President’s Column: A Basket of Unpredictable

Sep 01, 2019

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Isn’t it incredible that each shift we conquer the unpredictable so we can consistently meet the needs of our patients. How is that possible?

Despite thinking I am good in the kitchen, I still tend to catch myself watching cooking shows when I have some downtime. I especially am intrigued by those competition shows that have unpredictable items in a basket or behind a door. You know which ones I’m talking about. The shows where contestants are given a basket of cotton candy, peanut butter, lamb, fennel and crushed pineapple and are challenged to make a delicious entrée in 20 minutes.

I actually wince when they list the items, but I also have confidence they will succeed with a creative and delicious dish in the end. Using all the tools and equipment in the kitchen, they bring the best of themselves knowing the clock is ticking. Presenting the dish with pride and trust in their abilities they still recognize at times where they could have improved or enhanced the dish. And I watch in complete bewilderment. How did they do that with such ease — knowing they still have two more segments of the show remaining?

I gravitate to watching these shows because nurses work like this.

When we became nurses, we knew — and perhaps were even drawn to — the unpredictability of the profession. Each day, as we walk into work we know we will be greeting unpredictability. We recognize we are there to provide care with excellence, despite the unknown. Each day and night is drastically different. It is conceivable that any of us could be faced mid-shift with a co-worker going home sick, a code, a grieving family or a visit from a regulatory team — all while knowing one of the highest priorities that day might be shaving a patient, because you promised his wife that you would. We come with our clinical knowledge, instincts, ability to prioritize and, most importantly, compassion.

Unlike those shows, we are not in isolation with our basket of unpredictable items. We know we have a team who will fill in the gaps and see where we need support. Many times, I have clocked out and thought “We somehow got it done”; we made the impossible, possible. We gave exceptional care again despite being caught off-guard or interrupted with the unthinkable.

Typically walking out together with colleagues, we debrief where we could perhaps do things differently but give assurances to each other. Not all of us know how to make a great dish with Brussels sprouts, sweetbreads and bananas, but we know how to overcome the unforeseeable with excellence. And we’re ready to do it again tomorrow.

Share a story at Unstoppable@aacn.org about when you were in an unpredictable situation and you or your team showed excellence.