NAME: Karen Ann Doran
CURRENT POSITION: Cardiovascular Clinical Nurse Specialist
CURRENT AFFILIATION(S): Mercy Hospital, Coon Rapids, Minn
AREA(S) OF SPECIALIZATION: Cardiovascular
PROFESSIONAL EDUCATION: Masters in Nursing from the University of Nebraska Medical Center, Omaha, Neb
CERTIFICATIONS: CCNS
Karen Ann Doran is the 2004 recipient of the Clinical Nurse Specialist of the Year Award, presented by the National Association of Clinical Nurse Specialists at the annual March meeting in Orlando, Fla. Ms Doran was selected based on her outstanding level of skill and knowledge in a clinical specialty area, clinical nurse specialist practice competencies, commitment to quality patient outcomes, support for the advancement of nursing practice, and collaboration to improve patient care. Ms Doran was nominated by Mary J. Davern, director of Cardiovascular and Respiratory Services at Mercy and Unity Hospitals, part of the Allina Hospitals and Clinics, Minneapolis/St Paul, Minn. Ms Doran has been a clinical nurse specialist for over 20 years in numerous settings and institutions and is described as a "professional treasure."
What first motivated you to become a clinical nurse specialist?
My mother graduated from a nursing diploma program and always encouraged me to begin my nursing education in a baccalaureate program, emphasizing the many opportunities to learn and the flexibility to work in numerous areas of nursing. I followed her advice, and after graduating from a baccalaureate program, I worked as a staff nurse. I wanted to be involved in helping the military personnel fighting in Vietnam and accepted a commission in the Army Nurse Corps. I worked as an assistant head nurse in the critical care area. I was constantly learning new things and knew that I needed to expand my education. I felt strongly that I wanted to work in the hospital setting with patients and staff, so the role of the clinical nurse specialist fits my interests.
What, if any, professional or career issues did you face early in your career as a clinical nurse specialist?
One of the first responsibilities given to me in the 1970s was to transition the RN from the monitor watcher job and develop a cardiac monitor technician program, a change that was received with great skepticism by the medical director and the nursing staff. I relied heavily on the principles of being a change agent by involving staff affected by the change to be involved in the development of the new program. Through this issue, I learned the power of evidence to support change as we gathered data and communicated findings.
What do you perceive are the key issues for clinical nurse specialist practice today?
There is not enough time to complete all the work that has to be done, including the time needed to participate in or conduct research activities. Clinical nurse specialists need to find ways to link with other clinical nurse specialists and faculty members at Schools of Nursing to collaborate around research initiatives.
The economics of health care are a continuing challenge. Hospitals and health care systems face huge economic challenges. We need to keep defining our unique role and demonstrate the outcomes of clinical nurse specialist practice. A clinical nurse specialist is the best value in town.
To date, what do you perceive as your greatest accomplishments as a clinical nurse specialist?
As a clinical nurse specialist, I have contributed to the professional development of other nurses. I try to model the excitement of learning by constantly inquiring about the best approaches to care and the evidence supporting care decisions. It is not unusual for me to meet someone I worked with over 30 years ago who will tell a story about something I said or did that inspired them to continue their education-even to obtain a doctorate. What an honor to be part of their professional growth.
Another accomplishment was developing our Cardiovascular Women's Program. There is a huge gap between the prevalence of heart disease in women and the availability of resources to help women reduce their risk factors. I developed a Cardiovascular Women's Program to help identify and to reduce women's cardiovascular risk factors. Through the work of our Wellness Program, we now have a very successful year-long program for women. Outcomes have been achieved in smoking cessation, blood pressure control, physical exercise, heart healthy dieting, weight management, and stress management.
What do you enjoy or value most about the role of a clinical nurse specialist?
I love the variety of my practice as a clinical nurse specialist. I'm involved in working with nursing staff and the interdisciplinary team to provide evidence-based care to patients and families, setting up and implementing programs, participating in hospital and system wide committees, developing and presenting lectures, publishing articles, and conducting research. Everyday is different with new challenges and opportunities. I truly believe that if I am doing the same thing all the time, then I have failed to mentor staff to participate in advancing their knowledge and skills. As a clinical nurse specialist, I try to push ideas past the boundaries and to ask the hard questions.
What advice would you give a new clinical nurse specialist starting out in this role?
I have learned many things over the years, but I find there are 4 areas of advice that may help a new clinical nurse specialist. First, things constantly change. So much has changed in the world since I graduated and will continue to change. As a clinical nurse specialist, even if you worked years on a project, just know that it may be tweaked or totally changed as time goes by. You should thoughtfully consider your past project to make sure that it is always based on the best available evidence, which means you may need to give up ideas that might have been important at the time but not now. Second, the clinical nurse specialist doesn't need to know everything. When I first started my role as a clinical nurse specialist, I thought I needed to know everything, because I was the specialist. It has been so "freeing" for me to acknowledge that I will never know everything, but I know where to obtain the information. However, when asked a question I need to research, it is imperative that I get back to the person with the questions for follow-up and discussion. Third, the clinical nurse specialist needs to be approachable. Your expertise will be wasted if staff are uncomfortable contacting you for help. A clinical nurse specialist can't work in a vacuum. Our practice includes working with others in the clinical setting to improve nurse-sensitive outcomes. Make it a priority to have time for staff, welcome their ideas, acknowledge their enthusiasm, and build on their strengths. Last, a clinical nurse specialist must be visible. The best way to be visible is to make rounds, ask questions, and provide positive comments.
What did it mean to you to receive this award?
The award application was cowritten, without my knowledge, by colleagues working in 3 different hospitals. When I received notification in the mail, I was totally surprised and extremely honored. Since I have received this award, I have heard from fellow clinical nurse specialists throughout the United States that I worked with in the past. It has been a wonderful opportunity to reconnect with friends. This award has also given me the opportunity to reflect on my practice. I have learned that my "success" is truly a reflection of all the entire interdisciplinary team I work with everyday, including networking with other clinical nurse specialists. This award has been an incredible experience for me.