by Susan Trossman, RN

Nurses do amazing things every day -- often without receiving any public recognition for their efforts. The following three nurses, however, did receive recognition from their ANA constituent member associations (CMAs) for their valuable contributions to the profession, the workplace and patient care. This represents only a sampling of awards CMAs gave to their outstanding members over the past year.

Florida NP shines in neurosurgical nursing role

Florida Nurses Association (FNA) member Amy Eisenberg comes from a family of nurses; growing up in the Philippines, she was surrounded by many aunts and cousins who donned the distinctive white uniform and cap of a professional nurse.

Amy Eisenberg

"I saw their satisfaction in their personal and professional lives," said Eisenberg, MSN, ARNP, CNRN. "The love of nursing was within them, and it's within me."

To this day, Eisenberg has never questioned her decision to become a nurse. But she initially was less sure about her choice to practice in the United States.

"It was very, very difficult for me to adapt to this country at first," said Eisenberg, who arrived in the United States in 1982. "I was almost ready to go home after the first year. Everything was new to me -- the food, all the technical equipment. I was constantly disconnecting physicians when I tried to put them on hold, and they'd get very angry."

But Eisenberg dug in her heels, gained solid clinical experience working with neurological and neurosurgical patients, and in 1996, received her master's degree in nursing and became an adult nurse practitioner. She currently works as an NP at Mount Sinai Medical Center & Miami Heart Institute, where she collaborates with four neurosurgeons to determine neurosurgical patients' care throughout their hospital stay.

Because of her excellence in nursing practice and her commitment to patients and their families, FNA named her "Advanced Practice Nurse of the Year" in fall 2001.

Eisenberg decided to specialize in neurosurgical nursing partially because of her intense fascination with the complexity of the brain, and partially because of the wonderful patients and families she met during her early years in nursing.

"It's rewarding to watch patients, who might have had a craniotomy, regain their ability to walk and talk, and then go on to rehab -- or back home -- with home health nursing support," she said. "I also see patients who are 80 or 90 years old who used to love to play golf or garden. And after neurosurgery, they can get back to their normal lives and do the things they enjoy."

A typical day for the NP involves making rounds on all neurosurgical patients in ICU and on regular floors. During that time, she will review patients' progress, make care changes as needed in collaboration with the neurosurgeons and update the nurses on patients' plans of care. She also reviews CAT scans and other diagnostic tests, and serves as a resource to nurses in this complex specialty.

"All of these patients are challenging," she said. "We have to monitor them very diligently, and get them out of the hospital with no complications. Nurses are more comfortable talking with me about the patients and their concerns. And I enjoy consulting with them and taking an interdisciplinary approach to determine what's best for patients."

Eisenberg also provides formal educational opportunities to staff on neurosurgical nursing, and according to Patricia R. Messmer, the NP has been instrumental in reaching out to help other advanced practice registered nurses understand the role of research at the medical center.

Messmer, PhD, RN, BC, FAAN, associate for nursing research at Mount Sinai Medical Center & Miami Heart Institute, nominated Eisenberg for the FNA award, in part, because of her ability to serve as an effective intermediary between staff nurses and neurosurgeons. But there's much more to why Messmer put forth Eisenberg's name.

"She exemplifies the role of the nurse practitioner. She's well-rounded and stays up-to-date, so she can provide the best care to neuroscience patients," said Messmer. "These neurosurgeons are highly intelligent and respected around the world. For them to accept her as their partner speaks a lot about her.

"But what really stands out about Amy is the personal contact she makes with patients and their families. They all know her and are happy to see her coming. They rely on her to give them the information they need."

Over the years, Eisenberg has kept in touch with many of the patients she has taken care of, first in her position as nurse clinician, and now, as a nurse practitioner. She's attended a patient's wedding ceremony, and she often gets updates from former patients via Christmas cards and unit visits.

One patient who stays in contact with Eisenberg is a young Michigan woman who suffered a traumatic brain injury in a car accident while on a business trip in Florida. Since her recovery, she has gone on to marry, have a child and is expecting another, according to the NP. (Eisenberg also was selected to make a presentation about her work with this patient at FNA's Clinical Excellence Conference in 2001.)

"It is one of those beautiful stories," Eisenberg said. "These patients are like family, and it's important for me to give them personalized care."

And it's one of those stories that keeps her going to her job every day. Eisenberg likes the increased autonomy of the NP role and enjoys collaborating with neurosurgeons who respect her for her expertise.

