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Heather Richardson, RN, MN, NLCP, LNC

Alberta and Northwest Territories

Why did you decide to become a clinical nurse specialist?
I came into the CNS role late in my career, after 35 years of nursing. I spent time in a temporary role as a unit lead for quality and safety, and became intrigued with this aspect of nursing. In this position, I was looking at nursing practice and how what we do impacts patient safety through the care we provide. I considered how I could turn this into a full-time nursing role, and discovered that it embodied the CNS role.

Up until that time I had been unsure about a master’s because I was so late in my career. Eventually I recognized this as the path to my future, and I began my master’s in 2009. In 2011 I started in the role of a CNS. In 35 years of nursing practice I had done a wide variety of roles. There were elements of the CNS role in my previous jobs as educator, researcher, manager, safety and quality lead, but to pull it all together I needed the education, as well as the freedom, and flexibility that this role offered.

Basic words associated with my role are: nursing practice, education, research, policy/procedures, and leadership. My role includes identifying, developing and implementing patient safety and quality initiatives; defining research questions that can lead to improved nursing practice; and building capacity in the nurses at the bedside through education and leadership. My job is to facilitate the nurses’ role and often act as their cheerleader by recognizing that it’s nurses who have the greatest impact on patients.

How do you feel you help patients the most?
The CNS role looks at the complexity of the health-care system and identifies ways to close gaps where patients may not be receiving optimal care or are being harmed. The role looks to provide nurses with the tools and expertise they need to do the best job possible. When I look at nursing practice, we have a history that established correct processes and standards of care on what we believed to be best. I examine these past practices, always looking to see if they really are best practice, or just the way things have always been done. Nursing is about change; our role is to be finely attuned to the changes in our patients. I believe we must also be finely attuned to the changes in our practice, our role, our culture, our society and our health systems. Knowing what is changing around us gives us greater power to effect the changes we want to see.

What is the most rewarding aspect of your job and what is the most challenging?
For me, the biggest challenges are often the most rewarding. I find it rewarding to support nurses and see them improve their practice, which in turn facilitates changes to patient care. Introducing the concepts and practices of family-centred care into an adult critical care unit was a hugely rewarding challenge for me. Long-established critical care culture and resuscitation practices, preconceived biases, and fear of what change might bring — these were common themes in the beginning, but working with an incredible team to challenge and change these themes was a wonderful experience that taught me much.

Being able to measure and define a change is another rewarding challenge. Oftentimes we deliver education, but we don’t go back and see if it had the impact we desired. It’s a great feeling when we can go back, evaluate and find that we did create change that resulted in improved knowledge, skills and competency.

More about Heather:
I see the CNS role as the cornerstone of safe, quality nursing practice and advocacy in health care. I look forward to a day when all units or departments will have a CNS.

My advice for nurses is to get as much varied experience as you can in order to find what you love. Don’t be afraid of challenges, take on new things. I have worked in independent practice as a consultant, and for 15 years I ran my own consultation business as a research coordinator. I learned so much about the different health-care disciplines and the care that is delivered to patients. Now, as well as being in a CNS role and working in legal nurse consulting, I am a nurse life-care planner, a role in which I work as a consultant for a private firm to provide planning services for patients who have had catastrophic accidents. Think outside the box that you put yourself in and imagine how you can use the tools you have as a nurse. I believe nursing is one of the best careers available today. It offers so much variation and the ability to change your direction when you want a challenge. There are very few jobs where you can change your career trajectory at any time.