Join us to share your story on Caring for Others, Caring for Each Other, and Caring for Ourselves!
Conference Calls:
July 30, 9:30 - 10:30 am
August 20, 9:30 - 10:30 am
Email Mary Holtschneider for more information and call in number.
Next Steering Committee Conference Call
September 1, 2010, 10:00-11:00 am
Be part of the delivery phase of the NCNA Nurses Transforming Nursing Vision Statement.
In 2012, nurses in North Carolina will value and honor caring for others, caring for each other, and caring for ourselves.
Nurses Transforming Nursing is a program within the Professional Practice Advocacy Coalition (PPAC) of the North Carolina Nurses Association (NCNA) to transform the nursing culture through Appreciative Inquiry (AI). It continues PPAC’s goal to promote healthy workplaces for nurses across North Carolina and promotes the vision that “partnering with consumers increases the likelihood to optimize change within the health care system.”
Please see below for personal stories on Caring for others, caring for each other, and caring for ourselves.
Caring for others:
From a Psychiatric Mental Health Nurse Practitioner/Psychiatric Clinical Nurse Specialist: After all of these years, nearly 35 now, a nursing assistant, then learning to be a nurse, working as a nurse, in some capacity, a nurse. I have been an educator, a researcher, an administrator and now an Advanced Practice Nurse....and I believe that the one thing that always sticks out in my mind about caring is when it is random and unplanned.
Nurses are forever talking about caring for this and that: writing care plans, implementing nursing care, evaluating patient care and promoting self care. But what about random acts of caring? Like random acts of kindness, there are moments when we as nurses can truly be in the moment and recognize that caring can transcend beyond planning or projecting or maintaining.....to something that is just "being" in the moment and recognizing that it is missing from that moment. Random acts of caring are so powerful and meaningful not only to those who we take care of, but for ourselves. Think about it and try it....randomly!
From a nurse manager: I witnessed a nurse anesthetist colleague of mine do something that was truly wonderful. There was a man who was uncontrollably crying because his wife was being taken to the operating room to harvest her organs, as she was brain damaged from a bad accident. Acting in the moment, the nurse anesthetist stopped with the patient in the hall to give the husband some final moments with his wife. Unbelievably, a woman in the waiting room just started singing Amazing Grace, and soon everyone joined in. It was such a simple thing for the nurse anesthetist to just stop, but extremely important and caring. I can only imagine the difference that made in the husband’s grief experience.”
I've thought about caring for others and how broad it is. Isn't that what nurses do is care for others as part of their job description everyday? Each of us can share a story from everyday we go to work or go through life. Here's a favorite story of mine that I will always remember: I used to be a pediatric oncology nurse and loved it. The hospital facility where I worked practiced primary care nursing so that whenever a patient was readmitted, they would have the same nurse for continuity of care. This was about the third admission for a little 5-6 yo girl diagnosed with cancer. Since she was diagnosed, she hadn't spoken for months to anyone, even her mother. One night I came to work in my glasses when I usually wore contacts. I went into this little girl's room, did my assessment, made some small talk and of coarse didn't get a reply. Then as I was about to leave the room, she says, "Are those new glasses?" I said, "Yes, they are, do you like them?" She says, "No, I think they are really ugly!" Her mother was so embarrassed that this was her first words in months and tried to tell her that it wasn't nice to say that. I just thought she was telling it like it is! This is what I truly love about children; they will tell you exactly what they think. We all kept very straight faces and just kept right on talking- a little teary eyed. She talked from then on.
From Group member Kathy Heilig: “Caring for others is what nurses are trained to do….its what the profession is all about. The traditional way of thinking about that type of ‘caring’ is in the treatments and procedures that we do to the patient or consumer. But nursing is more than that…The most loving type of caring for others we can do is to help people understand that nursing extends beyond the boundaries of the things we do to people—that it’s more comprehensive than that. The real skill in caring for others is to help redefine the image of nursing in the dimension of thinking, planning, and interpreting healthcare; to help people understand that nurses are change agents. Nursing’s real talent is in the ability to integrate healthcare needs of others into a plan that includes a patient centered focus AND the skill to interpret that into a language that’s universally understood by all. Nurses can help legislators understand the barriers to receiving good care to enact legislation. Nurses can help mothers to understand why babies need immunizations and how it impacts an entire community. Nurses can help spouses grieve and understand the loss of a life partner and help them to access the resources they need to face their future. Advocating for the profession of nursing is the highest level of Caring for Others.”
