Operative Care Division
Portland Veterans Administration Medical Center
As a clinical nurse specialist in the surgical division of Portland’s veteran’s hospital, working with patients is only a part of Stephen Patten’s job. Sure, he helps prepare patients for surgery and recover post-operation. But he mostly focuses on two other spheres of influence – working with nurses to improve the quality of care, and developing systems and procedures to make surgery safe and effective.
Stephen’s role is akin to systems engineer of the surgical process, or, as he describes it, planning “how to do business in the O.R.” For a surgical procedure, he may interact with nurses from multiple departments, hospital clinics, surgeons, anesthesiologists, or pathologists -- any personnel that affects surgical outcomes.
For example, through checklists and consultations, Stephen ensures that:
- The correct antibiotics are given to a patient within one hour of a surgical incision, and discontinued within 48 hours
- Catheter use is discontinued within 48 hours after surgery to avoid infection
- Patients have taken necessary medications, such as beta blockers to protect their heart
Stephen works with 120 nurses in his division, which handles 8,000 surgeries annually. He incorporates research findings into the division’s policies, procedures and best practices to improve care. When nursing problems arise, Stephen’s on point.
“In the CNS role, you can be an expert within a specialty. It’s taking nursing to its highest level,” Stephen describes. “Through my education and 32 years’ practice as a nurse, I have had the opportunity to become an expert in the peri-operative setting and can help nurses from the youngest to the most mature to achieve the goals they want for their patients.”
Before becoming a CNS, Stephen worked at a trauma facility, where getting a patient out of the O.R. alive was an “adrenaline rush.” He’s traded that thrill for the satisfactions of teamwork and a thorough knowledge of operative care. "It’s a little mystifying. The doors close and no one else comes in. It’s fun knowing the mystery."