A Path of Purpose: The Power of Focused Support and Targeted Care

By Sharlene Meakins BSN RN

In A Path of Purpose Sharlene Meakins, BSN, RN takes you on a decade-long journey of twists and turns as she navigated the unlikely path to finding and fulfilling her life’s purpose, which led her to DD Nursing. She has since become one of the go-to consultants in the DD Nursing field, bringing together professionals across the community.
Shar’s passion is helping DD Nurses to understand, navigate and apply the complex guidelines and standards, while learning to build trusting relationships with service coordinators, agency administrators, directors, direct support professionals, families and individuals so that they can enjoy a lasting and fulfilling nursing career.
In A Path of Purpose, DD Nurses will find the encouragement and support they need as they embark on their own journey. Agency Directors will find the expert guidance they need to hire and support nurses entering the DD field. A Path of Purpose is a must-read for all members of the DD Community to provide the power of focused support and targeted care in community nursing.

• Language: English
• Publisher: AuthorHouse
• Release date: Dec 15, 2020
• ISBN: 9781665510523

Book preview

© 2021 Sharlene Meakins, BSN, RN. All rights reserved.

No part of this book may be reproduced, stored in a retrieval system, or

transmitted by any means without the written permission of the author.

Published by AuthorHouse 12/14/2020

ISBN: 978-1-6655-1051-6 (sc)

ISBN: 978-1-6655-1050-9 (hc)

ISBN: 978-1-6655-1052-3 (e)

Library of Congress Control Number: 2020924863

Any people depicted in stock imagery provided by Getty Images are models,

and such images are being used for illustrative purposes only.

Certain stock imagery © Getty Images.

Because of the dynamic nature of the Internet, any web addresses or links contained in

this book may have changed since publication and may no longer be valid. The views

expressed in this work are solely those of the author and do not necessarily reflect the

views of the publisher, and the publisher hereby disclaims any responsibility for them.

CONTENTS

Foreword

Introduction

Chapter 1     Nursing School a Reality

Chapter 2     Anticipation of a New Career

Chapter 3     A Nurse is a Nurse is a Nurse...Right?

Chapter 4     A Desire to Make a Difference

Chapter 5     A Journey of Faith

Chapter 6     A New Me

Chapter 7     A Turn in the Journey

Chapter 8     The Learning Curve

Chapter 9     Communication and Building Trust

Chapter 10   Recognizing Value

Chapter 11   The Value of Implementing Professional Insight

Chapter 12   Mentoring to Make a Difference

Chapter 13   Facing the Unexpected

Chapter 14   Direct Support Professionals are Our Heros

Chapter 15   A Paper Trail and Data Review

Chapter 16   Continue to Grow And Invest in Yourself

Chapter 17   Perception is Everything

Chapter 18   Overcoming Trauma

Chapter 19   Wellness Vs Illness

Chapter 20   Healthcare Outside the DD Community

Chapter 21   The DD Nurse and the I/DD Provider

Final Thoughts

Acknowledgments

Glossary

FOREWORD

It is a warm September day in 1984. A faculty member asks an auditorium full of new baccalaureate nursing students, Who is going to practice in the hospital after graduation?

I was the only student who did not raise her hand. As an older returning student with a number of health education undergraduate courses under my belt, I had entered nursing school possessing a novice understanding of the multitude of factors that impact one’s health and health behaviors. My 23-year-old brain at the time was thinking, What better way to promote health and wellness than through the practice of nursing, but not in a hospital? That turned out to be one of my best life decisions made at any age.

My first developmental disabilities nursing practice experience was with the state Office of Developmental Disabilities Services (ODDS). I practiced on a four-person team that traveled throughout the State of Oregon. We evaluated health-related services provided to adults with intellectual and developmental disabilities who received services in state and private Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR). This was the late 1980’s and the number of people living in these facilities was in the thousands.

I took pride in personally meeting and engaging with each person whose health and habilitative records I accessed. While my records evaluation targeted specific documents required for ICF/MR level services by the Code of Federal Regulation, I always made it a point to access and read each person’s admission summary – some of which were frayed and yellowed with age having been held in the person’s paper health record for well over 70 years.

