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President's Note
Rising Above: New
Questions, New Opportunities Giving Credit, Saying Thanks
DorrieFontaine,RN, DNSc,FAAN
Several years ago, Donna Diers wrote an
editorial about giving and taking credit. At the time, the former dean of the
Yale University School of Nursing was editor of Image, the journal of Sigma
Theta Tau International. Using her gift of simple and elegant communication,
Donna had a talent for making us rise above to pause and reflect about what
really matters.
In rereading the editorial, I was again
moved to recognize the power of her words and their value to nursing practice.
Giving credit. Saying thank you. Who are we forgetting to thank? What should we
take credit for as nurses and, as a result, stand taller?
As we approach Thanksgiving Day and the
holiday season, I find myself thinking about those I must thank for their wisdom
and care. Many are fellow nurses.
Recognizing the Potential
You may know Mary Foley as a talented
hospital nurse executive or immediate past president of the American Nurses
Association. I know her as a fellow teacher and doctoral student in the School
of Nursing at the University of California, San Francisco. The teacher part came
about last summer when Mary decided to tackle the growing shortage of nursing
faculty head on. She became one. (By the way, did you know the shortage of
nursing faculty is even worse than that in nursing as a whole? On average,
nurses are in their mid-40s. Faculty are in their mid-50s.)
Typical of Mary, she chose to teach
fundamentals, drawing in students with her passion and enthusiasm. I smiled when
a new master's entry student told me proudly "how cool" it was to learn patient
assessment from a past ANA president. I smiled because I knew her students were
learning far more as Mary introduced them to the magic of their new career.
Thank you, Mary Foley, a fellow association leader and stellar teacher.
Note for Rising Above: Would more bright
and clever nurses combine teaching with an advanced practice role if they
experienced the satisfaction and rewards of this logical combination? What if we
identified these nurses early on and coached them in that direction?
Identify Allies
Although Shelley Weilerman, critical care
nurse manager at the University of Mississippi Medical Center, may not be as
well known, the cleverness and impact of her actions are no less than Mary's.
Shelley introduced her institution's chief financial officer to the AACN white
paper on certification. She followed up with a meeting where she vividly
outlined how patient care and staff retention are improved by supporting CCRNs.
The outcome? Staff nurses who are certified can now earn up to $5,000 more per
year. New nurses in Shelley's units can count on being asked, "When will you be
joining AACN?" And, "When will you take the CCRN exam?" Thank you, Shelley
Weilerman, for rising above and finding new avenues to bring about the changes
we strive for.
Note for Rising Above: Am I rubbing elbows
with potential allies, but don't notice until I rise above? Should every nurse
aim toward certification or only the more dedicated ones?
Take Credit, Tell Stories
Two decades may seem like a long time. But
it is the blink of an eye for Patricia Benner, who celebrates the 20th
anniversary of her landmark book From Novice to Expert next year. The monumental
studies of Pat, her colleagues and students-many of them in critical
care-continue to point the way to developing expert clinicians. Coincidentally,
the first words printed on the coverleaf of her book are a vignette of a nurse
and patient with a "thank you" theme:
He could not speak, as he was intubated. He
could not write, as he was quadriplegic, and we didn't allow him to nod his head
due to his unstable neck fracture. His only communication was with his eyes and
his amazing ability to mouth words clearly and understandably � I just knew we
could resolve his problem � so I intervened in his behalf with his multiple
physicians � This incident is critical to me because it was what nursing is all
about for me. The point was made by one simple statement he made later in the
day. His words were: �Thank you. You've really helped me a lot. I don't want to
imagine what would have happened to me if you weren't here and hadn't cared.1'
Thank you, Pat Benner, for teaching many
generations the gift of taking credit for excellence in clinical nursing.
Note for Rising Above: How can we counter
the potentially damaging effect of media scare tactics by helping more nurses to
take credit and tell stories of clinical excellence? How can the trailblazing
work of Patricia Benner and her colleagues on clinical wisdom in critical care
help nurses become experts who think in action?2
Take Advantage of Wisdom
The 75-year-old mother of fellow nurse Ann
Williamson has resumed nursing practice. This is good, because patients,
families and nurses need her wisdom and care. Her decision couldn't have been
simple or easy, but I have no doubt that it was inspired by the same commitment
to patients and families that drew each of us into nursing. I hope that Ann's
mother will accept the gratitude of her nurse colleagues for leading the way by
her example.
