AACN News—July 2007—Opinions

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Vol. 24, No. 7, JULY 2007



President’s Note


Transforming Nursing Through the Power of Insight

Mary Fran Tracy,
RN, PhD, CCNS,
CCRN, FAAN

Following are excerpts from the keynote address delivered by AACN President Mary Fran Tracy, RN, PhD, CCNS, CCRN, FAAN, at the opening session of the 2007 National Teaching Institute & Critical Care Exposition in Atlanta, Ga. The full text with references is available online at www.aacn.org > NTI.

If you left your current position tomorrow, what one powerful insight would you be remembered for? If you don’t think you’ve had that one powerful insight yet, change the question to reflect the future tense. When you leave your current position, what one powerful insight do you want to be remembered for?

I’m asking you these questions because if we really commit to being powered by insight, answers to these tough questions will come more easily. We will answer not only with our words—but also with our actions. Congruence between words and actions is a critical element of being a skilled communicator. So, to just say “I am powered by insight” and to live the words are two very different things. I know I have to do both to fulfill my own expectations.

Imagine if each of us acted on an insight—just one each—that would result in more than 6,500 actions to make our patients safer.

Catalysts of Change
You know an insight is powerful when it changes your view of the world, the way you act and your impact on things that matter—like patient safety. Does this mean my one powerful insight has to be inventing the next big patient innovation like the ceiling lift or the balloon pump? While such aspirations are worthy, I have something more achievable—but no less profound—in mind for our patients.

Here’s an example of a brilliantly simple innovation that started as a powerful insight. It’s called the No Interruption Zone and costs less than $5 to implement.
The nurses at Sentara Hospital in Norfolk, Va. established a No Interruption Zone around their Pyxis machine because they recognized that they were often distracted while getting medications. This zone was initially created by simply making a box on the floor using red masking tape, and making it clear that no nurse—ever—should be interrupted when getting patient medications.

The results from this powerful insight have been so significant to the nurses at Sentara that many of the units have adopted it. In some cases they have installed a permanent No Interruption Zone with red tile or a red floor mat instead of tape.
Imagine that. That’s power. That’s our power.

Simple Questions, Complex Answers
Can you have, share and act on an insight like this? I know you can. I am certain that each of us has at least one such powerful insight.

When I shared my theme for the first time at last year’s NTI in Anaheim, I committed to ask two questions throughout my year as president and challenged you to do the same. The two questions were deceptively simple: What’s going well? What’s not going well?

My most surprising insight from asking these questions was that no matter whom I asked, I got the same answers. I really thought that the answers I would get from a nurse would be different from those of a pharmacist, or a housekeeper or a physician. But it seems our high points and low points, our concerns and victories are alike.

Another surprising insight I had was that we healthcare professionals remain a pretty optimistic bunch—even amid the chaos that most of us work in. Where I expected the list of concerns to be twice as long as the “what is going well” list, I found just the opposite. The people I asked were overwhelmed by change fatigue—the constant barrage of new initiatives being introduced. But they were also quick to talk about the good things they were doing to change their environments—especially on the unit or team level.

In order to gain the insight we need, we must give ourselves the necessary time and space. Insight requires self-reflection and inquiry. What is the true problem or process to be addressed? What role am I playing in the problem? How are my beliefs and expectations facilitating or hindering me from finding a solution? How can the perspectives of others enrich the solution pool?

One Insight Makes a Difference
I can almost hear you saying “but I am only one person. How can I possibly impact problems as big as the ones we’re facing?”

Change begins with the momentum created by one or two people—I see this in my units; don’t you see it in yours? You don’t have to be a formal volunteer to move AACN’s mission forward. Applying what we learn—the work that AACN has done for nurses like you and me who want to use the latest evidence in our practice—is the most valuable contribution we can make.

We as nurses are the creators and sharers of insights that ensure our patients’ wishes are honored—that they are not in pain and that they are better for the care we provide.
AACN’s vision is of a healthcare system driven by the needs of patients and their families. If this vision is to be realized, we must assume power and responsibility for fixing those things that have the public convinced they are in danger when they enter the hospital. We will know we have succeeded when we have loved ones in the hospital and don’t feel like we need to be there to watch over them every minute of their stay.