Is the Impossible Really Impossible or do We Just Think it is?

Posted on February 20, 2012 by

I recently purchased The Thank You Economy by Gary Vaynerchuk. In this book, just before the table of contents, was a list of quotes about various items that were thought to be impossible or totally impractical. The items ranged from radio and television to telephones and digital communications. These comments were not made by ignorant people. These comments were made by people who were educated and had made major accomplishments in the past. It reminded me of another person who made a clear but incorrect prediction about something he had a great deal of knowledge about.

On the windy dunes of coastal North Carolina, in 1903, the Wright brothers had the first flight of a powered, heavier-than-air craft. The primary claim to fame of the Wright Flyer was the ability to warp its wings to control its flight path. The first flights were short and straight. This was quite a feat for that time. When you consider that the two brothers were self taught in aeronautics (their primary job up to that point was running a bicycle shop), their accomplishment was nothing short of amazing. Ten months later, in Ohio, they succeeded in piloting their aircraft in a complete circle. This was accomplished at the break-neck  speed of 30 miles per hour. Once more, they accomplished something great

However, despite these monumental accomplishments, Orville Wright saw some things as impossible. In an interview published in the New York Times on February 27, 1914, the following exchange took place.

“Do you take the matter of making a flight across the Atlantic seriously?” Mr. Wright was asked.

“I do not,” he said. “I cannot do so and neither can any other aeroplane manufacturer who will speak frankly.”

Five years later (May 20, 1919), John Alcock and Arthur Brown piloted the first non-stop transatlantic flight from Newfoundland to Ireland (1890 miles). In 1927, Charles Lindbergh made his solo flight from New York to Paris (3600 miles). Did the laws of physics change between 1914 and 1919 to allow transatlantic flight or was it a new thought process that allowed such a journey to take place?

So back to the title of this paper, is the impossible really impossible? Or do we set up obstructions in our mind that prevent us from even considering what we can actually accomplish? What if we took those obstacles down and ruthlessly proceeded beyond them? While Orville Wright was a pioneer in aeronautics, he saw an insurmountable obstruction that would prevent a flight from crossing the Atlantic Ocean.  He looked at the world as he knew it and said, it is impossible.  What if he had maintained his earlier thought process of why not?

Where are you in your healthcare career? If you are not satisfied with your current situation, think of what you can do to change it. Find the barriers that are holding you back and seek ways to either go around, over or through the walls that are in your way.  Ask others for their thoughts. You might be surprised how another person looking at your problems can develop answers that never crossed your mind. Use the support of others around you and climb your highest personal peaks. The view from the mountain top is outstanding!

Climbers on a mountain.

The view from the mountain top is outstanding!

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Four Words That Should Make You Mad

Posted on February 7, 2012 by

I’m just a nurse.

I hear this statement time and again. It is hard to keep from getting mad at the person who spoke it. Though I try to be a person who is aware of and in control of his emotions, those four words seem to grate on me like fingernails being drawn across a chalkboard. I want to ask the person who uttered those words when they lost sight of their career and the immense impact it has on so many people. When did they relinquish their respect for their profession and themselves?  When did they lose sight of their immense body of knowledge and their power to improve the lives of people?

I know that the great majorities of people in the world are very humble. Almost to a fault, they downplay their role in most any activity they participate in. Ask the person who takes heroic measures, at great risk to themself, to save the life of another. The usual response is something along the line of ‘I just did what anyone else would do.’ We tend to minimize the importance of our actions even when we go into a situation that places us into grave peril in order to help a total stranger. I understand humility, but it is not wrong to acknowledge your achievements either.

In my work, I always introduce myself to patients and family with my name and what I do.

“My name is Don Wood. I am a nurse anesthetist with the anesthesia department and will be taking care of you today in surgery.” I am very careful to pronounce the words ‘nurse anesthetist’ clearly for several reasons.

