By: Fe Jacolbe, RN and Jack Jacolbe, IE
As a husband and wife team, they started recruiting, placing, and supporting nurses 20 years ago to help during the severe nursing shortage in the U.S.
Long after the doctors have given up hope to cure their patients, nurses will still be there until the end to care!
In hospitals, doctors’ main preoccupation is preventing patients from dying, but from what we have seen and experienced, nurses’ concern is for patients to continue living their lives. They are there from patients’ admission to discharge. While it is true that doctors give the “orders,” nurses are the professionals who execute and fulfill the promise of medicine to make patients get well again.
Due to life and death situations that nurses are constantly experiencing, the various array of responsibilities they are required to handle, and the time-sensitive nature of their assigned tasks, nurses have no time to care for themselves. This begs the question, “Who will care for our nurses?” Can nurses find time to take care of themselves? Why should we care if they cannot take care of themselves?
We have a more personal reason, but for this article, suffice it to say that we have nurses in the family. But, we also have a moral obligation because we know most of the nurses we placed personally… It all started 20 years ago when we joined hands to develop and operationalize a novel work-study project or internship program to bring in highly qualified nurses from the Philippines (details to be posted in a separate article soon) to do graduate studies and work with our participating hospitals.
The story of one nurse in particular prompted us to start this Charge Nurse Series to give voice to our nurses. This nurse feels that financial considerations are given more importance nowadays and even take precedence over the more important goal of caring for the patients. Mistakes or errors are committed in the process because of a lack of the required human resources on the floors. She has become so disillusioned with the present state of the profession and has considered changing careers.
The Hastings Report, Nurses, Medical Errors, and the Culture of Blame, gives a startling insight into what will happen to the nursing profession, “The study found that most errors fall within the realm of nursing practice and those physicians, administrators, and nurses themselves tend to see patient safety as largely a nursing responsibility. Asked to identify which profession has primary responsibility for ensuring patient safety, 96 percent of the nurses and more than 90 percent of the physicians, administrators, and pharmacists, assigned primary responsibility to nurses.”
Who should be blamed for the fatal mistakes of 100,000 people in a 1999 study from the Institute of Medicine?
A report by ProPublica has stated that “the latest study in the current issue of the Journal of Patient Safety, the numbers may be much higher — between 210,000 and 440,000 patients each year who go to the hospital for care, suffer some type of preventable harm that contributes to their death”, the study says.
If there is anybody to be blamed for these horrendous statistics, it can be distributed among everyone who are involved in the process from admitting to diagnosing to caring, and finally to discharging the patient. A Root-Cause-Analysis done by the Joint Commission shows who is responsible in the organization.
We have to help our nurses. Like the work-study project mentioned earlier, we decided to think and apply our combined talent in this blog to give the nurses a helping hand. What can we do?
Using the same tools we used before, we did an RCA, brainstormed, and planned and re-planned for many months using Microsoft Project. By applying PERT/CPM analysis, we arrived at a series of logical sequences of interventions that will result with the most cost-effective solution.
How do we change a culture? The simple answer coming out of our analysis is that we just don’t change a culture. We outgrow it by replacing the “old” with “new” and better habits. Change is hard, growing is easy. Change is optional, growing is natural. The nurses must do it themselves, one nurse and one institution at a time. How can the nurses do it by themselves? Of course, nobody can solve their own problems; otherwise they would have solved their problem long time ago. Yes, they need all the help they could get, but they also have to honestly believe that they did it!
For a Journalism and Economics student like our daughter, the initial and obvious intervention would be a cost-effective Newsletter Project to rally the staff to work as a team towards a specific goal. The Newsletter became a project under our Integrated Internship Program similar to our Work-Study Program.
This Charge Nurse Series will explain in details in the succeeding postings how we analyzed and prepared the multi-year project plan to develop the goals and framework of the newsletter and the strategy to get the resources to write, edit, format, and publish the newsletter. Thanks to the enlightened leadership and management policies of the Schulman and Schachne Institute for Nursing and Rehabilitation headed by its Vice President, Genevieve Sorensen, RN, new initiatives and interventions were being encouraged. The maiden issue of their newsletter was published on April 2009, at no cash-out cost to the institution. Editing and publishing work were done by the volunteers organized by the Editor, Fe Jacolbe, RN. Through this strategy, any organization can have its own publication.
In the process, copies of the newsletter were prized by the staff and surreptitiously copied to send to friends and families. The staff was proud to be identified with a facility doing great things, but most of all, they were responding as expected to the human nature of being grateful to be recognized in print for all their efforts. Two years and several issues of the Newsletter with “push and pull” articles, the facility was finally recognized and declared a Five-Star facility.
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