In a career spanning more than 40 years, Bobbie O’Connell, RN, has seen the growth of respect and autonomy for the nursing profession.
O’Connell, associate vice president of Patient Care Services at Good Sam, will retire on Aug. 4.
“I have seen growth of the profession and the teamwork that nurses bring to the care of the patient,” said O’Connell. “For example, nurses are given more autonomy in processes and protocols after a doctor puts in an order set and allows the nurse to determine the appropriate action for that patient.”
When O’Connell began nursing in the 1980s, nurses were usually expected to follow doctors’ orders without question.
“It was harder to question orders in the 1980s. Now nurses are expected to question orders when needed,” said O’Connell. “The level of respect that the nurses get as partners in care has been the most significant change in the profession.”
O’Connell grew up in New York, moving to Oregon with her parents in her youth. O’Connell went to Oregon State University where she met her husband.
While O’Connell was studying pre-nursing at OSU she volunteered in the brand-new Good Samaritan Hospital. That was the fall of 1976, Good Sam was less than a year old and she had an evening job developing film for the Radiology Department once a week.
“I came in for six hours, stood in the developing closet down in Radiology and developed films as a volunteer,” O’Connell said. “I had classes during the day, so I would usually show up at 4 p.m. and at work until 10.”
After graduation O’Connell and her husband moved to Arizona. There she completed a six-month critical care internship program at Phoenix Baptist Hospital.
“I was a little bit of an adrenaline junkie, so I really gravitated to the ICU,” said O’Connell. “Back then, you couldn’t be an ICU nurse without having experience somewhere, and most nurses either went to a nursing home to get their first experience, or you were lucky enough to get hired on as a Med-Surg nurse if you were really good.”
From Phoenix her husband’s career moved to Portland where O’Connell got a job in an ICU and started her family. Eventually O’Connell and her family moved to the mid-Willamette Valley to be closer to her extended family. Shortly thereafter she was offered a job at Good Sam.
At Good Sam O’Connell held several positions including the trauma program manager when the hospital was established as a Level II trauma center.
One of the most substantial advancements O’Connell has seen was the change from paper to digital patient charts, a process that evolved into Samaritan’s current Epic charting system.
“I love the doctor and the lab part of Epic,” said O’Connell. “When we first started electronic charting, a colleague said: ‘If you’re a really good documenter, you’ll do really well with the electronic medical record. If you’re a poor documenter, you’re only going to get worse.’ And I think that’s really true.”
Unfortunately, O’Connell said, the amount of documentation required today has cut down on the patient interaction that nurses had when she started her career.
“We’ve lost the human touch portion,” said O’Connell. “It used to be that every patient, when you put them to bed at night, got a back rub, got oral care, had their face and hands washed. That doesn’t happen anymore. Nurses don’t have time. Our requirements have changed, like the focus on quality indicators.”
Improvement in technology has also provided more opportunities for outpatient surgeries.
“All these procedures that we did open are now laparoscopic and we don’t make such large incisions anymore,” said O’Connell.
With the advancements in health care the demographics of patients has changed as well. Now the patients in the hospital are sicker than those 20, 30 or 40 years ago.
“The optimization with drugs, cath lab procedures and valve replacements, all that technology has enabled our patients to get outpatient care,” said O’Connell. “We’ve gotten technology so advanced that it has really created longevity and quite a bit more livability for patients. But what it does mean is that when they do get sick enough to be in the hospital, they’re just so much sicker.”
Education for patients have also improved in the four decades since O’Connell started.
“We’ve fine-tuned our discharge teaching,” O’Connell said. “Our patients are probably better educated post-hospitalization now than before. When a patient went in for their gallbladder back in the 1980s, nobody did any dietary teaching. They would teach you how to change your dressing, but that was it. We’ve come a long way with patient education.”
Although O’Connell is retiring from work at Good Sam she still plans on maintaining a presence in health care. O’Connell is the team commander for Oregon’s Team Two with the National Disaster Medical Systems. O’Connell joined the team in 2009 and has assisted in several natural disasters.