AACN News—June 2003—Opinions

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Vol. 20, No. 6, JUNE 2003

President's Note

Bold Voices
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 site at http://www.aacn.org > NTI.

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 patients.

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 for patients.

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 nurse.

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 their control.

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.

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