Fidelindo Lim, DNP, CCRN, FAAN, a clinical associate professor at New York University Rory Meyers College of Nursing, has worked as a critical care nurse for 18 years and concurrently, since 1996, has been a nursing faculty member.
In 2013, Dr. Lim conducted the seminal national study of faculty knowledge, experience, and readiness for teaching LGBTQ+ health in BSN programs across the U.S., and the groundbreaking findings of his research on LGBTQ+ health integration in nursing have been cited in six white papers and at least nine LGBTQ+ policy statements by leading stakeholders.
Dr. Lim has published over 200 articles on various topics, including clinical practice, nursing education, LGBTQ+ health, reflective practice, preceptorship, men in nursing, nursing humanities, and Florence Nightingale. He has been designated as a Nurse Influencer by the American Nurses Association’s (ANA) American Nurse Journal. Additionally, Dr. Lim is a Fellow of the New York Academy of Medicine and New York University’s Aging Incubator and an NYU Meyers Alumni Association board member.
In 2021, Dr. Lim was one of four nurses featured in the ANA-sponsored documentary film “American Nurse Heroes,” a multi-channel network television event celebrating the Year of the Nurse.
He’s the faculty advisor to various nursing student groups at NYU Meyers, including the Asian Pacific-Islander Nursing Students Association, Men Entering Nursing, the LGBT Nursing Student Association, and also a founding member of NYC American Association for Men in Nursing, which represents the goals of men in nursing and advancing men’s health. Dr. Lim frequently brings male nursing students to local New York City schools—including an all-boys school—to provide health education, introduce students to nursing as a career path, and have them see male role models. Dr. Lim has fostered salience in nursing education through high-quality extracurricular programming and active learning and is an imitable mentor and coach to countless students and nurses.
The series highlights healthcare leaders who are prominent figures in their organizations and are making transformational impacts in nursing.
Meet Dr. Fidel Lim, DNP, CCRN, FAAN, a New York University Meyers College of Nursing clinical associate professor.
Talk about your role in nursing and how long you have worked in the nursing field.
I have been a nurse for 36 years—nineteen years as a staff nurse on the night shift in the critical care unit. I have been simultaneously teaching at New York University Meyers College of Nursing since 1996.
Why did you become a nurse?
I got into nursing quite serendipitously. When I was 15 and a half years old, I was sent to Manila by my parents to get a college education. I didn’t know what career to take. I was going with the flow. My sister, who took me to the university to apply for college, was in her last trimester of pregnancy. In those days, college applications had to be done in person. She told me she couldn’t stand in line for long because of her swollen feet. So, I suggested that we go to the shortest line – which was the nursing program’s line.
What are the most important attributes of today’s nursing leaders?
Inspiring others (subordinates, peers, colleagues, students) to achieve their level best is one of the true marks of a leader. It seems rare to find this attribute these days. We have plenty of managers and taskmasters but only some true leaders.
What does being a nursing leader mean to you, and what are you most proud of?
I am proud to have mentored many students over the past two decades. Being a leader means modeling the behaviors you want others to manifest or emulate. A leader must be sincere and intentional in making authentic relationships, not fake camaraderie.
Tell us about your career path and how you ascended to that role.
My first job out of nursing school was as a public health nurse for the Philippine National Red Cross. The bulk of my role was conducting health education training for local villagers. I was particularly amazed to discover that I was comfortable standing in front of an audience, having fun connecting with people, and enhancing their health literacy. This inspired me to pursue my master’s in nursing education at New York University. I was fortunate to be taught by leaders in nursing education and practice. I was like a sponge. I soaked up every bit of inspiration, wisdom, technical and relational skills, emulated my betters, and made these my own. When I graduated from NYU in 1996, I was offered a job as an adjunct faculty member, and in 2008, I transitioned to a clinical assistant professor. Currently, my title is Clinical Associate Professor.
What is the most significant challenge facing nursing today?
