The Quixotic Nurse

As a nurse writer and blogger, I often use metaphor as a way to express deeper ideas about nursing and healthcare. In the past, I've explored the myths of Sisyphus and Hercules as they relate to nurses and the nursing profession, and my nature continues to point me towards metaphor as a tool for understanding.

I've recently been considering the figure of Don Quixote as another metaphor related to our often beleaguered profession; although much has been written about Quixote and the author Miguel Cervantes, I don't believe anything has been written about the potentially quixotic nature of nurses. So, my friends, I give you the notion of "The Quixotic Nurse".

(Note: this post is much longer than my usual 500-600 words. Please bear with me and consider this long-form post as a necessary means to my desired literary end.)

Nurses Leaning Into Uncertainty

Throughout history, nurses have provided care to those in need despite the cultural circumstances or political scenarios at hand. Nursing care, like medicine, is a necessary service that simply needs to be provided in a society at all times. No matter that bullets are flying, elections are being disputed, or a pandemic is raging, nurses are there with their patients even as uncertainty rules the day.

APRNs and 21st-Century American Healthcare

Advanced Practice Registered Nurses (APRNs) are an increasingly important fixture within the 21^st-century American healthcare system and nursing profession. Full practice authority is a central key to APRNs’ ability to fulfill the needs of the American public, and it’s time for such authority to be granted nationwide.

Nurses: Come Out of the Woodwork

Although Nurses Week is long over, the public face of nursing still needs a regular shot in the arm so that the public knows what nurses actually do. As nurses, do we describe our work in a way that gets the point across? Does the public know that we're more than the media makes us out to be?

Photo by Dmitry Ratushny on Unsplash

The "Nursing Class Hero"

This post was originally published on June 24th, 2013. It has been slightly edited and updated for your edification and enjoyment. 

Fans of the late John Lennon might bristle at my adulteration of the title of a famous song by the iconic musician and peace activist, but a "nursing class hero" is certainly something to be.

Nurse Empowerment: "Now" Is Always The Time

Nurses have a long history of being significantly disempowered. Historically, nurses served as "handmaidens" to all-mighty physicians, running at doctors' beck and call. The role of the nurse has changed over the years, but we nurses still need to feel empowered to fulfill the promise of our profession.

Nurses As Connective Tissue

Last night on RN.FM Radio, we were graced with three guests, including the editor and two contributing authors from a new book, "I Wasn't Strong Like This When I Started Out: True Stories of Becoming A Nurse". It was a fascinating and inspiring conversation, to say the least.

Nurses Rising

Nurses are legion. We populate almost every corner of the healthcare industry, and we are the largest segment of the global healthcare workforce. In terms of hands-on care, we're at the bedside, in the home, caring for residents of long-term care facilities, taking care of schoolchildren, ministering to the dying, and tending the wounded on the battlefield. Like I said, we are legion, and our importance to society cannot be underestimated.

Nurses Know the Score

Recently, a study funded by the Robert Wood Johnson Foundation (and recently published in the journal Research in Nursing and Health) demonstrates very clearly that nurses are excellent judges of the quality of care delivered in the facilities where they are employed. In fact, the study concludes that nurses' honesty and keen perception of what actually goes on in their workplaces could (and perhaps should, I would add) be a source of useful information regarding patient outcomes, quality of care, and other important factors.

Patients and Self-Advocacy

Several recent studies have brought to light some disturbing issues regarding patients, medical providers, and the relationships between them. These studies underscore the importance of positive relationships between patients and providers, and how important it is that healthcare consumers feel empowered to advocate for themselves.

The Consequences of Nurse Burnout

So, my friends, the votes are in and the verdict is clear. Nurse burnout has real consequences and a ripple effect that is far-reaching and pervasive. Now that we clearly know that the impact is real, just what will we do about it?

Book Review: "The Real Healthcare Reform"

Note: As with all of my book reviews here on Digital Doorway, I received no payment for this review other than a copy of the book from the authors in order to expedite the review process. 

