Susan Wise Stout may not be the most popular person at Memorial Medical Center, Baptist Campus, if you're talking to physicians, other RNs or hospital administrators. But it's another story if you're talking to any of the high-risk obstetrical patients who are there for an extended stay as she and her colleagues manage problem pregnancies.

Stout, a perinatal clinical specialist, said it's not always popular, but "You have to do what's right for your families. And the only people that can decide what's right for them are the patients and their families." Presented with their options, "it's up to them to make a decision. Then my job is to make it happen," she said.

Each week, Stout brings together all of the disciplines involved in care, from housekeeping to pastoral services, to meet with patients and discuss concerns that may be as simple as needing more food from the nutrition department or as complicated as a medical issue. Physicians are included in interdisciplinary rounds as equals, Stout said.

Outpatients are afforded the same review on a monthly basis.

Stout said that most surprising to patients is the level of case management they receive. "A lot of patients have cardiologists or nephrologists. My dialysis patients have all subspecialty disciplines: physicians, nurses and social workers.

"That's my function, to make sure that everyone understands what everyone else is doing," and at least for their hospital stay, patients can relax about their health care needs, she said.

Stout tells the story of a recent mother-to-be on complete bed rest and hospitalized for 14 weeks. It was the couple's first baby "and probably the only baby they were ever going to have. And they wanted a [baby] shower," she said.

"While that's not a high priority for a health care professional, it was a high priority for my patient and her family. So we as a group figured out how to do that, especially when the administration wasn't wild about it."

Stout had to apply the same creativity, with the same conviction of purpose, in order to become an advanced practice nurse. There was no perinatal degree program in her area, so she had to advocate for herself, which she recommends to staff nurses interested in advancing their careers.

"I have a 17-year-old and a 2-year-old, so it wasn't like I could leave town," Stout said. "I went to the university [Louisiana State] and said this is what I want to do. How can I get there?" She was afforded the invaluable opportunity to do a clinical rotation at several hospitals, enabling her to learn how things are done in a variety of settings.

"Nurses have to be open-minded to do things differently," she said, "so that's what I tell them to do: Go see how things are done."

Stout said her immediate goal is to complete a three-year dream of building a resource library for patients in a space set aside in a hospital remodeling project. She said she'll likely enlist the help of someone interested in a community service project to collect entertainment videos to supplement the health education tapes and publications she already has.

"I have the best job in the world," Stout said. "I'm afraid someone's going to figure that out."