The nursing profession’s most significant challenge is keeping nurses at the bedside where they are most needed. The staff nurse turnover is very high. Bedside work has now become a short stop for many new grads on their way to a career as advanced practice nurses and nurse practitioners. There was a time when there were much fewer career choices for nurses. So, nurses stayed on their jobs much longer or held the same job until they retired. Nursing has become the most flexible and dynamic role; the work choices are endless. There is an internal brain drain within the profession.
As an educator, one of the most significant challenges for me is the burgeoning technology, the latest of which is ChatGPT. Appraising students’ learning is much more complicated nowadays if we rely too much on writing assignments. There is also a big disconnect between how we train nurses and the real-time demands of the job. The nursing school focuses on layering facts on the student’s already full plate but is very lean on providing clinical experiences with actual patients. Competency is more important than comprehension.
As a nursing leader, how are you working to overcome this challenge?
Like any complex issue, the challenges in the nursing profession require collaborative solutions from various stakeholders. For example, hospitals should invest (financial and material) in enhancing the clinical experience of student nurses to transition them into therole. Providing opportunities for advancement within the institution is another solution.
As a nursing faculty, I am constantly reading and teaching myself how to hone my skills in teaching, managing large classes, crucial conversations with students, and mentoring others. I remind myself that nursing education should not only teach how to save lives but also how to live.
What nursing leader inspires you the most and why?
I am an avid fan of Florence Nightingale. I have read her most famous book, Notes on Nursing, many times. Nightingale’s erudition and no-nonsense approach to the challenges she faced is what I try to emulate. Her stamina for hard work was a wonder. She was the first and true nurse influencer. She did not depend on how many “likes” she got; she wanted to do what was right for the patient.
What inspirational message would you like to share with the next generation of nurses?
In nursing school, you get the lessons first and then get tested. In real life, you get the test first; then, you learn the lesson. In and out of nursing, you will discover many tedious things you will forget. But it is better to have learned and lost than never to have learned at all.
Is there anything else you’d like to share with our readers?
Have a growth mindset and be patient. Nursing education is different from what it used to be. But then, again, what is?
Blake Lynch, aka Nurse Blake, loves caring for and helping patients and caring for and helping fellow nurses. As a popular nursing influencer, internationally touring comedian, healthcare advocate, and keynote speaker, Nurse Blake uses humor to bring nurses together.
Working in trauma centers around the country, Nurse Blake started posting original comedy videos aimed at his profession to cope with the stress of his nursing job. His lighthearted videos connect with nurses, nursing students, and healthcare workers worldwide, and he entertains almost 4M followers on social media while lifting healthcare workers across the globe.
But Nurse Blake is about more than comedy.
He always wanted to be a nurse and started working in healthcare as a patient transporter at age 17 and graduated with a BSN in 2014 from UCF in Orlando, Florida.
Advocacy has always been a part of Nurse Blake’s life. During nursing school, he was the President of the Florida Nursing Student Association, and in 2013 he started Banned4Life, to end the permanent FDA gay blood ban, which ultimately contributed to the lifetime ban being lifted in 2015.
Now Nurse Blake uses his online content and comedy shows to advocate for underpaid healthcare workers.
He’s also the creator of NurseCon at Sea, one of the largest and most popular nursing conferences, and the NurseCon App, which provides free continuing nursing education courses, and author of the #1 best-selling children’s book “I Want To Be A Nurse When I Grow Up” just like the nurse from his favorite TV medical drama. Blake learns that it won’t be easy, but if he puts his mind to it, he can become a great nurse.
The series highlights healthcare leaders who are prominent figures in their organizations and are making transformational impacts in nursing.
Meet Nurse Blake, a nurse, creator, internationally touring comedian, healthcare advocate, and keynote speaker.
How long have you worked in the nursing field?
I’ve been a nurse for nine years now. I stepped away in early spring 2021.
Why did you become a nurse?
