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Lisa McDonald, RN, BSN, CNOR, RNFA, project coordinator and operating room nurse at Canton-Potsdam Hospital in Potsdam, N.Y.

July 2013

Q. Why did you decide to become a nurse?

A. Unlike many nurses, I’m not one of those people that knew from the time I was a small child that nursing would be my career. I entered high school in a business program and shuddered at the sight of blood! I did, however, always have a passion for providing care in some manner, and I soon realized that I preferred studying biology to typing. I explored the idea of becoming a veterinarian, but something sparked in me the first time I stepped into an operating room (OR) while working as a volunteer at a local hospital. That was when I knew for sure that I wanted to be an OR nurse, and that's where I've been now for 25 years.

Q. You recently helped lead a successful protocol to improve the experience of patients after total knee-replacement surgery. What inspired you to take this on, and what did the project accomplish?

A. I work in a small rural community, and what makes that experience unique is that I am personally connected to many of my patients in some way. When your patients are your friends and family members, they trust you to deliver the very best care. Our team had done a great deal of work to prevent orthopaedic infection, and in 2011 we got the opportunity to join Project JOINTS, an initiative through the Institute for Healthcare Improvement that focuses on reducing preventable hospital infections. The next step was to look at new ways to tackle pain control.

I began collaborating with our orthopaedic surgeons to research and develop a multimodal pain protocol for total joint replacement. This protocol uses different medications for postoperative pain control – some of which are actually given before and during the surgery. The program was very successful. In addition to improving pain control, patients started getting up and moving more quickly – in most cases on the day of surgery! They were getting discharged sooner, and infection rates continued to decrease sharply.

I am very fortunate to work with an excellent team and to have support at all levels for projects such as this. Most importantly, it has greatly improved the overall patient experience in our hospital, which is the most rewarding aspect of my work.

Q. In what other ways have you worked to ensure a better patient experience as an OR nurse?

A. As an OR nurse, you don’t always get to be around your patients while they are awake. In order to better connect with my patients, I started doing pre- and post-operative rounds to better understand my patients’ needs. This way I get to see the patient before surgery, explain what he or she should expect, and address any concerns he or she might have in advance. It comforts patients to know they’ll see me in the OR prior to anesthesia and that I’ll be with them throughout the entire process, including a post-operative follow-up in the office. Getting out of the OR and talking to the surgeons, patients and the patients’ families really opens my mind to more of the patient's full story, and I am especially gratified by the continuity of care I am able to provide in the process.

Q. What has been the greatest moment of your career?

A. While it is tough to identify the single greatest moment, this past year has undoubtedly been the greatest year of my career. I've done a lot of great work with Project JOINTS and have shared my experiences with other hospitals beyond my own community. It's been a really rewarding experience and has inspired me to begin taking classes to become a nurse practitioner.

The most exciting thing about all of this work is getting to talk to patients who have undergone surgeries since the new protocol was implemented. I often hear how the decreased pain makes for a very different experience in their day-to-day lives. It is really gratifying and makes everything I do seem worthwhile.

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