The first reason is to let the patient know that I am not an anesthesiologist. I believe the patient should know exactly who is taking care of them.  With the similarity (actually identical) of the service that nurse and physician anesthesia providers give; it is easy for the ‘you are a male therefore you are a doctor’ misunderstanding to arise. The second reason is that I am proud that I am a nurse. Though all anesthesia providers accomplish the same task, I feel that the nurse anesthetist brings something extra for the patient. We tend to view the patient in a much more holistic manner and address more than just the physical illness and disease.

As nurses, we accomplish great deeds for our patients. From offering a patient level explanation of a medical procedure to restarting a stopped heart, we make a difference every single day. When my daughter was in high school, she often watched the TV show ER. After one particular episode, she announced to my wife and I that she was going to go to medical school and become a doctor. I have no problem with that at all. She followed that statement by saying that it must feel great to save someone’s life. I looked at my wife (also a nurse), and we smiled at each other. I said, ‘Yes, it is a great feeling.”

I am always amazed to read the many stories of nurses who are constantly making a difference. Maybe they save a life by administering a vaccination to a child. Perhaps they review a medication order and catch a possible drug interaction or allergy that the other provider missed. Maybe they tell their neighbor that a colonoscopy is not as bad as they think and screening for colorectal cancer does save lives. The list goes on and on. You may not think you were doing anything significant today, but the care you provided might have its effect days or months from now.

So the next time you are feeling frustrated, overworked and tired, before you utter those four words that make my blood boil, think about the many things you have done as a nurse.

As nurses, we have taken the steps to learn a great deal of specialized knowledge. We have learned skills that, when used correctly, have a large capacity to improve the health of others. Our nursing touch brings comfort, hope and understanding to people who yearn for it. I AM a nurse. We ARE nurses!

P.S. My daughter never did become a physician.  She went into nursing. She is now a nurse practitioner working with an emergency medicine group in Florida – saving and touching lives every day.

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Nursing Coincidence and a Call to Action

Posted on January 25, 2012 by

It is truly amazing how two totally separate circumstances just seem to come together at one time. For me, it was the confluence of my educational process and the plight of a nurse in Arizona.
For those who don’t know, I am enrolled at Western Governors University in their RN-MSN program. I feel that it is time for me to challenge myself and advance my formal knowledge. Everyone in my family has at least a master’s degree. I’m not complaining; my two-year nursing degree and anesthesia diploma have provided the means to get everyone else in the family educated. However, it is just my time to advance. One of my current courses is entitled Professional Nursing Roles and Values. The research for my first paper involved the ethics and autonomy of the nursing profession. I read the ANA Code of Ethics from one end to the other (with suitable references in my paper).
On Monday evening, I made it a point to listen to RN-FM Radio on blogtalkradio.com. The subject was the intriguing “Death & Dying Dinner Parties” hosted by Laurel Lewis RN. These parties focus on having people discuss what they would like for the end life to be, ask questions and hear of options. Laurel was absolutely fabulous in the way she, as only a hospice nurse can, presented this unique concept.
However, the conversation soon shifted to another subject. This is a situation that every nurse should become familiar with and learn from. This is the story of how a nurse (Amanda Trujillo), performing her duties in educating and advocating for her patient was fired and has not been able to practice nursing for ten months. Her license is under review by the Arizona Board of Nursing. For ten months, they have been reviewing the actions of a nurse who was performing the actions of a professional nurse. The process is not finished though; the Board of Nursing now has requested a psychiatric evaluation of Amanda. The earliest resolution on this review appears to be two months henceforth. (I will refer you to a blog by Anna Morrison at iCoachNurses: http://icoachnurses.com/fellow-nurse-jeopardy-amanda-trujillo-msn-rn-dnsc-nps for a full accounting of events and updates.) All for performing the duties that she was educated, licensed, and hired to perform!
In reading the Code of Ethics, it is very clear that we are working for the patient. We may receive our pay from a different party, but our primary concern is the patient. We don’t work for a physician. Rather, we work in collaboration with a whole host of healthcare providers. We are autonomous providers of nursing care. We strive to educate our patients about their condition, medications, procedures and alternatives. We have an obligation to allow our patients to practice their right to self-determination. If you haven’t read the Code of Ethics lately, I suggest that you review them about every six months as a means of keeping your ethical compass calibrated. (To view the Code of Ethics, go to www.nursingworld.org and click on the Ethics tab.)
It was very troubling to hear Amanda speak of her situation. I sent an e-mail to the Arizona Board of Nursing that evening in support of Amanda. Unfortunately, regulatory boards are under no requirement to provide a speedy resolution to their reviews. The Arizona Board of Nursing looks as if they are trying to play the waiting game with Amanda.
In conclusion, I will ask you to do two things. First, go to the link I gave above for the iCoachNurses blog to keep current and voice your support for good, ethical and professional nursing. Second, the next time you apply for a nursing position, ask the interviewer a question – do they abide by and support the ANA Code of Ethics. If they stumble or mumble, stammer or stall, think twice about accepting a position with that organization.

