One of the most extraordinary experiences I’ve had as a critical care nurse was being a part of (AACN's) CSI Academy
Katherine Geyer has had many experiences in her young life, from backcountry guide and outdoor enthusiast who enjoys skiing and biking, to wife and mother, to critical care nurse and now student working on a Master of Science in Nursing (MSN). She’s versatile, full of energy and embraces positive change.
Her baby daughter, Eleanor, inspires her every day. “She wakes up smiling and joyful,” Katherine says.
Her career began as a senior field instructor at a wilderness therapy company working with at-risk adolescents and adults in the Utah backcountry. In this role, Katherine was responsible for facilitating participants in a cognitive behavioral therapy program using experiential education in a wilderness setting. She also oversaw the logistical planning of an ongoing eight-day shift, which included in-field medical treatments and first aid, coordination of backcountry hikes, mentoring staff and students in therapeutic communication, and implementing individual and group treatment plans.
An intense and meaningful wilderness first responder course in Zion National Park with the National Outdoor Leadership School led her to consider a career in nursing. Utah is also where she met her husband, Ethan, who was an assistant field director for the same wilderness therapy company.
“In addition to being inspired by people who embrace big, positive changes that come from within ... I am clearly inspired by nature. Being in the wilderness with time to reflect and get to know myself has made me who I am.
“Several of my colleagues from wilderness therapy used to call me a BMW, or Burly Mountain Woman. That title entails several job qualifications: busting a fire (the term for starting a fire with a bow drill), solid backcountry navigation skills, cooking over an open flame (that you start yourself), hauling a hefty backpack over rugged terrain, building a solid shelter to withstand both summer monsoons and winter snowfall, and digging a pristine latrine — all while taking care of a group of eight to 12 people.
“I am inspired by people who don’t see limits. It’s never too late. Change can only come from yourself; nurses are great role models for that.”
She is passionate about achieving the best outcomes for patients and improving their quality of life and believes that serving as a bedside nurse is one of the “most powerful roles” in healthcare “due to the unique opportunities you have to build impactful relationships when working so closely, so hands-on with your patients.”
Katherine loves the rapport-building process and often draws on her wilderness therapy experiences. “Working one-on-one with patients and getting to know them and what motivates them to change is a really exciting part of my job. Making intentional time in your shift to actively listen is essential. I once read that sitting at eye level with your patients for at least five minutes a day can make a huge difference in how they view their healthcare experience, and I try to incorporate this into each of my shifts.”
Affiliating with AACN
For her first National Teaching Institute, May 2014 in Denver, she “went to everything,” she says. “I was so thrilled to have my own podium presentation representing CSI Academy and my team’s work on early progressive mobility, but I also went to every lecture and celebration that I could squeeze in! I never knew that I was a conference nerd until then.”
She was also proud to earn CCRN certification, “It was the hardest test I’ve ever taken. You are expected to pass the NCLEX after graduation, but certification is a goal that you set for yourself. There is something really cool about that.” Her father recently recognized the CCRN credential on a nurse practitioner’s badge and remarked, “My daughter is a CCRN too.”
She recently left her position as clinical nurse IV in the Medical-Surgical ICU at Duke Raleigh Hospital, North Carolina, to enter an MSN program with a focus on family practice. She loves to learn and had strong support from her nurse manager to earn an MSN.
Being a member of AACN Clinical Scene Investigator (CSI) Academy team was the pinnacle of a great experience at Duke.
“One of the most extraordinary experiences I’ve had as a critical care nurse was being a part of CSI Academy. We covered a lot of different topics and part of it was leadership, financial savings and things like that. You really have to build rapport with each person before you can change a unit practice. And as a new nurse, and as a new nurse to the ICU, knowing my team and getting to sit down one-on-one with everybody and provide education and create these outcomes through our early mobility protocol meant so much to patients and families. It changed our whole unit’s practice.”
Katherine had many memorable experiences as part of the CSI Team at Duke, but one in particular really stands out.
“He was an older gentleman who had progressive lung disease with an overall poor prognosis, and he was on a ventilator. He was alert and oriented, interactive, his pain was well managed, and we told him about our protocol.
“And he wrote on a piece of paper: ‘I want to help you guys with this. I’ll be the first patient. I want to help change things for the rest of the patients you’re going to take care of after me.’ So we got him up and first we started slow. He became the first patient at our hospital to ambulate on a vent. We had an incentive program where we gave them Olympic medals for reaching their personal goals. We had an Olympic torch that was battery operated, and a flame was kind of flying. He put it on the walker, and he would wave to people. He had a trail of people, a parade, following him. And he’s was just smiling and waving.
“The protocol allowed him to be more comfortable, not sedated heavily. Communicative while he was still on the vent. Get out of bed, move around, feel more like himself. His improvements allowed him to be extubated and move out of the ICU, spend time with his family in a private room, see a room full of people that he loves, and then tell them what he wanted for end-of-life care in his own words, because he was able to speak. He eventually came back to us where his wishes were shared with us, and I believe this gave him back some dignity in an extremely difficult time. His family came back later, and his daughter thanked us for involving him in the protocol and giving him ‘purpose at the end of his life.’ Another patient’s family said, ‘I just want to thank you for allowing me to hear my dad’s voice again.’
“We understood some of the linear improvements we would see with the protocol (decreased vent days, decreased length of stay, decreased infections, systemic stability and improvement, etc.), but we did not grasp just how big of an impact we might have on quality of life at the end of someone’s life.
“I became a nurse, in part, because of my passion for the human connection and how it brings us together in times of joy, but also in times of adversity. Being a part of AACN CSI Academy and an early progressive mobility project has helped me foster that passion by creating a venue for improving quality of life outcomes in the critically ill. Moving forward, my hope is that the family nurse practitioner role will open up so many additional spectrums of care for me to continue pursuing that passion. Just as my previous careers have shaped the nurse that I am today, so will I carry my time in the ICU on my MSN journey.”