Paul Merrel (BSN `90, MSN `93) belongs to an endangered species:
he is an experienced critical care nurse who still practices at the bedside. And he’s never been tempted to leave.
“It’s what I feel called to do,” says Merrel, who’s been a nurse for more than four decades. “The bedside is where I like to be, and I’ve been fortunate to have found ways to stay there.”
These days, that kind of staying power is the exception. The mass exodus of nurses from the frontlines of patient care has been likened to an epidemic. New nurses typically work in acute care settings for a few years to gain experience, then quickly move on to pursue an advanced nursing degree or pivot into other roles, such as teaching, administration, or management. Many abandon the profession altogether. About a third of new nurse graduates will leave the profession within two years, according to the American Journal of Nursing.
Merrel, a clinical nurse specialist at UVA Medical Center for the last 27 years, never viewed his job as a stepping stone. Over the years, he has grown and evolved with the profession, working in a variety of roles and settings—from caring for patients who’ve had cardio-thoracic surgery to those who’ve received transplants or who need treatment for severe burns. For the past 10 years, his experience and training in adult trauma and pulmonary critical care has helped him provide care patients with highly complex needs, where the path to recovery requires long-term care plans and a team approach.
“What keeps me from burnout is that I’ve always had more to do, and better ways to do it, and I’ve been able to work as part of a team with other caregivers,” he says. “That collaboration has been a great source of satisfaction.”
Merrel basically backed into nursing. In 1971, he was a college dropout without much direction. He took a job as an orderly in UVA Hospital’s surgical recovery unit, and found he enjoyed the pace of intensive care, where there was always more to learn. He saw how teamwork made it all happen. He enrolled part-time in Piedmont Virginia Community College’s nursing program and eventually earned an RN in 1978. Seeking the professional benefits of a baccalaureate degree, he earned a bachelor’s degree from UVA in 1990, then a master’s degree in adult critical care in 1993.
“My first year as a nurse was the hardest,” Merrel recalls. “Actually, the first few years were really hard.” Today, he counsels new grads who feel overwhelmed with the demands of bedside nursing to give it more time.
Also, he advises: decide where your passion lies and where you want to make a contribution.
“Recognize that there are a wealth of roles that provide patient care that don’t require you to leave the bedside,” he says.
As a senior nurse, Merrel’s roles have multiplied over time and, to him, that’s a good thing. Hands-on patient care has expanded to include teaching at the bedside, mentoring younger colleagues as well as advanced practice students in the School’s clinical nurse specialist program.
“Becoming a clinical expert while staying connected at the bedside largely defines the CNS role,” says Merrel. “It’s what we do.”
Mentoring has kept him motivated and shaped his own practice, too.
“Teaching forces you to look at what you know and how you know it,” he adds.
Merrel turns 70 next month. He hasn’t yet set a retirement date.