Lawrence H Chyall, APRN-CNS MS CNRN CCNS
San Francisco, CA
BS (Microbial Biology) University of California Berkeley
MS (Critical Care Nursing Clinical Nurse Specialist) University of California San Francisco
PhD study in nursing, degree not completed, University of California San Francisco, Katherine Chesla PhD, Advisor
United Stated Department of Energy Internship at Lawrence Berkeley National Lab, Amy Kronenberg ScD, Advisor
NINR Doctoral Study Grant for Symptom Management Research
Vision for Neuroscience Nursing:
Common neurological disorders (Dementia, Chronic Low Back Pain, Stroke, Traumatic Brain Injury, Migraine, Epilepsy, Multiple Sclerosis, Spinal Cord Injury, and Parkinson’s Disease) have a collective prevalence in the United States of 124.5 million cases with an economic burden of nearly $800 billion (Gooch, C. L., Pracht, E. and Borenstein, A. R. 2017). It is equally important that these data do not include the human suffering of those afflicted by neurological disease and the families that care for them. Billions are also spent on neurological disease research and on the basic science of the brain and nervous system. Therefore all Americans are touched by neurological disease and all Americans fund research and clinical care through taxes and insurance premiums. To say that neurological disease is a big problem may well be considered an understatement.
Nurses are a strategic part of the solution to the big problem of neurological disease. The specialty of Neuroscience Nursing has a strong and dedicated corps of highly educated and trained professional involved in all aspects of disease prevention, treatment, care, and research. My vision for the future of our Neuroscience Nursing is that all neuroscience patients are treated by nurses with specialty neuroscience training, that neuroscience nurses practice to the full extent of their education and training and that neuroscience nurses have a visible seat at the table when policy decisions affecting our patients are made. Doing so will help ensure that our patients needs are met in the most skilled, compassionate, and cost effective way.
Vision for the Association:
The AANN is an essential organization for our specialty through its work in education, organization, and advocacy. Our members are dedicated to our profession and their patients. In the best tradition of American civil society, they collectively spend hundreds of thousands of hours of work to improve both our profession and the care of our patients. My vision for the association is to draw on the strength of our members to expand membership, increase our educational offerings, and increase our visibility on the national stage.
In order to increase our membership and increase our national/international presence we must appeal to the talented and diverse group of young nurses working in and entering our profession and use their creativity and energy to advance our association. Our commitment to the next generation of neuroscience nurses must be unwavering. Our organization can only grow through finding, keeping, and developing new members and new leaders. I have seen this principle at work during our annual meeting when senior professionals have their junior colleagues co-present. This kind of mentorship should be encouraged along with finding new ways to reach and inspire new members.
In my view, increasing our web-based educational opportunities as a supplement to our excellent journal, stroke conference, and annual conference would not only be a good way to disseminate the collective knowledge of our members but also an excellent way to be relevant daily practice. Not all members are able to attend meetings in persons but new technology is an excellent means of engaging and educating all members.
Accomplishments in Professional Positions:
The most important accomplishment in my professional career is the direct care I have provided and continue to provide to patients with Severe Traumatic Brain Injury and their families. While majority of my work today is in the admiration of our Joint Commission certified TBI Program, I maintain a practice at the bedside in the ICU because I want to remain connected to bedside but, more importantly, because I truly love caring for patients and families and I think I am at my best when I am engaged in that work.
Patients with Severe Traumatic Brain Injury are among the sickest and most vulnerable at the hospital where I work. Effective nursing care for this group requires knowledge, skill, critical thinking, and excellent communication skills. Over the years I have sought and obtained the education and skills needed to practice at the top of my license. I am privileged to say that I am considered an expert TBI nurse at my hospital. I am also privileged to mentor other nurses and share my knowledge.
Caring for the families of TBI patients is a significant role in TBI nursing and top notch communications skills are an important part of caring for families. As part of my role as a bedside nurse and my role as an administrator I have worked on improving my communication skills and the those of my colleagues by implementing IMPACT-ICU, a communication training program at my hospital.
Accomplishments in Leadership Positions:
I would like to highlight two of my leadership accomplishments. First, bringing the IMPACT-ICU program to my hospital. After applying for and being awarded a small grant to start the program, I discussed it with the many groups it would affect at the hospital including nurses, physicians, and hospital administration. I worked collaboratively with our Palliative Care service and with the IMPACT-ICU program originators at another hospital, and developed a dedicated core team of 6 nurses and physicians to help teach and support the program. I am pleased to say it has been a success. Nurses have found the training and support they received to be helpful and the hospital administration had found it so useful they have made it an institutional goal to train 25% of our ICU nurses by the end of the year.
I have also been successful in starting a program to educate nurses in our ICU on multi-modal neuro monitoring. Prior to my undertaking this project some of the stakeholders were in conflict with each other. I recognized that until the conflicts had been resolved we had little chance of succeeding with the program. I worked with the stakeholders to address and resolve their concerns, leading to successful program implementation.