Specialty Spotlight: What I Do As A Neonatal Clinical Nurse Specialist

This is the beginning of a specialty spotlight on different APN’s, so that we can see the variety of opportunities out there. These questions are based on career spotlight interviews on Lifehacker, but with a nursing twist. We’ll kick it off with my good friend Christina who is doing some amazing work in Indiana!

Tell me a bit about who you are and your current position.

My name is Christina Lopez and I am a Neonatal Clinical Nurse Specialist at Methodist Hospitals in Indiana.

What is a Clinical Nurse Specialist?

A Clinical Nurse Specialist is a clinical leader in evidence based nursing practice within a specialty area demonstrating a high degree of professional competence. The CNS is a practitioner, educator, researcher, consultant and leader in their specialty area. Essentially my job is to make sure that the staff (nurses, physicians, other department members), institution (hospital), and patient (and their families) cohesively work together. I also work with the administrative team to establish a strong philosophy of care, and develop models and standards to ensure competent, evidence-based practice care is delivered based on patient needs and available resources.

What drove you to choose this specialty?

For as long as I can remember I have always wanted to work with the neonatal population. For me, it’s mostly about advocacy and problem solving. Neonates cannot advocate for themselves, so we have to use our clinical skill and critical thinking to determine what they need. It’s almost as if it’s a puzzle, putting the pieces together to obtain the greater clinical picture. I also enjoy the family centered care aspect of this field. You not only have your patients to care for, but you have to work to educate their families. I wanted to be a CNS because I have a strong respect and appreciation for research and evidence based practice. There’s always new information out there, always an opportunity to better ourselves. I think that’s the most amazing part of our field – it’s constantly evolving and improving itself.

How did you get about getting your position? What education and experience did you need?

I put in an inquiry to a medical consulting company to see what my options were. She surveyed me based on my experience, education, and job location preference. Her title was consultant but she was essentially a healthcare recruiter.

For my education, I needed a Masters in Nursing and certification in my specialty area which is Acute Care Neonatal Clinical Nurse Specialist. When they interviewed me they wanted someone with experience, but they knew I had no experience as a Neonatal CNS.

The experience I did have was working as a staff nurse in long term care pediatrics before transitioning to being a staff nurse in a couple different Level III NICU’s in the Chicagoland area. Before I transitioned to this role, I had a full time job working at a Level III NICU, and I also worked a PRN registry job at a different NICU in Chicago. Outside of my school training, I knew this was the only way I would be able to get a chance to learn how other NICUs function. Neonatology is such a young field; I learned that there are many different ways to achieve the same goal. Overall, the principles are the same, but the execution is very different.

After combining my clinical experience and my work experience, I have been lucky enough to see what other hospitals are doing: what they’ve trialed, what works for them, what doesn’t, and what areas haven’t been explored yet. I have been able to take these ideas to my current job, support it with evidence based practice, and really start restructuring areas of need.

What kinds of things do you do beyond what most people see? What do you actually spend the majority of your time doing?

The majority of my time is spent on research and preparation. Anything I do I make sure I have the research to back it up. A part of my job is to make sure that we are the most current and up-to-date with our clinical practice. I also spend a lot of time communicating with different departments within the hospital and different support systems outside of the hospital. For example I’m working on infection control right now. I met with our infection control department to collect data, then I contacted the librarian for research articles, I met with pharmacy today to determine what we can and can’t do in practice, and contacted the buyers/purchasing department to speak with our equipment representatives. I also spoke with our Neonatologists and staff nurses for input for the new policies I developed, which then goes through an approval process involving shared governance. I literally need everyone’s buy-in for the work that I do.

What misconceptions do people often have about your job?

A lot of people think I’m only the staff educator. I run the Neonatal Resuscitation Program (NRP) for all the maternal and nursery nurses as well as the respiratory department, so they see me in this instructor role. Next week I’m going to learn to teach STABLE, which is a pre-transport stabilization course, so that will be another instructor role. I also am developing the orientation education for the new staff who have worked for less than two years. And I do in-services too! Yes, education is a component of my role, but I wear many different hats.

What personal tips and shortcuts have made your job easier?

Resourcing – do not reinvent the wheel. Every single preceptor has said that to me and it couldn’t be more true. Maintaining contacts in nursing school, with your preceptors, instructors, and coworkers can take you really far. I was always told to network and that provided such a strong support in helping me advance my nursery.

What’s the worst part of the job and how do you deal with it?

Transitioning from being a staff nurse on the floor to a desk job. I help on the unit when we have critical patients or when the nurses need an extra hand, but it’s not the same. Sometimes I miss running around on the floor for those 12hr+ shifts, being at the bedside for procedures, developing those patient-family bonds, and of course, the adrenaline rush! But if that’s the worst part of this job transition, then it’s not that bad! However, it is why I keep my PRN job. I still love being at the beside, and I don’t want to lose my skills.

What’s the most enjoyable part of the job?

I get to work on multiple projects at once. I enjoy multi-tasking, working with different departments, and attending conferences to learn about what’s the latest and greatest in neonatal medicine and my most favorite part: piloting new projects. I was given the opportunity to create my role, so I have a lot of autonomy. I get to set the standard and work alongside different people in the hospital to make great strides and changes for our neonates.

What do you do differently from your coworkers or peers in the same profession? What do they do instead?

Well compared to other specialized CNSs – Neonatology is its own little world, and everything in my hospital is catered to the adult world. The other CNSs have more resources available to them, and a lot of their work is established. While there’s room for every field to grow, our neonatal department is still becoming grounded. With such a young speciality, we are literally in the baby phase, and the adult medicine is so much more advanced.

I do a lot of the same stuff as other Neonatal CNS’s that I’ve trained with, and since there’s so few of us we use each other as a strong support system. I would say there isn’t that much difference in what I do, except that I am creating my position in my hospital, while the people I have trained with have come into their role after someone else had created the position. I also had great experience working at an institution where a couple of their staff nurses created the CNS role.

How do you “move up” in your field?

My role is where I stop in the hospital field. If I were to “move up”, it would be more of a setting change; I could go to the perinatal network or work on the business side. I can go with outside companies into research and so on, but it wouldn’t be in the hospital. There is also room to grow on the administrative side, however, that’s not a career path I would like to take.

What advice would you give to those aspiring to join your profession?

We were taught to network, get ahold of resources, and to join organizations, because those are going to be your biggest sources of support when you start your role. It’s hard to start something from the ground up if you don’t have a strong foundation. So really saving all those projects in nursing school, maintaining relationships with your preceptors, joining major organizations, going to conferences – they all help the CNS develop his/her role.  

Leave a Reply

Your email address will not be published. Required fields are marked *