The transfer in February of more than 130 patients – mostly children – from UCSF Medical Center at Parnassus to the trio of new UCSF hospitals at Mission Bay was by all accounts a well-executed move by an entire organization.
It was also an exaggerated example of a care transition and of the need for skilled clinicians – often acute care nurses, clinical nurse specialists or nurse practitioners – trained to ensure coordinated, continuous care as patients move between different locations or different levels of care.
Transitional care is a hot topic these days due to its emphasis in the Affordable Care Act, but, of course, overseeing transitions is only one of many clinical roles for acute care nurses. Others include patient monitoring, symptom management, patient education, family support, patient advocacy and communication. Acute care nurse practitioners (NPs) also diagnose and treat patients.
All of these roles are crucial for patients’ sustained recovery from illness and reintegration into their lives when they leave clinical settings. All demand training and high-level thinking. Yet outside of the nursing world, these roles are often misunderstood, and downplayed in vaguely patronizing ways, such as stories about nurses with hearts of gold, as though compassion – important as it is – were the only skill needed to perform the job. Such portrayals can be a source of frustration for nurses, leading to the emergence of groups like The Truth About Nursing and The American Nurse Project.
But some nurses take refuge in the knowledge that most patients and families who have suffered a serious health crisis know the role that nurses play. Often, these families have remarkable insights into how their lives might have been different if not for the work of expert nurses.
Consider Amanda Wallis and her daughter Kathleen (Katie) Blue. Now 24, Katie was born with a congenital heart defect – a double-inlet single ventricle – that required a series of complicated surgeries by a highly skilled surgeon to address. Though it was almost a quarter century ago, Amanda remembers vividly sitting with her intubated infant in the aftermath of the first corrective operation and observing Linda Roan (MS, 1986), a pediatric intensive care nurse at UCSF Medical Center.