AACN News—July 2003—Opinions

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Vol. 20, No. 7, JULY 2003

President's Note-Bold Voices Make Sure Our Story Is Heard

By Connie Barden, RN, MSN, CCNS, CCRN
President, AACN

Following are excerpts from the closing ceremony address delivered by 2002-03 AACN President Connie Barden, RN, MSN, CCNS, CCRN, at AACN's National Teaching Institute and Critical Care Exposition in May 2002 in Atlanta, Ga. Barden's theme for the year is "Bold Voices-Fearless and Essential."

The time has come to use our voices to steer healthcare in the direction it must go-not only for nurses, physicians and other healthcare team members, but also for patients and families who are quickly losing trust in our ability to provide them with safe, compassionate and expert healthcare.

For me as president of AACN this year, this means ensuring that AACN uses its voice as the undisputed leader for critical care nursing where it has the greatest impact on our ability to practice fully and safely and to deliver the best care to our patients. AACN will speak out on issues that affect critical care nursing practice and patient care, just as we have done by taking the stand that mandatory overtime is neither safe nor in the best interest of nurses or patients. Many other issues demand our attention, including those related to our clinical practice and to our workplaces. We will use our voice as the undisputed leader to influence these issues.

Speak Up
We must be certain that our colleagues know how vital nurses are to patient outcomes and why hospitals cannot afford to let nursing care be anything but the best.

This may mean talking with your manager, a colleague, a physician or even a reporter about issues that are important to nurses in your area. You may be tempted to step back and hope that someone else will handle an issue, but we must speak up and stop waiting for others to respond to our issues and dictate our fate. Our voice must be bold, clear and fearless, even when using it makes us uneasy or uncomfortable.

What is a "bold" voice? It isn't a blaming voice or a whining voice. It doesn't argue about who is right or wrong or about whose fault it is that we are faced with challenges. A bold voice moves past complaints to look for solutions. And, solutions will be found if we work with others and take the time, give the thought and have the patience to create the changes that need to occur.

Tell Our Story
Where and how can we use voice to alter anything in healthcare today? We can start by telling people what we do-regular people like neighbors, family, church members, friends, administrators, legislators and anyone else who thinks that nurses are simply nice people who do what doctors tell them, but never think or make decisions on their own.

They must know who we are and what we do. We save lives. We rescue patients. We act on behalf of others when they cannot act for themselves. We give treatments, monitor their effect, interpret data and direct care. And, because of our skills and knowledge about medicine, science and nursing practice, we prevent patients from having all kinds of complications and bad outcomes.

Until we give people the information they need to understand the importance of what we do, we cannot expect them to value it. And, until they value it, they cannot grasp the notion that the system will fail if there are not enough nurses around to take care of patients.

Deliver Our Messages
We must also become better at articulating what it is we need to provide excellent patient care. Too often, our response when asked what we need is to simply reply, "More nurses." Although we all agree that the nursing shortage will continue to have a huge impact on how we practice, there are other messages that we must deliver:

� To young people: Think about becoming a nurse! It's an exciting and challenging career. You can work almost anywhere-on a ship, on a plane, in a hospital or in a school.
� To nursing students: We welcome you to the bedside. We will mentor you and do our part to make you successful.
� To employers: We want to deliver the best possible care, and we want you to ensure that there are sufficient numbers of nurses and resources to allow us to do so. We will listen. We will learn with you.
We will serve on committees. And, we will tell you what we need to deliver good patient care. We will work hard, but we must be compensated appropriately for what we do. If we are to entice nurses to make a life-long career of this work, our salaries must reflect the fact that nurses are the backbone of the healthcare system.
� To legislators: We need your help. After all, we voted you in! You are in a position to enact laws to expedite nurses getting financial support for school, being able to move easily from state to state and being capable of functioning fully within the scope of their practice. You are also the ones who must make sure that healthcare is adequately funded so that hospitals can afford the resources they need-including adequate numbers of nurses-to provide care to our patients.
� To physicians: You are our number-one strategic partner in solving this crisis. We must work together-respectfully, collaboratively and continuously-to care for our patients and for the future of healthcare. No one knows better than you, our colleagues, that your work cannot be done without nurses.

Find the Courage; Find Your Purpose
What will allow and motivate us-you, me and AACN-to find the courage to be bold and use our voices in ways we have never used them? The inspiration that can give us courage and move us to be more than we think we can be is our sense of purpose. That which is so compelling and powerful that we become stronger, more determined and committed because we believe so much in its validity.

For me, this is where the buck stops. If our profession is in danger, our patients are in danger, and that is where I draw the line. AACN's vision of a healthcare system driven by the needs of patients and families cannot become a reality unless we begin to use our voices to make nursing known; to educate others about how our care changes patient outcomes and safety; and to be fearless in speaking about the realities of what we do and what the actual needs of nurses and patients are. Keeping patients out of danger requires that there be enough skilled, committed, well-paid and supported nurses. This purpose can carry us past our fears to use the bold voices needed to mold the future.

Join AACN and me as we begin this year using bold voices-fearless and essential voices that will shift the future of healthcare for us and for our patients.


Families Must Also Respect Nurses

Re: Viewpoint: Getting to Best Practice on Visiting Time (AACN News, May 2002):

As healthcare providers, we try to build trust and respect with every patient. But to be told that this is our job, when faced with threats of harm or lawsuits and other issues, I have to respond that families must instead earn my respect and trust.

As a critical care nurse with an MSN and 10 years of critical care experience, I understand that visitation is important to patient care and outcomes. In fact, I worked in a facility where open visitation worked well. However, the families respected the nurse's judgment and when asked to leave did so.

Now when we have a code and ask families to leave, it rarely happens. While working in the hospital, I have been threatened with bodily harm, dodged a punch, and told we would be sued. A family member actually struck one nurse. Dealing with intoxicated family members is becoming a constant. I could go on.

It's one thing to provide support, answer questions and address concerns, even with "overbearing" families, but a totally different issue when faced with these types of situations. I'm sure my facility is not the only one where issues like these arise. These problems take our focus away from what we are here to do, care for the patient.

I feel the authors should acknowledge that these issues are occurring, and that there must be some respect given to healthcare providers.
JoAnn Green, RN, MSN, CCRN
Painesville, Ohio

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