I knew a hot hospice nurse caring for my grandfather, and I’m like, he’s a hot nurse. I want to be a hot nurse. (Nurse Blake jokes).
My dad’s a respiratory therapist. He’s worked on the night shift for over 30 years. So growing up, he would tell me the coolest stories about him caring for others. So I think that’s what inspired me. I haven’t considered any other profession. I was in the healthcare academy in high school. When I graduated that summer, I was doing prereqs. So it was a no-brainer for me.
Do you miss being a bedside nurse and getting more content for your shows?
Yes. To some extent, people may call me crazy, but I miss the camaraderie of working in that team environment and patient interactions.
I stay up-to-date with all the evidence-based stuff and what’s going on. I get a lot of feedback from nurses who watch my videos, and we get their stories and stuff. Based on my time as a nurse, I have stories for years and years to come because so much can happen in a 12-hour shift, right? Like so many stories and things that can happen in 12 hours, I’ve had that experience multiplied by a few years, so I have endless content.
What are the most important attributes of today’s nursing leaders?
Equality and inclusiveness. Nursing leaders ensure their staff and their patients are safe. Many leaders care about making the higher-ups happy or just looking at a certain number instead of really caring. It’s truly caring about the patients and their staff. I tell nursing leaders that you should treat your staff the same way you want your staff to treat patients. The lack of bedside staff nurses in those leadership roles is the problem. That’s the huge disconnect.
What does being a nursing leader mean to you, and what are you most proud of?
It would be NurseCon at Sea, the nursing conference I have on a cruise ship. Seeing the nurses have their best life and feel so safe and just let loose to have nursing students who are 20 dancing on the dance floor in crazy costumes with a 70-year-old retired nurse. That’s what makes NurseCon at Sea so special. And that’s what makes me the most proud.
What is it like to watch NurseCon at Sea grow to become one of the largest nursing conferences?
It’s cool to see that community grow and thrive. I provide the ship. We have education, but the participants make NurseCon at Sea feel and vibe that it is.
What is the most significant challenge facing nursing today?
Staffing, staffing, staffing is the number one issue and affects nurses and patients at the end of the day. But it makes me so happy to see nurses going on strike. And record numbers like they are. Big hospital system striking like they haven’t seen it in decades. It’s inspiring to see nurses coming together over that.
As a nursing leader, how are you working to overcome this challenge?
It’s just giving them a venue and a community to let loose to forget about the stresses of their job. I tell nurses all the time you’re not going to be perfect. You’re not going to get it all done within 12 hours. You’re not going to do it. Just try to be the best nurse you can be. Do your best for your patients, knowing you won’t accomplish it all.
What nursing leader inspires you the most and why?
It was one of my professors. It was Professor Angela Renton. She was one of my professors in health assessment. I remember how she made me feel to this day. She would start every class and come in and say hello, future nurses. And just by saying hello, future nurses made us realize we will get through it. And that one day, we’re going to be nurses, and that she sees as not being lower than her. We’re all in this learning process together on a learning journey. So she’s someone I think about all the time. She made me feel just so warm and so safe with her. I try to take that energy and feeling into my show and NurseCon at Sea. How do I make people feel? How does the show make people feel? How do the people on this cruise feel?
What do nurses tell you after seeing one of your comedy shows?
I’ve been following them with a hidden camera because we all go through the same thing. They’re not alone. Some nurses say I considered leaving the profession because I’m so stressed out, and they just really needed this night. What’s so cool about my shows is nurses come in party buses. So they come in groups of like 30 and 40. They make t-shirts and posters, and the energy is unbelievable and wild. And again, even at my shows, you got the younger and more experienced nurses of all ages and backgrounds coming together. And that is just, like, so cool. So I think it’s just relatability. I’m telling my stories, how they happened in my life and my years as a nurse, and seeing what others went through is my most common feedback. Like we’re all missing a bladder scanner. Like we’ve all had the patient that’s pulled their flexi seal out.
