FEBRUARY 2010 • NURSE TO KNOW

Shellie Anderson’s debut as a front-line nursing manager coincided with an event that made medical history.

She directed the team of nurses who worked on Canada’s first living lung transplant. The patient received healthy lobes from two living donors at Winnipeg’s Health Sciences Centre (HSC). Before this successful operation, in December 1999, only about 60 other similar surgeries had been performed around the world.

Anderson couldn’t have imagined being involved in such a landmark case when her nursing career began at HSC in 1984. She was working in one of the centre’s adult clinical teaching units at the time. Many of the patients under her watch back then would be cared for today in their homes or communities. “You have to be much sicker now to get a bed than you did 25 years ago,” she says.

Anderson loved hands-on nursing. It’s all she’d ever wanted to do; her mother doesn’t remember her wanting to do anything else either. Leaving bedside care for the position in management was a huge switch. It meant Anderson had to leave her comfort zone and go from being an expert to a novice again. But she was determined to try it because she saw this new path as an opportunity to make changes in Canada’s health-care system. A decade later, she’s not certain how much change she’s been able to bring about, but she has no regrets ― the move has allowed her to grow professionally and learn a great deal about the health system. (Working at HSC has been a good fit, and she anticipates she will spend the rest of her career there.)

After the lung transplant assignment, Anderson returned to her old unit — but with a new gig. She took over her former boss’s job, managing the nurses there and then taking on the medicine float pool (health-care providers who can step in wherever they’re needed). Anderson had spent two years in the float pool herself and was excited about the opportunity to improve the worklives of these employees. “I realized the difficulties they were going through every day, how hard it is to just parachute in and not feel like you really belong,” she says. She loved the job; in 2004, she decided to take on full-time management of the surgical and medicine float pool, which includes support staff, an IV team and phlebotomists ― more than 300 people in all. Anderson was no longer on the receiving end of thank yous from patients and the gratification that brings, but she was confident about the difference she was making in patient care.

Anderson’s inquiring mind led her into yet another area of nursing that she was eager to pursue. She wanted to explore ways of delivering even better care that might challenge the status quo.

Enter Lesley Degner. Highly respected in the nursing community, Degner is a leader in nursing research and knowledge translation (KT). This term that encompasses the push to get proven research results and best practices used and to make the difficult leap from the pages of research journals and the experiences of a handful of individuals into the everyday practices of a much wider scope of professionals.

Nurses don’t get much chance while at work to read up on new developments in their field. Degner believed the responsibility for continuous learning was one that should be shared by nurses and their employers. With this in mind, she launched the Nursing Knowledge Translation Research Project (funded by the Canadian Institutes of Health Research) to look into research use on the job. Anderson took on the role of organizational manager for the project. At the same time, she also agreed to coordinate nursing KT projects overseen by HSC’s chief nursing officer and the executive team.

Participants in Phase 1 of Degner’s project are completing online surveys every six months. These surveys build a picture of nurses’ worklife in three of HSC’s clinical program inpatient units (adult medicine, mental health and surgery) that includes details on how research is being used. After nine rounds of surveys, this phase wraps up in April. That’s also when the team find out if they are getting the green light for Phase 2.

Anderson says that the work done so far has already begun to change the workplace culture: “It’s making it safer for nurses to ask questions about why they do things a certain way. Being able to ask those questions gives them more control over their practice because it opens a two-way conversation; people are learning from each other.”

If Phase 2 is approved, the next step will be to bring together advanced practice nurses (as tutors) and staff nurses to look at specific patient outcomes by mapping out patient experiences and reviewing the evidence to determine if how they were cared for is in line with best practices. If it isn’t, they will look at how to change what they call the mindline ― the practices and processes nurses carry out as a matter of course. Anderson sees the potential for nurses to experiment with new and challenging thought processes that could help improve patient care.

Her hope is that the second phase of the research might also improve recruitment and retention. The participants will be from the same three units ― known to be the places where many nursing careers begin at HSC. If newer nurses are involved, it could really make a difference to them deciding to stick around.

“This research and my whole job really fit with my personal philosophy,” says Anderson. “We have to do what’s best for the patient; we can’t just do what we’ve been doing for a million years because we’ve always done it that way.”

Her concern for others extends to her work in her community. She and her husband, Jim, spend many hours serving meals at Siloam Mission on Princess Street in Winnipeg. They also put together hampers of food and toys for Winnipeg’s Christmas Cheer Board, which helps out families receiving provincial assistance as well as many of the area’s working poor. Anderson was a community representative on the review committee working with school trustees, school representatives and parents to keep the local elementary school open. She doesn’t have children herself but felt that keeping the school in the neighbourhood was extremely important.

Anderson is just as committed to her nursing colleagues and the profession. She organizes volunteer efforts carried out by her chapter of the Sigma Theta Tau International Honor Society of Nursing. She is co-chair of HSC’s charity golf tournament, which most recently raised money for furniture for the patient and visitor lounge in the adult mental health unit.

She sits on the boards of the Foundation for Registered Nurses of Manitoba and the HSC nursing week awards committee, and recently accepted the role of co-chair of the nursing week committee for the University of Manitoba’s Graduate Nursing Students Association. She has been very involved in the College of Registered Nurses of Manitoba and has high praise for its work on standards of practice, “making sure that what we’re doing is up to date.”

Anderson is a lifelong learner and is now pursuing a master’s degree. Her thesis subject isn’t nailed down yet but will definitely focus on an aspect of nursing leadership. She’s interested in direct-care managers because they work so closely with nursing staff, support staff and patients. They set the culture of the unit they manage, she says, while maintaining a responsibility to their organization, its strategies and the financial constraints.

“I want to know what leadership means to the nurses and the teams that are delivering direct care — and what they need and want from their leaders,” she says. “That will make a huge difference to carrying out a vision and really putting it into practice.”

Her other passions? Anderson is a proud aunt of two and likes to get out on the golf course as much as she can. “Golf is just one more thing that requires continuing education ― at least the way I play!”

TARA TOSH KENNEDY IS A FREELANCE JOURNALIST AND AN ARTIST IN OTTAWA, ONTARIO.