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Take a Cue from Nursing History

Guest blog
05/11/18

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Lois J. Book, EdD, MS, BSN, RN-BC, Nursing Professional Development Specialist, Tampa General Hospital

It’s fitting that National Nurses Week ends this year on May 12—the birthday of Florence Nightingale. It brings to mind the powerful words she spoke in 1854 in response to what she saw in the hospital barracks housing the Crimean War’s sick and wounded: “We can do better than this.” As she made her solitary rounds with her little lamp, she saw doctors and caregivers not wash their hands, patients who weren’t helped to eat or get a drink of water, and others who, not turned, developed pressure ulcers.

Would she also say to us now, “We can do better than this,” after observing care on our units or reading our quality reports? I offer that we can and should always seek to apply what she said 164 years ago to our nursing practice today. Her words, in fact, deserve a closer look so that the deeper meaning doesn’t pass us by in our busy lives. 

WE is a group activity. It's not “I” or “someone.” It means you and me together: I will give my energy and knowledge to the team, so that the sum is greater than what I could achieve by myself. The “we” is demonstrated best when a Code Blue is called because all focus on saving a life. Can this be done every shift with that same focus and sense of urgency to keep our patients safe?

CAN declares that it’s possible to make a difference. As nurses, we can think critically, apply evidence-based solutions and create changes for the better. The CAUTI or sepsis bundles are examples of how evidence CAN be used to make change and consistency in practice for the benefit of patient outcomes.

DO is all about action. It’s the opposite of expecting others to make change happen for us or for our patients. It means being accountable and owning our efforts to improve. It's taking evidence from a study or a presentation at a conference and asking, “Could we DO that here?” What will it take to implement that here with our doctors and patients?

BETTER centers on the pride and sense of accomplishment you have. It's part of the deep, inner reason why you became a nurse in the first place. As Nightingale said, “If you are not continually moving forward in your nursing, you are going backward.” Does every nurse on the unit know the fall rate or pressure ulcer rate? Are they able to say with pride, “We have not had a fall in 90 days?”

THAN THIS is reality. It's the location of the needle on the quality metric today. And even if the current reality is stellar compared to a benchmark, there is always an opportunity to start something new or act on new evidence that will change the current status. Always add a trend line to a quality graph and a goal line so that all on the unit know where you are, where you need to be, and what way your current effort is taking you. A picture speaks a thousand words.

So during this National Nurses Week—and every week—be inspired by these words from nursing history. They bring clarity and challenge to our work every day. Don’t leave out any of the words. “We can do better than this.” Each one brings power to the charge of what high quality, highly reliable health care is.  

About the author. As clinical education team leader, Dr. Lois Book is responsible for the on-boarding, competency and continuing education of health care professionals at Tampa General Hospital. She also serves as coordinator for the Tampa General Nurse Residency Program, which achieved the ANCC/PTAP Accreditation with Distinction, the first Vizient/AACN Nurse Residency Program to do so. Previously, Dr. Book held positions as educator and director of education at hospitals in Illinois, as well as for two professional nursing organizations, APIC and AADE. She serves her profession by participating on the ANPD national education committee, the Vizient Nurse Residency Program annual meeting planning committee and with other state-level professional groups.

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