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Sonia Boccardi, RN, MScN, CNCC(C)

Quebec

Why did you decide to become a clinical nurse specialist?
I started as an educator in head and neck surgery and post-anesthesia care . I really enjoyed the teaching aspects and the policy development to establish hospital-wide programs. At the hospital they never made a distinction between a CNS and an educator; they were blended roles doing the same work. I had thought of pursuing a master’s and was approached and supported by the institution to do so. While I struggled to decide between a master’s in nursing or education, eventually I decided on nursing to help bring new policies and practices into the clinical setting through my role as a CNS.

How do you feel you help patients the most?
By imparting knowledge and experience to nurses. I provide support, guidance and education to nurses who then apply that knowledge in the care they provide at the bedside. I am not as involved in direct bedside care anymore, but I know I’ve helped patients because I see the nurses I taught giving the best patient care that they know how to give. I also help patients by being involved in changes to practice. I am involved in research and collaboration with other medical partners and when I see my efforts improving patient safety, it is a great reward.

What is the most rewarding aspect of your job, and what is the most challenging?
The most rewarding aspect of the job is when I work on a project and I am able to see it from beginning to end, from pre-implementation all the way to seeing the results I was hoping for. One example of this was when I worked on the opioid monitoring protocol. Across Quebec, there were many critical incidences of patients getting inappropriate doses. We worked on this protocol for over two-and-a-half years, looking at evidence and getting doctors and pharmacists involved as well as nurses. We did two weeks of intensive teaching for nurses and gave them tools as well, such as pocket cards. After the protocol was implemented, we were able to catch near misses and prevent adverse effects to patients. Although it was a long process, the ultimate end goal is to make patient care safer.

An ongoing challenge is physician buy-in. The process of having a policy approved is very long and cumbersome. Having physicians involved from the get-go can help with the buy-in. Team-based care helps reduce the hierarchy and can help with the process, so it’s worthwhile to push forward for collaborative care.

More about Sonia
I never shy away from a challenge that is given to me. I am a hard worker who excels under deadline pressure and I am honest in the sense that I will not sugarcoat things. This comes from experience — not only work but life experiences. I just finished a two-year project to move 60 per cent of the hospital’s clinical activities into a new critical care pavilion. I worked as a part of the transition team, preparing the clinical teams to work in a new environment using LEAN six sigma training. My main role was to help smooth the transition process and to make it a safe work environment for staff and patient’s alike. Mapping out projects in my head has now become second nature in my CNS role.