Patrick Smith, MSN, RN, is the heart failure nurse navigator at Abrazo Arizona Heart Hospital in Phoenix, Ariz. He has served in this position since April 2017. Smith was previously an orthopedic trauma nurse navigator at another hospital system.
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Q: What is the most important work you do as a nurse navigator?
Patrick Smith: As the heart failure nurse navigator, my emphasis is on educating my patients prior to discharge to help prevent their readmission. The Heart Failure Society of America defines heart failure as a syndrome characterized by “high mortality, frequent hospitalizations, reduced quality of life, and a complex therapeutic regimen.” Nurse navigators provide a personal and constant presence in both the inpatient and outpatient setting. We work to ensure patients and their families receive the best care possible and we always try to ease their stress levels while hospitalized.
Q: What do you like best about your job?
PS: I work with a multidisciplinary team of professionals whose focus is providing high-quality patient care. By using my nursing knowledge, critical thinking skills, and organizational and spiritual talents, I am providing patient-centered care while building a first-class cardiovascular center of excellence.
Having a supportive cadre of colleagues and hospital administrators has its own rewards. But being able to communicate directly with my patients, thereby fully understanding their needs, is a greater reward. It is true that simple gestures and acts of kindness make it all worthwhile.
Q: Can you share any particular patient stories or experiences that demonstrate the value of nurse navigation?
PS: I identified a need to provide improved home monitoring of a heart failure patient who recently had a CardioMEMS device implanted. After reviewing the data, I was able to facilitate a meeting with our heart failure medical director, cardiovascular center of excellence director, cardiology nurse practitioner, office staff, and the device representative. From this meeting there was a commitment of improved coordination of care and a scheduled monthly meeting to review all patients implanted with the CardioMEMS.
Additionally, as a nurse navigator, I devote time to sit with my patients and listen to their concerns, allowing me to treat them holistically.
Q: What is your biggest challenge as a nurse navigator?
PS: Dealing with a complex and diverse group of patients can test anyone’s skill level. Taking into account cultural, social, religious, and language barriers only creates a desire to approach each patient as a unique individual. It was King Solomon who said, “Give me the gift of a listening heart.” Faith, combined with a strong moral and ethical compass, has carried me through many challenges. I have always come through stronger because of the challenges tossed my way.
Q: What technology do you use in your position? What tools do you wish you had?
PS: We definitely live in exciting times in terms of breakthrough medical technologies. Building a reputation as a first-class heart institute takes an investment in these technologies. Here at Abrazo Arizona Heart Hospital, I use a wide range of communication devices, such as a cell phone and laptop computer. I leave my business card with each patient I educate and encourage them to call me if they have any questions. The development of a spreadsheet where I can track and follow-up on patients after discharge will be helpful in preventing hospital readmissions.
There are several remote monitoring tools that Abrazo Arizona Heart Hospital is planning to implement in the future that will coincide with the opening of a cardio-renal outpatient center. These devices collect the data and send that data electronically to a central monitoring station. Our approach to these technologies is to improve compliance, engage patients in self-care, and reduce hospital admissions. I honestly believe that a mating of wireless technologies, combined with a personal interest in the patient, will work towards these goals.
Q: What do you hope for as the future for nurse navigation in the United States?
PS: According to the American Heart Association, heart failure affects 10 per 1,000 individuals after 65 years of age. This emphasizes the critical need for nurse navigators, not only in heart failure but in all disciplines. The patient population is being admitted with more serious illnesses. Coordinating their care can help facilitate and resolve gaps in care, thereby building a bridge that ensures continuity of care.
The nurse navigator’s role will no doubt be refined to take on more responsibilities. My hope is that nurse navigators across this country will be leaders in their respective fields with unique talents that will impact every level of healthcare.