The First “Walk with Me” Tour: A Model for Other Nurses
Thursday, November 7, 2019
Posted by: Kanaka Sathasivan
Earlier this year, the words of Senator Maureen Walsh, who said nurses in certain hospitals “probably play cards for a considerable amount of the day,” upset nurses nationwide. From this accidental offense came a unique opportunity as the senator (and other legislators) decided to shadow a nurse to learn what a day in their life is really like.
Texas Nurses Association member Jason Spees, APRN, L.Ac., FNP-C, saw the steps Sen. Walsh was taking and how her new experience would now shape future nursing legislation she votes on. Within days, he contacted TNA with a fledgling idea: the “Walk with Me” program.
“Walk with Me is an opportunity for legislators to shadow a nurse for some or all of a shift in various environments, hospitals, skilled nursing facilities and home health care environments,” Spees said. “Legislators and their staff would get to see what is happening, boots-on-the-ground style. I feel this experience can shift the position of key politicians on nursing issues.”
Spees started to work with TNA Director of Practice Ellen Martin to structure the program, which TNA will launch in full next year. He also took steps to set up the first tour with the representative of the district where he works.
Spees began by identifying the representative of the district where his facility in Lakeway was located. He cleared it with the executive director to approve the visit, then made arrangements with other staff to make sure the two hours were productive. The last step was the invitation.
“I went to her office in person, spoke to the staff, introduced myself, explained why I was there, and told them my goals,” Spees recalled. Once the formal invitation had been given, the long process started. “I got contact info from the office staff, received another email from a staff member who referred me to another staff member.”
The process started in June, and after one rescheduling, the final visit was set for the last Wednesday of October.
The first tour
On Oct. 30, Rep. Vikki Goodwin and her assistant stepped into the breezeway of the facility. “She had a warm smile,” Spees recalled.
They were greeted by Todd Mackenzie, the executive director, and his administrative staff. Spees and his team prepared a corporate name tag for Goodwin and welcomed her and her assistant with scones and coffee. After some pictures, they sat down to discuss the medical system, issues for long-term care and rehab facilities such as reimbursement and insurance, and staffing.
Then they began to see patients. “I made sure all the staff were aware of the visit, and we asked for permission from the patients each time if it was okay for her to enter, being careful of privacy concerns,” Spees said.
“She observed some tube feedings, wound care and insulin administration, and we reviewed charting. I narrated as I went along, explaining background of the patients, considerations in treatment and the need for detailed charting.” Part of Spees’ goal was also to explain the challenges nurses face daily, such as double charting, safety, extensive electronic forms, and requirements for Medicare and Medicaid reimbursement.
As the two hours came to a close, Spees and Goodwin talked about Medicaid expansion and the need for funding for the elderly. “I also emphasized the social and humanitarian aspect of nursing, explaining how we engage and honor the geriatric population and the variation of living conditions in nursing homes.”
While nurses provide health care every day, many legislators don’t always know how the medical system works, the role of different medical and nursing staff, or how nursing care can make a difference to patients. Spees took time to clarify the differences between certified nurse assistants and bedside nurses, and the differences in treating an obtunded (or lethargic) versus an alert patient.
“I also talked to about the psychological impact for a patient going from a fully functional adult to a person with disabilities who now needs great assistance due to a disease or traumatic process.”
While the goal of the Walk with Me tour was to show the world of nurses to the representative, Spees had a realization while he took Rep. Goodwin on his rounds: “It can be intimidating on a Capitol Day to go into an unfamiliar environment and interact with legislators on their turf, not knowing the ins and outs of politics. But in this situation, the roles were reversed. So, it was easier to connect to her as a person in my own environment and show her the world I know very well.”
Spees hopes that this first successful tour will serve as the model for future tours all across Texas. Above all, he met the goal he had: “to make a cohesive human connection.”
With the support of TNA staff, he plans to develop a kit that other nurses can use to arrange their own tours.
Contact TNA if you are interested in setting up a tour in your workplace!