Recent back-to-back nursing meetings gave me a lot of food for thought. After attending conferences, I like to find the overall theme—not just from the scheduled topics, but from the posters and the exhibits and the general “buzz” from conversations. Here’s my take on the two meetings I attended this month.
This conference started with an opening session focused on quality from a consumer point of view. Keynote speaker Harry Greenspun asserted that today “it’s the patient or family’s responsibility that the right thing happens at the right time by the right person.” Nurses, he said, are the group that needs to engage and empower consumers (who, he said, should only be called patients when they are receiving care) in improving care.
ANA president Pam Cipriano added that “nurses are the ones doing the work on quality—all the projects and quality improvement is being done on the backs of nurses.”
While some sessions focused on specific clinical practices (reducing hospital-acquired infections or falls, for example), many focused on broader aspects of quality improvement—how systems can support QI change and integrate new technology (mobile apps, simulation).
There was also discussion relating to staffing strategies and teams (though the cynic in me feels that much of the strategies and goals are moot if staffing numbers aren’t appropriate) and a very good presentation by the Virginia Action Coalition, which looked at what organizational factors would promote the ability of nurses to work to the full extent of education and scope of practice. (Findings: having a baccalaureate degree was important. Also crucial was leadership that embraced change. Barriers were lack of interdisciplinary teamwork, workplace disruptions, and inadequate staffing.) Just think of what it could look like if there were enough nurses in hospitals and they were able to practice without bureaucratic constraints limiting full professional practice!
The bottom line: There’s a lot going on in many places to advance quality; the success of these efforts ultimately comes down to implementation by staff; Cipriano is right: ” . . . quality improvement is being done on the backs of nurses.”
The Creating Healthy Work Environments conference was also in mid-March. The focus was on helping nurses to “develop, implement, and maintain strategies that will improve their organization’s work environment.” It certainly covered this, and sessions included topics focusing on communication, safe patient handling, stress, work–life balance recognition programs, and one or two on staffing.
But I was struck by the preponderance of sessions dealing specifically with incivility and bullying (in both academia and practice settings). Many of the sessions described the various phenomena and their prevalence and offered suggestions for how systems needed to change (leadership setting the tone, zero tolerance, etc.). Clearly more needs to be done to provide support to individuals.
The bottom line: It’s pretty disheartening that the primary problem contributing to an unhealthy workplace seems to be how we relate to each other. If where you work has dealt with this issue successfully, we’d love to hear about it!