Speak Up for a New Tomorrow
By Connie Barden, RN, MSN, CCNS, CCRN
President, American Association of Critical-Care Nurses
Following are excerpts from the Presidential
Address delivered by AACN President Connie Barden, RN, MSN, CCNS, CCRN, at the
opening session of the National Teaching Institute and Critical Care Exposition
in San Antonio, Texas, in May 2003. Printed copies can be obtained by calling
(800) 899-2226. Request Item #006103. It can also be downloaded from the NTI Web
It is with great joy and pride that I raise my
voice to celebrate the courage we have mustered and all we have achieved
together in the past year. The boldness of our voices has begun to create the
change so desperately needed throughout healthcare-in our work environments and
in the lives of our patients and their families.
We are powerful as individuals, and we are even
more powerful in association. As your association, AACN has leveraged our power
to achieve significant accomplishments this year:
� AACN advocated for legislation to limit
mandatory overtime. Three states have enacted laws prohibiting this dangerous
practice, and 21 more have introduced legislation to bar it.
� AACN was a voting member of the Joint
Commission committee that developed core measures to guide quality improvement
activities in ICUs.
� In testimony to the Institute of Medicine
Committee on Work Environment for Nurses and Patient Safety, AACN demanded
healthy work environments for nurses and colleagues.
� AACN and the AACN Certification Corporation
published the most definitive report ever on certification's links to patient
safety, and nurse recruitment and retention. We have boldly challenged employers
to support continuing education and certification for nurses.
� AACN joined others in the nursing profession
to create solutions to help mitigate the devastating impact of the nursing
shortage. In alliance with industry partners, the Americans for Nursing Shortage
Relief was instrumental in ensuring passage of the Nurse Reinvestment Act. In
addition, AACN supported the advertising efforts of the Nurses for a Healthier
Tomorrow coalition and the Johnson & Johnson Campaign for Nursing's Future.
� AACN collaborated with other nursing
organizations to design Nursing's Agenda for the Future, a strategic plan to
ensure the future health of our profession. An important component is a
landmark, nationwide study to show the positive impact that nursing care has on
the financial bottom line of healthcare institutions.
The strength and energy to achieve all this came
from our common vision about the future of healthcare and our collective
realization that this future will not be created without our voice.
To find the best role for us in effectively
transforming healthcare, we must study and understand the forces affecting
nursing and healthcare. For AACN, this means listening to our members, studying
the environment, collaborating with others and experimenting and implementing
new designs for a future that brings us closer to our vision-one where the
healthcare system will be driven by the needs of patients and families, and
nurses will be present, making their greatest contribution.
I am tired of talking about the dire predictions
for the future. I'm ready for solutions that will take us to a different future.
We can create this future if we are willing to make commitments to:
Be Led by Our Purpose
Despite different points of view and priorities
about nursing and critical care, we share a common purpose so compelling and
powerful that we become more determined and stronger because we so believe in
it. To me, this is crystal clear: If our healthcare system doesn't work, then
our patients are in danger. That is where we must draw the line. If our patients
aren't safe or don't feel safe when they are in our care, things must change.
Anything that gets in the way of achieving the best possible outcomes for
patients must be eliminated.
If we do not act by speaking up, how can we
expect others to value who we are and what we do? Nurses save lives. Nurses
rescue patients. Nurses do for others what they can't do for themselves. We
interpret data, give treatments, direct care and act on the results. Because of
our knowledge and skills in medicine, science and nursing practice, we prevent a
host of complications and bad outcomes for patients. We take patients from
crisis to resolution. We bring about life-altering outcomes that are only
possible with expert care further validated when we become certified nurses.
Use a Bold Voice
After hearing from thousands of nurses who are
torn by challenges, yet speak with courage and make change responsibly, I am
convinced that developing and using a bold, focused voice is the only way we
will create the changes that must occur. 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.
AACN has chosen to focus its voice first on the
pain we experience in our work environments. Disrespectful and noncollaborative
behavior creates negative, demoralizing and unsafe conditions that directly and
adversely affect not only nurses' satisfaction, but also patient safety. Because
of this, AACN has demanded a "zero tolerance" stance on abuse and disrespect in
the workplace. We must set a new standard, where the contributions of all team
members, including families, are respected and honored in the care of our
We also need effective systems that support our
success. Broken systems that don't allow nurses the time needed to manage
patient care at the bedside increase the burden and contribute to bad outcomes
We must adjust our patient care models to
recognize the fact that we will never have enough nurses to continue practicing
as we do now. Instead, we must be willing to ask-and answer-the tough questions
about safe and effective staffing in critical care units. We must be willing to
look critically at the needs of our patients and match them to the abilities of
The AACN Synergy Model for Patient Care and
AACN's Blueprint for Staffing outline this approach perfectly. The clear fact is
that when the right level of nursing care is not available, negative patient
outcomes-complications and mortality-increase.
Be Responsible for Our Future
It isn't adversity that defeats people. People
are defeated by their inability to see how to change the way things are. They
often feel powerless, victimized and battered by circumstances that seem beyond
So, it is no surprise that nurses might wonder
how they, as individuals, can make a difference in this madness we call
healthcare. Yet, no one else is more qualified, more called, more prepared and
more driven to make the changes needed to create a better future for healthcare.
AACN believes that solutions to the critical
issues of inadequate staffing and the nursing shortage will not be successful or
lasting unless the problem of unhealthy work environments is corrected. Now is
the time to act-deliberately and powerfully. To focus our voices and our actions
on tackling the painful issues we face in our work environments. To work on
these issues relentlessly until they are resolved.
I invite you to raise your own bar and take the
step to becoming the powerful force that can create a new future. Tomorrow is in
our hands. And it is the voices and actions of thousands of critical care nurses
boldly declaring a new vision for healthcare and a new day for nurses that will
create that new tomorrow. Act boldly-it's up to you and me.