« The best reason | Main | Introduction to In Our Own Words: Medscape Nurses Blog »

May 04, 2005

Change is good

Enough has been said about the problems in the nursing field. It is refreshing to read about the implementation of solutions such as the one below.

Nurseandpatient72x991_1Last summer, we opened a Nursing Redesign Unit at our hospital, a chance for nurses to actually design how their own work should be done. We've had successes and we've had resistance, go figure.

We began with a week long retreat learning about redesigning our work and our roles. To use the lingo, we had "Lean Training", did the "Airplane" exercise, learned about "High Level Process Mapping", we brainstormed, set up home teams, learned about   "PDSA (Plan, Do, Study, Act)" cycles, set up a Kaizen board for our unit, we even spent 2 days in Personal Best Training. (Editor's Note: See  Plan-Do-Study-Act (PDSA) Worksheet -- IHI Tool)

Our first few months brought successes. We created care teams, specifically listing the roles of each member. We put our charge nurses and supervisor back to the bedside. Our nurse manager spends 4 hours a day with us on the unit. We redesigned our environment to reduce time spent searching for supplies. We created a more time efficient bed bath procedure and allowed our patients input regarding their personal care increasing patient satisfaction. We designed a more efficient shift report. We began self scheduling to improve staff satisfaction. We designed focus assessments which could be done in between the head to toe RN assessments done every 24 hours, cutting down on time spent charting.

Some staff resisted change, no longer wanting to offer solutions or try anything new, and they have left. We are having another retreat in June, a chance to regroup, refocus. With impending nursing shortages, we cannot downplay the importance of efficiently using the resources we have.

Bonnie Hermann RN, CMSRN

The Business Case for Quality: Case Studies and Analysis

Is Six Sigma the Answer for Nursing to Reduce Medical Errors and Enhance Patient Safety?

Institute for Healthcare Improvement

May 4, 2005 in What I Do | Permalink


Dear Bonnie,
I am a student nurse entering my 3rd year of the BScN program. I was impressed with your commitment to higher quality patient care, teamwork and a more productive work environment through the Nursing Redesign Unit at your hospital. Perhaps you can tell me the name of your hospital, as I am seeking to work in a progressive work environment dedicated to the perpetual improvement of nursing care.
Kate Anthony

Posted by: kate anthony | May 21, 2005 12:49:44 PM

I have been an RN for a while now. First as an ADN grad, then completed the BSN in 1998, and will graduate in August, 2006 in the MSN/FNP/Education tract at the local university in Western North Carolina.
Change is good. I have worked in ICU, Home Health, Employee Health and Education, and most recently in Neuro at a fantastic rehabilitation hospital in Asheville, North Carolina.
Every venue has been a learning experience for me and I enjoy working in a variety of settings, each of which I have started at ground zero and learned new aspects of nursing along the way.
I hope to take with me the learning experiences of all my years in nursing and move up to the next level as an FNP and hopefully as an educator one day.
The only constant has been change.
What has not changed are the grassroots of bedside care and choosing how I interact with clients.
I learned long ago when I see patients, often times they are not at their best.
Empathy and understanding goes a long way, and as years go by, I tend to talk less and listen more.
It is my hope that in the future, nurses will support each other more, become a science of their own and continually strive to advocate for patients, their specialized line of work, and for nursing as a profession.
Being a minority in the field has it's ups and downs, but at the end of the day, I still enjoy my work, and hope that I will still have that joy working with clients as an FNP.
Happy Nurses Week to all my colleagues world wide.

Chris Manick

Posted by: Chris Manick, BSN, RN | May 17, 2005 11:25:30 PM

This article shows there is still promise out there amongst bureaucratic institutions as long as transformational leaders exist! Wish this group had been at my facility!

Kerry Dudley, RN, BSN

Posted by: Kerry Dudley | May 10, 2005 8:21:53 PM

I have come to the realization that to practice Nursing is not just a profession it is a vocation.
I have been a Registered Nurse for 35 years and a Nurse Practitioner for 9 years and now at 56 I have the chance to expand my practice and work in Bariatrics ( no pun intended) and even do some theatrical acting and take up golf and bicycling and I am already teaching the NP candidates from St. Xavier and my big dream is to work in Africa someday with Dr. Paul Farmer as a Partner in Health...so Nursing is electric and eclectic!
It is grabbing life with both hands and living and loving ...patient care is hard and wonderful at both times and caring is creative and draining but wow it is so rewarding. So celebrate your gift of caring and nuturing and keep on Nursing...we need each other.

Posted by: Jeanne Dougherty | May 10, 2005 6:31:32 PM

The comments to this entry are closed.