Though some may instantly think of a hospital setting when they think of the nursing profession, registered nurses work in a wide variety of very different roles.
In celebration of National Nursing Week from May 6 to 12, the Comox Valley Record will feature two articles looking at non-hospital positions of registered nurses.
Mya Ambrose, nurse leader at Glacier View Lodge, gives a glimpse into what role a registered nurse plays in end-of-life care, particularly, in caring for those with dementia.
“Building a relationship, that’s really what it comes down to,” says Ambrose. “You build a relationship with the residents … and then it’s getting to know the family.”
Ambrose has worked nearly 20 years at Glacier View Lodge, which is a long-term care facility in Courtenay. The facility has 102 publicly-funded beds, including one respite bed to allow caregivers a break and 27 special-care beds in a secure wing for residents with behaviour disturbances.
Ambrose notes there are not enough beds to meet demand. So, a huge role of registered nurses is to continually monitor whether a resident needs to stay in the special care unit of the facility, or whether they can be moved into the general area of the facility to free up a bed for someone in the community who needs it — such as when a family is struggling to care for their loved one because that person has started wandering.
“Families are keeping them home for longer so there’s caregiver burnout,” she adds.
“The nursing role is support to family, it’s assessment of the resident, assessment when they’re admitted, how effective their drugs are, how they respond to the environment, what kind of rehab care (is possible).”
In terms of meeting resident needs, Ambrose says registered nurses look at things like falls prevention, medication dosages, whether the person can be rehabilitated in some way, and a whole variety of other things to try to help the resident have the most comfortable and happy life they can in the facility.
She adds educating the family is a big part of the job, too. For example, Ambrose says nurses can act as interpreters when families can’t understand why their loved one is acting the way they are.
“Behaviour has meaning, so if somebody’s behaviourally disturbed they’re not able to vocalize what their needs are,” she says. “We can act as that interpreter in a way, so we can frame that behaviour in a meaningful way.”
According to Ambrose, people with dementia can have good days and bad days rather than a steady decline, which can be hard for families to understand; part of her job is to help families understand how dementia progresses.
So, “you build a relationship with the residents so you know what’s their unique — every person is unique in their dementia,” she says, adding understanding a person’s unique case helps the team best care for them. “And then it’s getting to know the family — interpreting the progression, reassuring them that it’s a progression, and that is teaching and educating around the progression of dementia.”
Ambrose received the Excellence in Nursing Practice 2012 award from the College of Registered Nurses of BC for the leadership she’s shown, particularly around dementia care.
She says this role in nursing interests her because it is complex and challenging.
“I found that there was such a vast body of knowledge to this area, there was so much to explore and people don’t think of long-term care as being dynamic — (it’s) hugely dynamic, just hugely,” she says.
“Everybody expresses their dementia uniquely and it’s such an opportunity to bring all the vast knowledge of, like, mobility and neurology and cognition — it’s so vast, all that you bring in to assess that individual.”