Q&A with Deborah Klein: CNS in Coronary and Heart Failure ICUs

Advanced practice nurse helps lead AACN

Deborah G. Klein, MSN, RN, ACNS-BC, CCRN, CHFN, FAHA, is a clinical nurse specialist in the coronary and heart failure intensive care units and cardiac accelerated recovery, cardiac short-stay and post-anesthesia care units at Cleveland Clinic main campus. Klein boasts more than three decades of experience in critical care practice, education, consultation and research. She is known for her work in critical care, therapeutic hypothermia post-cardiac arrest, pain assessment in patients who are unable to communicate pain and end-of-life care.

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Klein is in the middle of a three-year term on the board of directors of the American Association of Critical-Care Nurses (AACN). She shared her thoughts on the importance of specialty organizations and the work of AACN, and provides sage advice for novice critical care nurses.

Q: When and why did you get involved in the AACN?

A: I have been a member of the American Association of Critical-Care Nurses since 1982, the same year I became certified as a CCRN. Back in the 1980s, when I was a few years in as a critical care nurse, I was attracted by the vision of AACN:  “Dedicated to creating a healthcare system driven by the needs of patients and families where acute and critical care nurses make their optimal contribution.” That says it all! AACN is well recognized as the “go-to” organization for acute and critical care nurses.

Q: Why is it so important for nurses to get involved in professional organizations?

A: No matter what field you are in – from critical care to pediatrics to oncology – there is an organization dedicated to excellence in nursing. These specialty groups typically provide nurses with certification programs; cutting-edge, evidence-based practice recommendations; outstanding nursing journals; networking opportunities and more. They represent your voice within the healthcare community.

Q: What would you say to nurses who think they don’t have time to get involved in their specialty organizations?

A: Becoming a member doesn’t mean you have to devote a lot of your time. Many people become members because they want to receive a journal, have access to free contact hours or get information related to changes in their specialty area. A lot of nurses join their specialty organizations out of curiosity: “I really like what I do. What is everyone else doing?” Of course, there are many volunteer opportunities for those who want to give back.

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Q: How has your involvement in AACN ultimately benefited your patients?

A: As a clinical nurse specialist, I have a responsibility to incorporate evidence-based practice every day in what I do. I have access to the latest information because AACN is at the table reviewing new research studies, summarizing the findings and making recommendations for practice. When you have access to all that information and to people you can call with questions, it can’t help but overlap into your everyday practice.

Q: Why did you became a member of the AACN Board of Directors in 2014?

A: I was selected to be on the ballot for the board, which is elected. The intent is to select a group of people that represents the mission and vision of AACN and at the same time can serve in a leadership capacity that is more than just operational, but does strategic thinking. The board really pushes the envelope as to where we can go as an organization and how we can best represent our members, our patients and our patients’ families. I was proud to be elected by the AACN membership, then elected again as secretary of the board for 2015-2016.

Q: What are the goals of the AACN board?

A: We are truly there to serve our patients, their families and our members. We also have a responsibility to keep a pulse on what is going on in the healthcare environment. For example, one of the things that has been identified by our members is the barriers to nurses being able to practice to the full scope of their practice. Other concern is not having enough nurses to do what we are being asked to do. In addition, the acuity of patients is changing, and we don’t always have the right resources available. The board tries to identify those barriers and develop solutions to help our staff nurses truly impact patient outcomes.

Q: So what are some solutions you’ve come up with?

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A:  One program we’ve developed is the AACN Clinical Scene Investigator (CSI) Academy. During the program, we partner with a hospital and help them empower their bedside nurses to really ask questions and develop projects to improve patient outcomes. For instance, not every hospital has a clinical nurse specialist. How can a bedside nurse lead the charge, for example, in reducing central line associated bloodstream infections, hospital acquired infections or falls? We work collaboratively with the leadership of that unit and that hospital, training the nurses in how to collect and look at data, then change practice and sustain it. Right now, the AACN Board is looking at the results of our CSI Academy and starting to publish the results. It’s incredibly exciting!

Q: You’ve had a lot of accomplishments during your career. Is there some achievement in the field of cardiac care that you are most proud of?

A: There are so many things! I am proud that as nurses we have been able to make incredible changes in practice that impact patient outcomes and patient and family satisfaction. We have challenged ourselves. I am also proud of the work I have done with end-of-life care here at Cleveland Clinic. I couldn’t have done all that I have without a phenomenal team of nurses I work with and an incredibly supportive leadership team. But I am most proud that the two units I cover – the coronary ICU and heart failure ICU – achieved Beacon Award Gold status from AACN in the last few months. That says so much about the care that we provide and the collaboration we have with respiratory therapists, social workers, physicians and other members of the healthcare team.

Q: With decades of experience as a nurse and clinical nurse specialist, what advice would you give novice critical care nurses?

A: Slow down, take it in and be open. You are entering a lifelong learning career in nursing. When you have a new experience, go home and read about it. Be open to learning, be patient with yourself, talk to your coach and recognize when you are overwhelmed. Also, take time for yourself. You can’t do this job 24/7, 365 days a year. You have to give yourself a break. Finding the balance between work and personal life is very, very important.