President’s Column: A New Way of Thinking

Jul 16, 2018

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Positive deviance is based on a very simple principle. It says, "It is easier to ACT your way into a new way of thinking than it is to THINK your way into a new way of acting."

Deviant practices are a mechanism that allows us to act our way into a new way of thinking. They jar us. They shake us up. They push us in new directions. And they do this simply by making us question our usual practices to allow us to arrive at a better result.

So let me ask you a question. How can we nurses act our way into a new way of thinking? And eventually a new way of being?

In 2016, the Institute for Healthcare Improvement — the IHI — facilitated a weeklong initiative called Breaking the Rules for Better Care. Senior leaders at 40 organizations across the United States asked patients, families and staff, "If you could break or change one rule in service of a better care experience for patients or staff, what would it be and why?"

Nurses, our healthcare colleagues and patients across the country identified nearly 500 rules to break to improve patient care. Five hundred!

The Breaking the Rules initiative found that in reality only a quarter of the rules getting in the way of patient care were imposed by outside regulatory agencies. That means 75 percent were the result of a misinterpretation of the rules or were self-imposed. That means 75 percent of the rules are within our control.

When we use our collective voice and the strength we have as nurses, we can invent our future not become victims of it. Our voice and our strength give us power. The power we need to change this profession we love.

The power we have as nurses inspired our theme this year: Our Voice, Our Strength.

I believe these words and the power behind them show us how to ACT our way into a new way of thinking.

Reinventing our future CANNOT be left to outside experts or a tedious study from a think tank. It must be from the efforts of nurses everywhere who are dedicated to the care we deliver and the lives of our patients. It must come from us. It must come from our community of exceptional nurses. It will result from the power of Our Voice, Our Strength.

Let's be courageous and reinvent our future. We can create the workplaces we want and need when we use our voice. Let's confidently step into our strength.

Let me hear your voice! Send me a message at