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President's Column: From Best to Better Practice

Mar 01, 2021

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Every March we celebrate certification. Despite all that 2020 threw at us, there was a 3% increase in AACN certificants — 128,993 nurses!

Certification captures what it means to be All In — the validation of our clinical knowledge, which reflects standards of excellence in the care of patients and families, and a demonstration of pride in our specialty. Now, more than ever we need to boldly articulate what is unique about acute and critical care nursing.

During this challenging time, we also broadly share our knowledge and expertise. In early 2020, in response to the pandemic, AACN made the “COVID-19 Pulmonary, ARDS and Ventilator Resources,” an online course that is available to support all healthcare providers. I am one of over 151,000 nurses who accessed this course, which, for me, confirmed what I know and gave me confidence. It also gave me the opportunity to ask questions, learn, refine my practice and most importantly to celebrate what is unique about critical care nursing.

Hundreds of nurses took the next step and completed the COVID-19 Pulmonary and Ventilator Care Micro-Credential, validating their knowledge of this focused subset of our practice. The importance of this aspect of practice is exemplified by hospitals that have supported nurses in applying for the micro-credential. Additionally, the California Emergency Medical Services Authority has also included it in a two-day program to provide COVID-19 online cross-training to nurses in the state, and there are tentative plans to release a Spanish translation of the course domestically and internationally. This Is Our Moment to celebrate the meaningful global recognition of acute and critical care nursing.

The uncertainty of the past 12 months provides us with an opportunity to not only confirm what is core to our practice, but also to challenge assumptions, strategies and practices. Perhaps This Is Our Moment to embrace uncertainty and move from existing best practices to even better practices. I see this not only in regard to COVID-19 but for other aspects of care, such as post-ICU syndrome, proning, family presence and our own well-being.

Organizational psychologist Adam Grant’s recent book, “Think Again,” explores the importance of rethinking. He says, “The purpose of learning isn’t to affirm our beliefs; it’s to evolve our beliefs." As an example of rethinking and the evolution of our beliefs, recall AACN past president Lisa Riggs’ powerful message to never forget our true north — the needs of patients and families. And, thankfully, we are getting closer to the time when families will again be at the bedside of patients.

The AACN Practice Alert, “Family Visitation in the Adult ICU” advocates for appropriate unrestricted access by a chosen support person. Despite this practice standard, a recent study in the American Journal of Critical Care found that pre-pandemic, only 51% of Magnet/Pathway to Excellence hospitals allowed open visitation and 18% allowed unrestricted visitation. A report in the Journal of Palliative Medicine finds that access restrictions caused by COVID-19 have further affected family members’ perceptions of their ability to cope, to advocate for and support the patient, to build trust with the healthcare team, and to receive the team’s emotional support. How can we use a rethinking mindset, and what we have learned during the pandemic, to advance meaningful presence for patients, family members and the healthcare team?

This Is Our Moment to clearly articulate and celebrate the core of our practice — captured in the unique knowledge and wisdom of acute and critical care nurses.

This Is Our Moment to explore, boldly investigate new possibilities and continue our pursuit of excellence, optimal outcomes and healthy work environments.

Tell me how you will use this moment to create your better future. Write to me at OurMoment@aacn.org.