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According to Linda Leekley, BS, RN and Stacey Turnure, RN--the authors of "The Real Healthcare Reform: How Embracing Civility Can Beat Back Burnout and Revive Your Healthcare Career"-- incivility "infects" healthcare workplaces in epidemic proportions. Based on that premise, the authors maintain that it is through embracing civility that true healthcare reform will take place.

Book Review: "The Craft of Compassion at the Bedside of the Ill"

Disclaimer: As always, I received no payment for this book review, only a copy of the book from the author in order to facilitate the writing of this post.

"The Craft of Compassion at the Bedside of the Ill" is a poetic and moving discourse on compassion by nurse, author and medicine man Michael Ortiz Hill. In this stirring book, Mr. Hill presents his view of compassion as a craft that can be learned, honed and developed, a notion that many in the nursing and medical fields would be wise to heed.

Nursing: Trouble in Paradise?

Despite the consistently wonderful press about the trust that Americans place in the nursing profession, not to mention the heady days of new nurses being assured a plethora of jobs upon graduation, the nursing zeitgeist seems just a little diminished and subdued these days. At least for now, many new grads are hard pressed to find work and there is little to cheer about when it comes to nurses' economic standing.

Happy Patients vs Healthy Patients

Recently, I published a blog post entitled "The Disneyfication of Nursing" wherein I examined the relatively new practice of "scripting" nurse-patient interactions, demanding that nurses communicate with patients in a specific manner.

The reality is that hospitals now want to provide care with an eye towards positive scores on patient satisfaction surveys upon which Medicare will soon begin basing some of their payments. While this is an understandable---yet short-sighted--reaction on the part of facilities that receive payments from Medicare, it is clear that there is a slippery slope that may very well backfire when it comes to achieving desired patient outcomes.

The Disneyfication of Nursing?

A recent article on Boston.com describes efforts by hospitals to offer specialized training to nurses in customer service and courtesy. According to some reports, many hospitals are hiring outside consultants in order to boost customer satisfaction surveys in response to Medicare's new ruling that they will begin basing a small percentage of payments to hospitals in accordance with facilities' "patient experience" scores.

Health Care Without Harm

Imagine hospitals and other facilities built without cancer-causing materials. Picture a hospital that supports local sustainable agriculture and organic growing practices. Imagine health care facilities that offer full disclosure of materials used in the delivery of care that might be harmful to consumer health, and fragrance-free environments that do not harm patients with environmental sensitivities.

Health Care Without Harm (HCWH) is "an international coalition of hospitals and health care systems, medical professionals, community groups, health-affected constituencies, labor unions, environmental and environmental health organizations and religious groups" whose mission is "to transform the health care sector worldwide, without compromising patient safety or care, so that it is ecologically sustainable and no longer a source of harm to public health and the environment."

While this may seem like a tall order---or perhaps a pipe dream---HCWH is indeed a growing global coalition looking closely at health issues surrounding mercury, biomedical waste, green purchasing practices, healthy building practices, pesticides and fragrances, and the widespread toxicity of materials used in the delivery of health care.

The stated goals of HCWH are:

1. Create markets and policies for safer products, materials and chemicals in health care. Promote safer substitutes, including products that avoid mercury, polyvinyl chloride (PVC) plastic and brominated flame retardants.

2. Eliminate incineration of medical waste, minimize the amount and toxicity of all waste generated and promote safer waste treatment practices.

3. Transform the design, construction and operations of health care facilities to minimize environmental impacts and foster healthy, healing environments.

4. Encourage food purchasing systems that support sustainable food production and distribution, and provide healthy food on-site at health care facilities.

5. Secure a safe and healthy workplace for all health care workers.

6. Ensure patients, workers and communities have full access to information about chemicals used in health care and can participate in decisions about exposures to chemicals.

7. Promote human rights and environmental justice for communities impacted by the health care sector, while assuring that problems are not displaced from one community or country to another.

Here on Digital Doorway, I will be following HCWH's development and reporting on issues raised through the various campaigns already underway. The health care industry is not immune from the reverberations of its own environmental effects, and I am very grateful to have discovered this robust international campaign with a goal of reducing the toxicity created by the health care industry while increasing sustainability and responsibility in the health care arena.