NAME: Kathleen M. Stacy, PhD, RN, CNS, CCRN, PCCN, CCNS
CURRENT POSITIONS AND AFFILIATIONS: Clinical Associate Professor - Hahn School of Nursing and Health Science, University of San Diego; Clinical Nurse Specialist, Intermediate Care Unit, Palomar Medical Center
AREA(S) OF SPECIALIZATION: Critical Care, Alarm Management and Patient Safety
PROFESSIONAL EDUCATION: PhD, University of San Diego
CERTIFICATIONS: CCRN, PCCN, CCNS
Dr Kathleen M. Stacy is a clinical associate professor at the University of San Diego, Hahn School of Nursing and Health Science, and a clinical nurse specialist (CNS) at Palomar Medical Center. Dr Stacy received a bachelor of science in nursing from SUNY at Plattsburgh, a master of science degree in critical care nursing from San Diego State University, and her doctor of philosophy in nursing from University of San Diego. Dr Stacy has been practicing and teaching critical care nursing for more than 35 years. She has held a variety of positions, including staff nurse, clinical educator, outcomes manager, and nurse manager. As an advanced practitioner, Dr Stacy collaborates with the healthcare team to facilitate the achievement of optimal outcomes for the chronically critically ill patient.
Dr Stacy's research interest is patient safety with a focus on alarm management and hospital-associated infections. Her initial research in the area of alarm management examined the contextual factors that influenced the nurses' response to the alarms. Dr Stacy is a member of the Healthcare Technology Safety Institute Clinical Alarms Steering Committee. Dr Stacy's initial research on hospital-associated infections examined nursing practices in the management of central lines. She has also conducted research on end-of-life issues.
Dr Stacy is an active member of the American Association of Critical-Care Nurses and has participated on numerous committees, work groups, and task forces. Most recently she was a member of the CNS Scope and Standards Task Force, which was responsible for the latest revision of the AACN Scope and Standards for Acute Care Clinical Nurse Specialist Practice. Dr Stacy has published several articles and coauthored 2 critical care textbooks: Critical Care Nursing: Diagnosis and Management and Priorities in Critical Care Nursing.
What first motivated you to become a CNS?
I have been a nurse for over 35 years, and when I started, the first thing I noticed was that there was no role model or resource for the new graduate nurse on the unit. I went through a new graduate program, which was taught by a group of nurse educators in a classroom; however, when we were oriented to the floor, there was no one person whom I could go to for questions. I found that the orientation to the floor was inconsistent, and I was oriented by nurses who had been in the unit for a long time but were not necessarily the best role models. Nor had they been prepared to take on the role of preceptor. I would ask questions and often received several different conflicting answers. I kept thinking there has got to be a better way to integrate new graduate nurses into an organization and new nurses into a unit. Around this time, the role of the CNS was emerging and programs were being developed to educate nurses for that role. I thought that would be the perfect role to accomplish this. Thus, becoming a CNS became my career goal.
What drove you to your clinical specialty area?
I started out in an orthopedic unit that took care of a lot of trauma and surgical patients. I worked there for a while and became increasingly interested in learning more about some of the complex patients. At that time, transferring to the surgical intensive care unit seemed to be the best way for me to accomplish this goal. I worked in an intensive care unit for 5 years and then decided to go to graduate school. San Diego State University had just started a critical care CNS tract, so I enrolled. For the first 15 years of my career as a CNS, I actually worked with both the intensive care units and the progressive care units. During that time, I developed a passion for caring for the chronically critically ill patient. So for the last 10 years, I have been a CNS in a pulmonary progressive care unit. I really enjoy working with patients whose clinical trajectory does not follow a set care path. This allows me to be creative in the development of an individualized plan of care for the patient.
What do you perceive are the key issues for CNS practice today?
One very important issue for CNS practice today is the APRN consensus model. I am concerned about the loss of specialization and confused about how that piece is to be operationalized under the consensus model. Recently, NACNS published a white paper on this issue ("Achieving Specialty Competency for Clinical Nurse Specialists"), and it stated that "CNSs must also acquire sufficient knowledge and skills in a specialty." However, is it not clear within the consensus model how that is to be achieved. We need to figure this out quickly as not to lose our ability to specialize and meet the needs of different patient populations.
To date, what do you perceive as your greatest accomplishments as a CNS?
I have worked with some very complex patients and knowing that I have been influential in their positive outcomes is probably one of my greatest accomplishments. Being able to successfully advocate for a patient and the other members of the healthcare team is an important aspect of my role, and knowing that I have made difference in a patient's life means everything to me. Teaching and mentoring new CNSs into the role are also something I am very proud of, as giving back to the profession is important.
What do you enjoy or value most about the role of a CNS?
I really enjoy working with complex patients and with the healthcare team that cares for them. I make rounds and review the care to ensure the patients are receiving high-quality and safe care. I also enjoy teaching and mentoring new CNSs about the role. Perhaps what I enjoy most is that the role is never boring, and every day brings new challenges. I get to work on a wide variety of projects, and I get to learn and grow myself at the same time.
What advice would you give a new CNS starting out in this role?
I would highly encourage any new CNSs to find a mentor to assist them with their transition from nurse to CNS. I would also encourage them to become active with their local chapter of the NACNS to meet other CNSs in their specialty area.