Please provide a brief background of your training and practice setting and years in practice.

I have been in healthcare profession for 21 years and the last 5 years was in the nursing profession. I earned my Doctor of Optometry in the Philippines, practiced for 16 years as a clinician and as Dean of Optometry in Cebu Doctors' University. I had my BSN in 2006 and started my nursing career in long-term care in 2007. Pursuing graduate studies in University of San Francisco as CNL (Clinic Nurse Leader) came as a natural interest and I'm currently contemplating applying to a PhD program in Geriatrics in 2013. After a year of being a charge nurse, I became a Director of Nursing, which I am still doing, and recently moved to Central Valley and joined Covenant Care family. I am a certified wound care associate and ongoing with my nursing rehabilitation certification.

What are you passionate about in long term care? How are you pursuing your passion?

I started my nursing career in long-term care and it was a culture shock for me as it is to many new nurses out there where culture would have it that their own families take care of their elderly. However, it did not take long for me to adapt the environment of care I am called for to do and the shock turned to love and passion but not without frustrations.

The cry of providing the highest quality of care possible to residents many times becomes mere rhetoric considering what one is confronted with: the feasibility of giving the best care out of the minimum staffing requirements, caregiver-patient ratios, budget constraints, availability of supplies, double standards of leaders, stringent rules and regulations of the state and many more. Then, "culture change" became a buzzword, and a national movement in transforming the delivery of long-term care services. The movement served as my shining light that I so passionately embraced, and committed myself in leading in my own small way and in becoming an agent to changing the culture of taking care of the elderly.

I see to it that as I pursue the culture change in long-term care, it has to be a fun process for myself foremost as a leader all the time --no matter how huge the bumps and odds that come my way. I committed to myself for wanting to do it as opposed to having to do it. Just like any other passion, I check my commitment regularly and have the clarity of mind and understanding of how time intensive it can be. Formal and informal mode of learning is a never-ending undertaking of mine. Motivating and inspiring colleagues and team members with enthusiasm, positiivity, and accountability, and with clearly defined goals, are indispensable ingredients to get the team going. Currently being in an organization where care processes support best practices is a fertile environment for me to implement culture change, and hopefully roll out the needed change at a steady pace. The culture change encompasses both tangible and intangible systems and processes.

It will not happen overnight, but as the beautiful French proverb goes: little by little, the bird builds its nest … and this rings so true for anyone who puts their heart and soul into building the nest of change with a solid organizational foundation of truly putting residents and patients first. Thus, my journey continues with my organization to make our facility a real home!

What advice would you give to a new graduate contemplating a career in long term care?

The decision for me to pursue nursing as my second career came out as an easy one, but actualizing the care as nursing student during the clinical rotation was a roller coaster of emotions as fear and being overly compassionate sucked up my energy as I almost passed out while assisting my first C-section procedure. Then I realized I was not cut out for the acute care setting and by circumstance I took my first nursing job in long-term care. I never regretted it and will continue to do so for as long as I can.

There is so much opportunity to make a difference and to be able to touch and be touched by the elderly as you experience nursing through their eyes and soul. It's rewarding to hear their stories about the good old days or as they sing along and nod their heads to familiar good old songs. In long-term care nursing, you become not just their nurse but also their companion, friend and family member. Reaching out and building relationships with the interdisciplinary team offers invaluable enrichment, as nursing care is not delivered in isolation but across the spectrum of healthcare.

You can carve out your area of expertise as you take on a career in long term care in the areas of nursing leadership, quality assessment nurse expert, clinic nurse leader, resident assessment expert, MDS nurse, nurse educator and staff developer, treatment nurse, rehabilitation nurse, infection control nurse, administrator, case manager, and nurse consultant. Caring for the elderly is just as rewarding as the other career paths in nursing as you learn a lot more in an environment of many diverse people in long-term care.

What additional training do you wish you had that may help with your current practice?

A strong program preparing long term care nurses to improve recognition of depression in patients and residents with cognitive deficits, and most importantly the non-drug interventions that are evidence-based that will sustainably support nursing care. A good number of nurses are not prepared to recognize and manage the complexity of depression in dementia.

How has CALTCM impacted your practice?

I am in my third year of exposure to CALTCM. The organization is extremely rewarding. I am able to access and adopt innovations and teaching models and approaches in bringing about improvement of the quality of patient-centered care especially with the Interact tool being adopted company-wide in my current organization. The rewards I am seeing come in many ways – seeing myself more motivated as I attend the annual meetings, seeing how my colleagues and from other disciplines gain greater momentum in affecting change through the various organizations CALTCM is closely collaborating.