"I'm very satisfied with what I'm doing right now," she said. "You have to be passionate in what you do, and I'm passionate about nursing and delivering excellent care."

On a mission to prevent workplace violence

One thing that can be said about Illinois Nurses Association (INA) "Staff Nurse of the Year" Debbi Reed -- she has perseverance.

Debbi Reed

For example, she did not let a few obstacles, like a fear of needles and a lack of a high school diploma, prevent her from becoming an RN. At 30 years old, she hit the books, obtained her General Educational Development (GED) certificate and then entered a program to become a nursing assistant. While in that role, she took advantage of a federal job training program that allowed her to start nursing school.

But once again, Reed faced a potentially huge obstacle. Halfway through nursing school, the government stopped funding the job training program, leaving Reed to fend for herself. Yet she beat the odds and graduated with her associate's degree in 1983 at the age of 33.

One only has to look at Reed's patient care plan during her Labor & Delivery rotation to know that her fate as a psych nurse was sealed. In that plan, she detailed numerous psycho-social interventions aimed at assessing the patient's feelings. What Reed missed, her nursing instructor pointed out, was critical physical interventions, such as checking the patient's uterus.

"When I finally got into my psych rotation, I loved it. And I still do," Reed said. "When patients come in, they often are debilitated physically, emotionally and mentally. After building therapeutic relationships with them, I can watch them get better and be able to do things that they used to do."

One of Reed's early staff nurse positions was at a Veterans Administration hospital in Kansas City, MO. She also found time to volunteer for a ground-breaking program for Vietnam veterans, an effort that earned her a "volunteer of the year" award.

"When I began working in the VA system, I realized that there were far more male veterans than female, and that the majority of the men were diagnosed with Post Traumatic Stress Disorder," Reed said. "At the time, PTSD was one of those buzz terms, and I became interested in learning more about it."

Her interest led to her wearing two hats.

"When the vets would come into the hospital with a diagnosis of PTSD, I would assess them and then suggest they attend the support group that was being offered at the vet center across town. So when they were discharged, they were able to continue to work on their issues in a supportive environment with other vets who understood the difficulties they were experiencing," said Reed, who also volunteered as a co-facilitator at the center.

In 1990, she came back to her home state of Illinois, working first at a psych unit at a small hospital and then at the state-owned Zeller Mental Health Center. At Zeller, her perseverance yet again paid off -- this time for patients and health care workers alike.

She and other nurse members of her collective bargaining unit believed that their workplace lacked adequate staffing, important violence prevention protocols and basic equipment that would help staff stay safe when patients became violent. They asked administrators to work with them to create a safer environment, but their initial requests went unanswered.

After one of the RNs was critically injured by a patient in November 1999, Reed and other nurses stepped up their efforts -- garnering the attention of state legislators and the media -- and won major workplace safety measures. While serving as president of the local, Reed helped change management's attitude that violence was just "part of the job."

She also worked to ensure that RNs were at the table when it came to determining what was needed to maintain a safe work environment, as well as monitoring the implementation of those improvements.

It was Reed's achievements in the area of workplace violence prevention that won her recognition by INA as "Staff Nurse of the Year" in fall 2001.

P. Joan Larsen, RN, then a member of INA's Economic and General Welfare Commission, nominated Reed for her "initiative and ability to put forth her ideas and get things done."

"I think if there is anybody dedicated to the profession of nursing, it's Debbi Reed," Larsen said. "She believes in nursing, what nurses do and the power they have. She doesn't say 'let's wait and see what happens.'

"I know if I were sick, I'd want her to take care of me. She is a well-rounded, knowledgeable professional, and she wouldn't let anything get past her."

While Zeller has come along way, Reed sees workplace violence as a statewide problem in all health care settings. In her new role as a "compensated member" working as an INA staff specialist, her goal is to institute a statewide training program that helps nurses defuse escalating violent behavior in patients. (Reed took a leave of absence from Zeller in July 2001, although she still serves as chair of RC-23, a group of 1,400-plus nurses who work for the state.)

In her INA position, she services the contracts of Illinois facilities and tackles important nursing issues, such as privatization of public services, mandatory overtime and safe staffing. And she clearly enjoys it.

"Instead of being a patient advocate, I'm a nurse advocate," said Reed, whose mantra these days involves telling nurses to get "educated, agitated and organized."

"I feel the only way to change things is for nurses to get organized, so they get the protection they need to speak out for patients. I feel very fortunate to be an INA member and UAN member."

