Caitlin Shelton checked an elderly patient’s intravenous drip, trying to flush it out so antibiotics could be administered.
“How does it feel?” she asked, making sure the patient was still comfortable on a recent afternoon on the telemetry floor of Guthrie Cortland Medical Center.
The flush wasn’t going through. So Shelton, a senior in Tompkins Cortland Community College’s nursing program, got help from registered nurse Susan Tate, who adjusted the port in the patient’s hand, making sure there were no kinks in the line so the saline flush flowed smoothly.
The task was followed by lots of small talk, many words of thanks from the patient, and then Shelton was off to chart the patient’s progress. Then on to check the vitals of other patients.
It’s a typical day, a busy one, in the life of a nursing student. Shelton juggles her twice-a-week nursing rotations with lab work and lectures the rest of the week, her regular paying job — working at other posts throughout the hospital — and life with an 8-yearold daughter as a single mother.
Shelton’s always felt called to nursing, especially after caring for her ailing father years ago. She cares about her patients.
“It’s about building trust, fostering a trusting relationship has the best outcome in the end,” she said.
Tompkins Cortland Community College nursing student Caitlin Shelton visits with one of her patients Tuesday at Guthrie Cortland Medical Center in Cortland.
When Shelton graduates as a registered nurse in May, she already has a job at Guthrie Cortland Medical Center.
She hopes to land in the intensive care unit or emergency room, or maybe in the telemetry ward — which monitors people for cardiac complications — where she was Tuesday.
The vast majority of people who go into the nursing field do so because — like Shelton — they want to help people, said Kim Sharpe, the nursing department chairwoman at Tompkins Cortland Community College.
They must be compassionate and non-judgmental too. A nurse must put aside personal opinions and just provide care for the patient, Sharpe said.
“Once you become a nurse you’re signing on to care for anybody, whether a drug abuser or a pedophile,” Sharpe said. “It doesn’t matter what they’ve done — when they’re on the bed for you, your job is to care for them, not judge them, not give them advice.”
Self care is also important, said Sharpe, especially when entering a field that is facing shortages due to much of the work force retiring. Nurses must know how to say no to taking on an extra shift or to caring for too many patients at once.
According to the Center for Health Workforce Studies at SUNY Albany, America will need 11.6 million health care workers between 2016 and 2026 to fill new jobs and to replace workers who leave the occupation or retire — 3.5 million of them to fill new positions.
Personal care aides — 191,000 yearly— top the list of annual demand among health care, but registered nurses are second, with 90,000 needed each year.
A new partnership between TC3 and Guthrie Cortland Medical Center hopes to turn out more nurses to help meet the need. A recently announced program will train 20 more students through the college nursing program starting in 2020. When the evening program is running, the program will have 150 students.
The expanded program will graduate registered nurses in December and allow students to do their hospital rotations in evening shifts.
What makes a nurse?
At TC3, nursing students must have passed high school biology, chemistry and math with an 80 or higher or have taken a college-level course. They must take anatomy and physiology as well as liberal arts courses.
After the first three weeks in the program working in the lab, though, students start working in the clinical setting.
“My feeling is, if this decision isn’t for them, I don’t want them to invest an entire semester before they realize that, I want them to see whether they like it early on,” Sharpe said.
Strong students are good in the hard sciences, but still have the soft skills and desire to care for people, Sharpe said.
Science and math are Shelton’s strong suits. She has no aversion to blood and her empathy runs deep.
“Because think of it, half of it is mental, not being home and doing your normal life, and putting your care in someone else’s hands,” she said.
It’s the mix of everything that makes a good student, Sharpe said.
“If you’re not good at biology, chemistry and anatomy you are not going to be able to pass the nursing program and get a license,” Sharpe said. “Some people think more in terms of the soft skills, compassion and caring — and that’s important, too — but that alone doesn’t make it.”
Hands, ears, eyes of medicine
Nurses, nurse practitioners and doctors all work alongside one another at Guthrie Cortland, said nurse practitioner Stanley Cadet. Nurses play a crucial role.
“They are our eyes, our ears, our hands,” he said. “They are everything for us.”
Outside the patients’ rooms, Shelton’s eyes constantly scanned the electrocardiogram monitors in the hall monitoring all the floor’s patients. Shelton was on the alert for an abnormal rhythm or a disconnected monitor.
She also knows what’s normal for her patients, what their skin looks like when it’s healthy versus infected, and warning signs to watch for that show a change in condition.
It’s these observation skills and time with the patients that leads nurses to get to know them best, said Cadet, because nurse practitioners and doctors have limited bedside time.
“It’s important to have strong nurses who can see problems before they happen,” Cadet said. “If patients decline, or if they are getting better.”
Relaying that information to the doctors or nurse practitioners makes everything run smoothly and ultimately improves patient care, he said.
“We need to have good student nurses to have good nurses,” he said. “And that helps the patient, it helps providers provide better care.”
Preparing for the nursing shortage
Sharpe says she always recalls a need for nurses in the work force. But the problem is exacerbated now by an aging work force facing retirement.
“We do in the program, talk about the fact that you can’t take care of somebody else unless you take care of yourself,” said Sharpe.
There wasn’t much time for self care on Shelton’s shift. She was constantly walking between patient rooms for everything from helping them back into bed from a bathroom trip, to checking their vital signals.
She also likes to show them she’s there to help in other ways.
“I do everything I can to make it better and address their concerns while they’re here,” she said. “I ask them, ‘What are you concerned with?’ It could be emotional or physical. ‘What can I help with?’”
An important role of the nurse is to advocate for their patients, she said.
Working too much also causes burnout, another top reason that nurses leave the field, Sharpe said.
Shelton says the hospital does a great job of combating burnout because managers are constantly present on each floor, listening to what nurses need and making sure they aren’t stretched too thin.
And she always feels like she’s part of a team.
Like when Tate stepped in to help her with the patient’s IV, Shelton always knows she has others to rely on.
“I don’t feel like I”m working alone, there’s always someone to help,” she said. “It really takes a team.”
A calling more than a profession
Nursing can make good money. And provide job security, Sharpe said. But those are the wrong reasons to get into the field — she’s seen some try.
“Very few of them ever become a nurse,” she said. “Once you get here, you can’t do it for that. It’s too big of a job to do it for the money. You have to really want to take care of people.”
The program shows students how to model empathetic behavior and the acceptance of diverse backgrounds and to leave preconceived beliefs at the door.
“You have signed up for a job that requires you to leave that at the door,” said Paula Moore, Shelton’s clinical instructor. “The expectation is you give them the best. They are a human being in that bed.”