President’s Column: The Sky's the Limit

Oct 01, 2019

Added to Collection

Something hit me like unexpected turbulence at the family members’ orientation for my husband’s new job. (He’s a pilot, by the way.)

Each spouse was asked to stand up, introduce themselves and share a fact about their family or where they work. I’m usually at the front of the alphabet, so I went first. “Hi, I’m a nurse!” The next person stood; she was also a nurse. What a coincidence.

Then, as people kept sharing, it was almost uncanny. More than half of the room consisted of pilots whose spouses were nurses. It’s not unusual for pilots to be married to a nurse or to have one in their family, we were told.

I flashed back to all the work stories my husband and I have shared, and I realized what should have been obvious to me before — the nursing and aviation professions have a lot in common. They both include critical thinking, patient/passenger safety, safe staffing concerns, unusual schedules, high-tech resources and teamwork.

As a pilot, my husband talks about safety checklists, facing the unexpected, understanding the nuances of each airport and burdensome Federal Aviation Administration rules and regulations. For every anecdote he shares, I have a comparable nursing story.

However, even with the similarities, it seems to me that nursing can still learn much from the aviation industry in key areas, such as training, culture and incident reporting.

One of the most important examples is crew resource management or a “shared mental model.” This principle refers to how members of a team interact and the factors that influence performance, including cooperation, leadership, workload management, situational awareness and decision-making. Sound familiar? Seems like our everyday work and the elements of a healthy work environment to me.

I wonder how applying crew resource management and similar less technical skills could affect our profession and patient care.

A few features of crew resource management that could be readily adapted to healthcare include:

  • Pre- and post-flight briefings
  • Recognition of fatigue as a factor in performance
  • Regular assessment “check rides”
  • A blame-free reporting culture
  • The “sterile cockpit” principle

Imagine the “sterile cockpit” principle in the healthcare setting — a unit environment free from distractions during key times of critical patient care, such as when passing or preparing medications and giving or receiving nursing report on a patient.

Plus, fatigue and burnout are common issues for pilots and nurses. As a rule, most major airlines employ teams of psychologists or human factor specialists, who are available to their crews. But, those types of resources are an exception in healthcare.

Many high-risk industries incorporate ideas that offer insights we can learn and apply to nursing and healthcare. Of course, adopting new, outside processes would require adapting them to our unique healthcare environment, but it could empower us to be proactive rather than reactive to unit or hospital incidents.

What principles or processes in industries other than healthcare can be adapted to nursing? Please share your ideas with me at