- The Washington Times - Sunday, May 4, 2003


  Karen Kelly, a registered nurse at Inova Fair Oaks Hospital in Fairfax, doesn’t get to know her patients as she once did. The beds at the orthopedic surgical unit are like revolving doors as patients recover from surgery and are discharged from the hospital in record time.
  “Things are done so quickly now, we’re lucky if some patients are here for 23 hours,” says Ms. Kelly, who has been a nurse for 35 years.
  Years ago some surgical procedures would require a two- to three-week hospital stay, but now most patients stick around for just three days. The short recovery time doesn’t give Ms. Kelly much opportunity to bond with patients.
   “You don’t ever get the same rapport as you did before,” says Ms. Kelly, 57. “Generally, people appreciate what you do.”
  On this day, Ms. Kelly’s eight-bed unit is filled with seven patients recovering from various surgeries. They run the gamut from hip and knee replacements to a gastric bypass.
  Ms. Kelly, clad in white with a stethoscope hanging around her neck, sits patiently in front of a computer tucked away in a corner of her third-floor unit. She’s attempting to master a new computer system that came online just the day before.
  She spends about 15 minutes navigating cautiously from one screen to the next as she tries to input all the data from a patient assessment she did earlier in the morning.
  “This is certainly time-consuming,” she says after finally finishing with one patient’s record. She has six more to go.
  But Ms. Kelly takes a break from the computer to deliver medication to a patient being discharged later in the day. She glances inside a three-ring binder, covered in photos of her grandchildren. The binder has all the pertinent information about the patients in her unit.
  Ms. Kelly is gentle and soft-spoken. She checks the elderly woman’s blood pressure, hands her a pill and water and begins to slowly remove the IV from her arm. She spends an extra couple of minutes explaining the IV machine to the patient’s husband. Within minutes, she’s done and on to the next room.
  Ms. Kelly flows across the hall — knowing exactly where she needs to go next. The patient is nauseous and vomiting as she recovers from her surgery. Ms. Kelly quickly shuffles down the hallway to an oversize machine that dispenses medicine.
  “It’s sort of like a candy machine but you get medicine instead,” Ms. Kelly says. She keys in some codes and a drawer containing the appropriate liquid medicine opens. She puts the medicine in the woman’s IV to help alleviate the nausea.
  Juggling all the needs of the patients can get tricky at times, says Ms. Kelly, who works in the orthopedics unit with a nursing assistant.
  “It takes a lot of practice to prioritize,” she says. “But sometimes they all need [our help] at the same time.”
  About 11 a.m., Ms. Kelly attends a “Discharge Planning Meeting,” where she reviews each of her patients with a group of case managers, nutritionists and pharmacists. It’s a way to “identify a patient’s needs” and prepare them for their discharge from the hospital. The meetings are held twice a week to keep the hospital staff on top of the current cases.
  Ms. Kelly’s shift starts at 6:45 a.m. but the Reston resident arrives at the hospital between 6:15 a.m. and 6:30 a.m. to gear up for the day. She must get herself acquainted with the patients and their current status.
  Her first order of business is to listen — by phone — to a report left by the night nurse. It gives Ms. Kelly a much-needed update on the patients.
  After checking on the patients and making sure they take their morning medication, Ms. Kelly does a full body assessment on each of them.
  Ms. Kelly says that on some days the orthopedics unit can be hectic but other days — like this day — it’s calm.
  Before her 8-hour shift ends, Ms. Kelly tapes a status report for the incoming nurse.
  Ms. Kelly’s 35-year career has included pediatrics, geriatrics and orthopedics. She’s worked in North Carolina, Australia, New York and Maryland before joining the Fairfax hospital more than eight years ago.
  Despite her long career, Ms. Kelly doesn’t seem tuckered out from the pressing job.
  “I get a lot of rewards from doing this,” Ms. Kelly says. “Most days it’s an adrenaline rush.”
  

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