Transformation of a culture

After our first day at The Telluride Experience (The Academy for Emerging Leaders in Patient Safety) I am struck by many things. It’s encouraging to see so many nursing and medical students coming together to discuss the issues facing modern healthcare. Each person here has a strong spirit and dynamic energy that it going to be put to good use not only this week, but in the future as we each return home and begin to tackle the tough issues on the front lines. Our discussions have led to numerous questions. As I recount some of my thoughts from the day, I will share these questions.

This morning we watched “The Faces of Medical Errors…From Tears to Transparency: The Story of Lewis Blackman.” It’s a poignant retelling of how the system failed one family and ultimately resulted in the unnecessary and untimely death of a 15-year-old boy. One line hit me particularly hard. As Lewis’ mother recounts the story, she says (and I’m paraphrasing) that the nurses and medical staff were running around, only thinking about each task that they had to do.

Tasks. They dominate my nursing career. There are medications to administer, assessments to document, and procedures to be done. All the while we are running for supplies, juggling multiple phone calls, requests from patients and their families, and still trying to make sure we take a few minutes to grab a bite to eat and recharge ourselves for the rest of the shift. We get so inundated with small tasks that it’s easy to lose sight of our ultimate goal.

Today I was reminded that while tasks dominate my day, I must remember why I’m doing these tasks. The goal of each task must be linked to helping my patients and promoting a safe hospital environment. 

Thinking about all these tasks has lead me to my first big question. What can we do to improve our systems and streamline or eliminate tasks that are inefficient or unnecessary?

The struggles facing healthcare are numerous, and each feels almost insurmountable. There is no easy solution. There appears to be two dominate personality types in healthcare. Those that are extremely proud, or—the opposite end of the spectrum—those that are timid. Our pride and our meekness are killing people.

I have practiced nursing for about two years. In my short practice I have seen both attitudes. We need to drop any pride that doesn’t listen to insights from others, and speak up when we see something wrong. We need a dramatic culture change. Now.

I fear that those so deeply immersed in the culture will resist the changes that we desperately need. This leads to my next question. How do we change the culture when there is a large gap of clinicians who are far from retiring, but still too stubborn to adopt new behaviors?

I am encouraged to see so many people from across the country eager to help transform the culture of healthcare. Hopefully I have what it takes to bring these ideas home and begin to do my part in transforming our antiquated culture.

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