Lucille - Keep Adding Lenses

Lucille -







Executive nurse leaders are truly trying to balance the multiple demands and competing priorities in the whole universe of healthcare, for the ultimate good of the patient and staff. But the reality is the competing priorities are so large and so complex that it is very murky. It’s hard to see what it is one is doing, especially when one is in the trenches, so to speak. It’s not part of the educational process to be educated about how your administration functions. We learn our own roles, but we don’t learn the role of the other. So we deal with our allocation and we don’t see how it fits into the big picture.

The result is that we’re all living in what I’d call silos, not seeing or understanding the complexity of the decision-making by another person. We just look at the final decision and judge it. It’s very easy to make judgments that are sometimes incorrect. My view of the nurse executives I’ve worked with is that they work very hard to make the best decisions they can within the structure that exists for them.

It’s easy, when you’re four inches away from the patient – and I’ve been there – to make some judgment about them or the administration that may or may not be accurate.  That piece is separate from and yet intertwined with how to communicate across these silos in which we find ourselves. Touching the heart is something that takes time, and that is easy to put aside when you’re rushing and doing all of the things that need to get done. After all, a nurse’s role is to be with the patient on the sacred ground of that patient’s life.

Nursing involves both technical and thinking skills about the patient. But it also involves technical and thinking skills about processes and systems. That’s not as evident, nor is it something that we have time to do. And it’s not something that you do easily and consistently when you are learning the basic technical skills of nursing."Nursing involves the whole person of the patient, but it also involves the whole person of the nurse." The problem is, if you don’t progress to higher levels of learning in a formal way, you get stuck delivering good technique, but never get to the highest level of thinking. I’ve personally never known a nurse who would say, “I’m a bad nurse.” Being a good nurse is important to them. But there’s a difference between being a good nurse, and being at the highest possible level of thinking.

My comment to students is that to graduate from my program you must be technically proficient. That is absolutely necessary, but  not sufficient by itself. Sufficient means you also have to be able to simultaneously employ critical and reflective thinking skills.

One of my students commented that as she progressed from an LPN to an RN, her perspective changed because she had added knowledge, and information, and viewpoints. She found herself looking at familiar situations and seeing them from an entirely different lens. It’s the addition of those lenses that makes the highest functioning level of a nurse. The more lenses we can put on, the more ways we can see and hear things.

Nurses talk about having an intuitive feeling about patients.  Those who have been in practice and seen enough patients develop antenna that help them to recognize subtle changes –physical changes, communication changes, psychological changes.  But truly, picking up on subtleties requires a nurse who’s reflective, one who can say, “I’ve seen this before. I’ve heard this before. This doesn’t feel right.” It involves all the senses.  Nursing involves the whole person of the patient, but it also involves the whole person of the nurse.

I am passionate about nurses advancing their knowledge level and finding ways to make that possible.  That’s my passion in life.  I ask myself how I can start with the student at the very beginning level, and inspire them, and encourage them, and then keep them going?  It’s never ending.  We’re not the only profession in which it’s never ending, but it must be when you’re taking care of human needs. We do what we do for a variety of reasons and they’re all good, as long as it’s for the ultimate benefit of the patient.  That’s what most nurses would say:  “It’s for my patient.

Power Strategies:  Universality, Influence, Love
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