Caring for each other:
A nurse colleague’s son had died and was going to have his organs harvested at our organization. As his mother, she wanted to be present for the harvest of her son’s heart. I was the Director of the OR and no family members had ever been allowed into the OR during a harvest. Even though this had never been done before, I decided that this was an important request to honor for a fellow nurse. I notified all the OR nurses and the nurse anesthetist that the mother who was a nurse was going to be present for the harvest of the heart. There were no objections. When her child came into the OR, I realized that he was a red headed teenager just like my own. This made it even more of a meaningful experience for me. As the heart was about to be harvested, the mother and I walked into the OR together. She began to sing a lullaby to him that she used to sing to him as a baby. I as well as all the other nurses in the OR began to cry. We left the OR and hugged. She thanked me so much for letting her have this closure that she needed. I knew that if she wasn’t a nurse, this would have never been allowed and was so glad that we could grant her this opportunity in her time of need.
My thoughts on Caring for Each Other relate to Swanson's theory. Empowering/enabling or facilitating each others' passage through life occurs through emotional support at work. In my experience, even if nurses have nothing in common with colleagues, they discuss life events and either by just sharing their personal experiences or by eliciting advise from others, their own path in life is made clearer. Nurses care for each other during work hours by validating nurses' feelings about life experiences by being emotionally supportive.
From a Psychiatric Nurse Practitioner: After all of these years, nearly 35 now, a nursing assistant, then learning to be a nurse, working as a nurse, in some capacity, a nurse.
I have been an educator, a researcher, an administrator and now an Advanced Practice Nurse....and I believe that the one thing that always sticks out in my mind about caring is when it is random and unplanned.
Nurses are forever talking about caring for this and that: writing care plans, implementing nursing care, evaluating patient care and promoting self care. But what about random acts of caring? Like random acts of kindness, there are moments when we as nurses can truly be in the moment and recognize that caring can transcend beyond planning or projecting or maintaining.....to something that is just "being" in the moment and recognizing that it is missing from that moment. Random acts of caring are so powerful and meaningful not only to those who we take care of, but for ourselves. Think about it and try it....randomly!
Caring for ourselves:
As a nurse manager, I gave up our conference room to turn it into a tranquility room. My nurses are caring, giving, and very hardworking. I felt it was important to give them a place to rest, meditate and renew their energy. The tranquility room provides this place for nurses. Movies, pretty pictures, music, a window, and a massage table were incorporated into the room. A program for healing touch was initiated and training provided to the nurses so that they could do healing touch on each other. Staff has learned how to take care of themselves, so when they are stressed, they can engage in healing touch in the tranquility room. A favorite patient was about to die and I was able to call the healing touch staff to give myself some time away and a sense of relaxation to help refocus on the patient when I returned. When I resumed taking care of my dying patient, I was able to be more energized and more able to cope again. As nurses we typically don’t take enough time for ourselves so that we have a greater capacity to care for our patients.
Feeling the need to be more energized and take care of myself, I signed up to take a fitness boot camp course at the gym. I decided to recruit four of my nursing friends. None of us had exercised in a long time. One of us hadn’t exercised in 25 years. After participating in boot camp every one of us was feeling so much better physically. Boot camp gave us more energy, made us feel better about ourselves, and gave us a chance to support and spend time with each other. Everyone could definitely feel a big difference. None of us would have continued exercising without the others’ support.