NDNA nurse successfully blends alternative and traditional care

North Dakota Nurses Association member Karla Sayler, MS, RN, describes herself as "cautious" and "conservative" when it comes to alternative care. She never took an herbal remedy or even had a therapeutic massage.

Karla Sayler

But she read research, which showed that many U.S. consumers routinely relied on -- or at least tried -- some type of alternative care -- be it going to the chiropractor or taking a dose of ginseng. And they were largely satisfied with these alternative health care strategies.

Research further showed that consumers generally did not tell their health care providers that they also used alternative care treatments, a finding that troubled Sayler.

That lack of coordination between alternative and traditional therapies, such as combining herbal remedies and prescription drugs, can lead to negative patient outcomes, she said.

But instead of overlooking patients' use of alternative treatments, she made a case to administrators at St. Alexius Medical Center in Bismarck to embrace alternative care. Her efforts led to the creation of the Center for Integrated Medicine, the first hospital-based alternative care center in North Dakota.

"Karla recognized that alternative care has a place in the regular scenario of heath care," said Karen Macdonald, MS, NP, RN, who nominated Sayler for "Outstanding Nurse of the Year" for 2001. "Her starting the center was a significant event for nursing that warranted this recognition."

Sayler, the director of Women's and Children's Services at St. Alexius, now oversees the center's operations, as well as those of several hospital units, including labor and delivery, mom/baby, NICU, children's care, including critical care, and women's surgery. In that role, she oversees budgets, operations, strategic planning and staffing -- and always with the eye toward improving patient care and services.

"It's been very challenging and rewarding," Sayler said. "There's always something new to learn, and challenges to meet."

Of her growing role as center overseer, Sayler said, "I'd always been more of a skeptic than a proponent of alternative care. I've had to open my mind and stretch my thought process to embrace this. But I've seen some wonderful progress made by patients. And now we are looking at more innovative, creative and even courageous programs to offer in the future. Of course, it's important that the services are science-based."

The center opened one and a half years ago with just a massage therapist, and an acupuncturist joined the staff one year ago. Recently, more staff came on board: a chiropractor and two nurse practitioners, who focus on wellness and emphasize the critical balance of mind, body and spirit. The center's square footage also has dramatically increased, from 1,000 to 7,000 square feet. The space was designed to create an overall sense of healing -- from the colors on the walls to the music to the furniture.

Currently, patients come to the center largely as outpatients. However, massage therapy is offered free to all postpartum mothers, and other hospitalized patients can receive a massage for a charge.

"The new moms love the massages," Sayler said. "Labor is such an intense experience -- every muscle aches like you just ran a marathon. So moms have viewed this service as very positive."

Sayler's overall mission for the center is this: She wants patients, who decide to blend the alternative with the traditional, to receive safe, coordinated care. This means that all types of providers need to be aware of all treatments the patient is receiving. She also believes that center's like hers will help raise the overall quality of alternative care. Her center staff, for example, are certified in their specialties, an important point she routinely stresses with physicians. (Some physicians have begun to send their patients to the center, and Sayler would like to see an increase in physician referrals.)

Sayler's predisposition to be an agent for change actually led her to choose nursing as a career. When Sayler began working at a local nursing home in high school health careers class, she was disturbed by what she saw.

"I got the feeling that most staff were there for their paycheck, and not out of concern for the patients' well-being," she said. "I didn't see residents getting the individual care I thought they should. And I felt as a nurse, I could make a difference."

Sayler went on to become a med-surg staff nurse, then became certified in oncology. She also worked in risk management and quality review, as well as served as NDNA's executive director from 1992 to 1996.

It's her work at NDNA that got her noticed by Macdonald. During that time, Macdonald was serving as the executive director of the North Dakota Board of Nursing.

"We worked together on all the cutting-edge issues, from defending entry into practice to gaining prescriptive authority for advanced practice registered nurses," Macdonald said. "She's just a delight to work with and very straightforward. There's no game-playing with Karla."

Sayler said she was quite honored and very surprised at receiving recognition for her efforts with the center. "We're just starting this endeavor, and there's still so much work to do."

But she is not surprised with what a career in nursing has afforded her.

"Every position I have had taught me so many things -- personally and professionally," she said. "Nursing is full of wonderful opportunities."

Contact your state nurses association to learn of any "Nurse of the Year" programs or awards it may offer. For information on contacting your state nurses association, go to www.nursingworld.org/snaaddr.htm or call (800) 274-4ANA.

Susan Trossman is the senior reporter for The American Nurse.