AACN News—April 2007—Opinions

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Vol. 24, No. 4, APRIL 2007


President’s Note: Powered by Insight

Curiosity: Not Just for Cats


Tracy

The only very interesting answers are those which destroy the questions.
—Susan Sontag

And, I would add, those answers that produce new questions. At last May’s NTI, we set the stage for a new AACN year, during which we have focused on gaining new insights and uncovering their power. I encouraged you to join me in asking three questions. What’s working? What isn’t? What could we do differently?

Spend time with a 5-year-old and you’ll remember that asking questions comes naturally to human beings. Why is the sky blue? Why can’t that lady walk? Why does it hurt? While our curiosity reappears whenever we encounter something unfamiliar—think of your unit’s last orientee—we also learn to keep it in check. Perhaps we’ve been discouraged because questions seem to highlight what others don’t know. Perhaps we’ve discouraged ourselves when others don’t share our curiosity.

AACN is committed to promoting and supporting lifelong learning. For me that means continuous learning, not just conferences, workshops and academic degrees. Continuous learning demands curiosity and curiosity is the threshold to gaining insight.

Prototype of Curiosity
If asked, would you describe Leonardo da Vinci as a painter? Sculptor? Anatomist? Architect? Aeronautical engineer? All of these and more are correct. Da Vinci was, in fact, incorrigibly curious and a mesmerizing prototype of never-ending curiosity. For example, as the first person to examine and record anatomical cross sections, da Vinci would dissect each body part from at least three angles believing that multiple perspectives gave deeper meaning. Today we take it for granted that a 12-lead electrocardiogram is desirable because it examines the heart’s conduction from different angles.

We can all take a lesson from da Vinci’s continuous learning through curiosity. Michael Gelb applies da Vinci’s genius to our everyday lives in a very, accessible book titled “How to Think Like Leonardo da Vinci.” How developed is your sense of curiosity? Are you comfortable asking questions? What about being questioned? Do you like exploring an issue from different perspectives? Susan Sontag, the late essayist and novelist, was known for her seamless thinking. She often explored different perspectives by asking, “While X is true, isn’t there a case to be made for Y?”

Asking questions is a direct path to exploring, growing, learning. Gelb suggests sharpening our question-asking skills in several ways. Ask simple and naïve questions that sophisticated people may overlook. Ask awkward ones like: Is the real issue about family presence or about our discomfort with being on display while we do the important work of nursing? One method for fully exploring an especially vexing problem is to repeatedly ask why. Each answer should generate another why, just like our 5-year-old friend would do.

Curiosity in Practice
Bradi Granger has developed a clever approach to capturing curiosity. Her “stick” method is simple (that’s stick as in adhere, not as in twig). As a clinical nurse specialist at Duke University Medical Center, she recognized that nurses are insatiably curious, full of questions they forget when they’re asked on the spot. So, when nurses at Duke think of a question—which is usually at the bedside—they immediately write it down using a Post-It® note from pads all around the unit.

Someone collects the notes for a unit committee to review and look for answers, mostly by consulting the literature. The answers are posted on the bulletin board for everyone to see. If there is enough evidence to answer the question, unit practices are changed as needed. If there isn’t and the question is amenable to study, staff members volunteer to join a small research team. It’s a simple strategy that emphasizes evidence- based practice. You may have noticed that Duke nurses often have posters at NTI. That’s why.

I’m sure you have equally clever ways of unleashing your own curiosity and that of others. Would you consider sharing those by writing to me at insights@aacn.org?

What do you see?


See something a new way and you’ll never see it the old way again. Each of my columns this year will feature a different graphic so we can share a different dimension of seeking insights. —MFT

Searching for truth. This man is clearly a liar. Look at his face sideways, so that his nose is facing down, and you can literally read it on this face.

http://www.planetperplex.com/en/paul_agule.html
Letters to the Editor

Remember to Consider Organ Donation


Mary Fran Tracy’s note on nursing presence was great. (AACN News, December 2006) I agree that nursing presence is just as therapeutic as many of our empiric interventions. Presence distinguishes nursing from medicine. Nursing presence is vital in our highly technical critical care units where there are so many tasks to do that we cannot get focused on task completion.

Nursing presence is especially essential when dealing with end-of-life patients as two of the clinical practice awards demonstrated. The recipients exemplified the best of nursing presence, aesthetics and ethics as well as the empirical, technological interventions so common in critical care. However, I was disappointed that there was no mention of consideration of organ donation in two excellent patient candidates for donation. How many lives were lost due to this oversight?

It is ironic that an article about the Department of Health and Human Services initiative to increase potential donors appears on the facing page.

I recently attended the Second Annual National Learning Congress on Organ Donation and Transplantation, where I received the U.S. Department of Health and Human Services Medal of Honor Award for Citrus Valley Medical Center in West Covina, Calif. Many donor families were there to share their gratitude at being given the chance to donate their loved ones organs. "It turned my loved one from a victim to a hero" and "Give every family this chance" were statements I heard from families who had lost a loved one. Many are working tirelessly now for the cause.

We recently notified our procurement agency of a potential donor, a young woman with a spontaneous intracranial bleed with a Glascow Coma Scale of 5. I am happy to say that, with our aggressive care, this young woman eventually woke up. Her family never knew the procurement agency had been out to review her case. Early notification is key.

I suggest that critical care nurses consider that they can save lives beyond the walls of their own critical care units.

Eileen Duris, RN, BSN, CCRN
Claremont, Calif.

President Tracy’s Column a Source of Encouragement


I was compelled to write after reading two recent “President’s Note” columns in AACN News—“Overrun by Rules” (January 2007) and “Taming Runaway Change” (November 2006). You are my hero! Although I have never had many heroes, I think I have found one in you.

I have been a critical care nurse for 20 years and, for the most part, have loved every minute of it. Your words have given me some much needed encouragement.

Both these columns resonate with so much truth. They have given me the courage to stand up and speak up. Keep them coming.

Rich Gillard, RN BSN CCRN
Milwaukee, Wis.
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