The Challenges and Joys of a Nurse Infection Preventionist

Nurse Infection Preventionist

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I was 13 years old when I bought my first encyclopedia of infectious diseases. I was fascinated by the subject. I’m not sure whether my parents were thrilled or concerned by this obsession of mine, but I would carry that book in my backpack and pull it out throughout the day to read in my spare time. Medicine fascinated me, and infectious diseases even more so. Once I graduated high school, I knew beyond a shadow of a doubt that I wanted to be a nurse.

I spent 8 years in the emergency department (ED), first as an emergency medical technician and then as a nurse, before transitioning to the practice of preventing and controlling infections. I theorized that beginning my career as a nurse in the ED was a sensible move; it would give me a good foundation as a nurse before specializing in the field of infectious disease—and it did! After 5 years of nursing in the ED, I began looking for options to specialize in population health and infectious disease. I find it interesting how one becomes an infection preventionist (IP). Infection prevention and control doesn’t yet have a specific educational pathway, so for many of us, it’s something we stumbled upon.

Because May is International Nurses Month, I want to highlight some challenges and joys of being a nurse IP. However, I also have some wonderful infection prevention colleagues with microbiology and public health backgrounds. No matter the background, the complex career of preventing and controlling infections has unique joys and challenges.

The Challenges

One of my favorite quotes comes from Albert Einstein: “It’s not that I am so smart; it’s just that I stay with problems longer.” Einstein reminds us that it is not our intelligence or previous knowledge that most propels us forward in life. Instead, our persistence—despite the challenges that lie before us—leads us to succeed. It is with persistence that I’ve overcome the challenges of being a nurse IP. I could write a book about all the challenges I have faced as a nurse IP. But for today, I’ll mention 2 of the most significant challenges I have stayed with just long enough to overcome them.

Nurses know nothing about epidemiology. Or at least I didn’t, not as a brand-new nurse IP. This was the most significant learning curve in my career. Although I would eventually obtain my master’s degree in public health, I struggledwith the concept of epidemiology in my early days as an IP. We are not taught epidemiological principles in nursing school, and I knew little about incidence rates, prevalence, or how to investigate an outbreak. I probably asked my preceptor to explain the concept of surveillance 3 or 4 times. It was incredibly frustrating. I knew nursing, I knew infectious diseases, but I did not know epidemiology, which is required in infection prevention and control. Luckily, I joined a fantastic team and had an incredible preceptor who, over time, could teach me essential concepts. All this took a lot of time, admitting my limited knowledge of the subject, and intentionally working to overcome it. But I stayed with the challenge long enough that I was eventually able to not only apply the principles in practice but to also teach them and create courses through which others could learn and apply those same concepts.

We are not the most loved or celebrated role in health care. While working in the ED, I received many accolades for my role as a nurse. Doctors liked me, and other nurses enjoyed working with me. However, that changed when I became a nurse IP. It turns out that health care workers only sometimes love IPs. After all, we’re the ones coming to them with the unfortunate news of outbreaks, infections, the need for practice change, and constant reminders to wash their hands. It’s understandable that we may sometimes be met with disdain. Our health care colleagues are working hard to provide excellent care to our patients, and it’s discouraging for them to hear that a patient has acquired a health care–associated infection (HAI) or that their unit has an outbreak. It’s stressful news, and we are the deliverers of it. However, it’s equally discouraging for the nurse IP to be met with hostility, disregard, and scorn. As a new nurse IP, I found it challenging to go from being loved in my profession to being disliked. But despite the occasional discomfort, I stayed. I sought to overcome the strained relationships between infection control and frontline health care staff. I developed relationships with the health care teams and fought for their respect. Over time, I’ve regained the appreciation of my health care colleagues. They may not always like what I say, but they respect me and my role.

Despite the challenges, I persist because I see how rewarding this career can be. When we stay in the challenges long enough, we can overcome many of them.

The Joys

I do not continue in this career for the challenges it has brought. I stay for the many joyous moments I’ve experienced. I love my job; I get so much joy from our work of preventing and controlling the spread of infectious diseases. It’s fascinating, enthralling, and exciting for many reasons.

We save lives. Sometimes I wonder how many lives I’ve saved as a nurse IP. We calculate this occasionally to show the health care community the tremendous value of improving the prevention and control of infections. We’re preventing morbidity and mortality in health care through targeted interventions designed to prevent the acquisition and spread of infection. And quite simply, I find that incredible. It underscores why I continue to persist in this career, despite its challenges. I take great pride and joy in the fact that my infection prevention colleagues and I are decreasing the health care cost, preventable illness, and death in health care facilities. It’s beyond exciting to watch the decreasing trend of infections after working long and hard to determine potential reasons for a high infection rate, then applying interventions to decrease those infections successfully. Someone out there is alive because an IP investigated, discovered, and applied practice changes to reduce infections in a specific area of medicine. And that, my IP friends, is something to be celebrated.

We are the Sherlock Holmes of health care. I’ve always loved a good mystery. As a nurse IP, we can act as detectives of health care. We are, in a sense, solving crimes by working to determine which organism, practice, product, or knowledge gap has led to the spread of HAIs. This is captivating, exciting, and tremendously fun. If you’re a nurse trying to determine whether infection prevention is a career you’d like to pursue, ask yourself whether you enjoy a good mystery. If you do, then you’re likely to enjoy the career of preventing and controlling infections. We’re constantly solving the mystery of rising infection rates and intervening to prevent the next “crime.”

Being a nurse IP is not for the faint of heart. I thought my job as a nurse in the ED was challenging, and many times, it was. However, my career as a nurse IP has also come with its trials. But despite the challenges, I love the satisfaction I get from helping improve the care of our patients through the prevention and control of infections. I’ve seen the downward trending graphs of infection cases indicating the lives we’ve saved, and I have loved the thrill of solving the mysteries left behind by the microscopic organisms wreaking havoc on our health care communities. A nurse IP may not be the easiest role in the health care community, but it is among the most rewarding.

I want to wish a very happy International Nurses Month to all my fellow nurse IPs! May you persist through the challenges of this career and enjoy all the ups and downs of this most rewarding profession.