What inspirational message would you like to share with the next generation of nurses?
Know you have a voice. If there’s ever something you’re passionate about and want to change, do it because if you don’t, who will?
Nurses are astute clinicians often endowed with a keen helping of intuitive discernment. This ability to sense that something is wrong — or about to go wrong — has likely saved countless patients’ lives over centuries of nursing care. Whatever it is and wherever it comes from, a nurse’s intuition is something we can choose to pay heed to and to increasingly nurture, sharpen, and trust as the years go by.
The Nurse’s “Spidey-sense”
When I was in nursing school for my associate’s degree, I had a professor who was a long-time nurse of considerable skill and knowledge. She was an excellent storyteller (always a good attribute in an effective teacher), and I remember several of her stories today.
One story that stands out is when she described what it’s like when you’ve been a nurse long enough that your nurse’s intuition is a reliable tool of clinical assessment and nursing “air traffic control.” The air traffic she referred to was the constant barrage of information and data coming at you from all sides. When your intuition is allowed to live and breathe, those inner feelings of knowing can sometimes mean the difference between making an excellent clinical judgment call rather than possibly missing the mark.
The professor often referred to this power as a nurse’s Spidey-sense, akin to the inner radar-like warning system with which Spider-Man was so well-equipped. If you’re familiar with this comic book phenomenon, what would have happened to Spider-Man so many times if he’d dismissed his Spidey-sense as just so much mental noise? He may have been attacked unawares, missed the opportunity to save a helpless citizen in distress, or otherwise ignored a clear signal that it was time to perk up the ears and swing into action once the source of his inner tingle could be determined.
(Another story my professor told was one where she and her husband were in bed being rather amorous, and she developed a sudden-onset headache. Paying attention to the signs, she realized that his nitroglycerin patch had come unglued from his arm. She affixed itself to her, thus flooding her body with the medicine, dilating her blood vessels, and causing a splitting headache. While this wasn’t exactly her nurse’s intuition, her clinical judgment was unclouded enough to realize something was wrong, and she could remove the patch and relieve her symptoms. If memory serves, we teased her mercilessly about this story for quite some time. But I digress.)
Listening for the “Tingle”
In the Spider-Man comic books, I recall his Spidey-sense being graphically shown by the artist using squiggly lines emanating from Spider-Man’s head like an energetic crown as he picked up on something not being quite right in the air around him.
There are schools of energy medicine where this might be referred to as disturbances in “the field,” some nurses who have practiced meditation, Reiki, Qi Gong, Tai Chi, martial arts, or other endeavors may readily understand what this type of energy and experience signifies.
Anyone can learn to listen to their intuition, and certain practices and techniques can strengthen intuition. However, one thing that intuition calls for is for us to listen to its call when it happens. For some, it might be a tingle in or around the head like Spider-Man; for others, it might be a chill down the spine, the hairs on the back of the neck pricking up, or perhaps gooseflesh up and down the arms. Or maybe it might simply be an inner knowing — perhaps that still small voice noted in the Bible — that something isn’t right.
Whatever form in which it comes, the well-trained nurse with keen clinical skills, considerable knowledge, and the wisdom to listen to the tingle of their intuition may very well save a life, catch an error, prevent a patient from crashing, or otherwise save the day because they took the time to tune in.
Don’t Ignore It — Nurture It
A nurse’s intuition isn’t something that can be effectively taught in a nursing textbook or lecture. Still, the nurse interested in learning to trust their inner knowing can use that skill to become a highly successful clinician and a powerful healer.
We can ignore that still small voice inside of us — perhaps at our peril or that of our patients — or we can choose to nurture, feed, and water it. As thoughtful nurses, we can make sure that when a tingle of recognition of a problem or danger arises, we’ll be more likely to pay attention to the signs, listen carefully, and take action when action is called for.
If your nurse’s Spidey-sense occasionally sets you alight like a flashing signal at a dangerous railroad crossing, learn to focus your attention and use it to be a more effective clinician and a more successful nurse.