My collection, validation of the synthesis of such data, allowed me to draw conclusions regarding the person’s responses to their actual and potential health risks. Even as a relatively new RN, I began to recognize patterns of factors that affected peoples’ risks. In addition to the origin of their developmental/intellectual disability and other medical/psychiatric diagnoses, the top contenders included:

• the person’s method of communication

• the communication practices of staff responsible for the person’s care

• the person’s physical environment

• the person’s social environment and relationships with others

• the competencies of individual medical professionals and staff assigned to provide the person’s health and habilitative supports

• the practice competencies of individual RN to whom the person was assigned

And thus began my passion for DD Nursing practice.

Within the next 12 years, these facilities would all close. People were transitioned into private homes, foster homes, and congregate living situations. My nursing practice transitioned as well. The state-level regulatory evaluation of people’s health and habilitative supports now took place with the community agencies that were providing residential and employment services to the former facility residents.

It was during my practice with ODDS that I became a Certified Developmental Disabilities Nurse. I started the Greater Oregon Nurse Associated with Development Disabilities (a local chapter of the Development Disabilities Nursing Association) and provided continuing education events for nurses practicing in the field of DD.

It was also during this time that I had the good fortune to meet Sharlene Meakins. While Shar was a relatively new RN when we first met, I found her application of nursing science and ethical principle within her DD Nursing practice to be head and shoulders above the rest.

From 2002 forward, my nursing practice journey ventured on a different route. I took a practice position with Oregon’s state office for seniors and then taught at Oregon Health & Science University School of Nursing. With no teaching responsibilities in the summer months, I opened an independent RN consulting business. For the past seven years, my practice is in nursing regulation at the Oregon State Board of Nursing.

To this day, Shar and I interact professionally and she has become a trusted colleague and friend. Every day I express gratitude for experiencing the most perfect nursing practice journey and gratitude for colleagues like Shar Meakins who have profoundly contributed to my journey and to the profession of nursing.

Gretchen Koch, MSN, RN

Policy Analyst at Oregon State Board of Nursing

INTRODUCTION

"When you are a nurse, you know that every day you will touch

a life or a life will touch yours."

~ Anonymous

How often have you heard the question, Which hospital or clinic do you work at?

People often misunderstand the work of a community nurse. Their concept of a nurse is someone who gives injections, takes vitals, and administers medications. However, we are often behind the scenes traveling to individual’s homes where we utilize our observation and assessment skills daily. We determine the needs of each patient which includes much-needed staff observations to be able to assess their health, activities of daily living support, and environment.

We as nurses, serve as an essential part of an individual’s health care team to help facilitate life with health and wellness. We evaluate data and read progress notes to monitor for any signs or symptoms of change in an individual’s health status. We not only complete documentation for assessments, care plans, protocols, and nursing orders, we also teach, train, and serve as an ally to professionally support each individual. As community nurses, we apply our nursing skills and scope of practice to individuals with a broad list of diagnoses, skill levels, and health needs.

By picking up this book, you represent someone who has the heart to follow A Path of Purpose with a passion to provide focused support and targeted care of others. My desire as you read about my personal journey is that you gain insight and direction for your own life and career. For chapter by chapter notes you can go to sharlenemeakins.com/resources to download journal pages for your own convenience. Whether you’ve just started as a new nurse, or have been a nurse or caregiver for several years, you will find it beneficial to reflect on your own journey and make course corrections where needed.

I recommend underlining, writing in the margins, and even journaling thoughts and ideas that come to you as you move forward in seeking and fulfilling your own purpose. Each of our journeys is exciting and unique just like the individuals we serve. My hope is that each of our lives is a reflection of love, kindness, joy, and peace as we walk in confidence and boldness to make a difference.

I decided to write this book because I wanted to make a broader impact in the Intellectual and Developmental Disabilities (I/DD) community. Often, as a new DD Nurse, I felt alone and had difficulty getting my footing since my expectations as an RN were different than what I was experiencing. I not only want to connect with my fellow DD Nurses but also encourage any of you who are feeling the calling to step out and start a service that would support the DD Community. I can honestly say from what I have experienced and observed, many who have started in this field have found their own path of purpose in serving individuals with developmental disabilities. The courage, strength, and love for life these individuals impart brings a new perspective to life.

I began to wonder, what have I learned and what can I impart to nurses inside and outside of the I/DD community? I would want to share my years of experience and understanding of:

1. How to communicate, listen, and observe individuals with I/DD

2. How to be a key player as a member of the individual support plan team

3. How to be an ally for an individual with I/DD

4. How to communicate with healthcare and mental health providers

5. How to develop a good working relationship with the staff

6. How to implement creative measures to implement a healthy lifestyle

7. How to