|
How did you begin working with systems?
From the time I was 12 years old, I've known that I
wanted to be a nurse. After working as a nurse manager,
I saw that I wanted to communicate with the administrative
side of health care and speak its language. Nursing
needs a voice in the boardroom.
My MBA led me to look at systems theory and ways to
conceptualize systems within hospitals. Ann Van Slyck,
MSN, RN, FAAN, was one of those people [I admired].
She helped design a plan for managing patient care for
a hospital in Phoenix and then started a consulting
firm to share it. I saw her creation, which was a systems
approach, as a method of promoting the professional
practice of nursing.
Health care needs to embrace systems that don't ask
a nurse to do more than integrate new systems into what
they already do. Patient acuity, for example, is about
the patient, so it should be part of the patient's medical
record, not a separate system.
Nurses engage with our patients in many ways, and a
systems approach best captures all that varied information.
It can be used at the bedside as well as the boardroom.
I want to make what the nurse does more visible and
recognize all available skills instead of just targeted
tasks-to celebrate the things the nurse already is doing
and document it.
We all bring a certain foundation to nursing practice.
The technical aspects may differ but there are some
things we all do.
Using the systems approach, I work with a core group
of staff nurses and nurse leaders to look at the facility
and define its patient population along a continuum.
I want to reach and assist the nurse in the back hall,
the nurse on the evening shift who may or may not get
recognition for what he/she does.
Services need to be quantified and weighted for their
importance with each patient. The nurse needs tools
to highlight what's already being done. There are tools
that a nurse can quickly use to document the teaching,
interventions and professional services provided.
However, these services also might be exhibited in
other ways, such as showing a lower acuity or capturing
information about how quickly the patient has moved
along the continuum of care.
I'm very concerned. The average age of a nurse last
year was 47. Aging baby boomers soon will need nurses
and there's not a large enough workforce to take on
the task.
The profession has expanded. Ten years ago, the hospital
was the major employer. Today, nurses have moved far
beyond the hospital into such directions as home care
and insurance. Many more avenues are open to nurses.
This diminishes the employment pool for hospitals.
Good leadership is the key. We have to listen to our
staff nurses and be proactive so nurses can deliver
good care, feel good about their work and respond to
personal needs. Some of the recent legislation comes
from unmanageable workloads and environments that are
not nurse-friendly.
We need systems, for example, that help hospitals implement
staffing by looking at patterns of high turnover, such
as admissions and discharge, and implementing creative
staffing, while being sensitive to nurses who have work
schedule constraints.
What I'm seeing around the country is that nurses love
what they do and they want enough time to provide everything
their patients need. One ramification of the nursing
shortage is that people are coming together to promote
and articulate what nurses do. They also are becoming
more vocal about the good parts of nursing. Nurses are
getting in touch with what they value.
In his research, Peter Buerhaus, Ph.D., RN, FAAN, also
has shown that there is a correlation between the number
of hours of nursing care and better patient outcomes.
We've got to retool our systems for that nurse at the
bedside and celebrate doing what they do best. The professional
nurse at the bedside is needed to provide quality care
and my mission is to provide systems that support this
precious resource.
Nurses do make a difference and we can celebrate that
through the systems we embrace.
|
