Fifteen Minutes with Karen Stenger, RN, MA, CCRN

KStenger

Karen Stenger, RN, MA, CCRN, advanced practice nurse in Intensive and Special Services, entered Iowa State University as a math major. But during her first semester, Karen had two experiences that changed her focus. For Karen, the study and practice of nursing is more than a career, it truly is her passion. She is a leader who embraces each new challenge. One of Karen’s keen interests is to bring evidence-based practice and research to the bedside. Not surprisingly, her efforts have not gone unappreciated or unnoticed. Karen was named to the list of 100 Great Iowa Nurses in 2006, was honored as one of this year’s Health Care Heroes by the Corridor Business Journal for being “a tireless advocate of our safe patient handling program,” and just recently, Karen was on the MICU team that received national recognition for reducing ventilator-associated pneumonia rates.

How did you get into nursing?
I went to Iowa State to study math. But there were two events during my freshman year that literally changed my life. The first happened in a lecture hall, filled with students. The girl next to me dropped her notebook, and as I leaned over to pick it up for her, I saw that her leg was shaking. I looked up—her eyes had rolled back and she was seizing. I didn’t know what to do. And even though I was surrounded by people, it felt like I was all by myself. I stood up and called for help, but the instructor kept talking. Eventually, we got help for her, I saw her off in the ambulance, and I found out she’d never had a seizure before. For me, the feeling of not knowing what to do was a huge, huge deal. When I wasn’t in class, I spent most of my time in the library—I liked the quiet of the top floors. Not too long after the incident in the lecture hall, I was studying in the library, and suddenly heard books falling. I went to see what had happened, and there was a man seizing—the books had been falling on him. This time there was no one there to help me. Nobody. Eventually, help came. But all I really remember was walking home from the library and thinking—“Not doing math!” I didn’t know exactly what I wanted to do—whether it was something in medicine or nursing, I just knew that it had to be in health. I came to the UI with some friends from Iowa State—we roomed and studied together. I definitely loved nursing, but I also took pre-med classes. When I graduated from nursing in 1986, jobs were hard to come by. I really wanted to work in intensive care, even though I hadn’t had a clinical there. At the time, the UI nursing department started a float pool for the SICU nurses to help meet the staffing needs. They decided to have three new graduates start that pool. So, that’s what I did, very naively.
Was that like learning how to swim by jumping into a river?
Yes, except that my river was filled with really great people, and my two colleagues are still nurses in SICU. There were so many people who were there for me and taught me things at the bedside.
When did you know you wanted to return to school?
Almost as soon as I had graduated! When I started in SICU, I realized I needed more education because there was so much I didn’t know. I earned my certification in critical care [CCRN] in 1988 and my Master of Arts in 1992.
What are some of the things you do in a typical day?
There is no such thing as a typical day. But I do love my days spent with nurses in our new Nurse Residency program, when I get to work with these amazing professionals. All of us should have lots of hope for the future of health care because the nurses who are coming in are so much smarter than we were. And as you’ve noted in other interviews, there are a number of people who switch to nursing from other careers. Of the 12 residents I have this semester, nine have advanced degrees in other areas of study. As an advanced practice nurse in the ISS Division, I have many responsibilities. My passion is for neurosurgical patients, and I teach that content to the new nurses. But I have other responsibilities for the division, too, such as cardiology, respiratory therapy, and safe-patient handling. Ergonomics has become a big thing. I never went to school to figure out how to safely lift a patient. But in 2002, we had many staff injuries, so we started a project on just that.
What kinds of challenges have you faced?
When I started in SICU, I loved cardiology. If I was asked to work extra and I could take an open-heart admission, I absolutely loved it, because you can turn that patient around in three days. But when I applied for an ANM position, they asked if I would teach neuro. On the inside I was thinking—“I really don’t want to do neuro,” and on the outside I was, “Yeah, sure, I could do that!” So, when I got the position I had to learn about neuro. I had a great mentor who said, “You either love neuro, or you don’t know neuro.” She was right.
What gives you happiness?
You know, I’m so lucky. I love my job, I love the patients, and I love the people I work with. It’s easy here because patients really come first. I’ve been so lucky to be able to work with such great bosses and teams. And I also think about all the people—all the patients, and what they have to go through—how strong and resilient the human spirit is, and how I love my million-dollar hugs from patients. It’s just amazing to have the opportunity to be on journeys with people; I can experience it with them, watch and learn from them, and help somebody else the next time.
Do you participate in research studies?
What we do is more the evidence-based practice of taking the research to the bedside. There are a lot of people that I work with that are involved in those projects—they are all real team efforts, whether it’s the safe-patient-handling program or the VAP [ventilator-associated pneumonia]. One project that is very meaningful to me was working with Dr. Hurtig on augmentative communications. The team’s research literally gives spinal-cord-injured patients “a voice” when the patients’ injuries prevent them from communicating. I remember one patient and his family in particular. The patient was a ventilator-dependent quadriplegic who had been very active and had made his wishes known prior to his injury that he didn’t want to be kept alive using extraordinary means. He couldn’t speak or write, but with the augmentative communication he was able to confirm for us his ultimate wishes. And he was able to tell us something else very important. He’d bought his wife a present for their anniversary and he wanted to be sure she would find it after he was gone. I can’t tell you how important it is to be able to make this kind of research available to someone in critical care who has things on their mind and no way to express them.
Do you have any advice you’d like to pass on?
Two things, well really, three things. You have to go where the opportunities are and grab hold of them—don’t close the door; don’t say, “I can’t.” Be resilient and try to figure it out. And knowing what you don’t want to do is as important as knowing what you do want to do. The other thing is “1440.” Do you know what that is? It’s the number of minutes in a day. 1440. Don’t waste a minute.