AACN News—September 1999—Opinions

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Vol. 16, No. 9, MAY 1999

President's Note: ‘Out-of-the-Box’ Ideas Can ‘Rock’ Your World
By Anne G. Wojner, RN, MSN, CCRN

President, AACN

A few weeks ago, Jan Foster, a close friend and secretary-treasurer of AACN Certification Corporation, joined me at a reunion concert featuring Foreigner and Journey. My 17- and 13-year-old daughters would have been horrified to see their mother and “Miss Jan” dancing in the aisles and singing along with these rock bands the entire evening. The show was great, and certainly brought back memories!

I, like many of my baby boomer colleagues, love rock ’n’ roll, and believe that I grew up with the best of it. It’s hard to compare today’s musicians with great artists such as Eric Clapton, Bruce Springsteen and, of course, the Rolling Stones. I find it reassuring that they continue to produce exceptional, original music well into their 50s and 60s.

However, most of the rock groups from the ’60s, ’70s and ’80s that are still touring no longer consist of the original band members, nor do they play new tunes. Groups such as Foreigner, Journey, Santana and Chicago consist primarily of musicians who have learned to fill in the gaps for those who are no longer willing or able to “rock on.” Consequently, maintaining our musical traditions becomes more challenging each year, because, although the replacement band members are extremely talented, the music just doesn’t feel or sound the same.

Just like baby boomer rock ’n’ roll musicians, the nursing workforce is also aging. In fact, most AACN members, as well as the nursing profession at large, fit a demographic profile that is similar to mine: We are “40-something” females. Within the walls of academia, the average age of the nursing faculty has risen even more sharply, to “50-something.”

Although we are attracting younger nurses to both practice and academic settings, many of them find it difficult to fit in with the crowd. Compared with the “average” nurse today, our younger nursing colleagues think differently, don’t support doing things “the way we’ve always done them” and prefer to beg forgiveness instead of asking for permission. To the more “seasoned” nursing professional, this may seem like disaster; but is it?

When people who are different from the norm step into our lives, they tend to “rock our world,” making us feel threatened. Whether it’s a difference in appearance or a difference in philosophy, we tend to fear those who are from outside our box.

Over the course of history, people who didn’t fit existing molds have been persecuted, outcast and ridiculed. Yet, the greatest moments in the history of mankind, not to mention nursing, have in common the leadership of “out-of–the-box” thinkers.

These types of leaders are often labeled by the status quo as “dangerous,” “different” or “black sheep.” They don’t fit in. They challenge the way things are done, and they propose new rules that are based on a different set of values. Quite commonly, the status quo tries to remake these pioneers into a more comfortable, traditional image. However, just like the musicians who try to replace old rock stars, this kind of change is unnatural; it simply is not meant to be. Most importantly, it builds a climate of distrust that is based on disrespect for diversity.

Have you ever been labeled a “black sheep”? It’s not the most comfortable feeling. Nevertheless, “out-of-the-box” leaders consider such labeling to be fantastic compliments. Holding on to the “way we were” at a time when change is the only constant in our workplace just doesn’t make sense. Instead of being “turned off” by style differences, we should be “turned on” to new ideas, new rules and a new way of thinking about nursing. If clinging to the past was of value in helping us to climb this mountain, we wouldn’t be facing the challenges we face today.

I’m not suggesting that we should carelessly toss aside everything near and dear to our professional hearts. However, I believe there comes a time when we must reflect on what was, kiss it goodbye, assess our current reality and deliberately set off in a direction that best suits our needs and the needs of those we serve. Sounds easy, right? If only it was!

We are on a journey into the future, and no one knows exactly which way we should go. Unlike a traveler at a fork in the road, it’s not even clear where these roads or paths are. I am certain each of us would agree that to retreat or stand still,

instead of continuing to move forward and explore, would not serve us well. Change is difficult and requires tremendous courage. If we don’t keep our eyes focused ahead, we will be incapable of responding to the needs of current and future generations of both nurses and patients.

Think about what should change in your workplace. Is it a specific practice; the culture; teaching methods; attitudes and behaviors; or values? If we turned to our new or soon-to-be nurse colleagues for some “out-of-the-box” suggestions on how to enhance our relevancy and improve our workplaces, we would be moving ever closer to ensuring a fantastic future for our profession.

As for rock ’n’ roll, I’m learning to enjoy today’s new groups. My daughters are exceptionally good at mentoring their “old” mom. I particularly enjoy the Dave Matthews Band and the New Radicals; yet, I never would have discovered them had it not been for these two very different, “out-of-the-box” leaders in my life. Without a doubt, my daughters will continue to help me build my CD collection with “new tunes for new times.” So, while I’ll always love my rock ’n’ roll, I guess the best way to sum things up is with the words of Bob Dylan: Like a rolling stone, life goes on.

My Turn: Transport Decisions Require Input of the Bedside Nurse

Shown is the LifeWATCH patient transport service of Wesley Medical Center in Wichita, Kan.

By Tamara J. Bauer

The decision to transport a critically ill patient to another facility is often made quickly—whether it be a trauma patient requiring immediate surgery, a newborn needing the highly specialized care that is available only in a neonatal center, or a cardiac patient needing further tests and procedures in an ICU. Critical care nurses are involved in this transfer process, either directly or indirectly. We prepare patients to be transported and care for them en route or when they arrive at the receiving center. Therefore, we are the best ones to ensure that the transport is in the patient’s best interests and that it is done safely and by qualified individuals.

When a transfer is required, a referring facility may have several options available, ranging from a local emergency medical service ground transportation team to a regional flight team. The facility may deal with a transport team on a regular basis or have little experience with them. The question is: How do we, as critical care nurses, evaluate the options available for transporting our patients and make sure the best method is selected?

An important factor to consider in selecting a transport service is whether it is accredited by the Commission on Accreditation of Medical Transport Systems (CAMTS). This accreditation is a voluntary process through which a medical transport service is certified as meeting certain standards, which address issues of patient care and safety in fixed and rotorwing services as well as ground, interfacility services. These accreditation standards are reviewed periodically, with input from all healthcare disciplines, to reflect the changing environment of medical transport.

CAMTS, which became operational in 1991, is a nonprofit organization dedicated to improving the quality and safety of medical transport services. Sixteen member organizations, including AACN, are represented on the CAMTS Board of Directors.

Many critical care nurses are directly involved in flight nursing or in preparing or accepting patients transported by ground or air, making involvement with the commission a natural fit. As a member of the commission, AACN has input to ensure that the quality of patient care is maintained throughout the continuum of care.

As of March 1999, 71 medical services, including one in Canada, have been fully accredited. This number represents approximately 25% of the existing programs in the United States.

Any accreditation process can be a challenge. However, by voluntarily participating, transport services are able to verify their adherence to quality standards and to demonstrate that in their industry. The process also forces services seeking accreditation to organize their practices into written policies.

Representatives of the accredited services say they feel that the process strengthened their programs.

Other organizations that are members of CAMTS are the Aerospace Medical Association, Air Medical Physicians Association, Air & Surface Transport Nurses Association, American Academy of Pediatrics, American Association of Respiratory Care, American College of Emergency Physicians, National Association of Neonatal Nurses, National Association of State EMS Directors, National EMS Pilots Association and National Flight Paramedics Association.

Tamara J. Bauer, RN, CCRN, CFRN, is the AACN liaison to the Commission on Accreditation of Medical Transport Systems. She is a flight nurse for LifeWATCH, a CAMTS-accredited transport service at Wesley Medical Center in Wichita, Kan.

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