Minority Nurse is thrilled to feature Keith Carlson, “Nurse Keith,” a well-known nurse career coach and podcaster of The Nurse Keith Show as a guest columnist. Check back every other Thursday for Keith’s column.
Nursing is a second career for Derek J. Flores, RN, CHPN, BS, a hospice nurse in Colorado since 2012.
In 2020 Flores was a featured guest on the TV Show, The Doctors, sharing his expertise on end-of-life hospice care. He’s also written two books to increase knowledge of end-of-life care. Flores’ first book, Seven Keys to a Peaceful Passing, walks patients and families through common challenges and decisions they must make during their hospice journey. His second book, Letter to a Hospice Nurse, celebrates the lives of hospice patients and gives a format for surviving family and friends to process grief.
Flores has a Spanish mother and Mexican father and credits his background, education, and experiences for helping him connect with his patients to provide good outcomes.
The series highlights healthcare leaders who are prominent figures in their organizations and are making transformational impacts in nursing.
Meet Derek Flores, RN, CHPN, BS, and hospice nurse in Colorado.
Talk about your role in nursing.
I’m a hospice nurse case manager in the Denver Metro area. I work with a varying census of patients facing a terminal diagnosis. Besides regularly visiting my patients, I coordinate care between other disciplines, including CNAs, social workers, chaplains, and volunteers. Our team serves a widely diverse community of beautiful people from various backgrounds. Many of my patient visits can be considered ‘routine,’ others unexpectedly are filled with urgency to treat symptoms at the end of life. I work in the world of the ‘dying.’ It is a place and space where the dignity of each person is cherished and celebrated.
How long have you worked in the nursing field?
I earned my LPN in 2011, then passed the NCLEX-RN in 2012 after graduating from Laramie County Community College in Cheyenne, Wyoming. Nursing is a second career for me. I graduated from Colorado State University in 1991 with a BS in business administration. I spent a dozen years working in various industries in marketing and sales departments. I even had my own business for a few years.
Why did you become a nurse?
The seeds for me becoming a hospice nurse were sewn while observing both of my parents care for their aging, then dying parents. The love and compassion I saw from them was an inspiration. My mother, whose name is Crisela, has family roots in Spain. The Archuleta family arrived in Mexico in the 17th Century, then migrated to northern New Mexico, where they were farmers and ranchers. My mother’s first language was Spanish. She worked as an elementary school teacher in Pueblo, Colorado for many years before retiring. My earliest memories are of my mom and grandma speaking Spanish in the kitchen while the smells of a delicious dinner were in the air. The love, devotion, and endurance she showed in the care of her parents moved my heart. My mother and her siblings cared for Grandma Rita and Grandpa Ambrosio for fifteen years before Grandma passed peacefully at the age of 103.
My dad’s family was from southern Texas and Mexico. My late father, Jim, worked as a teacher specializing in special education. He was also a former Green Beret, champion runner, and weight lifter. He showed compassion for his students and the tenderness he had in the care of his parents at the end of their life. My parents were the first generation to earn bachelor’s and master’s degrees, breaking down societal barriers during my formative years in the 1970s and 80s. Their example set a standard for pursuing higher education and service to others.
I began the journey to become a nurse during a difficult period of my life as I turned 40 years old. During this time, I began to work as a CNA. My experience as a CNA helped form me into a well-rounded nurse. I learned how to provide basic care to my patients, who often lived in difficult conditions. After watching some of my supervising nurses do their work, I realized, ‘I can do that’! The next thing I knew, I was in nursing school. My family’s example of hard work and never giving up helped me make a career change.
What are the most important attributes of today’s nursing leaders?
In the hospice environment of today, a nursing leader has many hats to wear. In nursing school, we are taught to become multitaskers. As a hospice nurse case manager, I lead my interdisciplinary team by being responsive and communicative. If someone asks me a question, I respond as quickly as possible. I like surprising people with very quick responses. This level of communication sets a ‘Nursing Leader’ apart.
