Wisdom Teachers

Silo to hello: Keep job distinct, seek partners

Shortage of IPs opens up career track

Barbara SouleHaving worked in infection prevention for more than three decades, Barbara Soule, RN, MPA, CIC, has come full circle. She started as an infection preventionist in 1975 when many hospitals were forming infection control programs to meet new accreditation standards by The Joint Commission. In 2004, she became practice leader for infection control services at Joint Commission Resources Inc.

Soule was drawn to the field as it was being formed, having spent many hours in the lab as the child of a mycologist father. "I was very interested in it because I grew up in the lab around Petri dishes and cultures," she recalls. "I thought the field sounded very interesting."

Soule found kindred spirits in attending her first conference of the Association for Professionals in Infection Control and Epidemiology (APIC), a group she would ultimately become president of in 2002. "I went to my first APIC conference and found that the people who were in this young profession were very bright," she says. "They were problem solvers — very committed, passionate, and energetic. I thought I would like to work with these kinds of people. I went back to my hospital and said, "We need to put together an infection control program.' They said, "OK, why don't you do it.'"

The field originally had a somewhat narrow scope of practice, focusing on areas such as surveillance, data analysis, and education in infection control. That's in sharp contrast to a climate today that finds the IP expected to deal with everything from pandemic flu and bioterrorism to that doc that won't wash his hands. OK, some things never change.

"It is a much more expanded role," Soule says. "We went from being specialists to being generalists with a specialty."

As a result of the expansion of duties — and demographic trends affecting the nursing profession as a whole — there actually is a shortage of IPs in the health care system, she says. "We're still predominantly an RN profession, but there is a shortage of IPs and other people [with different training] have been coming into the field," Soule says. "Whatever background they bring, they have to figure out what are the gaps in their knowledge based on the competency and skills they need to have to practice effectively. They need to work with mentors to fill in their professional gaps. Each person needs a personal development program."

Regardless of background, new IPs should follow some time-honored strategies, Soule advises. Infection prevention is less about bugs than humans, requiring relationships and partnerships to get an expanding job accomplished. "Learn how every department and service functions so that you develop relationships with people in those areas and know how things work," Soule says. "When things don't work, you will know that too."

As a more diverse work force takes on an evolving job, there is increasing interest in exposing medical and professional students of all stripes to a basic course or two. That could lay the groundwork for infection prevention to become an earlier career course, as the traditional pattern of a "second-career" segue from nursing or another area gives way to a new generation of IPs. "We have been trying to make that happen for a long time, to get infection prevention education into the curriculum of nursing schools and medical schools and other professional schools," Soule says. "It would be great to have a whole course on it as part of the basic curriculum for medical training."

Some graduate degree programs are now available, and the general trend Soule sees is a distinct profession that is increasingly interactive with complementary disciplines. "I would really like to see us have some infrastructure for infection control so we know that people coming in are competent," she says. "I don't see this profession as a stand-alone silo, but aligned with quality, patient safety, and environmental issues."