By Marija Potkonjak
East Valley Tribune
July 17, 2006
Karen Mask was cool. For the past two years she’s kept up a grueling schedule — studying nonstop. All her efforts and sacrifices have led to this day — her first as a nurse at Banner Desert Medical Center in Mesa. If the rookie nurse was nervous, she didn’t show it. “It’s a little less nerve-racking for me,” says the 37-year-old Chandler resident, who as a nursing student spent last summer working on the hospital’s pediatric floor.
Mask is entering the nursing profession in the midst of a critical shortage that health care professionals believe will get worse before it gets better. Nursing school applications are up, but supply is dwarfed by demand. There aren’t enough nursing programs or instructors to go around, and hospitals don’t have the space to accommodate hands-on instruction.
Mask, who has a degree in psychology, is one of the fortunate few who actually got into a nursing program in Arizona. Some applicants will spend up to 12 months on a waiting list. In May she graduated with a bachelor’s degree from the accelerated nursing program at Arizona State University’s Polytechnic Campus in Mesa.
Mask left a successful career in retail to embark upon this journey.
“I wanted to do something a little more rewarding,” says Mask. “You can sell toys, but what are you really doing?”
A SYSTEM ALMOST OVERWHELMED
In this nursing shortage it’s an employee market. With her degree, Mask had her pick of jobs.
She choose pediatrics because “it was the most rewarding, and I enjoyed building relationships with kids and families.”
Mask reports for duty at 7 a.m. on a Monday, and the first task is filling out paperwork and meeting the woman who will mentor her through the next few weeks — Cathy Smoot, a pediatric nurse for 25 years.
Nurses like Smoot are now teaching on the job. Some nurses are loath to teach new charges — too little time and too many patients. But Smoot has a passion for teaching, and she’s been mentoring beginning nurses for 10 years.
“Nursing is like anything else in life,” says Smoot. “You have good days and you have bad days. You have students who want to learn and students who don’t.”
Some health care professionals are concerned about the situation.
“Nurses themselves have become educators,” says Mary Jo Beardsley, a clinical instructor at Gateway Community College in Phoenix, who is checking up on the few students allowed on the floor. “It’s a different world training nurses today. We have to train them quickly, and sometimes they’re not nearly as prepared. It’s a Catch-22.”
Compounding the problem is the lack of training in clinical settings. The number of pediatric patients is kept low, and that limits the number of students who can train on the floor. Hospital administrators don’t want to inundate their smallest patients with students.
Smoot leads Mask and a student nurse, Amy Smith, to an empty nurses station. The lights are dimmed so patients sleeping in nearby rooms aren’t disturbed. Under this eerie lighting the shift change takes place — the nurses who worked the night pass along information to the day shift.
Smoot does all the talking. Mask listens and takes notes, nodding her head to show that she gets it. They’re updated on vital signs and the the patients’ emotional conditions.
“Mom and dad had a fight last night,” says night nurse Kari Beltran. “They’re fine now. Dad is here, and mom went home.”
Smoot raises her eyebrows as if to ask how bad it got.
“Cell phones were thrown,” Beltran says reluctantly. “It’s probably the stress of being here.”
ON THE FLOOR
Smoot, Mask and Smith will care for four patients over the next 12 hours. The maximum number of patients per nurse on the pediatric floor is four. It’s still early and most of their patients are sleeping (“I don’t want to wake them up and shine a bright light in their eyes,” says Smoot), so the team briefly checks in to make sure everything is going smoothly and then sets about checking charts and making sure the patients are getting the right medication and meals.
When they finally get to conduct assessments of the patients and change linens, the team has to suit up. Smoot puts on a surgical mask, gloves and gown. Their young patients are in isolation, so the team takes extra precautions.
One of their patients is 9-month-old Sofia Gonzales, who has been in the hospital for the past five days battling a respiratory infection. Sofia’s mother, Sandra Cervantes, is in the room watching as pediatrician Dr. Judith Barnes-Clark examines the baby.
“She’s having an excellent day,” says Barnes-Clark. “It’s a big difference from when she came in on Wednesday.”
Basking in the all the attention, Sofia smiles despite the tube that is in her nose.
“Oh, she’s loving it,” says Cervantes, grateful for her daughter’s sudden burst of energy.
After leaving the room, Smoot and Mask remove their surgical masks, gowns and gloves (in that order) and put on new ones before heading to the next room. The child is a toddler in the care of Child Protective Services.
The little boy wakes up alone in the room, and the nurses will take turns spending time with him through the day.
“When I was in school and doing the peds rotation, I must admit I was the only student who did not go home and cry,” says Smoot, who wears a button with the word “pain” stricken through on her name tag.
Mask follows Smoot from room to room, assessing the patients and updating the medical charts. Nursing today is much more complicated than it was when Smoot entered the profession. Nurses have a lot more responsibility.
“Nurses aren’t just seen as doctors’ assistants these days,” says Mask, who believes that’s a common misconception about the profession. “They’re able to think critically and make an impact on patient care.”
Mask returns to Sofia’s room to check on her.
“We see the nurses here all day long,” says Sofia’s mom. “It’s extremely inspiring. We see how caring they are, and that helps us get through the day.”
Once again the center of attention, little Sofia smiles and kicks her legs. Mask shines a light in her eyes and then quietly leaves the room.
“That kind of interaction is what makes it all worth it,” says Mask as she removes her surgical gown. “You connect with the kids and that makes the parents feel good. They know everyone is focused on making their child feel better.”
