Saturday, August 18, 2007

A remarkable profession

I met this week with the staff of Three West, a nursing unit that includes both telemetry (heart) and oncology (cancer) patients. These meetings were make-up sessions because the busy 3W nurses did not have time to attend my last ’round-the-clock employee meetings.

3W is a busy place with nurses caring for patients in space that, despite various improvements over the years, maintains the same basic configuration as when the hospital opened. Patient room sizes are unchanged, but over the years we’ve added more medical equipment, and visiting is no longer limited to a few hours a day. We pack more electronic equipment into today’s care environment. The nursing station is a center of biotelemetry displays. Caregivers use electronic health information systems[1] in charting areas that are undersized. As we move to CPOE[2] next year, the need for more equipment will only increase.

The 3W census is high, and the work demanding. So what did I hear from staff when we met during morning and afternoon shift changes? They suggested ways to better meet the needs of patients. They talked about more special patient chairs, about bed replacements, and about the better use of space in patient rooms. They told me about the importance of patient safety, and they suggested ways we might improve customer service.

These are nurses you read about –professionals with demanding jobs in the complex world of acute care hospitals. They wear sensible footwear and scrub tops. They spend remarkably long hours on their feet. They meet exacting standards every day. They deal with complex medical problems and with difficult family situations. Yet, they have smiles for patients and encouragement for families.

The whole nation knows about the nursing shortage, and these nurses experience it firsthand. There are openings on 3W, and recruitment is underway. In the meantime, nurses work overtime, and the hospital fills gaps with per diem and agency nurses.

There’s an open house planned for job applicants[3], and some 3W staff members plan to participate so prospective employees get a chance to meet the people with whom they would work. The professionalism and collegiality of nurses are the best recruitment tools we have.

The day before I met with 3W staff, I received a letter from the son of a patient who died recently on that nursing unit. Here’s part of what he said:

…I want you to know how much we appreciate the care and compassion that the staff provided to my father. It was reassuring to our family to know that he was well cared for and valued in his final days.
“Well cared for and valued.” Who could wish more for one’s parent during a difficult hospitalization?

It’s a remarkable profession, nursing, and it’s a remarkable group of individuals who choose to practice their profession in the demanding world of an acute care hospital.

[1] In 2006 the hospital installed Sunrise Clinical Manager (SCM), a product of Eclipsys® Corporation, that provides immediate, secure access to patients' health information and improves the quality and efficiency of care. SCM features a state-of-the-art workflow engine, embedded evidence-based content, and sophisticated clinical documentation capabilities. For more on SCM at Community General, see the Eclipsys news release.
[2] CPOE means “computerized physicians order entry,” and Community General will be implementing CPOE in 2007. Studies indicate that the structured orders of CPOE systems can significantly reduce the potential for serious medication errors.
[3] There's a job fair, Monday, August 20, on 3W from 11 am - 2 pm and from 4 - 6 pm.


Terry said...

I applaud your effort, Mr Quinn, to personally meet with your nursing staff. It shows that you care about what nurses think and what they go through. You must have a great staff for them to be so loyal to their work area and patients. But the fact that they are so busy that they can't even attend a meeting is troubling.That in itself, speaks volumes. Most nurses would rather have a root canal than attend meetings they feel are non-productive. Forty-five minutes at a meeting is 45 minutes you have to make up when you get back on the floor. My suggestion is to hold meetings away from the work area.Someplace pleasant and relaxing.Away from the beepers, cell phones and intercoms. Be innovative. Go outside under a tree.Take them to lunch. Members of management go on retreats all the time to help them emotionally recharge and brainstorm. Invite "battlefront nurses"to give you a real unbiased assessment on what needs to be done.You want a big turn-out? Have a chair massage therapist available for your staff. They way they work, they deserve it!

Tom Quinn said...

D. sent me the following e-mail message on August 20, 2007:

Thank you for your very appropriate words and sensitivity for a unit that handles two major services and does it well.