“We are not the caregivers of the patients, we are the care prescribers. It says Montse Martinez, attached to the Nursing Department as head of the Knowledge and Evaluation area of the Vall d’Hebron Hospital. “A nurse assesses, diagnoses and sets a work plan to achieve health goals”. Martínez knows that, when push comes to shove, only patients they are aware of the true role of these health professionals. The covid-19 has highlighted the importance of Nursing, but the collective, formed in a 80% by women, still have the feeling that their role is often simplified. “It takes a scientific and innovative vision of our profession, which has a direct hit in the health of patients,” he insists.
In recent years, the specialization, represented in the figure of advanced practice nurses (APNs), has been making its way into nursing Field, which reflects the desire to respond to the different needs of patients, who are increasingly older. It is also a test of complexity of a profession that, as a result of the health crisis, has not only proved necessary, but also essential. This May 12 marks the World Nursing Day.
Anna Herraiz is an advanced practice nurse at Spinal Cord Injury Unit of the Traumatology and Burns Hospital of Vall d’Hebron. “The advanced practice nurses (EPA) are those who have the experience, that is, they have more knowledge,” says Herraiz. The EPA are nursing professionals with a specialized approach, ability and knowledge to make complex decisions and extensive practice. They have a specialization in Master’s degree. Do they charge more for having this specialty? “Do not. We have no more remuneration for this specialty, and this is one of our demands”, defends Herraiz.
Spinal cord injuries
The job of this nurse is to prevent patients with spinal cord injuries have injuries outside the hospital. “And, when they are inside the hospital, I train my colleagues in the prevention of these sores,” Add. In 2013, she became the first advanced practice nurse at the Vall d’Hebron Trauma Hospital. The hospital has had Herrainz’s specialty since 2018, although she has been working with spinal cord injuries since 2006. “These specialties are created based on the needs of the patients, to make the continuity of care outside the hospital,” says Herraiz.
Specialties are created based on the needs of patients, to continue care outside the hospital
Spinal cord injuries are a very unknown pathology which, as this nurse explains, scares people a lot. That is why it often happens that patients with minor complications they go to the hospital. “And sometimes it’s not necessary. That’s why I have a ‘feedback’ with the CAPs in the area and with social health centers that need help with the care of these patients,” he says.
Herraiz, who has rotated throughout the hospital, affirms that he likes working in this unit, despite the fact that it is “hard” because the patients who are in it will not recover. “They will lead a more or less adapted life, but they will not have the life they had before. It is doing a break and start living differently, and that sometimes is not easy”. The profile of the patients is very varied, from very young people to very old people. “The emotional involvement is very high”. Herraiz’s work also consists of to adapt the patient to lead a life outside the hospital, since many spaces are not adapted for these citizens.
The testimony
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One of them is David Coca, 45 years old. He became quadriplegic in 2017 after a motorcycle accident. He is a patient of Herraiz in the Spinal Cord Injury Unit. “She has helped me gain a lot of freedom because, when I went out on the street, I found it all again” says Coca. He, for example, spent practically every week in the CAP Emergency Room. Helped by Anna [Herraiz] we had to show the CAP nurse and doctor how things had to be done because they were totally unaware of spinal cord injury. They didn’t know what to do,” he says.
For him, the most important thing he has learned from his nurse is to know what happens to him, when it happens to him and why it happens to him. “For example, when I have more spasms than normal or my legs feel very hot, it’s because I have a urine infection, for example,” says Coca. “I don’t feel the pain, but I identify it in another way. And that has been taught to me here,” he concludes.