Director of Clinical Research: Interview with Alisa Rock, RN, DNP, ACNP

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Director of Clinical Research: Interview with Alisa Rock, RN, DNP, ACNP

Providing hospital-based advanced practice nursing

By Keith Carlson, RN, BSN, CPC, NC-BC
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What is your position and where do you work?
I am the director of clinical research and education at Methodist Hospital of Southern California

What are your daily responsibilities?
I provide data management for the specific disease programs at the hospital, including acute coronary syndromes, acute M.I. [myocardial infarction], stroke and heart failure. I help to manage those programs along with the various nurse coordinators so that the programs deliver the highest possible quality of care.

I also direct educational activities for all of the clinical staff within the institution. I work closely with many wonderful coordinators who are truly disease-specific experts in their chosen fields.

Do you provide clinical oversight in terms of how those programs function?  
Yes, both nursing and clinical oversight. We basically conduct nursing research into the quality of the services and care that we provide. Then, we deliver evidence-based feedback to those programs regarding how they can potentially make adjustments and changes to the processes and protocols that they use on a daily basis.

The goal is to use evidence-based data to drive programmatic changes and promote the adoption of best practices.

How does shared governance factor into this mechanism of feedback and change?  
Our nursing staff uses a shared governance structure in order to share responsibility for various aspects of the care that each unit provides. Unit-based nurse councils are an important part of the ways in which changes to the delivery of care are made.

Tell us more about these unit-based nurse councils.
The Professional Development Council looks at clinical ladders and the delivery of care. The Interprofessional Practice Council is a multidisciplinary council focused on patient-centered care.             

Meanwhile, the Quality and Safety Council consists of representatives from each unit. This council hears our feedback, taking that information back to the units. Our data examines quality metrics to determine which aspects of care are not meeting our threshold for success.

Shared governance is an evidence-based way to invite clinical bedside staff to lead the decision-making process and be actively involved in altering the delivery of care when a problem is identified. It gives the staff direct lines of communication to the nursing directors and managers.

The Advisory Council hears the feedback and then the decision-making is made at a unit level, which is more meaningful to the bedside staff. The staff is not told what to do or what to change; their voices are heard and considered in order to determine what changes are implemented.

Tell us about the arc of your nursing career.  
I was an RN from 1996 to 2002, earning my nurse practitioner degree in 2002. From 2002 to 2012, I worked as a nurse practitioner in the acute hospital setting.

I’ve always worked in acute care as a nurse practitioner and am now a hospital-based advanced practice provider. I’ve never worked in primary care. For 10 years, I served in interventional cardiology and cardiothoracic surgery. I was deeply involved in pre- and post-procedural care for both acute and chronic cardiac patients. I achieved my DNP in 2011, but did not fully transition to using it until 2013.

Was the goal of becoming a DNP to use your knowledge specifically in research?
 
The goal of getting my DNP was to familiarize myself with the strongest evidence-based processes for implementing best practices on a programmatic level. My nursing career has evolved to focus on population-based health, delivering high-quality, evidence-based care to disease-specific populations.

What advice can you offer for nurses who may be interested in pursuing an advanced practice degree?  
I would encourage them to choose a specialty that they love, regardless of whether or not they’ll be well paid or receive a certain level of notoriety or recognition. They shouldn’t even think about whether they’ll find a job in that area of specialty or not.

The motivation should be the love of what you do. You need to be able to go home every day and be proud of the work you’ve done. It can’t just be about making more money than you could make at the bedside. The motivators of respect and money won’t get you through school and they won’t help you to be the best provider you can be.

You have to love what you do and trust that there’s a place for advanced practice providers. Even though I didn’t know there would necessarily be a place for me, I moved forward to fulfill my goals and to do the work I knew I wanted to do.

How have the opportunities for NPs and advanced practice nurses (APNs) grown in recent years?  
I think there are a lot of opportunities at the bedside for APNs to interact with specialists and hospitalists and expand the ideas of where we expect to see NPs in the inpatient setting.

Advanced practice nurses extend the ability of physician providers to see even more patients and share their expertise with a larger population. We handle a lot of the routine care so that the physicians are free to accomplish more in the course of the day. When I came to this facility 13 years ago, there was one nurse practitioner on staff; now, we have many. A large volume of allied health professionals has been added to the staff, including many PAs. These individuals are experts in their fields.

There are many opportunities for advanced practice providers to work for hospitals and gain a great deal of experience, developing expertise that’s widely respected among the medical staff. At the community hospital level, this is relatively new, whereas academic facilities embraced APNs much sooner. So, even M.D.s are recognizing the contributions and value of advanced practice staff.

What feeds your spirit at work? What keeps you coming back day after day?  
This is a relatively small community. When you know that the next patient you see could be your next-door neighbor or your best friend’s husband, you see that your work could potentially benefit someone you know or a loved one of someone you know. That’s why I continue to do this.

I think it’s important to assure that the care you provide every day is the best that it can be. You want to promote a program from which you would be proud for your own family to receive the very same care.

Can you share some of your professional goals for your career?
My role as an education leader is new. I’d like to pursue my studies and my reading so that I can be as well-versed as possible in the current evidence-based research in this specialty area. I want to function at a very high level so that as a leader, I can support high-quality education activities for our staff.    

Keith Carlson, RN, BSN, NC-BC, has worked as a nurse since 1996 and has maintained the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students.

This article is from workingnurse.com.

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