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How many lives have you touched?

Posted on January 17, 2012 by

…we often forget the many times we have made a difference… Continue reading →

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Alternatives in Nursing: Is it Time For You?

Posted on November 21, 2011 by

Many people, almost 3 million, have chosen to make nursing their career.  Many of those people are satisfied with their choice, while others have run into large roadblocks. Nursing today has advanced so far that there are many routes to circumvent any roadblock that may arise.

We often use the word empowerment in nursing.  How to empower nurses, patients and every person we encounter in life. It is high time that we take our words seriously. We must learn that with the proper effort, any goal is within our reach. We need to realize that many of the obstructions preventing our progress are often self-imposed. We need to break through these barriers to let the nurse in each of us go forth to make a positive influence in the world. An exceedingly lofty goal? I set my personal sights in life at a very high level! Truly, we all should aim high.

My postings to blogs and other discussions focus on the positive aspects of nursing. Many of the comments to these columns focus on how hard it is to provide care in the high stress, short staffed and bottom line hospital world of today.  The number of these post has led me to think about ways that the person who finds the stress of traditional nursing overwhelming, can best survive, intact, in today’s nursing world. No matter what solution I think of, I always come back to the fact that people must empower themselves in order to continue their chosen career of nursing.

For the nurse who truly wishes to stay at the bedside in the hospital atmosphere, there are sources for helping with the stress that accompanies this type of work.  Many facilities have an employee assistance program (EAP), stress management or similar programs available.  These programs are particularly effective in dealing with the short-term problems that may be affecting nurses. These are usually advertised as part of the employee’s benefits along with paid time off, health insurance and educational assistance programs. Everyone takes advantage of the time off and health insurance benefits, why not make use of the EAP benefits as well? The interaction is confidential. What is discussed is not reported back to your employer. The type of program might include stress management techniques, alternative therapies or simply the ability to vent your problems out loud to a non-judgmental person who can offer an independent caring ear. It is surprising how your problems change when you actually speak the words instead of stewing the words inside of your mind.

Maybe bedside nursing is no longer an option for you. Family commitments might conflict with rotating shifts and long hours. Forty years ago when I went to nursing school, your employment prospects were limited to working in a hospital or in a doctor’s office. The nurse of today has an infinite variety of workplace opportunities available.  Positions within the insurance industry, advanced practice nursing, independent practice, home health and hospice are but a few of the many opportunities that are available today. Pursuing advanced education is possible by way of the Internet. Some of this education may lead to an advanced degree (BSN, MSN) while other courses may lead to a certificate in a multitude of areas (risk management, simulation, medical coding, or legal nurse consulting). A click of any search engine will yield a variety of options available for today’s nurse.

