“Lunch?” I heard my co-worker say to me one Friday around noon. A few of my coworkers were headed to get lunch at a nearby sandwich shop, and I was being invited to join. I was sitting at my desk, deep in focus on one of many design document spreadsheets.
“What?” I said as I turned my head toward him with a bit of confusion. I was relatively new to the role and working in IT. I had come from working on the inpatient floor as a nurse. I did not understand the question. I said, “We can do that? We can leave and get lunch?”
Here I am over 20 years later, and for some reason I find myself reliving that moment in my mind. My question and response may seem bazaar to someone who has not worked in clinical care. Some may even think ‘why would you not be able to leave and go get lunch?’ However, I know that any nurse (and/or other healthcare professional), understands this all too well.
To have the opportunity to eat lunch is not a given across the profession. In fact, taking 30 uninterrupted minutes to sit and renourish one’s body over the course of a 12.5-hour workday, can feel like a luxury to a nurse. Nurses learn this incredibly early in their careers. Yet, this is a cultural experience of our profession that does not need to occur.
We, nurses and healthcare professionals, create the systems (e.g., processes) that are necessary to deliver care for patients. Those systems should be designed to support delivering quality care for patients AND the responsible nurses and healthcare professionals. To effectively deliver care for patients, we need our nurses and healthcare professionals at their own optimal operating capacity and capability. Being able to eat lunch over the course of 12.5 hours is part of that optimal operating capacity and capability.
Unfortunately, there is often an underlying or unspoken belief that the need for a break to eat, or even use the bathroom, is a sign of weakness. You are not strong enough if you cannot power through the day without eating or taking a bathroom break. Yet, we will teach our patients how they need to do the exact opposite to care for themselves. Now, looking back 20 years later, I can see how that is a belief and/or cultural expectation that needs to shift.
Time to Shift that Mindset.
Nurses are humans too. I mention the topic of lunch because it reflects a persistent blind spot (at best) within the profession. Over the last few years, I have seen an increase in attention and promotion of encouraging self-care and burnout reduction strategies. However, we continue to see that one of the more basic needs that could be met (lunch) is often left up to an individual to manage (e.g., find a way to make it happen), rather than an organizational system or process set up to support any and all nurses on a given day.
The need for organizational systems to support nurses extends beyond far beyond lunch. There are many other areas where nurses work around challenges. Finding equipment, finding answers, finding resources, and finding linen are just four areas where nurses are continuously searching for something to work through the next step in the process of care. Yet often each one of these ‘finding’ steps takes up valuable time. So, the nurse is challenged to take that time or create a workaround, to cut that lost time down.
What if nurses did not have to look in every room and closet for a piece of equipment?
What if the linen cart was always stocked enough?
What if the meds were always in the med room when you were due to give them?
What if the ID band always scanned and lessened the risk for an override or late administration? (Better yet, what if it was not an ID band, but rather a biometric)?
What if you did not need to rush through discharge patient education?
These are just a few examples that I believe many, if not most, nurses who work in direct care can relate to, in terms of areas where you either lose time or do not have enough of it in a day.
I believe these “what if” statements are possible. However, these require more than the bedside nurse. These need system support to create processes that ensure they work well for all involved. (This also includes lunch).
In the age of the growing uncertainty of AI’s place in our lives, there are some areas where technology can assist in these ‘What If’ statements. None of those ‘What If’ statements posed would eliminate the need for a nurse. Instead, such tools would be what we hope technology can be: a tool that meets a specific unmet need.
I’d challenge you to consider your own What If. What would it take to make that thought a reality in the day to day?
Hopefully that sentence resonates with you. Everyone has ideas that come to us – all of a sudden – and usually when we are faced with a challenge. Ideas are important because they are the currency for innovating – for developing new solutions to existing problems. Without ideas we would be limited in creativity, change, and improvements in our lives. In health care, ideas have led to new solutions that transform the way we collect, communicate, exchange, analyze, and evaluate information. Yet, we need more ideas that lead to new solutions that can even further improve the structure, process, and outcomes of quality health care delivery.
A few months ago, I was invited to guest lecture to graduate nursing students at Northeastern University about innovation. I asked each student to formulate a problem that they see each day while working and bring it to class. During class we identified each problem and then I asked each nursing student to formulate a potential solution. Every student had a very real problem they are faced with each day at work – some were more complex than others – but we were able to form solutions that were reasonable and achievable with the right support, enthusiasm, and guidance. The nursing students felt empowered to work to address the identified problems. I hope that they did follow up and begin the process toward improving the desired outcomes.
I offer this scenario to encourage others to develop their ideas and foster further innovation in health care. Each day I see new problems that need to be solved. This blog, Know My Voice™ started as an idea. I wanted a way to share my informatics perspective, or voice, with a larger and broader audience than I could physically reach in the same amount of time. I look forward to seeing the future developments and impact of Know My Voice™ over time.
Know My Voice®
