AACN News—March 2009—Opinions

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Vol. 26, No. 3, MARCH 2009


President’s Note


Caryl Goodyear-Bruch RN, PhD, CCRN

When Success Trumps Failure


People have a way of becoming what you encourage them to be — not what you nag them to be.
— Scudder Parker

You can’t miss the big poster in the workroom behind the counter at my local post office. It proudly announces: “‘The US Postal Service will never have the quality or the timeliness that we do for our customers.’ Let’s prove them wrong!”

Citing a competitor’s put-down of the Postal Service, the poster reaffirms negative perceptions about its service. The poster is probably intended to inspire and motivate postal workers to be innovative and efficient. To me it communicates lack of appreciation for what postal workers do well and advocates a defensive posture.

What Is Appreciative Inquiry?

Appreciative inquiry (AI) focuses on what works in an organization, instead of what doesn’t. This rapidly growing approach to change confirms that identifying what we do right makes all the difference in achieving positive outcomes. Negative begets negative and positive begets positive. So with AI we acknowledge the contributions of individuals and focus on what we want to create. You can learn more about it at Case Western Reserve University’s
In Your Unit

How would appreciative inquiry work in your unit? Using AI you would ask: What does our unit do well? For example, we maintain a zero VAP rate and pressure ulcers are the exception. Family satisfaction scores are consistently off the charts. We have a waiting list for hiring because staff turnover is so low. We started the journey toward a Beacon Award for Critical Care Excellence.

Next you would find out: How did we achieve those successes? What processes made positive outcomes possible? Can we use those processes to fuel other successes? Which one will we tackle first?
What are your unit’s unique ways to create success? Units resemble one another in many ways, yet each one has a distinct culture and personality. Pinpointing how your unit is unique may spur you toward positive patient outcomes and more satisfied nurses.

Telling Your Unit’s Story

What works in a unit’s journey to quality and excellence needs to be shared. Telling your unit’s stories transforms innovative work processes into a framework for future achievement. Some units already have. Did you know that creative solutions posters from NTI are posted online at www.aacn.org/creativesolutions? Starting this year they will also be posted in Sigma Theta Tau International’s online library.

What a goldmine of achievement and innovation! Most posters report success. Even posters that describe a failed attempt report what was learned and point out new directions to pursue. No matter the results, one thing becomes obvious: Injecting positive action into a unit makes a tremendous difference in patient outcomes and nurses’ satisfaction with their work.

Celebrate, Celebrate

I hope every NTI poster receives as much visibility in its unit as it receives nationally. “Use every success as an excuse for a celebration,” Alan McGinnis insists in his book, “Bringing Out the Best in People.” This means to me that each milestone toward a goal deserves meaningful recognition.

How does your unit celebrate and make known its successes? You should proudly proclaim them. Not only to the nursing team, but to everyone else who comes into the unit. Posters describing achievements instill confidence in effective work processes. Perhaps more importantly, they inspire us in our journey to create a unit that is the best of the best. What kinds of posters and signs hang on your unit’s walls?

A Natural Approach

Appreciative inquiry is a natural for nurses because it fuels what we find most satisfying: caring for patients and their families. As individual nurses, AI helps us strengthen the meaning of our work. As a group, when clinical leaders and managers apply AI the expectation for success empowers and motivates us.

I visit many extraordinary high acuity and critical care units as I travel across the country. Some units recognize and proudly display their achievements, yet many others overlook what works and focus on what doesn’t. Whichever kind of unit you work in, I know it has many successes. Would you write to me at confidence@aacn.org and tell me about your unit’s accomplishments so I can brag about them?