 

Each person must make an honest assessment of their present work status life position and where they want to be.  Maybe you need to start taking the first steps towards your future while continuing on with your current position. As Steven Covey stated, we must start with the finished picture in mind. We need to have a personal and professional goal to work towards.  When you are taking concrete steps towards achieving your future goal, it becomes a little easier to accept your current position.  All the while knowing that better days are ahead.

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Defining Healthcare – Are we all Using the Same Definition?

Posted on November 1, 2011 by

While reading some online content the other day, I happened across a paragraph that gave me pause.  The article was addressing the work of primary care providers.  Nothing earth shaking in what I read until I saw a sentence that said we should ask the patient how they define health. WOW!!! This is an major point that we often overlook.  Taking notice of this one item can explain a great deal about our patient’s health behavior.

Those of us who have chosen an occupation in the health and wellness field have been well educated in the classic definition of health. We study normal lab values, charts, tables and a plethora of other items that we use to define good health. Variations to these normal values are usually indicative of some disease process. When a healthcare provider sees a value outside of the normal, we have this deep, burning desire to manage and correct the process that produced the offending value.  We will often consult fellow practitioners to get their consul on how to best address the problem that we have found. Then we use a variety of medications and procedures to try and bring all of the values we measure back to the physiologic normal.  At that point we pronounce the patient healthy.

According to the Centers for Disease Control and Prevention, there are approximately 12 million workers in the healthcare sector.  That seems like a lot of people until you consider the population of the entire United States, slightly more than 300 million people.  Thus, only about 4% of the population looks at health the way that a nurse, pharmacist, physician or other healthcare worker does.  The other 96% probably define good health or wellness in ways that we find difficult to comprehend.

When a healthcare worker sees a patient who is diabetic, they will usually pronounce their management as being good when associated with either a fasting blood sugar between 70 to 120 mg/dl or a hemoglobin A1c of 6 or 7%. We have all read studies, viewed slides and listened to lectures that tell us that these values are indicative of good health. But what about the patient? How do they define good health in their own mind?  The variety of answers will truly astound many people, but it will explain a lot of unhealthy behavior.

Most people usually seek medical care for one of two reasons. Either they are in pain or they are leaking a red, warm, sticky fluid from their body. Otherwise, they will pronounce themselves healthy. It is easy to see how this applies to those who have not been sick previously. But many people, even in the face of a diagnosed chronic disease, will consider themselves healthy if they subjectively feel good. Never mind the dire warning of future consequences if they don’t take their prescribed medication. They feel good right now, so they must be ok. Unfortunately, this is when the patient decides to abandon their medication or other treatment.  You see, by their definition, they are now well again.

It is important for us to determine how the patient defines good health. In order to gain their compliance in helping with their treatment plan, we need to know how the patient views what we are doing for them.  Some people are inquisitive and will seek out knowledge about their disease process from us or other healthcare sources.  Others are not interested in our dire predictions about increased risk of stroke, heart attack or other serious event if they don’t take their medication.  They are living in the here and now. Tomorrow is another day that will be addressed when it arrives.   Once we determine the patient’s definition of good health, we now have some insight into how we need to approach them. It may mean that this patient will benefit from a support group or more frequent follow up visits. It may mean that they will actually read and utilize the patient education pamphlets we give them.

Whatever the situation is, we must take the time to get the patient’s idea of good health. If we ignore this critical point, we may constantly wonder why the patient is not getting any better in spite of all of the advice and medication we may dispense. Working towards a common goal with a common definition will probably make life better for everyone.

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Nurses: Are We Caretakers or Leaders?