A hospice organization is multi-faceted with clinical, administrative, and management pieces. The clinical part of my work is also just as important because our patients depend on us to manage symptoms in often very stressful situations. When this happens, everyone looks to us for good nursing judgment, a cool head, and a soft heart.
What does being a nursing leader mean to you, and what are you most proud of?
I have been and will probably always be a bedside hospice nurse because my personality makeup doesn’t do well behind a desk or in the same location all day. I work out of my car, driving to each patient’s location. I lead my hospice team as a case manager by being attentive to my patients and team. My hope is they are inspired and motivated by my actions.
I’m most grateful for recognizing that nursing is a vocation I have been called to do. It’s rare that I don’t feel I have contributed to someone going through the most difficult time in their life. I’m most proud that I live out the legacy of my parents, Jim and Cris. Their example of serving others drives me each day. I’ve always wanted them to be proud of me.
Tell us about your career path and how you ascended to that role.
I’ve alternated throughout my career in hospice between case management and on-call roles with both for-profit and not-for-profit companies. The caseloads in some hospices can exceed twenty patients, so my career path has been marked by individual experiences with patients in difficult situations and measured by how I assisted them to be free of the symptom or symptoms they were struggling with.
Hospice nursing can be very emotionally trying, so I have taken sabbaticals by working in pediatric home health. I found that medically challenged children bring joy to everyone around them. They have helped heal my heart when I needed it most, preparing me to return to hospice nursing to do the work I’m called to do.
What is the most significant challenge facing nursing today?
My nursing work must be completed within a limited amount of time. There isn’t any wiggle room for this, so I can’t even list this as a challenge. It simply has to get done, no matter what. I never have a day like the previous one, so planning every moment of my week is almost impossible. I always have to try and stay ahead of the next patient emergency or death by pushing to get tasks done in the moment. I know if I don’t get something done now, it might not get done at all.
My family is most important to me. I am recently married at 54 to a wonderful woman, Kirsten. After many years alone, I now have a wonderful and kind companion. We enjoy our life together, including time with three adult daughters, one lovely granddaughter, and another who is making her debut in a few months. Our hearts are full.
I share my professional challenge of having enough time to meet all my work and personal responsibilities because it is common for hospice nurses to quit after their job takes over their lives. It’s not uncommon to work a full day, kiss your loved one as you arrive home, then head to your home office to work another few hours before you go to bed. It’s super easy to have hospice take over your life. Quite often, hospice nurses are paid on salary, so at some point, you may decide you’re working for a much-reduced rate than you thought you were. Then you choose to leave. The result is that patients get shortchanged by nurses who are rushed to get everything in their day completed. I encourage hospice nurses struggling with situations like this to ask their manager for adjustments. Caseloads can be lightened, geographic work areas can be shrunk to decrease time driving each day, and changes can be made if a manager wants to keep a nurse. Don’t be afraid to speak up if you have difficulty getting everything done.
In the end, if nurses and their managers don’t find solutions, the result can often be rushed nursing visits or nurses who aren’t fully present to their patients because they multitask. Our patients aren’t aware of all of the demands of our positions. They want to share what is happening with themselves on that particular day – needing us to meet their needs.
As a nursing leader, how are you working to overcome this challenge?
I try to put my patients first by being present to them. If I were to fail them by supporting them with my full attention, then not much else matters. I think my efficiency and proficiency in this role have improved over time. I also get up very early in the morning when I have work to do so I don’t take time away from my family.
I also have a mission outside of my bedside nursing practice. I write and publish books to increase knowledge of end-of-life care. My first book is Seven Keys to a Peaceful Passing and my second is Letter to a Hospice Nurse. I’ve also created journals that nurses and families can use to communicate with each other and keep track of important tasks like medication administration.
What nursing leader inspires you the most and why?
