Nursing practice has become more and more complex. Some roles have been more established, and some continue to develop. If you asked a group of nurses about the type of specialties they work in, you would likely hear about the ones that nurses have traditionally practiced in –emergency care, intensive care, maternity, pediatrics, med/surg, and the list goes on. But how many would mention transfusion medicine as an area of nursing practice? Certainly for many direct care nurses, the ability to practice nursing outside of the traditional specialties may seem unfamiliar, especially when the role doesn’t require patient interaction 100% of the time. We’ve all heard it before, “nurses who don’t work with patients aren’t real nurses.” And I’m sure many would disagree with this statement. What I would argue is that as healthcare continues to advance and become more and more complex, we will see more nurses in roles that have not historically been labelled as “nursing.”
A good example of this is the emergence of the role of the Transfusion Nurse. Transfusion Nurses are a relatively new development in transfusion medicine. While there was a heavy emphasis on improving the quality and safety of blood, there has been a greater shift towards transfusion and patient safety. Similar to any medication and procedure, errors do occur, and can result in devastating consequences for our patients. Given the complex nature of transfusion processes, and that nurses are on the front line of transfusion practice, there has been a new role for nurses in transfusion safety.
Transfusion Safety Nurse, Transfusion Officer, Transfusions Leader, Clinical Resource Nurse for IV Therapy, or Clinical Coordinator are just some of the titles that are assigned to nurses working within this speciality. Internationally, titles such as Transfusion Safety Office/Nurse, Haemovigiliance Officer/Nurse and Transfusion Practitioner have been commonly used. Perhaps the many titles is in part due to the broad range of responsibilities of Transfusion Nurses.
While our work differs quite a bit from the work of direct care nurses, it is also very similar through the use of the nursing process. We assess (investigate transfusion reactions and incidents, conduct audits), diagnose (report transfusion reactions and incidents), plan (develop policies and procedures, educational resources for healthcare professionals and patients), implement (educate staff, develop and maintain transfusion medicine websites, ensure compliance with standards, liaise between lab staff and clinical staff), and evaluate (follow up with transfusion incidents and reactions, and serve on transfusion committees).
While there are no specific courses that can be taken to become a Transfusion Nurse in Canada, nurses working in this area have experience in project management, quality improvement, and health literacy, to name a few. With a new role, comes room for innovation. Most recently, in collaboration with the Provincial Health Services Authority (PHSA) Learning Hub, and Learning Development at B.C. Children’s and Women’s Hospital, Transfusion Safety Nurse Clinicians developed educational materials that would standardize critical content while also allowing for site-specific practices. This was developed because of the finding that age related practice variations among pediatric and neonatal patient populations created challenges to ensure consistency for common, critical areas of practice.
Flexibility, autonomy, the ability to utilize problem solving skills, work with interdisciplinary teams, collaborate, develop ideas to improve processes, and ensure best practice continues to be some of the many joys of the job. As nurses, our education and practice provides us with a broad skill set beyond direct care. Our sound knowledge of what constitutes as safe patient care, and the policies and processes that are needed to achieve this will continue to position us well to contribute to all aspects of healthcare. Having the opportunity to be part of a growing nursing speciality has reminded me that as nurses, we need to continue to utilize our untapped potential. As healthcare advances, nursing as a whole must continue to highlight our ability to create positive change in every aspect of healthcare. As nurses, our work goes beyond caring for patients at the bedside. We improve the quality of healthcare, we identify solutions to create change, and we bring people together to make this happen.
Let’s never forget that we are innovators, collaborators, and leaders.
ABOUT CLARE O’REILLY, RN, RSCN
Clare is an Irish-born and UK trained RN with a Graduate Certificate in Transfusion Practice from the University of Melbourne. Clare has worked as an RN in Ireland, England and Canada in various specialties such as pediatric oncology/hematology/bone marrow transplant, adult nursing, blood donation, platelet apheresis, and haemovigilance/transfusion safety. Currently, Clare works as a Transfusion Safety Nurse Clinician at BC Children’s and Women’s Hospitals where she strives to bridge the divide between the transfusion laboratory and clinical environments. Her duties include; coordinating the follow-up of transfusion reactions and adverse events, maintaining the Transfusion Manual, creating education resources such as the Better Blood Transfusion online education modules. In her spare time, Clare enjoys reading, hiking, and knitting.