Posted on August 3, 2011 by

While I was doing some research on a favorite subject of mine, leadership, I took time to reflect on the many definitions of a leader. A leader, depending on the source of your definition, is one who guides, leads or influences others in a particular direction. Indeed, modern leadership has been defined by many current authorities as the art of influencing one or more people in a positive manner.
Yet, when I talk with some nurses about leading their patients, they fail to see nursing as a leadership activity. When pressed about their thoughts about the role of the nurse, they tend to see their role as temporarily being in charge of the care of an individual. They are there for a short period of time to take care of the patient. Those words struck home with me. So I looked up the definition of the word ‘caretaker.’ This is generally defined as one who is in temporary charge of something (a building or a government), usually in the absence of its owner. The differences between the two views were immediately apparent to me.
Leader
First, the leader definition indicates that there is an interaction between at least two people. People! You may refer to individuals or groups, but the bottom line still goes back to people. This also indicates why leadership is such a fluid activity. There are many components to the interaction between individuals that must be accounted for. Education, maturity, goals, and motivation differ with each person involved in a leadership scenario.
We must also factor in the particular situation that leadership is being used. It is very appropriate to change your style of leadership depending on the situation at hand. The use of an authoritarian leadership style is very appropriate during an emergency situation. The leader will direct all followers since there is no time to get input and discuss possible routes of action. On the other hand, with educated and motivated individuals, many projects can be accomplished through the use of a participative style of leadership.
Good leadership also shares a vision of the future, where do you want to lead this person. How often do we paint a picture of where we want our patient to eventually arrive? We must have this goal in mind if we are to be a positive influence to our patients. Indeed, we should strive to involve the patient and their family members together in setting goals and planning the route to take.
Caretaker
On the other hand, the caretaker definition specifically relates to objects such as a building. References to a caretaker government are as close as the definitions come to any reference of people. In this situation, the goal is only to maintain the status quo until someone else comes along to assume control. The caretaker is not interested in improvement, only the prevention of any deterioration in condition.
The caretaker definition also specifies that the relationship is a temporary matter. There is no goal setting for the future or plans for improvement. The caretaker knows that their time is limited. Any changes or improvements await the arrival of the person who will relieve the caretaker. The personal goal of the caretaker is to make it to the end of their time period without upsetting any apple carts along the way. Now that I think about it, I have known several caretaker nurses in the course of my nursing career. These are the ones who say (usually in all seriousness), I just need to keep them alive until the next shift gets here.
So What Are We?
I like to think that nurses of today are truly leaders, that they have the long term interest of an individual at heart. This long term outlook can be contagious (the best type of contagious) to patients and their families. It is in our best interest as healthcare providers to instill this long term plan for improvement with those we take care of. Though we are only with the patient for the time period of our work, we can still inoculate our patients with a vision of increased health and wellness for the future.
The problem that I see is that most nurses see leadership skills as something reserved for those who have access to the administrative suite, sometimes referred to as ‘the suits’. Yes, some of those positions are leadership positions, but the person who occupies that position must possess the skills of a leader. Leaders are people, not offices. Each and every one of us can be a leader to someone through the knowledge and use of some basic leadership skills.
Leaders come in a variety of positions. If you look at your job description, I am willing to bet that, while it may not mention being a leader, there is no prohibition against being a leader either. It is time for all of us to increase our knowledge of leadership and practice these valuable skills. It is through the constant use of these skills that we become better leaders. This benefits our patients when practiced at the bedside and benefits us as individuals when we apply for positions of greater responsibility and authority. The leadership you practice with your patients today can pave the way for you to advance into the administrative suite tomorrow.

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Happy Nurses Week! (and a present)

Posted on May 9, 2011 by

I think Florence would be proud to see how nursing has advanced over the many years since she opened the Nightingale School. Nursing has progressed far beyond the boundaries that were originally envisioned. Indeed, a good description of nursing today would be boundless. We have increased the educational levels found in both the academic and practical aspects of nursing.  Nurse practitioners have further pushed our frontiers back in areas ranging from obstetrics to pediatrics to geriatrics. Nurses are a formidable force within the current healthcare system.

Even as great as that sounds, we still have a long way to go. I think that much of nursing’s potential is still untapped. As a group that comprises over half of the healthcare workforce, nursing should be able to have a major say in the future direction of healthcare.  This was part of the findings from the Institute of Medicine’s report on The Future of Nursing. This is an achievable goal, but it is not something that we can just walk in a policy meeting and lay claim to. There are certain keys that will give nurses entrance to the committees, study groups and other policy making functions that are found anywhere from the local level to national and above.