I had a colleague named Ted in the first years of my nursing career. I identified with him in several ways. He looked a lot like my dad with his black wavy hair and chocolate brown skin and had a similar background. Seeing another person like me, with Spanish and Indigenous roots, gave me the strength to look outward to solve our patients’ challenges. Ted is one of the most knowledgeable hospice nurses I’ve known. I still use his recommendation to help patients suffering from chronic nausea.
What inspirational message would you like to share with the next generation of nurses?
I’d encourage anyone considering a career in nursing to look deep and find the one thing that fills their heart. If it is helping those in need, you’ll never have a day in nursing where you don’t take away a feeling of satisfaction for your hard work. If you are a young nurse struggling to get traction in your career, please reach out to an experienced nurse to find a solution to your challenges. I’d also suggest that once you have a few years of successful experience, you realize you are a hot commodity. Don’t be afraid to ask for a competitive wage or salary. Negotiate the time off from work you need for your family and yourself. You are in high demand!
Is there anything else you’d like to share with our readers?
Nursing should be a vocation for everyone who chooses to do this work. By finding the intersection of your heart and mind, you’ll never work a day. Instead, you will have a life filled with purpose, struggle, and satisfaction for the benefit of others. You’ll have a life that matters.
When Nick Escobedo DNP, RN, OCN, NE-BC, director of Inpatient Oncology at Houston Methodist Hospital, started his nursing career, he didn’t expect to land in oncology nursing. During May’s recognition of Oncology Nursing Month, Escobedo says the career has offered distinctive opportunities for personal and professional growth.
“I went into a basic acute care setting right out of nursing school because I wanted to get a good, solid foundation for myself in practice,” Escobedo, a former president of the Oncology Nursing Certification Corporation, says. But the learning process opened up new, and appealing possibilities. “I had an opportunity to learn the skill of chemotherapy,” he says, “and the more I got to learn about it and spend time working with patients, I quickly learned this specialty was for me, and I wanted to do that full time. It chose me.”
What sets it apart from the science and the practice part of nursing, he says, is that cancer affects every body system. Oncology nurses treat patients through a span that lasts from cancer diagnosis to remission or to end of life.
“I got to use my critical thinking skills, and I got to have knowledge of all the latest and greatest therapies available,” he says. Escobedo, a dedicated lifelong learner, says it’s imperative that he stays on top of understanding new technology and the range of cancer drugs and treatment options available to patients and the safest ways to administer them.
Thankfully, oncology nursing is very collaborative, he says, and so nurses work with physicians, frontline providers, therapists, chaplains, nutritionists, clinical pharmacists, and volunteers to understand how the different pieces help drive the care of a patient. Escobedo says a nurse might check in with a clinical pharmacist to find out more about a particular drug to learn about interactions, how a patient might respond to it, and how to use it safely.
Additional education is essential for oncology nurses, he says. “My journey toward certification was big,” he says. “That was one of my ways at looking at my competence as a clinician, to say I was an expert in the care of oncology patients. So my journey to pursue that certification and have knowledge to be successful was key. I’m a big advocate for certification.”
To balance the intensity of understanding the drugs and treatments used for cancer, Escobedo says the relationships oncology nurses develop with their patients is special. “You develop long-term connections with patients and their family members,” he says. “They give so much of themselves.”
Those strong connections can help nurses and patients through the celebrations of successfully completing cancer treatment or the more difficult prognosis or outcome. “This is very hard work,” says Escobedo. “The reward is that we get to do that work, but we need to balance that with resilience. This is tough work and we have to promote and champion a little of that balance. We try to look at the celebrations that happen.”
The success stories are uplifting and have a lasting impact on nurses. “We hear from patients who were treated years ago, and they come back to check in,” he says. Patients relay news of celebrating weddings and anniversaries and the arrival of children and grandchildren. Some have even paid it forward and after being treated for cancer, have embarked on fundraising campaigns to help others.
