Sally - Hold Each Other Accountable

Sally -







When I was three I wanted to be either a nurse or an Indian maiden. I’m not Native American, so I became a nurse. Now, however, I jokingly tell myself I’m in the Indian maiden stage of my life. I say that because I am more adventurous and not fearful of the future. I’m able to lead in uncharted territory. I have a vision, but I’m also open to new ideas and experiences. So, in a way, I’m realizing both of my dreams.

I believe people must be genetically wired to be nurses. Did you know there are almost three million nurses in the United States? I find I bump into other nurses and I just know, “That’s a nurse.” Nurses nearly sparkle and seem to have an aura about them and it helps us to be drawn to each other. I connect with nurses all the time in places that are not medically oriented. It’s not like I can look at an entire room and say, ‘There’s one.” But many times there has been an immediate bonding that happens during casual conversation when I encounter another nurse. I think it’s almost spiritual – like we’re drawn to each other.

I, like many other nurses, have been told, “You should have been a doctor.” What people don’t understand is I chose nursing for a reason. Nurses tend to look at the world in a more holistic manner. We have a rich history of being able to provide care in a broad context. We do that by taking the time to understand the patients and the world they live in … who their families are. Nurses have this intuitive sense that there is more to a person than just the heart rhythm on the monitor. Nursing is bigger than medicine. That’s not to say physicians don’t care, because they do. But nurses look at the whole pie; the bio, social, psycho and spiritual.

Often nurses will say, “Well, I’m just a nurse.” I wonder why they would belittle their role in the health care partnership. I have never been inclined to minimize my contribution and I don’t think nurses should try to make their profession feel less than somebody else’s.“Nursing is bigger than medicine.” Nursing is the most trusted profession. It has been the most trusted for as long as trusted professions have been surveyed, except for after 9/11. That one year firefighters and police officers came out number one and nurses were number 2. But now nurses have returned to the top spot. So why, if the public thinks so highly of you, would you think so little of what we do?

Not only do nurses belittle their profession, sometimes they just won’t be there for each other. When a nurse is reaching burn out, or is in over his or her head, usually many nurses will rally and provide support to that individual. But there are other times when no help is available and you’re there alone. Maybe the nurses have their reasons for not being supportive, but I always feel two or three together can handle a lot more than one.

In addition to supporting each other, nurses need to hold each other accountable. I mean sometimes something doesn’t go well or somebody says something inappropriate or something doesn’t get done that needs to get done. We really need to step up to each other and make sure things get corrected. So many nurses write problems up and hand them to administration to fix rather than deal directly with each other. Educationally we need to help people be more comfortable with communication. Teach nurses to say, “You know, when I came on duty yesterday I noticed this didn’t get done. Can you help me understand why this didn’t happen?”

The irony is nurses listen to patients all the time. Why can’t they listen to their colleagues? Maybe the “offender” forgot or had some other crisis they didn’t think to mention to you. Maybe they didn’t know the duty was suppose to be done because nobody ever told them. There could be a million reasons. But there needs to be an opportunity to have that dialogue instead of just running it over to somebody else to fix.

Accountability is something I’ve been very interested in recently. The Institute for Healthcare Improvement has a 100,000 lives initiative. It was spun out of a book called To Err is Human which said that 98,000 people die annually in American hospitals because of medical mistakes. So this group has come together to set a target for saving 100,000 lives by putting into place certain practices that are proven to save lives. I was struck when I reviewed the practices because many of them are simply basic, good nursing care. They just had the celebration for over 122,000 lives that were saved.

What mystifies me is, it took a campaign in 2005-2006 to get people’s attention? I think the accountability piece is missing because of a fear of conflict. People don’t like to confront each other. Nurses aren’t trained to have good, confrontational conversation without sounding negative. I don’t know why some nurses may not confront. Maybe they are burned out, or maybe they are just mentally ticking off the tasks and not putting together the whole story. They aren’t realizing why this task is so important in relationship to the whole picture for the patient. So maybe a task gets missed because of a lack of critical thinking. It’s wonderful this has become a focus, but it’s something we should have been paying attention to all along.

I recently left my job as a nurse administrator to complete my doctorate degree. As I journeyed into nursing my dad pointed out there will always be people who are sick. You will always have a job. As I enter new, uncharted territory in my career, I know nursing will continue to provide exciting adventures for me.

Power Strategies: Accountability, Adventure, Communication
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