The first key is formal education. If you don’t have a BSN, then get started on the road to increase your formal knowledge.  Already have your BSN? Then set your sites on a MSN, MBA or other master’s level course. These initials behind your name show that you are serious about your future in this great profession. These initials show that you have made a commitment to become knowledgeable in the full spectrum of nursing. When you have knowledge that spans from the bedside to the board room, you are in a position to have a say in the future of not just nursing, but all of healthcare.

Informal education can be just as important. Skills that are essential to becoming a nurse are taught in nursing schools. But there are many other skills that will enhance and multiply the subjects you learned in school. Knowing the ins and outs of communications, planning and goal setting are but a few of these important enhancements. Similarly, the ability to read non-verbal language and think critically can be extremely important when dealing with people outside of the nursing field. Your ability to utilize emotional and social intelligence skills can bring you to the forefront of nursing no matter what the setting is. We must be just as comfortable discussing changes in policy and its impact on healthcare as we are discussing any number of health subjects with our patients.

The third key we will need to become a formidable healthcare force is the realization that we are capable of anything that we put our minds to. I want to scream every time I hear a nurse say “I’m just a nurse.” Who said that we don’t have an inherent worth? Who relegated us to the ‘also ran’ category of healthcare?  Who started this ‘just a nurse’ business? Unfortunately, it can be traced back to our own doorstep. In nursing’s past we acted as a subservient group to physicians. Today is different. We collaborate with all medical professionals in providing excellent care. We need to notify our attitudes that things are different today.  As Vickie Millazo says,”we are nurses and we can do anything!” We need to update our thinking to agree with what the rest of the world already thinks about us. You don’t get rated as the most trusted profession for 10 years running without being great at what you do.

So Happy Nurses Week! Give you’re a pat on the back for the great work you do in the multitude of settings that you practice in.  Then when you are finished, take the next step to make your profession even greater.

Oh, about the present I mentioned earlier.  In honor of Nurse’s Week, I am giving you 50% off of my book, The Intelligent Nurse! All you have to do is go to the website for The Intelligent Nurse (www.TheIntelligentNurse.com) , click on the graphic of the book and it will take you to a page where you can order a copy of the book.  When you check out, enter the code 4E4JUBXM and you will receive a 50% discount.  This offer will be available until May 30, and is only available through my website and does not apply to books ordered through Amazon or any other resellers.

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Giving Back to Help Build the Future

Posted on November 8, 2010 by

Each year for the past 4 years, I have been invited to share my knowledge of anesthesia with groups of surgical technology students. This take place at the same college I graduated from 37 years ago. The college and I have both matured over the ensuing years. The school does not carry the same name that it did back in 1973. However, the mission is still the same, to educate students in health sciences.

I often regale the students with a few interesting facts about the college’s history. These include how the school’s name has changed twice since I attended (probably to distance the school from me) or how Capper Road was only paved in front of the school (the other mile to the main highway was a dirt road that became a mud bog in rainy weather).  After this, I share some of the wisdom and knowledge that I have acquired over the many years. I do my best to make the information relevant to the things that these students will be exposed to when they start their clinical rotations in the operating rooms of several local hospitals.

When I was first asked to speak to these students, their professor told me that she didn’t have a budget to pay guest speakers. I told her that I have a soft spot in my heart for my alma mater and for students. If she would be so kind to write me a thank you letter, I would consider that to be payment in full. She wrote me a very nice letter that first year and I have been coming back ever since. Indeed, I look forward to doing my presentation each year.

I feel that we all have an obligation to share our knowledge with those who are coming up behind us. We, who have experienced life, can present practical lessons that will stay with the students far longer that dry text books.  We can add a dimension to their education that can only been seen through experience. In addition, there is the interactive aspect where the student can ask questions to clarify something or seek out your thoughts on various aspects of your presentation.

