National award recognizes Frederick Health nurse for leadership, advocacy

Mar. 17—When she was in first grade, years before Marianne Hiles became a clinical nurse specialist at Frederick Health Hospital, she imagined life as a nurse as part of a creative writing assignment.

"When I grow up, I want to be a nurse," Hiles wrote. "I will go to the hospital very early and come home very late."

Hiles, 52, recited the story with a chuckle on Friday morning.

"I have no idea where that came from," she said. "No one in my family is a nurse, but it's always something that I've wanted to do."

Her story hangs on her office wall at Frederick Health Hospital, where Hiles specializes in women's health and perinatal care.

This month, Hiles was recognized as Clinical Nurse Specialist of the Year by the National Association of Clinical Nurse Specialists for both her work at the hospital and advocacy in her field.

She was nominated by a colleague in the U.S. Air Force, who Hiles said wrote a heartfelt letter to the organization with her support.

Aside from the patient care and nursing mentorship Hiles provides at Frederick Health, she is the co-chair of the county's Substance Exposed Newborn work group, which aims to educate community members about the affects of substance use during pregnancy, and is a conduit between the hospital and the Frederick community.

One of Hiles' overall missions as a clinical nurse specialist is to decrease negative health outcome disparities in perinatal care.

Hiles referenced a recent federal study by the National Center for Health Statistics that found an increase in the rate of maternal deaths from 2020 to 2021, with the highest mortality rate among communities of color.

"Our maternal health outcomes in the United States are dismal for a developed country," Hiles said. "My goal is to make a difference in the lives of women and children, especially in our community, with the health disparities and access to care."

One way she can improve health outcomes in her orbit, according to Hiles, is by training other nurses on recognizing implicit biases and teaching them the scope of health disparities affecting patients.

Another is the implementation of disparity-reducing measures, like reacting quickly to patients in need of critical care with the hospital's obstetrics rapid response team, or acting on protocols for patients who develop high blood pressure.

As a clinical nurse specialist, it's Hiles' job to help integrate these best practices in patient care, a role that was put to the test during the COVID-19 pandemic.

"Because, my role was to bring that evidence to the bedside," Hiles said. "And every day, there was something new to bring to the bedside. We would develop protocols, and then the CDC would come up with something new, so we'd have to change the protocols."

Each of Hiles' pursuits is in service of an ultimate goal to ensure patients and caregivers experience the joy of holding their baby, skin-to-skin, for the first time.

"For the whole family unit, whether there's a father or a support person," Hiles said. "It's just such a special time in a person's life to have a baby and it's the starting point of the rest of of that baby's life, but also for the mother, it changes the whole dynamic of her life."

As part of her award, Hiles was invited to the National Association of Clinical Nurse Specialists' annual conference in Portland, Ore., earlier this month.

There, she gave a presentation about her work in perinatal care, as well as her advocacy for a bill in the Maryland General Assembly that would grant prescriptive authority for clinical nurse specialists.

Hiles testified in support of the bill, SB 213 in the Senate and HB 278 in the House, earlier this year.

"I think it's really important to bring awareness to the clinical nurse specialist role and ... the way that we can improve outcomes for patients in all specialties, not just women's health," Hiles said of her advocacy and mentorship.

Hiles has ambitions of going back to school to earn her doctorate and be a pillar for the next generation of nurses.

"That's really what it's about," Hiles said, "empowering others to do this work."