After my sister was diagnosed with breast cancer, it was recommended that I be tested for the BRCA gene which she carried. Our family has a long, and sorted history of cancer, so when my test came back BRCA-1 +, it took very little deliberating to decide to have prophylactic bilateral mastectomies. I was already a 20+ years survivor of Burkitt's Lymphoma, I had no intention of adding breast cancer to my list of battles. During the recovery from my mastectomies, I had a lot of time to really consider how many other ways I was taking care of myself and minimizing my risk of suffering from the same conditions that I help people care for everyday. It was then that I realized that though I had undergone a major surgery to "keep myself healthy", I had bigger issues that needed to be addressed. I was grossly overweight (and still hate to admit it), a terrible insomniac, borderline hypertensive and so out of shape that, after surgery, it was usually all I could do to stand up without using my arms. That was November of 2008. In January of 2009, I decided things were going to change. No more excuses about travel and stress. I travel 2-3 weeks out of the month for my job and the stress of some of those weeks can be extraordinary. That used to mean a very nice dinner and a couple glasses of wine at night to "unwind", but no more. Now, I start every day on the road in the hotel gym, and sometimes I end the day there as well. (At home, I work out from an hour to two and a half every day.) I search for hotels with full kitchens and on every occasion possible, make my own meals including brown bag lunches. In August, I took another step and became a vegetarian to aid the battle with my genetically high cholesterol the way that nature intended, rather than the pharmaceutical companies. Surprisingly enough, 3 days after I gave up the meat, I slept all night long. I rang in the 2010 New Year 60lbs lighter, well rested, with perfect blood pressure, borderline cholesterol levels but no medications, and the ability to run, (yes run!) several miles. I can't say I never enjoy a nice dinner and some wine, but now, it's not coping, it's celebrating!
My mother worked 2 jobs and looked after neighbors and her family very “admirably”. Every now and then I saw her cry because she put herself last. I learned that I would never put myself last in any situation. “If I don’t look after me, then I won’t be there.” We need to look at ourselves.
I was diagnosed with breast cancer in 2008. I was a workaholic and felt that I always did many things for others instead of myself. It was a life altering experience because now I have a structured self care process. I put myself as number one on my list. “We have to look after ourselves because no one else will.”
PPAC_Nurses Transforming Nursing Summit Summary October 2009
The NCNA Professional Practice Advocacy Coalition (PPAC) hosted the Nurses Transforming Nursing Summer Summit on August 26 at Southern Regional AHEC in Fayetteville, NC. Over 30 nurses and healthcare consumers participated in NCNA’s ongoing journey to transform the culture of nursing and healthcare in North Carolina through the use of Appreciative Inquiry (AI). AI promotes change through creative dialogue, excitement, and a focus on what works well versus problem identification and negativity.
Prior to this Summit, PPAC hosted a 2008 Roundtable in Raleigh to explore the use of AI as a tool to effect sweeping change. Based on feedback from the Roundtable participants, PPAC hosted four focus groups in Winter 2009 in different geographic regions across the state: Burlington, Greenville, Wilmington, and Asheville. At these focus groups, participants became Discovery Agents and interviewed a wide-range of nurses and healthcare consumers about their peak experiences with nursing and their bold wishes for how healthcare should look in the future. Again, the focus is on the positive and not the negative. Many of the Discovery Agent stories are listed on the NCNA website under the Nurses Transforming Nursing webpage. Several of the participants from the Roundtable and the focus groups also attended the Summit, providing continuity in this evolving process.
The AI approach includes four phases, which are Discovery, Dream, Design and Deliver. All of these phases are important in effecting change. As the Winter 2009 focus groups centered on the Discovery and Dream phases, the Summit focused on the Design phase. The Summit participants delved into the AI process and explored “provocative propositions” which truly challenge the culture of nursing to adapt to a new and healthier future. In order to prepare for the next phase of Deliver, the participants formulated the following vision statement:
APPRECIATIVE INQUIRY
- Discovery Agent Questionnaire
- Discover Agent Tips
AI promotes change through creative dialogue, excitement and a focus on what works versus problem identification. Consumer participants will have an opportunity to share when they had a positive experience with nursing care and their hopes for the future in health care delivery. Each nurse will be a “Discovery Agent” and spark provocative discussion with prompters like:
- Describe a peak nursing experience when you felt exceptionally high levels of energy, confidence, and satisfaction being a nurse.
- What makes nursing in your practice setting exceptional?
- If you could change the culture of nursing in NC, what would it look like in 2011?
- What type of relationships among nurses and others would promote a transformed nursing culture?