Each year has its special quirks. This year, the computer in the class room used for the presentation, was missing in action. It apparently had been taken by the IT department to update several things 2 months ago and never returned. The professor told me that she would call for a replacement immediately but it would likely take at least thirty minutes. My answer – PowerPoint doesn’t own me.  I am a speaker and I would start speaking on schedule. If the computer showed up we would use it then. you see, I don’t believe in wasting anyone’s time. When I am speaking, my motto is to start on time and end on time. I make a lot of friends by sticking to that motto.

The presentation went well. Since it was a two hour presentation we had a 10 minute break in the middle and many students came to talk to me about various items in my talk.  It was nice to see such an engaged group.

My parting remarks are the same each year. I thanked the students for choosing the health care field and encouraged them to progress both personally and in their profession. Then I told them that I had a vested interest in their good education. You see, as we age, we become more likely to have need for health care.  It is in the interest of every current health care provider (nurse, physician, respiratory therapist, etc.) to help in the training of new providers since these are the people that will taking care of us. We should teach well!

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Attitude — Do You Have the Right One?

Posted on October 26, 2010 by

It is often said that attitude is everything. I submit to you that this statement must be qualified to say that the proper attitude is everything.  This seems to be particularly important when it comes to the health care industry. In these times of increased awareness for patient safety, I see plenty of people with attitude but the safety level appears to have been level for the past few years.

Having lived most of my hospital life in and around operating rooms, there is no shortage of nurses who are willing to show you their attitude. This is particularly true when any new safety item trickles down from the ivy towers of academia, accreditation or outside organizations. I listen to people tell me why this procedure or that process won’t work in their operating room.  Apparently operating rooms are like snowflakes in that no two are alike.  What works at Johns Hopkins will never work in any other OR in the world, or so many people would have you believe.  When I ask what method will work, I am either met with a blank stare or a comment about how that problem has never happened at their hospital.  The big question is how can that attitude be changed?

We probably need to first look at  how the negative attitude set up shop to begin with. Was it something that they brought with them from childhood or from sometime later?  Have they been nurturing a bad attitude since they started their health care training? If we can identify any common ground, then we should be able to perform some attitude readjustment before people start to work with patients. Lacking that information, we still need to change the prevailing attitude that prevents us from making progress in patient safety.  I think that the only way you will be able to grab someone’s attention to start changing attitudes is to make it such an overwhelming event that there will not be any doubt about the hospital’s intent.

But how can you make such a grand statement?  What about having everyone (nurses, surgeons, anesthesia, techs) show up for work one day and not have any patients? A full day involving everyone in getting on board the same train and taking the same trip. When everyone has the same destination in mind, projects like patient safety are much easier to accomplish. But wait, I can hear the attitude from many people already!  You can’t close the OR on a weekday and have everyone but the patients show up. What about the lost revenue, the surgeons lost time, administrators not attending meetings, and so on?  If you want a comparison to show people why this is necessary, just add up the cost to do this for one day. Next to that figure add up the cost of a wrong site or wrong patient surgery.  Don’t forget to add in the legal cost, rise in liability insurance cost, the hospital’s share of the patient’s bill that will not be reimbursed because it was preventable and loss of patient revenue when the public hears (and they will) about the mistake.  Actually the cost for one down day in the OR isn’t all that too much after all.

This is the type of demonstration that administration needs to show the OR staff for them to know that the hospital leadership is serious about effecting change.  This will reinforce the fact that everyone’s attitude must change to embrace proven procedures that have been worked out and shown to enhance patient care and safety.

The Latin proverb — extremis malis extrema remedia — ‘extreme remedies for extreme ills’ holds quite true for this subject. We must take the extreme  measures necessary to keep from needlessly causing harm to others.  While patient safety statistics are often quoted as occurring to “one patient in” what ever denominator you like, the fact remains that if you are that “one person” then it occurred one time too many.

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