WORKING NURSE: What is your nursing specialty and where do you work?

JANICE C. DELANTY, RN: I am an emergency department staff RN at Hu Hu Kam Memorial Hospital in Sacaton, Ariz., which is located on the Gila River Indian Reservation.

What drew you to ED nursing?
I have been an RN for over 25 years. Like most of us, I started on med/surg. Early on, I was offered an internship in ICU, where I increased my skills and knowledge, eventually becoming a CCRN. While I enjoyed the challenges of caring for critically ill patients, I eventually started to want more variety. Of course, that is what the ED is all about.

Was any additional training or certification required?
In addition to the ACLS accreditation I already had, I was required to complete PALS, ENPCC and TNCC, and continued with my education until I earned a CEN. Everything I have learned has given me the confidence to be able to work fast and assess situations quickly, which can be critical in a busy ED.

How long have you worked for Hu Hu Kam Memorial Hospital, and how did you choose to work there?
I have worked in Sacaton for eight years. A former colleague of mine, whom I trusted and admired, had become CNO here at Hu Hu Kam Memorial. She called with a job offer that promised a slightly slower pace and a unique experience. It definitely has been a wonderfully unique experience, but she fibbed a little about the pace.

What does a typical day involve for you?
I work three to four days a week, completing 12-hour shifts beginning at 6 a.m. I am one of the more senior nurses in the emergency department, so most of the time I am in charge. After getting report from the night shift, I access staffing and patient acuity, and then just let it happen. There are no dress rehearsals in the ED.

What are your favorite aspects of the job?
The Native American community where I work is constantly trying to maintain their culture. My job is to preserve their health while respecting their cultural beliefs at the same time. We use a family care model approach to patient needs.

Tell us about the unique aspects of working with that population.
We are sent to classes on cultural sensitivity. Even though the hospital is located on the Pima-Maricopa Indian reservation, ecompassing the Gila River Indian community, we serve other tribes: Choctaw, Cherokee, Navajo, Apache, Hopi and the Arapaho for instance. A Lakota native from South Dakota would have a different cultural approach to their care than a San Carlos Apache.

Any challenges or least favorite aspects?
The Gila River community has the largest per capita diabetic and dialysis population in the world. The ED staff is always challenged to maintain endocrine and renal health as much as possible. It is heartbreaking to see so many of my patients having to endure these diseases.

Our entire community is usually predisposed to diabetes and kidney disease, which affects everything from pregnancies to healing. Many of my patients will tell me, “I take Losartan to protect my kidneys” or they will say “I do not have diabetes yet, but I take Metformin because I have glucose intolerance.” I am well supported at the hospital and I can call a certified diabetic educator to send a referral at any time.

What advice would you give to a nurse looking to become an ED nurse?
To be a successful, responsible ED nurse, one must learn to be a good team player, always keep up your skills, and maintain your own physical health. I always respect and appreciate those nurses who take their medications, get regular check-ups, and eat properly.

When I am in charge, I always try to tell myself that I must not expect anyone to work harder than I do. The Emergency Nursing Association (ENA) always offers the best training and credentialing for ED nurses as a whole. There are now clinical care specialists for the ED, pediatric ED nurses, trauma ED nurses, family nurse practitioners doing fast track in EDs and so on.

A general staff ED nurse can wear many hats. I like to attend staff meetings regularly, help out with committee work when possible, to be better equipped and informed to help the hospital serve the community.

I am always telling some eighth-grade boy or girl, “it's not too soon to think about nursing school, you know. It is a great career and there is such a shortage.” How fortunate I am that I am 60, my best years of my career are now with people I love.

FURTHER REFERENCE:

Organizations:
Emergency Nurses Association
www.ena.org

For information about diabetes, contact:
MED2000 Inc.
PO Box 211655, Bedford, Texas 76095
(817) 354-3900
med2000.net