Shawn Tyrrell started in nursing in 1975, where she worked every shift at the hospital. After spending time in the OB unit, she served two years in the medical/surgical unit. She’s also been a practitioner and teacher at Rush University Medical Center.

From her many years on the unit floor, she has developed a deep understanding of service, patient satisfaction, quality clinical outcomes, and employee satisfaction. Now, as Adventist Hinsdale Hospital’s Chief Nursing Officer, she’s ready to use her skills and experience to prepare the nurses here for a nursing revolution that will focus on care transforming lives.

“I never planned on doing what I’m doing, I love, love, love patient care. But since 1985 I sacrificed that passion to be in a leadership role that could impact patient care on a broader level.”

Tyrrell’s heart is still clearly on the nursing floor.

“Nurses are the drivers of patient advocacy,” she says with the excitement of a new nursing graduate on her first day on the job. “They’re the ones who see patients every moment. They’re the ones who see the subtle, the not so subtle, what the patient needs, at any time. Physicians and social workers are patient advocates, too; but for nurses, it’s more involved because of the constant contact.”

But as a leader in health care nursing, Tyrrell not only has to be concerned with the advocacy and clinical roles that nurses play, but also how technology, economics, and the changing healthcare environment impact how they do their jobs.

A different kind of nurse

“I see a different kind of nurse in the future from what we have now,” Tyrrell says. What she sees is a nurse who is as comfortable texting a message as with starting an IV. A nurse who has as much of an eye for cost control and market share as for patient satisfaction. A nurse who can manage interruptions as well as nursing schedules.

Tyrrell outlines seven “pillars” of nursing: Seven responsibilities that nurses in the new health care environment will have to master. Those seven pillars of responsibility are:

• Provide exceptional clinical quality and patient service and safety. Measuring patient care outcomes and hardwiring clinical excellence will remain a primary focus for nurses.
• Maintain and improve patient satisfaction. This is a “customer service” program for patients, and includes soft skills such as interpersonal communications, proper greetings each time a nurse interacts with a patient, and making sure the overall hospital experience is a pleasant one for the patient.
• Decrease costs and help the hospital financially. This is where adaptability and comfort with new technology come into play. “Nurses will have to continue to use technology more smartly and creatively,” according to Tyrrell. “They will have to use more technology, such as converting from phone calls to texting. They need to be open to trying new methods, new ways of doing old duties.” Tyrrell says the efficiencies from using texting instead of phone calls, for example, can improve productivity and save the hospital money. Some U.S. hospitals even use Wi-Fi VoIP phones, laptops, PDAs -- even iPods – to track medical equipment, document patient information, and interact with other health care specialists. “Adaptability will be key,” Tyrrell notes.
• Create the best teamwork, and increase employee satisfaction, engagement, and retention. Nurses have to work together to harness the wisdom, knowledge, and experience of the 50+ nurse, as well as embrace the new ideas and technological skill of younger nurses just entering the field. “The average age of our nurses is 45,” says Tyrrell. “Only eight percent are below age 30 in Illinois. That means we’re going to have to work harder to attract and retain the younger nurse—especially given that 64% of nurses say they plan to retire within the next 10 years.” Tyrrell maintains the floor nurses have a powerful impact on retention: “If you’re working with a team you like and can trust, you’re less likely to want to leave.”
• Enhance the spiritual life of the patient – and of fellow nurses. Nurses no longer work in an environment where caring for the clinical needs of a patient is enough. “We’re looking at nursing to help the patient achieve his or her full potential,” Tyrrell says. That includes addressing not only the physical needs of the patient, but also the emotional and spiritual needs. “As nurses, we have the ability to elevate humanity. And that’s what Jean Watson’s Carative Model will help us do,” according to Tyrrell.
• Grow and increase our market share. Nurses as marketers may seem like a contradiction in terms, but with the financial challenges brought about by the recession and health care reform, nurses will have to step up to the plate and do their part to grow the patient population.
• Get involved in the community. Nurses of the future will play a key role in their communities. When nurses are involved in the community, the community gets to know them and trust them—and therefore those nurses and their hospitals will be the first ones people will turn to when a medical need arises.

Nursing the nurse

But isn’t all of this a little overwhelming for the nurse? Are there really enough hours in the day for a nurse to provide quality clinical care and patient safety—and be a cost control specialist, spiritual advisor, marketer, and technology wizard?

“There’s certainly a lot of moral and physical distress for nurses,” Tyrrell acknowledges. “Nurses are interacting (with patients and doctors) and doing so many things that they spend less and less time with patients. The average nurse is interrupted 11 to 16 times per hour, and when nurses feel they don’t have quality time with the patient, they become distressed.”

There is hope on the horizon. Tyrrell believes Jean Watson’s Carative approach to nursing is the answer.

“At the core of Watson’s model is love and respect – not just for the patient, but for the nurse as well,” Tyrrell explains. “That means there has to be visibility and openness. It means we have to care for the nurse as much as for the patient. It also means management has to do its part: We can’t lay it all on the nurses. On my watch, we are going to be strong as a team. I’ll be showing them financials, giving them the respect they deserve, valuing their input and suggestions. Nurses will be more empowered.”

A blueprint for change

To help nurses navigate the sea of change in health care, Adventist Hinsdale Hospital is implementing Magnet principles: a set of criteria designed to measure the strength and quality of nursing at a particular hospital. The seven pillars outlined by Tyrrell – along with the focus on empowering nurses and involving them in patient care decision-making—is at the core of the Magnet program. A Magnet hospital is one where nursing delivers excellent patient outcomes, where nurses have a high level of job satisfaction, and where there is a low staff nurse turnover rate and appropriate grievance resolution.

Nurses in a magnet hospital are also involved in data collection and decision-making in patient care delivery. The idea is that Magnet nursing leaders value staff nurses, involve them in shaping research-based nursing practice, and encourage and reward them for advancing in nursing practice. Magnet hospitals have open communication between nurses and other members of the health care team, and an appropriate personnel mix to attain the best patient outcomes and staff work environment.

“On a practical, day-to-day level, the Magnet program will make the nurse’s job easier,” Tyrrell explains. “If we have great teamwork, for example, there will be continuity. A nurse won’t have to live in fear that his or her shift won’t be fully staffed. There will be trust and respect among members of the nursing staff, as well as between physicians and nurses.”

When that happens, Tyrrell says productivity and efficiency increase, making it possible for nurses to do more in less time and with less stress.

“There are a lot of changes happening in health care and nursing,” Tyrrell says. “But what has and will remain is that nurses will be the drivers of patient advocacy.”

They’ll just be doing it using different technology and different approaches.