Interview with Kathy Quan, Author of The Everything New Nurse Book

Kathy Quan RN BSN has been a nurse for over thirty-five years. After a couple of years of med surg nursing in a local hospital, she pursued her goal of becoming a home health nurse. Today she works part time for hospice as a Quality Assurance/ Performance Improvement specialist.

Kathy has always loved to write and when she found an opportunity to combine writing and nursing she grabbed it. In 2004, she became the Guide to Nursing at About.com. She held this position until Nov. 2007, when About.com chose to combine the nursing site into a new health careers site. At that time, Kathy started TheNursingSite.com as a new home for her articles. She also writes TheNursingSiteBlog.

In 2006, Kathy became a published author with The Everything New Nurse Book that has seen several printings and modifications. Since then she has added 6 books to her resume including The Everything Guide to Caring for Aging Parents.

Her peers have honored Kathy for her books, her blogs and her websites. You can find out more about Kathy at KathyQuan.com

What event or series of events led you to pursue nursing as a professional choice?

I don’t have anything profound. It was something I had thought about since I was a little girl. After another dream was extinguished with an injury, I resurrected the idea and plunged into the nursing program.

Name 1 or 2 specific challenges you have faced in your career in nursing and the steps you took to overcome them?

In any profession you will meet and have to deal with people you don’t like or respect. You have to keep up appearances, take the high road and be professional. Smile and move forward. That’s easier said than done some days. But you just have to keep reminding yourself that you are not going to let this person take you down. In the end I made the choice to move on and it was a good move for me professionally and personally. I had hoped the other person would have been let go, but by taking myself out of the situation I found so many more open doors and opportunities. You have to step outside your comfort zone to reach for bigger and better things.

Working as a QI specialist I deal with egos all the time. Nurses are overachievers and think they are always perfect. I examine the details to make sure the I’s are dotted and the t’s are crossed. Sometimes I have to deal with people who are incredulous that they omitted something or didn’t complete a page, or need to add more documentation. You have to learn how to soothe those egos and still get them to see their way to clear to fix or complete their documentation. You have to have a thick skin and not take things personally. I constantly have to remind staff I’m here to protect them and help them.

Can you give us an example of an interesting case or project that you have worked on and your role in helping to achieve a positive outcome?

A few of years ago Medicare was reviewing hospice in general for cases with extended length of stay. No one can play God, but the rule is that the patient should have a terminal prognosis of 6 months or fewer to live. When they live for 2-3 years, it raises a red flag as to how terminal they are. And so Medicare made a huge probe of agencies for patients with an extended length of stay.

The agency I worked for at that time got a probe for about 40 patients. It was a huge project to look through every volume of those patient’s charts for sometimes very minute details to help prove that the patient met criteria for hospice care in the beginning and continued to do so at each and every recertification period. We learned a lot about documentation issues the nurses were having and how to help them do better. We learned a lot about what types of changes indicated a decline and what really didn’t. In the end we prevailed, but we also had new information to help us do better.

Can you describe what a typical day looks like for you or the activities you spend the most time on at work?

My day involves reading through hospice charts both concurrent and discharged to make sure we have all the ducks in a row. For instance, all the paperwork is complete and signed, orders are present and signed, and medications are reconciled and updated. Then I explore to make sure we met the needs of the patient and family such as controlling symptoms of pain, dyspnea, anxiety and agitation, and constipation.

I sit in on the weekly team meetings to hear and participate in discussion of the patient’s issues during the past few days. We also discuss how new patients meet criteria and how well we met the needs for those who have passed. What can we learn or change to improve the quality of care? Team meetings take up a huge portion of my time, but allow me to provide feedback and suggestions to improve as well as to help staff think critically and make better choices.

I collect data for statistics that we review quarterly and annually to assess our care and determine what we continue to do right and what we can do to improve in other avenues.

What aspects of your work do you enjoy the most?

I enjoy working with staff who are open to improving their documentation. As a part time writer I love helping nurses find an easier and better way to take credit for what they do and not just mark off a box. I enjoy knowing that we as a company make a difference in our patients’ lives because we value our staff and emphasize quality of care in all that we do.

What advice would you give to new graduates for getting hired after graduation?

Be patient and have an open mind. Your dream job is somewhere way off in your future and not the present. Be willing to relocate and to take on a job you wouldn’t necessarily accept under other circumstances. Get some level of experience and you will have many more doors open to you in the future. Think outside the box when you develop a resume and be your best fan when you interview. Be confident, but not cocky. Keep your social media private and clean. And have a professional email address. Your name @ your Internet provider. And whatever you do, always keep learning. Go back to school if a higher education will help you get hired.

What is the key strength you bring to your career and how would you advise new graduates to mine their own strengths to further their careers?

Nurses are overachievers by nature. Attention to detail and perfectionist tendencies are two key elements for my role in Quality Assurance/ Performance Improvement. But passion and empathy are probably the two most important strengths any nurse needs to succeed and to provide the best quality care possible to his/her patients. They aren’t skills you can learn. They are innate qualities that bring people to the nursing profession. Let them shine through in the best of times and strive to bring them to the forefront in the worst of times.

We’d like to thank Kathy for being so generous with her time and sharing her insights and advice with our readers. You can learn more about Kathy at her blog, Kathy Quan.