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Clinical Nurse Leaders: Innovators and Advocates for Older Patients

Clinical nurse leaders (CNLs) have an eye for continuous improvement, and the COVID-19 pandemic pushed that instinct into overdrive. Since then, CNLs have quickly adapted their approach to patient care, often on the fly and as new information emerges. Nurse leaders have doubled down on advocacy efforts, particularly for those disproportionately impacted by the virus.

Lamar University’s online Registered Nurse (RN) to Master of Science in Nursing (MSN) program equips healthcare professionals for careers as CNLs, preparing them to care and advocate for those with chronic and complex conditions, including older patients. Below are some of the novel solutions and approaches nurse leaders adopted to navigate the pandemic and continue to implement to improve patient outcomes.

A PPE Distribution Network

During the early months of the pandemic, widespread personal protective equipment (PPE) shortages threatened the safety of healthcare workers worldwide. In response, nurse leaders and entrepreneurs established the Strengthen Healthcare Ability to Respond to Emergencies (SHARE) program. The group’s primary goal was to locate, collect, purchase and distribute critical protective equipment to frontline workers.

Just 30 days after its launch, the SHARE program had distributed more than “100,000 pieces of donated PPE to hard-hit facilities across the U.S.,” allowing healthcare workers to continue safely caring for the influx of COVID-19 patients.

While the world is no longer dealing with the severe PPE shortages that existed during the peak of the pandemic, the healthcare field has had to learn from this experience to prepare for future PPE resource strains. The Centers for Disease Control and Prevention (CDC) outlines a handful of PPE considerations for federal, state, local public health officials and other healthcare-related industries. It includes an outline of a hierarchy of controls, surge capacity and supply conservation strategies. CNLs and other healthcare professionals can stay up to date with these considerations in order to improve future care.

Virtual Tech

Nurse leaders have long recognized the value of virtual technology, such as providing more accessible healthcare to rural locations or helping elders maintain a social network. As a result of the pandemic, many nursing homes and hospitals had to prohibit or severely limit outside visitors to stem virus transmission, negatively affecting patient morale.

Nurse executives were quick to notice and respond. They now routinely use video chat and phone calls to keep loved ones up to date and foster ongoing interactions. This makes care more accessible for patients everywhere and helps healthcare providers reach more patients. For example, a 100-year-old patient who had not seen or spoken with her children in weeks expressed “immediate sighs of relief and happiness” when connected virtually, says the Patient Experience Journal.

Frailty Scores as Part of Care Plans

Frailty scores help assess a patient’s risk and predict poor outcomes. U.S. clinicians began relying more heavily on these scores to determine if patients would benefit from aggressive COVID-19 interventions, including ICU admission and ventilation.

Beyond the pandemic, nurse leaders have since recognized that the metric could prioritize patients’ strengths instead of just focusing on their diagnoses. This slight shift in thinking has moved the culture of care from disease-based to goal-based and resident-centered. Frailty calculations also offer an objective reference point when discussing expectations with family members.

New Dialogue About Aging

Ageism remains a prominent issue, and the pandemic highlighted the prevalence of agist systems and policies. For example, dismissive phrases like “COVID only harms older adults” imply that their lives are less valuable and minimize the seriousness of the pandemic.

The Reframing Aging Initiative, spearheaded by the Gerontological Society of America and promoted by nurse leaders nationwide, has sought to change the conversation. With resources for healthcare providers and the public, the initiative has increased advocacy efforts for older adults and restructured common misconceptions about aging. The new dialogue will likely influence policies and improve care overall.

Prioritized Residents’ Well-Being

Due to social distancing guidelines and disrupted visitation schedules, nursing home residents lost much of their autonomy and freedom during the pandemic. Residents were “eating less, talking less, and moving less,” notes an article in Geriatric Nursing. Elderly patients still have limited autonomy and freedom, but nurse leaders have since implemented several changes to prioritize resident well-being.

In some locations, transportation aides not only deliver meals to residents but also stay a while to visit. Residents are encouraged to sit outside if the weather is nice and incorporate music and television to enhance their days. Some facilities have even held outdoor concerts for residents to watch from their balconies in order to boost patients’ moods and create a stronger sense of community.

Learn to Provide Care Across the Lifespan at Lamar University

Ultimately, CNLs are natural innovators who were instrumental in navigating the pandemic and continue to be critical to improving care. With their unique mix of skills — bedside and research experience combined with an understanding of global health, organizational efficiency and at-risk populations — CNLs have the potential to solve healthcare’s most complex and pressing problems.

Nurses with an online RN to MSN from Lamar University can use established and new innovations to support the needs of their patients with leadership expertise. Courses such as the Nursing Practice: Care of Communities course and the Nursing Practice: Compromised Multiple Health States course equip them with the skills to work with patients of all ages (including older adults) and apply their knowledge to improve care overall.

Learn more about Lamar University’s online RN to MSN program.

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