NAME: Linda M. Gorman, PMHCNS-BC, MN, CHPN
CURRENT POSITION: Palliative Care CNS
CURRENT AFFILIATION(S): Cedars-Sinai Medical Center
AREA(S) OF SPECIALIZATION: Palliative care, end-of-life care, pain management, psychosocial care
PROFESSIONAL EDUCATION: Master in Nursing, UCLA
CERTIFICATION: PMHCNS-BC, CHPN, OCN
Linda M. Gorman, PMHCNS-BC, MN, CHPN, was named Clinical Nurse Specialist of the Year at the 2009 National Association of Clinical Nurse Specialists (NACNS) annual conference in St Louis, Missouri. This award provides national recognition to a NACNS member for outstanding competency, exemplary practice, and professional achievement as a clinical nurse specialist (CNS) in the 3 spheres of CNS influence: patient care, nursing, and healthcare delivery systems. Ms Gorman was nominated by Marilyn J. Shirk, MN, RN, CNS; Rita Hand, MSN, GNP-BC, CHPN; and Robert J. Taub, MD, Cedars-Sinai Medical Center, Los Angeles, California. Her colleagues remark, "She is able to bring together multiple considerations like diagnosis, prognosis, pain management concerns, quality of life, nursing care needs, individual values and preferences, cultural and spiritual considerations, as well as family dynamics to affect an optimal plan of care.
Her physician colleague states that she "is very effective in difficult conversations with patients and their families because of her clarity and sensitivity. A frequent comment is 'now we have a better understanding of our situation, what to expect, and where to get help.' She is a resource for medical and nursing staff who are faced with end-of-life discussions involving complicated families."
Ms Gorman has received multiple recognitions for her contributions to patient care and the medical center. They include the Nurse of the Year Award 2001 (out of a staff of more than 1,500). She has also received the President's Award, the highest award given to exemplary medical canter employees. She received the Award of Excellence from the Southern California Cancer Pain Initiative in 2000. Most recently, the candidate was awarded the Nurseweek Nursing Excellence Award in Clinical Care for her State/Region.
For the past 20 years, Ms Gorman has provided exemplary care to hospice and palliative care patients. She is a certified hospice/palliative care nurse and an oncology certified nurse and is board certified as an advanced practice registered nurse in adult psychiatric and mental health nursing. She has served as a president of the Hospice and Palliative Nurses Association and currently is on board of directors of the Hospice and Palliative Nurses Foundation. Her book, Psychosocial Nursing for General Patient Care, was named as an American Nurses Association Book of the Year in psychiatric nursing category.
What first motivated you to become a CNS?
When I went to graduate school at UCLA, the CNS role was in its infancy. The role seemed to suit me because of the clinical focus. I was in the psychiatric nursing program but knew I wanted to bring those skills to the acute care hospital rather than the psychiatric setting. So the CNS role appealed to me. My education prepared me to be a consultant to address problems and be a change agent as well as expert clinician. I knew I would need that if I was going to be successful in bringing the psychosocial component to the acute care hospital. The psychiatric nursing skills and the consultation skills have been essential throughout my career.
What motivated you to specialize in hospice/palliative care?
As a mental health CNS, I was "adopted" by the oncology unit nurses at my first CNS job. Those nurses recognized they needed help with their patients with advanced disease. I loved working with cancer patients and naturally fell into developing more skills out of my psychiatric nursing comfort zone in pain and symptom management. I was always comfortable with dying patients and felt I could make the most impact with helping nurses provide the highest-quality care to these patients.
What do you perceive are the key issues for patients and CNS practice in the area of hospice/palliative care today?
For patients, it is access to high-quality palliative care throughout their illness trajectory to manage uncomfortable symptoms and have their goals addressed and followed. In the palliative care field, I think most programs utilize the NP [nurse practitioner]. The CNS role with preparation in program development, identifying quality outcomes, staff education, and research is well suited to the palliative care role and should be promoted more to hospital/nursing administrators as key to palliative care program success.
To date, what do you perceive as your greatest accomplishments as a CNS in this area?
My program has grown from a small one seeing a few hundred patients a year to its present form of 4 full-time professionals seeing well over 1,000 patients/year. I feel as the CNS for this program, I have been instrumental in bringing palliative care to all areas of the medical center and to our community. I think I have helped influence nursing practice in the palliative care field. My greatest reward is seeing the growth in this field.
What advice would you give a new CNS starting out as a CNS or in hospice/palliative care?
Patience. Take the time to learn the culture of your work environment before telling coworkers what needs to change. Also, there is an adage I learned from a leader in palliative care-"ask for forgiveness not permission." Sometimes, you just have to take a chance and try a new strategy to achieve a change. These two might sound contradictory, but I think you need to include both in your approach to a new role.
What are the key lessons you have learned over your career as a CNS that you would like to share with your experienced CNS peers?
Keep focused on what you are trying to accomplish. It is easy to get distracted by crises that take you away from what you know needs to change. Take some time each week to look at your goals and any small ways that you can work on them even in the mid of multiple responsibilities.
What does being recognized as CNS of the Year mean to you?
Recognition by one's peers is truly the highest recognition. I am humbled when I see all the accomplishments of my colleagues and other NACNS members.