Medical Center nurses’ role has grown in scope and responsibility

The nursing profession has a long and impressive history. Nurses have always been the backbone of healthcare. We, in eastern Maine, can boast the best nursing professionals of any in the country. One hundred years ago Bangor General Hospital was one gray stone building with five iron beds. In those days, the nurses gave compassionate care under the orders of a small group of physicians on the medical staff. Over the years, the role of nurses has grown in scope and responsibility.

As Bangor General became Eastern Maine General and then finally, Eastern Maine Medical Center, the nursing profession also grew and changed. Nurses are seeking higher levels of education and certification. They are sharing the responsibilities of decision making with the physicians through joint practice protocols and clinical pathways. They are practicing primary care within the communities, under the supervision of doctors. And at Eastern Maine Medical Center they are at the center of many important research projects–projects which will have a role in changing the way medicine is practiced at EMMC and potentially across the country.

Groundbreaking Orthopaedic Research

On Grant 5, nurses are teaming up with orthopaedic physicians to study joint replacement surgery in a way no one else has. Nurses and doctors in the orthopaedic service set out to determine the kinds of factors influencing the relative success of joint replacement surgery. They have just wrapped up the first year of a study that is just getting started in other parts of the country.

Joint replacement can restore mobility and allow patients troubled with joint problems to continue living comfortably and independently. Eastern Maine Medical Center’s study tracks these patients to determine risk factors that could produce complications. The data will help this team stratify patients by risk to permit appropriate interventions and improve outcomes. Nurses have been instrumental in gathering the appropriate data from patient records and supplying vital information.

This important work is receiving national attention. Recently, the EMMC study gained an $87,000 two-year grant from the Orthopaedic Research and Educational Foundation. The grant will allow EMMC researchers to follow patients from their surgery through two years of follow up to measure their success.The research includes 13 doctors and all of the orthopaedic nurses.

Paula Lowney, RN, case manager for these patients, says the study will help healthcare providers better anticipate the needs and boost the outcomes of joint replacement patients. We can evaluate the effectiveness of nursing interventions, such as patient education and the use of clinical pathways.” It will give us a better idea what factors influence short and long term outcomes.

Nurses Help Lead Study on Emphysema Care

One floor up, on Grant 6 West, doctors and nurses specializing in pulmonary medicine are conducting another important study. They are looking into alternative ways to care for patients with chronic obstructive pulmonary disease (COPD), a group of lung disorders that includes chronic brochitis and emphysema. Funded through a consortium of public and private sources, this research team will compare the results of two different types of treatment for COPD. Emphysema is a chronic lung disease that often requires hospitalization when it flares up. Traditionally, special breathing devices called nebulizers have been used to administer inhaled medicines. In addition, doctors order intravenous antibiotics and steroids to help clear up the problem.

In the EMMC study, nurses and respiratory therapists are giving a randomly selected group of these patients an alternative treatment regimen using less expensive metered dose (aerosol) inhalers rather than nebulizers for inhaled medications and oral antibiotics and steroids instead of IVs to treat flare ups. Our hypothesis, says Lorraine Rodgerson, RN, department head nurse of Grant 6W, is that the less expensive approach to treatment is as effective as the traditional, yet more costly, treatment of COPD. Again, this research could have national implications, potentially lowering hospital costs for these patients, many of whose bills are paid with tax dollars through Medicare and Medicaid.

Nurses Assist in Preventive Research

In the Diabetes and Nutrition Center, the clinical team has been working under a $5,000 grant from the Eagles Club to look at ways to reduce the risk of diabetes complications. Diabetes is a serious, chronic disease which is the leading cause of blindness and limb amputation, and a major cause of heart disease, stroke and kidney disease. One in every seven healthcare dollars is spent treating diabetes complications.

The study models a national research project called the Diabetes Control and Complications Trial, which proved that many complications can be prevented or delayed through better control of blood sugar and frequent healthcare follow up. The local research was aimed at determining if this kind of tight control and follow up was realistic in a rural population like ours.

EMMC’s research was headed up by Pat Stenger, RN, diabetes educator and coordinator of the Diabetes and Nutrition Center, in coordination with Karen Lutz, a registered dietitian in the center and numerous primary care physicians. Our study found the biggest influence on people’s ability to maintain a preventive level of control was the frequency of healthcare visits. We met these patients every three weeks, and, through those visits, were able to help them feel motivated and supported, observes Stenger. The key to making this type of model work is developing a network of healthcare resources that can provide that support and encouragement to these patients wherever they are in Maine. If we can do that, we can save lives and lower the cost of healthcare dramatically.

As healthcare advances into new terrain, in search of more knowledge about the best ways to care for the sick and injured, nurses are there. They are there as partners, side by side with physicians and other clinicians and technologists, working to determine what works best and most efficiently. And they are there, at the patient’s bedside, continuing to earn for the profession the reputation made famous by Clara Barton, Dorthea Dix, and others: always compassionate, always competent, and always advocating for the best possible care for the most vulnerable among us.

This article was provided by EMMC Public Affairs.