Making house calls helps keep patients at home
Nursing and caregiving are a proud tradition for Shirley Crawley, RN, MSN, AGPCNP-BC, who decided at a very young age she wanted to follow in the footsteps of her mother and grandmother.
“Back then, they would have Take Your Daughter to Work Day and my mom worked in a nursing home at the time. She had an elderly patient who liked to color. The lady asked my mom what my name was, and my mom said, ‘Ask her,’” Shirley recounts. “The lady turned to me and said, ‘Hello ask her!’ I thought it was so funny. We spent the day coloring and I had so much fun with my mom, following her around and teaching me everything. From that day on, I wanted to be a nurse.”
In her junior and senior years of high school, Shirley got hands-on training nursing training from a vocational program, which allowed her to graduate from the Buffalo Vocational Technical Center as a licensed practical nurse (LPN), in addition to a Regents Diploma. She went on to earn her associate degree and became a registered nurse, before working for a nursing agency that led to a more permanent nursing position at Roswell Park Comprehensive Cancer Center.
“I stayed for about a year as an agency nurse before I became a permanent employee. I loved it so much and when the manager I was working with asked me to come on board full time, I had a daughter at the time, and wanted the stability. I ended up working on 6 East at night, then was on 2 West for a little while before applying for a job in radiation medicine,” Shirley says.
Shirley worked for 13 years in radiation medicine, earning her bachelor’s and master’s degrees at Daemen University at the same time, before moving to urology for a year, then changing to travel nursing for a year. It was at the height of the Covid pandemic; her mother was ill and being a traveling nurse allowed her the flexibility to travel back and forth to North Carolina to care for her before she passed away.
Patient care doesn't stop at the hospital door
When Shirley returned to Buffalo, she returned to Roswell Park as a nurse practitioner with the Patient Assistance in Care Transition (PACT) program. The goal of PACT is to send care providers into homes, post-discharge, to reduce readmission rates and divert people from needing to go to the ER.
“The statistics and data show that patients who most often go back to the hospital and are readmitted return within the first 48-72 hours, usually due to not enough patient education or poor medication compliance. When a patient is discharged, there’s so much information thrown at them. There are things they miss. The idea is to send a provider soon after they get home, because nurses can diagnose whether someone needs to return to the hospital and they can write prescriptions. I don’t take place of the patient’s primary clinic but I am their eyes and ears,” she says.
Shirley visits patients’ homes to talk with them about their medication, why it’s important to take it at the designated times in order to continue to stay healthy, and to make sure they understand any other instructions they were given after leaving the hospital. She also advocates on the patient’s behalf as needed, making sure they have all the information and tools they need to heal at home – and talks with them, their caregivers and loved ones about hospice and palliative care options and services and the importance of having advanced directives for end-of-life care and decisions. Those conversations are difficult enough to have as it is, she maintains, and being able to have them at home, in a comfortable and familiar setting, can help put the patient’s mind at ease.
Not one to sit still, Shirley is finishing her Doctor of Nursing Practice degree and will have completed the program in about a year. “After that, I’m never going back to school,” she laughs.
Inspiring future nurses
Shirley continues to enjoy working with and for Roswell Park and providing care to her patients, wherever they may be. “When I worked at the hospital, the team there was so good. Even just the atmosphere – when you walk through the doors and you hear the music, you see the volunteers greeting people, it’s such a great atmosphere. There’s a sense of teamwork and stability. This is somewhere I see myself staying long-term and maybe even retiring from here,” she says. “I could see myself growing here, and working with oncology patients is very rewarding. I was very apprehensive about it at first and thought it was going to be sad but you build rapport with patients and staff.”
Nursing careers at Roswell Park
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She encourages young nurses and those considering entering the profession to embrace the highs and lows of being a nurse: “You can see how you’re helping people, even if what you do doesn’t always get the results you want. You can see how it’s helping patients. We sometimes buy time for our patients and their families to get things in order and even that’s rewarding.
“Being a nurse is a great profession. But you have to have the heart to do this,” she continues. “It’s a stable profession that pays well and you can grow and advance in it. The other aspect is, it’s not limited to one area, you can work in many different fields. You have the ability and opportunity to find work that’s right for you in nursing, whether that’s oncology or primary care or surgery. I love oncology, I love this patient population. There’s something very special about Roswell Park.”