May 2, 2019

Demands on nurses are changing, and Dawn Luzetsky wants to ensure her pediatric colleagues have the support they need at a time of transformation. Johns Hopkins Children’s Center’s new senior director of nursing leads nearly 1,100 nurses, nurse practitioners, clinical technicians and front-desk personnel in caring for sick children. Luzetsky, raised by a single mother who was also a Johns Hopkins nurse, took some time out to share her thoughts on nursing and leadership.

What is still one of the most misunderstood aspects of nursing?

The direct clinical care — the nurturing, caregiver-at-the-bedside aspect. Nursing goes beyond that. We are heavily involved in research, right back to the days of Florence Nightingale and the sterile field. I feel like we are still evolving the profession in the public eye. Nursing is still female dominant, but it does not need to be. We are slowly seeing an increase in male nurses, and it is great to see that increase in diversity.

What are the biggest challenges facing pediatric nurses today?

The increased complexity of the work, especially in academic medicine. Nurses coming out of nursing school are dealing with very sick, medically-complex patients. Plus, we’re entering into a nursing shortage because of a mass retirement of baby boomers. We need to start thinking about how we can use technology to support bedside nurses and not necessarily think it is about more personnel.

Can you give us an example?

My doctorate project was on the pediatric intensive care unit; it has 40 beds covering over 2.5 city blocks, with an extremely limited line of site. Almost 60 percent of the nurses had less than three years of experience, while experienced nurses felt huge stress as to whether they could give the latter adequate bedside support. We created a virtual mentor—a nurse who sits in a telemedicine room and monitors all bedsides through streaming video and audio. She focuses on novice nurses; they can call with questions or be guided through procedures. We have found the newer nurses find that so helpful. I would have to hire 15 nurses to do what that one nurse does virtually.

Burn-out is a familiar refrain in health care today—how do you address it?

My goal is to continue building a pediatric flex-pool of experienced nurses who can work anywhere. For instance, if the emergency department is over capacity and stretching what it has, wouldn’t it be great to send over a nurse to help them? This is part of a larger vision I have to put our nurses on the map for excellence in care and research. I want nurses to really feel their work is always evidence-based. Also, I think happy nurses are ones who can come in and hassles are out of their way for delivering care. When I do leadership rounds, I ask: what’s your hassle factor today that we can help alleviate? When our nurses finish every day feeling they were recognized as professionals, their opinions counted and they were valuable team members that helped make the best experience possible for their patients and families—then I will know I have succeeded.