“Our patients push us to have that drive,” he says, “And we see lots of really good outcomes.” Patients can go through treatment that is long term and so being able to go through the process with them is something oncology nurses find so rewarding, says Escobedo.
Escobedo encourages nurses who are interested in exploring oncology nursing to find a way. “If you think you could be good at it, why don’t you try it?” he says. Find good mentors and be sure to seek out projects and opportunities that will get you out of your comfort zone. “Nurses don’t get lots of oncology nursing experience through training or nursing programs,” he says. “This is a full and rewarding specialty.”
Please tell me a little about your background. How and why did your career path lead you to transplant nursing?
I am an advanced practice nurse specializing in solid organ transplantation, especially for kidney/pancreas and liver transplantation. My scope of practice covers transplantation evaluation and post-transplantation care.
My journey to transplant nursing started in 2013 when I first met the liver transplant program surgery director, Dr. Hoonbae Jeon, at the University of Illinois Hospital and Health System. I was a student of the University of Illinois at Chicago nurse practitioner program and shadowed Dr. Jeon and his team in clinic and hospital settings. Dr. Jeon’s passion for organ transplantation and clinical practice of giving hope inspired me. I first became the kidney transplant coordinator and managed the waitlist and coordinated living donor transplantationat the University of Illinois Hospital and Health System. I also managed post-kidney/pancreas transplant patients as a nurse practitioner.
During this tenure, I interconnected my clinical with my research and defended my PhD in nursing dissertation about kidney transplantation at the University of Illinois at Chicago. With national transplant registry data, I identified the inferior outcomes of kidney transplantation for patients who had impaired physical function.
In 2016, as a nurse practitioner, I joined the transplant nephrology team at Loyola University Medical Center. Working with Dr. Amishi Desai and Dr. Raquel Garcia-Roca, I managed kidney/pancreas transplant patients and acute, chronic kidney disease and renal failure of non-renal organs such as heart, lung, and liver transplant recipients.
Now, I joined the Northwestern Transplant Surgery program and started to expand my scope of practice to managing liver transplants.
What are some aspects of your nursing role that you didn’t expect?
I initially did not expect that there were such various and strict governmental policies in the organ transplant society. Also, each transplant program has its institutional policy and criteria, which transplant nurses should know throughout the transplant spectrum.
The need for organ transplants is increasing. As a transplant nurse, how does that impact your work?
Because the demands for organ transplants have increased, we, transplant nurses, have met more responsibilities to screen suitable donors, optimize the transplant candidates, and maintain the graft functions healthy to utilize one of the most limited and scarce resources, donated organs.
What additional training has been helpful in your career?
I started my nursing career in the cardiovascular intensive care unit at the Samsung Medical Center, South Korea. I learned how to interpret cardiovascular testing results such as EKG, echocardiogram, stress echocardiogram, coronary angiogram as well as to manage the advanced life saving devices such as ICD, pacemaker, ECMO, IABP, and CRRT.
This training helped me significantly screening cardiovascular diseases of transplant candidates on the kidney transplant waitlist. Also, I studied advanced physiology and pathophysiology, including renal, immunology, and heart, in my PhD program. These gave me the fundamental knowledge to manage immunosuppressants and various complications of transplant recipients.
How has the ITNS had an impact on the work you do, your career trajectory, and/or your pride in transplant nursing?
Dr. Joyce Trompeta at the UCSF transplant program has mentored me throughout my transplant nursing journey. She was the president of ITNS and recommended that I join ITNS leadership. Since I joined ITNS, I have met phenomenal transplant nurses who everyday help patients deal with the fear and uncertainty of transplant outcomes and complex health conditions from the complications.
From those nurses whom I met at ITNS, I have learned not only knowledge but also empathy toward the transplant patients. Most importantly, I learned I was not the only one who often felt powerless, anxiousness, and sadness when the transplant outcomes became poor, and grafts were lost. Support and encouragement from these transplant nurses are my utmost motivation to remain in the transplant community.
