, and the nurses usually choose to participate, Shupe added, pulling out her Bible marked to Luke from which she reads on those occasions. And nurses feel free to pray with patients before surgery when asked. “Sometimes a patient will say ‘will you hold my hand and pray with me before surgery?’ And it doesn’t matter what religion they are—they are apprehensive, and you calm them. In this atmosphere we feel fortunate to be able to do that.”
Shupe is also co-chair of the philosophy and action committee where she helps organize an annual Mercy Day drive to collect substantial amounts of money and goods for Mercy shelters. The hospital also donates school supplies and provides mentoring for students at area schools, has each department support a family or two at Christmas, and builds a house yearly for Charis House, a community housing program, with which she helps.
Chief of staff Dr. Eugene Davison, a general surgeon, appreciates the professionalism and dedication of nurses like Shupe. He was attracted to the hospital in part by the strength of the nursing program. It has remained strong despite “the tremendous pressure on nursing in the U.S.” When he began there 25 years ago, there were 6.7 nurses per patient per bed, and now there are about 5.5 per patient, which is still significantly higher than the national average.
“I think that emphasis on nursing care is essential to compete in the market for good nurses. Hospitals with high acuity of illness patients need that particularly. The future is bleak in nursing so Saint Joseph’s will have to be innovative to keep their staff at a high level,” he said. “Nursing here has always been one of the really strong points. They do a superb job. They have people dedicated, knowledgeable and prepared here,” who are able to spend more time with patients.
Sister Jane Gerety, RSM, vice president for sponsorship, is mindful of the resourceful and determined Mercy sisters who founded the hospital as nurses and is glad that still today doctors here know they are leaving their patients in good hands.
“Nursing has primarily been a women’s profession. Here at Saint Joseph it’s recognized as a profession all on its own with its own expertise … and governance,” she said. “It’s like the nurse knows what she knows how to do and does it as best she can, the doctors knows what he or she knows and together they are really partners. It’s a very empowered group of nurses we have here.”