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 Interview: Rosemary Oldham

An award-winning registered nurse turned infection preventionist traces her growth in a skilled nursing center.

 

Sometimes, one finds their calling after their start. In an interview with Provider, Rosemary Oldham, RN, MDS coordinator and infection preventionist (IP) at Hyden Health and Rehabilitation Center in Hyden, Ky., shares her career path from needing a job to choosing to stay and growing into different roles.

Provider: How did you get started in long term care?
Oldham: I needed a job. I started my journey in long term care truly for the job, and then I fell in love with it. I entered in as a staff nurse, I started on a floor at the current nursing home where I am. I did that for four and half years. I loved it and exceled.

I truly do long term care just for the elderly. I love them. They are the reason why I stayed.

Provider: What is your typical day like?
Oldham: My day is busy. I come in, I do my rounds. If there are problems, I do my minimum data sets [MDS]. I work on infection control, I report, I work on scheduling, billing, you name it. It’s a busy job, and you have to stay on top of it.

Provider:  IP—how did you get into that?
Oldham: I got the position a year and a half ago. What happened is my director of nursing switched from the Medicare coordinator and infection preventionist to her current role. So I took over. I moved into her position. And the IP position, I love it.

Provider:  Why do you love it?
Oldham: I have enjoyed really learning. Your everyday nurse is not going to understand multi-drug resistant organisms [MDROs]. They are not going to understand really what is out there, how to report it. And so that learning process of transferring myself from a regular staff nurse into an IP nurse into that different side of nursing—I loved that challenge. I’m always ready to learn something new.

The thing with the IP position is that it’s ever-evolving. And to keep up with it you’re always going to learn something. There’s always some new organism or some new thing you have deal with. So someone in this role has to figure out what that is, how you’re going to prevent it, and how you’re going to stop it, which to me is interesting. So this is a very educational position.

Provider: How do you lead education for the other staff on these topics?
Oldham: Inservices. I go around, and I talk to everyone. We have really highly inserviced staff, and in terms of infection prevention, we focus on what the standards are.

I’ve invited people into our buildings from our state regulatory office to go over all areas. And so we have grown to improve, we have a lot more to go and it’s ever evolving. And when I say that I mean it leads back to antibiotic usage. To doctors, to your nurses, to orders, there’s so much to it.

Provider: Will you stay in this role or take another?
Oldham: You never know. One thing that I will say is that, after doing IP, I realize that a license in epidemiology would be a nice thing. If I go further in that, I will try to get state certified. You have to go through a rigorous test, so then you are a certified infection preventionist.

Provider: How do you keep up on your learning for IP?
Oldham: We do a lot with the Centers for Disease Control and Prevention. We also have people in Frankfort here in Kentucky who run our statewide programs, and I learned a lot from them.

I also reach out to a lot of long term care facilities to see what they are doing to fight MDROs. It’s a very different role from acute care. I was a staff nurse in a hospital before, and working in long term care is much different because it’s a home environment.

Provider: What advice would you give to someone who wants to grow in their role like you have?
Oldham: Compassion. That is legit. You have to want to learn. Unfortunately, you have the fact that the everyday Joe can pass nursing school. But you have to have compassion in order to grow into anything in long term care. If you don’t, you will not survive, you will not evolve, you will not do well.

Provider: What’s the biggest thing you’ve learned?
Oldham: I’m satisfied where I am right now. I learned a lot of things as far as people learning people skills, being around people, learning that life is not black and white, life is gray, everyone’s situation is different.

This role gives you better people skills; you have to deal with the general public. It makes you softer in some ways but it makes you harder in some ways. Death is a hard one, but you deal with death better when you see it more than once.

Provider: Do you have a story of a resident that stands out to you?
Oldham:  Yes. This particular resident that I had changed the way I view long term care. I was a nurse for six months. I was living the hustle and the bustle, trying to get my shift done. He had a trach and could not talk to me. He tried and couldn’t speak. When I think about him now, I can see his face and the things that he asked me.

So one day he has an appointment to have the trach out. I was off for two days, and I came back in the morning shift. I worked day shift at the time.

I came back that morning, and I heard a resident that I’ve never heard before. And he was saying, “Rosemary, Rosemary,” and I hollered down to the nurse that I was going to get a report from, and I said, “Who is that?” and she said his name, and he was one of the residents that I cared for.

And in that moment, I knew. I knew that resident. Every day I talked to him, and he knew me. He knew who I was. From that minute on, he never forgot my name, he hollered at me whenever he got mad.

Provider: What did you learn from that?
Oldham: So for somebody who can’t talk, you think that they don’t see you, that they don’t hear you. You’re living that daily bustle, and my name was the first thing I ever heard him say. From that moment on, I knew I was doing the right thing. And that was the very first patient that in that moment I was like, “Oh my God, he knows my name, and he’s never said a word.” And that forever evolved me into nursing.

From that moment on, I have more than a little more for my patients with dementia. For my patients who anybody else would think that they don’t know. You walk into these rooms, and just because these people don’t talk to you, it doesn’t mean that they don’t understand you. I’m telling you, that moment was an ever-changing point for me in my career.

He saw me beyond my role; he saw me as Rosemary. He called me Rosemary Annie. And he continued to call me that until he left. And I still have people that call me Rosemary Annie.

He was on a mechanical diet, thickening liquids. I would have to thicken his Sprite, and he’d drink that Sprite and he’d say, “Oh baby that’s good. That’s the best thing I ever drank.” Those type of relationships have kept me going. Those type of residents have pushed me to where I am now.

That’s a story of the man I would never have thought knew my name, even though I talked to him every day. But to hear him, that was just a pivotal moment.
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