Gayleen Stephens has been working as an endorsed Nurse Practitioner (NP) since 2010 in Acute Care as a Cardiology NP. Based in New South Wales, Gayleen is currently working at a private hospital in coronary care.
Tell us about your nursing journey
I started my nursing career in 1995. Acute care has always drawn me. The dynamic environment due to the acuity of the patients has intrigued me. Advancing my knowledge and skill has enabled me to understand the pathophysiological processes causing the patient to experience their symptoms.
Working together within a team to stabilize these acutely ill patients and witnessing them pulling through and eventually being discharged home is very rewarding. These experiences motivated me to pursue a career in critical care nursing, specifically cardiology. With this as my goal I proceeded along the path of a Graduate Certificate in Cardiology and worked for 3 years in cardiology /cardiothoracic nursing. With my post graduate qualification, I immigrated with my partner to the Netherlands and pursued my career in cardiology there. The skills and knowledge I gained in the years working overseas prepared me to progress my career further and enabled me to accept a position as a trainee NP. And I haven’t looked back since. In my role as an NP, I have been exposed to many challenges in providing patient care; how to make care more accessible for patients; adapting care plans to be patient centred to meet patient needs; and advocating best practice for delivering care to patients living with cardiovascular disease.
With the above goals in mind, I was fortunate to work with a team of specialists who supported these ideals and worked collaboratively to achieve them. This resulted in; 1) the development of a postoperative wound clinic for patients following cardiothoracic surgery; 2) a pre assessment clinic for patients referred on to our team for cardiothoracic surgery and 3) implementation of the NP role in the clinical setting.
A number of positive outcomes resulted following the implementation of the wound clinic: 1) there was a decline in postoperative wound infection mortalities, 2) earlier diagnosis and commencement of appropriate treatment of surgical site infections and 3) a reduction in comorbidities of patients following surgery. The pre-assessment clinic was formed by a multidisciplinary team who met weekly to discuss high risk patients, determine a comprehensive care plan with the aim of limiting adverse effects resulting from the planned intervention. The discussions amongst the multidisciplinary team sometimes resulted in procedures being cancelled if the surgery was deemed not beneficial to the patient’ s wellbeing. My NP role was then beneficial to provide the patient and their family with the necessary education and support required to understand the decisions made by the team, often challenging!
Can you tell us about your current role as an NP?
I currently work at a private hospital as an acute care NP in coronary care. My services relate to providing care for patients with all forms of cardiovascular disease. The core principles of my care are providing patients and their relatives with education regarding their disease process, management of their symptoms and when to access care.
In the clinical area I am involved with advanced patient assessments, requesting relevant diagnostic tests, developing treatment plans for the duration of their admission, corresponding with other healthcare professionals involved in the patients care and advocating for the patient’s needs. I am also involved in providing clinical supervision and education to the nursing staff.
The most rewarding aspect for me is following the patient’s journey; from admission with an acute cardiac episode, to stabilization and discharge and organising the provision of follow up care once discharged from hospital. Patients are appreciative of the patient centred care they receive from a NP. This appreciation is often provided in the responses made to the in-patient surveys.
How do you think health consumers will benefit from seeing Nurse Practitioner?
The NP is a great asset to patient care. With the core principles of the role being grounded in nursing philosophy, patients receive a comprehensive, holistic model of care to assist them in managing their disease process/ health deficit. The healthcare is provided in a manner which includes the individual in the decision making regarding their care.
This for me is the strength of the NP role!
There are so many opportunities for us as NPs to make a difference. Just think of the areas such as chronic care, preventive medicine, aged care and palliative care. And let’s not forget the acute care setting such as ICU, Emergency and Truama, Cardiac care and Vascular care. The professional opportunities are endless. As a group and individually, NPs just need to make hospital executives and legislatures aware of the service and contribution we can provide to ensure that we remain one of the best healthcare systems in the world
What are you hoping to achieve in your current role as a NP?
My aims are to increase the awareness of the NP role within clinical areas, to support trainee nurse practitioners in their role development, and encourage any nurses who aspire to become a NP. I would love to see more NPs as clinicians providing services capable of meeting the gaps in healthcare. This includes areas such as cardiology, geriatric care, diabetes, oncology, pulmonology and mental health.
I am currently developing an improved cardiac service for my current employer which involves assessment and screening of patients at risk of cardiovascular disease including atrial fibrillation, a nurse led heart failure clinic and a cardiac rehabilitation program for private health care.
What advice do you have for anyone wanting to become a NP?
Go for it, you won’t regret your decision.
It is a role that provides you the opportunity to exhibit your contribution to the healthcare system. In choosing an area of expertise, you have the ability to gather data and show colleagues and other health care professionals what is achievable in regard to patient care and how we can better employ our resources, making health care accessible and affordable for all.