What Keeps Nurses Going Strong In Spite Of Everything? (Part III)
As we close out National Nurses Week today on May 12, Florence Nightingale’s birthday, the essence of her mission to pioneer and transform public health lives on. In the final installment of Medline’s blog series, we hear from Linda in Georgia. This nurse veteran shares how she’s driving home her mission to improve infection prevention and create an environment where patients and nurses can feel safe and empowered.
MARTIE: Thanks for joining me today, Linda. Tell me about your nursing career and your pathways. I love to hear these stories.
LINDA: I became a certified nursing assistant when I was 15. That’s when the physician came in, you stood up. Doctors were also smoking in the dictation room – that’s how far back I go. Then I got my ADN back in 1977. I also have a BSN, MSN, CIC, and a PH certificate. I worked my first five years as a nurse in neuro-intensive care, went to education and then public health for about 14 years. After that, I decided to go to the ER to be a staff nurse.
MARTIE: That’s a switch.
LINDA: I was so sick of management I could’ve screamed. Then when I was at the ER, I thought, wow, it would be nice to go to Alaska. So I went to Anchorage as an agency nurse up and had a great time.
MARTIE: You must have seen a lot.
LINDA: Scheduling was great and I could still see my family and friends. Then when I came back, I thought it might be time to get back to management. That’s when I took on the role of director for two medical units. Today, I’m a director of infection prevention and employee health. I’m stretched to the max right now.
MARTIE: You have a lot going on. And I’m sure you’re background in public health is good for infection prevention.
LINDA: I’ve done a lot. My public health experience has been a great asset.
MARTIE: That’s what I love about talking to nurses. Almost everyone we’ve talked to started as a CNA and really understands that essence of patient care as they develop their practice.
So tell me, what’s a great day look like and what gets you excited?
LINDA: We’ve really been working on CAUTI. Our utilization rates of Foley catheters are very low. It’s a good day when we start with that. If we do have an issue, I make it a point to catch a nurse manager in the morning to ensure the night shift nurse can do the re-education. That’s also a good day. You may think I’m obsessed with Foley, but we do Foley rounding in the ICU every day, and I like to go up there and round and see the ICU nurses. I couldn’t say that about 15 months ago. They didn’t like to see me coming. Now when I go up, nurses greet me and tell me what Foley can come out or needs to stay in. It’s a whole new culture change on how they view Foley catheters…just because the patient is in ICU, they really all don’t need a Foley catheter.
MARTIE: You are singing to my heart and I totally agree. I love the fact that you’ve done such a great job of influencing practice.
LINDA: We started in the ER first and tried to get them to not put in a Foley every time someone came in. It was pretty successful. The only reason we’re having success is because of the nurse managers and educators on the frontlines. They are holding their staff accountable for when to use a Foley. They’re really on top of it.
MARTIE: There’s so much work coming out now about the early identification of sepsis. I applaud you and I think that’s fantastic work.
LINDA: We’re working on our VAPs and recently went about 600 days without one. When we did get one, we (unit managers, educators, and ancillary departments who touch the patient) got together to analyze what happened and how to prevent it. We’ve been at zero with CLABSI and CAUTI. Anytime we have one, then we all get together to see how we can prevent the next one from happening.
MARTIE: I call it perpetually chasing zero. You have to understand you’re chasing it. When you introduce something that creates a break or that moment, you have to understand what happened.
So let me ask you this. I know there are those days when you walk out frustrated with shoulders heavy. What causes that frustration?
LINDA: I don’t think we have enough staff in this department. For the work that has to be done and reporting requirements, that’s a lot of pressure to gather information and also, create solutions. I’m not able to get upstairs to round with the nurses to really educate. We did have an infection prevention ambassador class where dozens of nurses were trained. They’re getting surgeons to wash their hands. They’re speaking up. They have great ideas and it’s amazing. They’re truly educating their colleagues.
MARTIE: You’re empowering nurses and I love that. You’re moving that knowledge and expertise at the bedside and mobilizing it. That’s awesome.
LINDA: I just get really frustrated with not being able to get everything done.
MARTIE: We hear this from every nurse we’ve talked to. Not enough time with patients. For you, it’s not enough time with nurses to advance the learnings. So let me give you this. You are now in charge of a hospital. You get to put on the tiara and change the world. What would you do to improve the delivery of better care?
LINDA: Hmm. Do I get all the money I want?
MARTIE: Sure – let’s do it!
LINDA: With my endless bank account, I’d empower the patient by having enough staff to educate patients. Those bedside nurses are swamped, so I’d hire enough staff and maybe some patient educators, too. I’d have everyone go to a class on a Culture of Safety, make sure there was no retaliation when they told a surgeon to wash their hands and that would be the culture around here – if someone’s doing something that could potentially harm a patient, speak up. That would be for infection or anything that could harm a patient.
MARTIE: I think you would do awesome.
LINDA: Perhaps one day, it will happen…that staff will realize that they have the duty to speak up to prevent harm to their patients.
MARTIE: But these are lessons on how we can transform healthcare and create a culture of safety. People shouldn’t be fearful of retaliation or power structures. Patients and their families should always be at the center of the conversation.
So where do you see nursing going in 5 to 10 years?
LINDA: That’s a scary thought. There are a lot of people going into the profession for the salary and salaries aren’t going to increase at all. If anything, they’re probably going to decrease and we’re already seeing that. I think there will be a nursing shortage…again.
MARTIE: I use the analogy that the silver tsunami is coming to nursing. Not only people leaving the profession but knowledge and expertise. I’m blessed that I get to talk to people all across the country and the fear is, who are the knowledge experts? Who can nurses turn to as a mentor with depth, knowledge, and intuition? When you start to see that leave the profession, that’s worrisome to me.
LINDA: I think we have that with physicians, too.
MARTIE: You’ve been so gracious with your time and I want to say “thank you” for all the differences you’re making with patients. I applaud you and you are my hero!
Author's Bio: With nearly 30 years of clinical experience and extensive nurse leadership, Martie Moore provides direction and counsel for clinical programs, new products, and patient care initiatives to hospitals across the country. Prior to joining Medline, Moore served as Chief Nursing Officer at Providence St. Vincent Medical Center in Portland, Ore. Under her leadership, Providence St. Vincent earned a third and fourth designation for Magnet. (Only 57 hospitals in the world have achieved this level of designation.) Moore also helped launch the Medline Pink Glove Dance campaign at Providence St. Vincent, the facility where the now-famous video competition began.
Moore received her Bachelor of Science in Nursing from St. Martin's College and her Masters in Organizational Management from the University of Phoenix. She has published and presented nationally on changing cultures to assure patient safety and holds a national certification for healthcare quality. In addition, Moore serves as a member of Sigma Theta Tau International Honor Society of Nursing, American Organization of Nurse Executives and National Association for Healthcare Quality. She also served on the faculty at George Fox University in the Healthcare Administration Program.
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