Note for Rising Above: Will grateful
colleagues and excellent technology be flexible enough to allow us to benefit
from the wisdom of Ann's mother instead of burning her out as she runs up and
down hallways working overtime?
Thanksgiving 2003. A time to be thankful.
Thank a colleague and take credit for what you do each day for excellence in
patient and family care. And, at the table on Thanksgiving Day, honor them in a
quiet moment of gratitude.
P.S.: Share the Energy of Confidence
"Let me know the day [you take your CCRN
exam], and I promise to send you positive energy and good thoughts," I told
Julia during the NTI in May. I said the same to each one of you in my August
note. "E-mail me your exam date at dorrie.fontaine@aacn.org. I promise to think
of you and send each of you good thoughts as well. It's the least I can do to
help you create the possibility of CCRN for yourself." Thank you to the many
nurses who took on the challenge of becoming CCRNs and accepted my offer. I've
been told that my "passing rate" is near perfect, so it's not too late for me to
think of you. Send me a note.
Note for Rising Above: I marvel at how
confidence from a respected stranger can be as energizing as that of a trusted
friend. What does this mean for my work and home lives?
References
1. Benner P. From Novice to Expert:
Excellence and Power in Clinical Nursing Practice. Upper Saddle River, NJ:
Prentice Hall; 2000.
2. Benner P, et al. Clinical Wisdom and
Interventions in Critical Care: A Thinking-In-Action Approach. Philadelphia, Pa:
WB Saunders; 1999.
Letters
One Voice Is Better Than None
In response to the letter from the nurse
who was retiring (AACN News, September 2003), I am sorry to hear that she, like
many others, chose to retire early with a broken heart.
If every nurse whose heart aches decides to
retire without speaking up, then nothing will change. If we as nurses feel
passionately about how we are treated and fear for our patients, it is our
obligation as professionals to do something about it.
We may each have just one voice, but that
one voice can say so much and inspire so many others to speak up. If we all
choose to do nothing to change the way things are, you can be sure no one else
will do it for us.
Mary T. Carlisle, RN, MS, CCRN, CCNS, ACNP
Bowie, Md.
Think More About Our Families
Regarding the President's Note column (Is
It a Snake or a Rope? AACN News, September 2003), the "snake" or "rope" analogy
is terrific. I hope many readers will begin to think more about the families in
critical care (our second set of patients) and how we all look at end-of-life
issues and nursing competencies in that arena.
I will now adopt the AIR squared mindset as
an attitude for myself and encourage others to do the same, especially the
graduate students. Thanks for such an inspiring lesson!
Terry Tucker, RN, MS, CCRN, CEN
Baltimore, Md.
Saying �Hello' to Something Different
When I retired from critical care a few
years ago, I knew I had to shake things up in order to say goodbye to my once
wonderful and powerful world. I did not retire with a broken heart.
I bicycled for 366 days around the world. I
travelled 20,000 miles through 46 countries on six continents and saw so much
good in the world.
My views toward material possessions have
changed. In many countries my bike and baggage had more value than some of the
people would accumulate in their lives. But, they seemed content and happy.
Listening to people talk about their hope for the future and "good health" was
inspiring.
I do miss giving special care to special
people, but I left many coworkers who were intelligent, attentive, responsive
and reasonable.
Else Von Schopp, RN, CCRN
Brentwood, Calif.
Respect Key to Retention
Commenting on solving the nursing shortage
by education and retention methods, companies still don't get it. You can keep
infusing new blood, but it gets old and then it gets treated the same. Companies
save a few bucks with the new crop of nurses and get rid of tried and true
nurses, and the nightmare goes on.
As far as retention schemes go, most nurses
perceive them like the prize in the kiddie box at McDonald's. When companies
abide by standards like proper staffing and begin to treat nurses with more
respect, they will keep them around. Until then, I will travel and not depend on
some "suit" that has never been an RN to dictate numbers as a guide to
healthcare.
Steve Jaubert, RN, MN, CCRN
Kenner, La.
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