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Karen McQuillan,RN[/caption] As a critical care nurse with more than 30 years of experience, Karen McQuillan, MS, RN, CNS-BC, CCRN, CNRN, FAAN, said she is enjoying her one-year term as president for the American Association of Critical-Care Nurses, the world's largest specialty nursing association. McQuillan, who has worked as a clinical care specialist at the R. Adams Cowley Shock Trauma Center, University of Maryland Medical Center in Baltimore since 1987, said the AACN's theme for this year is Courageous Care, a daily part of both acute and critical care nurses' work. Nurse.com recently spoke to McQuillan about her goals for 2016, and what she wants all nurses to know about the specialty of critical care. Q: Why did you choose critical care as a specialty and what do you love about your job? A: I earned my pre-nursing degree from University of Maryland at College Park in 1979, my Bachelor of Science degree in Nursing from University of Maryland, Baltimore, in 1981. As an undergrad, my dormitory was connected to the shock trauma center and I served a clinical rotation there. I quickly became fascinated with critical care and I still find the work to be incredibly challenging and rewarding. As critical care nurses we have the incredible privilege and responsibility to provide care for our patients who are among the sickest and most vulnerable. Q: Can you describe your role at the trauma center and your work outside the facility? A: In March, I will be celebrating my 29th year in this job. I love having the ability to make a difference in the lives of others, to impact patient care and to also mentor other nurses. I have served as an investigator, author and presenter on issues related to nursing, and I also hold an associate faculty position with the University of Maryland School of Nursing. Q: How have your responsibilities changed over the years? A: It used to be that when I found a problem, I fixed it, but now I love to mentor nurses to create the change. Nurses have the incredible ability to identify problems in their clinical settings and they typically have great ideas for solutions. Over the years we have begun to see significantly more elderly patients in critical care. While we still see young people who have suffered a traumatic injury, people are living longer and are presenting with more comorbidities. Nurses are challenged with caring for very complex patients and their families who may require support with end of life decision-making. In addition, many surgeries have become less invasive, while technology such as mechanical ventilators, infusion pumps and extracorporeal membrane oxygenation have all become smaller and more mobile and portable. These changes have made it easier for nurses to mobilize patients earlier. Q: What does the AACN hope to accomplish in 2016 to support nurses in critical care? A: We are continuing to expand our hospital-based AACN Clinical Scene Investigator Academy to additional hospitals across the nation. More than 200 nurses at 60 hospitals across the country have participated in the program that empowers bedside nurses as clinician leaders and change agents whose initiatives measurably improve the quality of patient care with bottom-line impact to the hospital. The 16-month program teaches nurses how to make the business case for specific approaches to improving patients' experiences with care, improving clinical outcomes and reducing costs. In the first six cities where the CSI Academy was held, hospitals saw a $28 million cost savings based on improvements by nurse-led teams. Nurses were able to lead changes that reduced ICU stays by one day, decreased ventilator days by one day and reduced infections and patient falls by 50%. Q: What steps does an RN have to take to become a CCN? A: After obtaining RN licensure, nurses learn to care for critically ill patients by attending classes on this specialty and working with a preceptor in an intensive care unit. Advanced practice nurses require a master's degree or doctorate. Critical care nurses work in a variety of settings including at the bedside and as educators and researchers, nurse managers, clinical nurse specialists and acute care nurse practitioners. Although certification isn't mandatory for a specialty area such as critical care, many nurses choose to become certified to validate their knowledge in the care of critically ill patients. The CCRN is for nurses who provide direct bedside care to adult, pediatric or neonatal critically ill patients, and the CCRN-E certification is available for nurses who monitor and care for patients in a tele-ICU setting. A CCRN-K is for nurses whose non-bedside practice influences organizations, nurses and patients to positively impact care provided to acute/critically ill patients. Q: What have you learned during your career you'd like to share with other nurses? A: I think it's important for nurses to realize the importance of self-care. By caring for ourselves as well as our patients, we can avoid compassion fatigue, moral distress and burnout. Research shows nurses are vulnerable to all these phenomena, and studies focused on interventions that can help determine how to best foster resilience among nurses are still needed. One important aspect of being resilient is being courageous and seeking out activities that help us renew [ourselves] and to ask for support when we need it. This isn't always intuitive or easy, but it's essential for those of us who care for others.