Describe a peak nursing experience when you felt exceptionally high levels of energy, confidence, and satisfaction being a nurse or with healthcare:
80 year old diploma graduate: Things were very different when I was a student in 1947. We were just starting to use penicillin, and we had to administer it every three hours around the clock. There were no prepackaged sterile needles - we had to boil the needles under a flame. We did not have the machines that we have today. But, we made people comfortable, and a nurse’s job is to make people comfortable. It is important to take care of the whole person and keep a positive attitude. There are many ways to keep people comfortable without using machines, such as arranging them in bed, keeping their call bell in reach, giving them sufficient water to keep hydrated, and watching for changes in their mental state. Nurses are always there, unlike the MD’s who come and go. Back then we really worked well with our nurses aides and were a team. We helped each other and treated everyone with respect. A good nursing team can hasten a patient’s recovery.
Posted on our NCNA Facebook Page from a CCU nurse: I cared for a woman that had come into the CCU the previous day. She had pregnancy-induced cardiomyopathy and was in respiratory failure when she hit the door. They had rushed her for an emergency C-section. The baby was in the NICU...Mom was in CCU...and frazzled Dad was running back and forth between the two. I was able to get her extubated and her invasive lines removed. Even though I was not an OB nurse, I had also had a C-section with my child so I was able to start her post-partum teaching that she was missing out on by being in CCU. I also got to take her over to the NICU to see her baby for the very first time. That whole weekend caring for that family was very rewarding.
Posted on our NCNA Facebook Page by a non-nurse consumer: A few years ago, I had to have a biopsy of breast tissue. It was an outpatient procedure, but my first major surgery since my wisdom teeth were removed. I was nervous and felt lonely and scared while waiting in the "holding bin" dressed in the surgery robe. My husband had left. When the nurse called me back to take my vitals, I started crying, and my blood pressure went up. She calmed me down, listened to my fears, even hugged me. She took my blood pressure again, and it had gone back to normal.
From a student nurse: “I cared for a patient who had very bad progressive cervical cancer and had just come back from surgery that was very invasive. She had not been bathed in several days and had not had a single visitor. I went in and asked her if ther was anything I could do. She said that she just wanted her hair washed more than anything. I washed her hair and was so glad to be able to do a little thing for her that she appreciated so much.”
From a bedside Medical ICU RN: “A year after graduating from nursing school I noticed that things just began to make sense on the unit. I really started understanding the anatomy, physiology, pathophysiology, and pharmacology of my patient population. This allowed me to connect to my patients themselves and see beyond their condition.”
From a non-nurse consumer: “Several years ago I had a seizure. I awoke in the Emergency Department with a kind nurse who kept me informed. I had no family here. She was there for me and assured me that I was going to be okay. I don’t remember the doctor.”
What makes nursing in your practice setting exceptional?
From a nurse manager in an Intensive Care Unit: “Critical care nurses are exceptional to begin with. They not only perform bedside nursing but deliver emotional support to families. Critical care nurses are intelligent, assertive, and creative thinkers.”
From a bedside OB nurse: “The people I work with form a multicultural community. The nursing staff has worked hard to honor the various cultures in the area.”
From an Operating Room nurse: “Increased technology has been a great benefit. Laproscopic procedures are less invasive. Cataract surgery has improved to 24 hour stay versus a 12 day stay in the 1960’s.”
If you could change the culture of nursing in NC, what would it look like in 2011?
- More collaboration with MD's and RN's
- More nursing-run health establishments
- Nurses driving more decision-making processes in the hospital
- Working together more toward a common goal of patient safety and health
- More efficient documentation systems
- Nurses being ready and willing to look for and discover solutions to problems integrating positive thought processes into nursing practice
- Nursing students developing conflict resolution skills in school
- Interdisciplinary communication
- More respect and mutual support
- Smiling faces!
- Easier healthcare access for the uninsured and underinsured
- I want nurses to be excited about the area that they work in!
- Respect the humanity of everyone and be true to the vocation of nursing as it is not just a job.
- Listen to the patient and don't assume anything!
Non-nurses from around the state told us their dreams for changing the delivery of healthcare:
- More team work in healthcare with less emphasis on title
- Decreased wait times for appointments
- Affordable health insurance for all
- Better training for nursing professionals
- Decrease costs but not at the expense of quality
- Longer time given to patients
- Lower the patient to nurse ratio
- More compassion from and interaction with doctors
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