The July-August 2011 edition of Nursing Economics features a conversation with Peter I. Buerhaus PhD, RN, FAAN (one of the co-authors of the Needleman article published in the New England Journal of Medicine in 2011 that addressed the issue of hospital mortality and nurse staffing).
The PDF file for the Nursing Economics interview of Dr. Buerhaus can be found at http://www.nursingeconomics.net/necfiles/CrucialConversations/cc_JA11.pdf
On page 170 Dr. Buerhaus makes the following statment:
"I am somewhat frustrated in that studies we and others have published that show relationships of staffing and adverse patient outcomes have not led to nurses taking more responsibility for these outcomes. Instead, they are blaming hospitals, saying in essence, “Our hospital doesn’t treat us well; therefore, adverse outcomes continue to be experienced. If they would just listen to us and improve our life, we could do better to decrease adverse outcomes.” Many RNs are not stepping up and taking responsibility and saying, “These outcomes are occurring, and they are associated with nurse staffing. What can we do as nurses to improve and assure they are not occurring in our institution, and on my nursing unit?”
This fundamental issue of professional responsibility is clearly outlined in the ANA foundation documents. Nurses are expected to behave and act according to the standards of professional performance.
Two books have recently been added to my recommended reading list. Carrots and Sticks don't work by Paul Marciano (2010) and The Knowing-Doing Gap by Pfeffer & Sutton (2000).
An epidemic of failure to act plagues the human race. In nursing failure to act is unforgivable and it is also a failure to meet the nursing standards of practice and performance.
In a perfect world, the knowing-doing gap should not occur within the nursing practice arena. Unfortunately, it does. Education is just the beginning, to make changes one needs to take action. Action partnered with self responsibility and accountability. Too often blame for less than ideal practice situations is assigned to someone else. "if only they"...
Watch for further discussion regarding the concepts of commitment, engagment and action in future Prairie Rose editions. If you have ideas, thoughts let us know..let's start a robust and necessary conversation.
Becky,
ReplyDeleteThank you for this post and for recommending my book -- Carrots and Sticks Don't Work. I agree entirely with your message that nurses need to take more responsibility. I also believe that it is a doctor's responsibility to treat his/her nurses with respect. The research evidence on the association between the extent to which doctors treat nurses well and, subsequently, treatment care, is well shown. Warmly, Paul
Greetings Mr Marciano,
ReplyDeleteIt is a pleasure to have you notice this Blog!
I have recommended your book to many others, in fact the Nov-Dec-Jan edition of the Prairie Rose (the paper newspaper that goes to all RNs, LPNs and student nurses (~14,000)in ND)will have your book featured as the Recommend to Read book.
Thank you for sharing this body of work.