Nurse Pockets

Working with people & companies who can help you...

Well I've just updated my May '10 entry called 'Nursing Notes....200 years later' and let my pen flow a little more freely!  As Helen Keller said, "College isn't the place to go for ideas."...Neither is healthcare.  Very little has changed....so ideas are what we need...

The challenge of how to start small on any large scale change is overwhelming when you work inside the healthcare system.  Unless you've travelled outside of it and experienced a different world for a while, you can not possibly know how the rest of the world negotiates value out of companies who want to sell you something but who do actually want to genuinely help you achieve your objectives and do have something great to offer.  Instead, in healthcare we screw them down as hard as we can after using them for months of research and development and then go and ask for a better quote from their competitor who has not invested a cent and laughs all the way to the bank and cares very little about the success of your project.  You may have gained a few dollars, but you've lost a relationship and probably a success story.

Imagine applying a simple concept like this in your hospital....on a small scale...working with a supplier and building a relationship.... 

....I've seen it done...in Australian and US IT projects. 

We need to make friends with some Suppliers who can invest in us, help in the research and development and stop treating them like 'used car salesmen'.  That's how the rest of the world lives....in a cooperative relationship that's mutually beneficial...we both have something to offer each other.  Meanwhile, antiquated systems remain...and nursing becomes obsolete...

I know I can hear your 'but, buts'....BUT ...as Florence said,

 "I attribute my success to this - I never gave or took any excuse."

It can be done.

Nursing Notes....200 years later!

Don't dismiss ideas that seem too simple or too small! 

Writing a 'note' is a rather basic idea, but done effectively in Nightingale's day could improve patient and hosptial outcomes.

In fact, many of Nightingale's achievements were surrounded by, or evolved from her idea of introducing systematic handwritten records for the medical profession (Hughes 2006).  That was in the mid 1800's.

I often wander if Nursing Notes achieve what they were set out to achieve in the 19th Century?  Is it time for another review?  In my recent permanent part-time job I couldn't help but notice how little the nursing notes were referred to by the medicos and allied health team on the general wards.... given the content, of some of them, their neglect was totally understandable at times....

When were they last reviewed in context of nursing in the new millenium?

 
Does anybody else think it strange that we are still hand writing and deciphering them when everyone else in the world is using computers?  What is the use of more hospital beds when we haven't got staff to cater for existing ones?  Shouldn't we be forging greater efficiencies and smarter ways of working to improve outcomes for the hospital, patients and staff? 

In relation to the use of hand held PDA (pocket PCs, palm pilots, iphones) one DON of a major Melbourne hospital admitted to me, "We wont change until we're forced to...and that's not until new graduates enter the hospital carrying them."  Now the very title 'Director' usually implies being involved in the 'direction' of the workforce or company we lead...but I could be mistaken (apparently I am).  Well if you're wanting an opportunity to contribute to positive change, there's one right there!   Start a revolution and carry your own!  It's affordable, easy to use, touch screen and tax deductible work tool...don't hold back!

The more computer literate we become, the closer we are to being able to bring nursing onto a relevant platform in the 21st century.  Without serious technological change the profession and the health welfare of our future is doomed!  I am not sure anyone really gets that yet?  I am not sure who cares about the fact that (on the whole) we are still etching (ill-egible writing, excuse the pun) onto stand alone, isolated, antiquated 'tablets' compared to the rest of the world.

Some nurses think we've 'moved on' from Florence's day...as if she is somehow outdated?  If you look at the spirit of the woman, I can guarnatee that if she was alive now she would have raised funding for, and had every nurse in her hospital trained and on mobile devices that syncronised patient related records and activities.  She might have started on a smaller scale, but she would have proved the advantages and ended up managing a nationwide project, guarnateed.  You only have to look at her involvement in the development of the "'Pie chart" to see her commitment to excellence above and beyond in the realm of data management and it's relevance to day to day patient management.....If she was alive she would make sure she had access to computers and nursing would not look like it does today!  Of that I feel certain!

"I attribute my success to this - I never gave or took any excuse." - Florence NIghtingale

What's the big idea?

Be encouraged!!  Sometimes a simple observation, followed by a question and then some research can result in innovation that brings about major change!!  Before you know it, you may discover something that changes the face of healthcare and impacts patient outcomes.

Florence Nightingale happened to observe the high number of deaths in maternity wards and merely asked herself the question, "Do more women die after giving birth in a hospital rather than at home?  And if so, why?"

 
Her meticulous research and documentation showed that the death rate was higher in hospitals so changes were made to services that resulted in the saving of women's lives.

Innovation does not have to be complicated and ground-breaking to be significant.  Often it is a simple idea and incremental rather than radical.

What have you noticed lately?  What question does it raise for you?  What research can you do?

Florence Nightingale...discoveries..

I was invited to speak recently at a Melbourne Public Hospital so found myself doing a little extra research as it was International Nurses Day (the anniversary of Florence's birthday) and International Midwives Day. 

I discovered that Florence Nightingale studied Greek, Latin, French, German, Italian, history, philosophy and mathematics as a child and went on to read widely in multiple languages throughout her adult life.  She studied parliamentary reports on public health for three years before doing the existing nurse training in her day.  She started nursing at 30, was an invalid of sorts by 37 and was blind the last 9 years of her life before dying at 90 years of age!!  Still, she managed to unaugurate training for midwives and nurses establishing a school of nursing amongst a host of other things.  What I didn't realise....

was that she was quite the statistician...(more about that soon) and hospital hygiene and sanitation was what she specialised in!!!  Don't you find that a little ironical given that we think we've 'moved on' from Nightingale's day yet 850,000 bed days are tied up treating hospital-sourced infection in Australia alone (costing healthcare more than $1 billion in lost bed days every year)?   

I'm not saying we should go backwards or endorse all her attitudes and methodology, but I am saying I think we need to "go back" to innovative thinking to go forward.....