The CNO Perspective


According to the American Nurses Association (ANA), there are around 3.1 million registered nurses in the United States, with 2.4 million of them actively employed. As the largest occupation in healthcare, nurses are integral to hospitals, clinics and other healthcare organizations around the nation. While the nursing profession can be very rewarding, it also has its challenges. With nurses and the important roles they play in healthcare in the spotlight during National Nurses Week, West Tennessee Medical News turned the spotlight on three area Chief Nursing Officers for their perspective on the rewards and challenges facing nurses today.

Tina Prescott

Nurses are often on the frontlines of caring for patients and can have some of the greatest impacts on their care. The desire to serve others is often a reason for choosing the profession and some even feel it is a calling. "As a senior in high school, I made the decision that I wanted to do something in the healthcare arena, and based that decision on subjects in school that I liked better than others. The sciences and math courses were my favorites, outside of any sports of course," said Tina Prescott, Vice President and Chief Nursing Officer for Jackson Madison County General Hospital. "Initially, I was torn between medicine and nursing, but while a freshman at Union University, it became clear to me that a career in nursing was the path that I should follow. I enjoy caring for others and the nursing profession has allowed me to serve in so many roles, caring for others in times of need. I know within my heart that nursing is truly a calling, my calling, and I am glad that I answered God's calling for my life."

John Jones

John Jones, Chief Nursing Officer for Tennova Healthcare -Dyersburg Regional began working as a nurse's aide at seventeen. "I have always enjoyed helping others," he said. "I knew right away I was in the right field. It just felt right and I received a lot of self-fulfillment from helping my patients."

"I knew that I wanted to be a nurse when I was in high school," said Donna Barfield, Chief Nursing Officer for Tennova Healthcare - Volunteer Martin. "I chose the nursing profession because I wanted an opportunity to care for people and hopefully make a difference in their lives. I did not realize at the time what an impact my patients and their families would have on my life. Being a nurse is such an honor and I cannot imagine devoting my life's work to any other profession."

Donna Barfield

As with many professions, mentors can play an important role in a nurse's development, both personally and professionally. For Barfield, it was her father. "He was the first person who encouraged me to be a nurse," she said. "While he was not in the healthcare field, my father spent his life helping others. His example made such an impression that I wanted to enter a profession that would allow me to help others."

"I have been blessed with many mentors along the way, from high school teachers who pushed me to see the many opportunities available in life, to nursing instructors who shared both their knowledge of nursing and the professionalism needed within nursing to function as an advocate for patients, to colleagues that I work closely with in my current role who I admire for their drive to improve our organization," said Prescott. "I would be remiss if I did not credit my parents for all that they have provided for me in life, giving me such a loving Christian home, always pushing me to do my very best in whatever I chose to do, and supporting me in so many ways."

"I would consider the first Director of Nurses that I worked for to be my mentor," said Jones. "She was a strong, yet compassionate leader who knew how to treat and care for people well all in the same moments of making important management decisions. I have always tried to lead as she did."

"As a nursing leader, a mentor early in my leadership career was a director of one of the Med-Surg Units at Jackson-Madison County General Hospital named Frances Davidson. She was so well-respected for her nursing leadership ability within the entire hospital. Her staff loved her, administration loved her, and her peers within the hospital loved and respected her," said Prescott. "I learned so many things from her, such as dealing with difficult patient situations, how to advocate within the hospital structure for patient and staffing needs and most importantly, how to support our amazing staff so that we can work together to give the best care for our patients."

Nurse-physician relationships are one of the most important drivers of the work environment. And while the relationship has grown and improved, as with every relationship this one too requires effort on both sides. "The team approach and collaboration between physicians and nurses has certainly evolved over the years," said Barfield. "Physicians and nurses work together in very stressful situations and if there was one thing that I could change about their relationship, it would be increased positive reinforcement for a job well done."

"Healthcare is a very challenging, dynamic profession and all members of the healthcare team are so vital to the patient's overall care, but need to work together to ensure the best outcomes for our patients," said Prescott. "To use a football analogy, where the physician is the quarterback, my goal is for the nurse to be viewed as the team's best wide receiver, one that always catches the ball (highly reliable from the standpoint of clinical quality and patient safety) and runs it in for a touchdown (from the standpoint of the overall patient experience). While nursing has made strides in this arena, I see this as an opportunity for improvements in the future. I am generally blessed with medical staff at JMCGH that recognize the value the nurse plays as the patient's advocate and care provider, working together with nursing to address any clinical quality initiatives and helping to foster this environment in the hospital setting."

Healthcare faces many challenges which also affect nursing. Increased regulations seem to top the list for two of our area CNOs. While Jones would like to see the stringent governmental regulations on healthcare and hospitals lessened, it's the nation's nursing shortage and the added workload it places on his staff he finds most challenging.

"One of the main challenges nurses face is the ever-increasing oversight of the healthcare industry," said Barfield. "There are approximately 47 regulatory agencies that provide oversight which often result in increasing documentation requirements for nurses."

"Charting/documentation per all the governmental regulations and legal requirements have always weighed heavily on nursing, as well as the rest of the healthcare team. It just seems to become a bigger issue as time goes by," said Prescott.

Barfield would like to see there be more affordable health insurance for patients that allows them to choose their physician/provider and healthcare facility. Prescott agrees that access for patients to the care they need, in the appropriate care setting is an area she would change. "We have too many in our communities across West Tennessee that simply do not have access to the care they need and use emergency rooms in our region to get access to that care," said Prescott. "This is a very expensive way to provide care, and one that is not sustainable in the future."


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