By Matt Skoufalos
From the age of five, Tamara Kear knew she was going to be a nurse when she grew up. She can’t think of a time she’d considered any other profession.
“When I got into high school, I created my course load to lead me toward that direction and never went back,” she said.
Kear was raised around hospital talk because her grandmother, Mary, supervised the in-house bakeshop at Union Hospital in Terre Haute, Indiana. But during her own childhood doctor’s visits, “nurses were scary to me,” Kear said. It didn’t deter her from her chosen profession, but it made her realize that nurses didn’t have to be frightening – and when she became one, she carried the memories with her.
In the middle of her nursing school education at Gwynedd-Mercy University in Gwynned Valley, Pennsylvania, Kear’s father passed away. Suddenly, her mother, Marilyn, a Realtor, was looking at a career change, and she decided to enter nursing school as well. So while Tamara’s career was beginning in the med/surg unit at Doylestown Hospital in Doylestown, Pennsylvania, Marilyn was setting out on a path that took her from public school nursing to an eventual career at Children’s Hospital of Philadelphia (CHOP).
It was at Doylestown Hospital that Kear made her entrance into nephrology, the specialty that would occupy the bulk of her professional career. Her earliest moments in that education came on a floor where patients were receiving dialysis treatment.
“There was a very small patient underneath her covers in her bed, all balled up,” Kear said. “The nurse said, ‘Make sure this patient doesn’t get peritonitis.’ I spent the night reading through the policy and procedure manual, got a little bit of help from my supervisor … and my patient didn’t get peritonitis.”
“[From that experience], I realized how much I enjoyed caring for the chronically ill population who had a lot of physiologic imbalances,” Kear said. “I knew from the beginning that this was probably going to be my career path.”
Not long after, she got a job in the dialysis unit at Thomas Jefferson University Hospital in nearby Philadelphia, and six months in, began a master’s degree program to help patients with kidney failure. That led to an internship with a local organ procurement organization, and an advanced practice role as a clinical specialist at Jefferson. The majority of her career since has been spent in nephrology nursing.
Kear attributes the reason she’s stuck for so long in the field to a single word: community. In the years she spent in patient care at Jefferson, many of her patients received continuing care. Some would be in three times a week for a decade or more, and others far more briefly. However long she spent with them, Kear enjoyed the sense that she was making a difference in their lives, whether improving the quality of care they received, or simply making them as comfortable as possible throughout a difficult experience. She also honed her voice as a patient advocate, a skill that’s aided her on her parallel career track as a 20-year undergraduate nursing educator.
“I’ve had the opportunity to see my students go on, change roles, get degrees and move the profession of nursing forward,” Kear said. “I continue to see the impact of the changes they’ve made.”
One of the challenges she faces as an educator is preparing her students for practice. The activities of nursing students are restricted by a variety of regulations, some from the world of health care, and some from the world of academia. In preparing them for graduation, residency, and eventually, a full-time career, Kear stresses the importance of delivering “the best education we can provide” through a variety of settings.
“It’s a very exciting time for us, but we struggle with building the pipeline and workforce issues,” Kear said. “Those who enter nephrology nursing, we’ve seen traditionally that they stay within the specialty.”
In addition to her efforts in the classroom, Kear also has traveled internationally with her students to provide health care to places that may not have electricity or clean water. In collaboration with Good Samaritan Hospital in La Romana, Dominican Republic, Kear’s students help deliver care into communities where Haitian immigrants live and work in the sugar cane fields.
“They have physicians, they have translators, but they don’t have the strong nursing piece,” she said. “We do our best to understand their culture, and then we bring the education that they may not have. The students become flexible; they learn to improvise to provide care without the modern conveniences.”
Kear said her students often develop an understanding of social determinants of health in countries where people form strong community bonds out of the necessity of survival. Americans who haven’t enjoyed those experiences at home return with a sense of connection, “and they come back enriched by what they have in those countries, which has nothing to do with money,” she said.
“When our students look at some of the challenges that we have in the United States, sometimes those challenges are no different,” Kear said. “Although the environment may look very different, a lot of those inequities still exist. That helps the students put it in context.”
In her free time, Kear enjoys spending time with her husband Brad; both are active runners. Their daughter, Kathryn, is a dietetic intern at Brigham and Women’s Hospital in Boston, Masachusetts, and their son, Colin, is studying business at the University of Vermont.