Professional Documents
Culture Documents
Clinical Nurse Specialist
Clinical Nurse Specialist
Consultation
I am frequently consulted by staff nurses, referring physicians, or other APNs to assess misshapen heads by physical
assessment or reviewing radiographs. These consultations provide opportunities to teach health care professionals how
to recognize the differences between positional plagiocephaly and craniosynostosis, leading to earlier referrals for
improved outcomes.
Evidence-Based Practice
Collaboration on research with the pediatric neurosurgeon has yielded data demonstrating that the new surgical
technique decreases patients’ hospital stays, lowers costs, and improves patient outcomes. When parents noticed a
sharp decrease in fussiness in their baby immediately after surgery, I developed a questionnaire to survey parents’
perceptions of fussiness and irritability in their baby before and after surgery. Statistically significant decreases in
fussiness and irritability were found postoperatively, suggesting that babies with craniosynostosis experience increases
in intracranial pressure.
Leadership
In this unique role, I can provide care throughout the continuum, using clinical pathways to help families navigate the
hospital system in an efficient manner. Bringing a baby to an unfamiliar city for surgery by surgeons that they have
never met is a daunting experience for most parents. My leadership skills are put to the test coordinating preoperative
donor-directed blood, arranging lodging at the Ronald McDonald House, scheduling preoperative workups and follow-
up appointments with the neurosurgeon, plastic surgeon, ophthalmologist, and anesthesiologist, and coordinating the
postoperative molding helmet.
Collaboration
Collaboration occurs at many levels. First, I have a collaborative practice agreement with the pediatric neurosurgeon, as
required by hospital policy and the state board of nursing. I collaborate with the staff nurses who care for the babies
with craniosynostosis, providing in-service educational programs about the disorder and conducting rounds with them
on the postoperative patients. Collaboration also occurs with other members of the craniofacial team, such as
ophthalmologists, genetic counselors, plastic surgeons, and orthotic designers. I confer with referring health care
providers to provide continuity after the patient leaves the hospital and between follow-up visits.