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Transfusion Medicine: Celebrating the year of the Nurse and the Midwife by learning about the nurses

Authors: Clare O’Reilly, Transfusion Safety Nurse Clinician
                 Crystal Brunk, Regional Transfusion Medicine Clinician

In honor of the 200th anniversary of Florence Nightingale's birth (12 May 1820), the World Health Organization designated 2020 as the “International Year of the Nurse and the Midwife”. As we know, Florence created her legacy by using data to drive forward habits of good hygiene, handwashing, and evidence-based practice but what would Florence think about the vastly diverse roles that Nurses and Midwives have in 2020. Furthermore, what would she think about the role nurses play in transfusion medicine, would she have even guessed this field would develop and evolve into what we know it as today?

As passionate transfusion nurses ourselves, we wanted to take the opportunity that the year of the nurse and the midwife has given us to look at why nurses become nurses, dig deeper into why nurses get into transfusion medicine, highlight the fact that nurses are involved in almost every step of the transfusion process and celebrate our stories. To do this, we circulated three simple questions to our global network of nurses who are involved in different areas and aspects of transfusion medicine. We got eleven responses spanning across Canada, Australia, Belgium, England, and Ireland and although we wish we could have captured more countries, our network has limits. The forthcoming is a result of the amazing responses we did receive.
 
Our first question: What inspired you to become a nurse?

For some it was a calling “I thought it had to be enriching to work, to be close to people in such intense moments”, some bore witness to nurses in action and some transitioned to nursing after having another job or initial training but for each person nursing always emerged as being the right fit “It is actually the nurses who walk beside the patients and help them navigate their health journeys. I realized that was the role I actually wanted, and so my path to nursing was set”. The themes of giving back to others when they need it most, making connections, and working in a challenging and enriching environment rose out of the answers to this question and truly resonate with us as well. “I wanted a job that achieved more than earning a wage, a job where I felt I contributed something to my community”.

Our second question: How did you end up in transfusion medicine?

Let’s start by saying nurses are critical participants in the transfusion process: from working in blood donation clinics, to collecting pre-transfusion patient blood samples in a clinic or hospital setting, assessing a patient’s need for transfusion while juggling many other tasks, prescribing blood products, administering blood products to patients for various reasons from oncology to surgery, following up transfusion reactions or adverse events and minimizing the side effects of transfusions. Nurses also play a vital role in patient blood management, anemia management and avoidance of transfusions BUT what we sought to know was how does a nurse really make transfusion their passion because let us tell you, right now it is not in the traditional list of specialities.  
 
Answers here sum up a very non-linear path to transfusion medicine as there were those who heard something or other about transfusion medicine and sought it out after being intrigued and inspired to those who thought why not give this a try. “I have never heard of this role until I saw that posting” and “I stumbled across the transfusion safety officer RN position” to those who graciously accepted an assignment they were not looking for. The themes here were all about looking for challenges and wanting the opportunity to advance the field or to advance patient safety (making Florence proud once again). To quote our gracious colleagues “this role was one I relished and had a far-reaching impact on improving patient care” and “there’s always something new to learn and it requires holistic care of the patient.” The theme of pulling nursing skills into a non-traditional nursing field is evident along with out of the box thinking.

Last question: Share an interesting fact about transfusion medicine nursing or something about transfusion medicine nursing that people do not know.
 
  • Interpretation: Did anyone know we do not all speak the same language? Transfusion medicine is really about communication, bridging our gaps and connections
  • Fluid Overload: TACO (transfusion associated circulatory overload) the transfusion reaction that is so easily missed or chalked up to something else
  • Iron Overload: risk in long-term chronic transfusions that if left untreated can cause serious organ damage and again is easily missed or mis-managed
  • Iron for treatment: sometimes transfusion nursing is about preventing transfusions through anemia management programs and patient blood management programs
  • Standards, standards and more standards: transfusion medicine is full of them no matter what country you live in, and understanding and complying with them gives transfusion practitioners drive
  • Check, check, check: “I think I completed the patient identification checks 10 times before actually administering the product”; transfusions are really a “liquid transplant” making them both terrifying and exciting
We have come a long way from Florence who would have seen transfusions from person to person without any knowledge of the ABO system to our now highly regulated practice. “Personally, I prefer to talk about quality in the transfusion chain without calling it medicine or nursing because for me it’s mainly about applying quality principles in the multidisciplinary setting of transfusion”. It is safe to say that Florence would be proud to see that current transfusion practice is evidence based, data driven and that the patient is still at the heart even in this non-traditional nursing field. We are even more sure that she would be excited to see how the profession has developed and we encourage our readers to read up about Florence and learn a new fact about her. 

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