I am mature enough to realize that some of the projects I introduce will fail. Over the past four years at the hospital where I work, I’ve introduced many successful projects, especially when my efforts were engaged for the current bid for magnet status. But sometimes, they don’t take off. Sometimes, they die horrible deaths. I think it’s important to just realize this and move on.
I’ve always thought nurses could do their jobs easier and faster if they would utilize the power of the computer to do their work. I wasn’t really talking about medical recordkeeping (although this is important, I don’t think it’s revolutionary). I’m talking about the utilization of computer technology to move nurses away from doing their business in real time, and moving them toward doing some of their tedious work in virtual time, using message boards, blogs, wikis, etc.
My idea was that, since so much of nursing has to happen in a group setting, and since this group effort has historically happened in real time meetings, it would be beneficial to make it so that nurses didn’t have to meet face to face. They could meet virtually, collecting and comparing data, setting agendas, distributing documents, all in the background with discussion. Then, if needed, more effective real-time meetings could happen.
With this added efficiency, the number of real time meetings could be reduced. This could be a real benefit to our industry because hospitals can not be shut down during a specified meeting time. The patients are still there (and still coming), which means most of the leading nurse clinical leaders are not able to attend meetings (because they are too busy taking care of patients.) This means that most critical meetings are happening between people that are not associated with bedside care, and who do not know (or do not remember) what the bedside environment is like.
So I (with lots of help from my sister, Karen) set up a php-based message board for our unit. My plan was to get all of the committee members, clinical nurse leaders, and other members of nurse leadership to write their thoughts. They could update the floor on what the various committees are up to. They could receive input from floor nurses. They could provide evidence-based practice by disseminating articles and websites of interest.
I presented the message board to our Shared Leadership committee. I set up an internet connection to an overhead projection of the message board, and illustrated its use. It was one of the most powerful and well-received presentations I’ve ever given (and I give them a lot), and everyone wanted to get on board. It was exciting. The head of nursing wanted to initiate a discussion with our IT department to set up servers that could run the php board securely. Everyone wanted in. I proudly patted myself on the back, ready to sit back and Watch Everything Change Forever.
Some things I did not anticipate:
1. My Brother-in-Law, Adam, had been harping on me to get a firm grip on what the message board was going to DO for the nurses, and get a good background on web usability. I did not do this nearly enough.
2. Unlike most modern industries, you can be a great nurse and not know SQUAT about computers. In fact, some of the best nurses I know do not have an email address (which, for me, would be like living without running water or electricity). What I mean is, there is no base of computer knowledge that I could depend on. Unlike corporate life, or life in the finance industry, or IT, or higher education, you simply do not need to be good at computers to provide good patient care. So there is no push to “get good at computers” without doing more work on #1 above.
3. Related to #2, you do not need good writing skills to be a good nurse. Contrary to my own self-centered thinking, you don’t need to write a blog, or engage in public speaking, or come up with new documents to be in nursing. So writing for a message board is not necessarily going to be the biggest item on your list of Nursing Things To Do. I could not get any of the committee chairpersons to write for the message board. My requests for committee information usually took the form of a forwarded email with an attached .doc file of the last meeting minutes (which is not what I wanted – I wanted something more personal to get nurses involved, not some dry meeting minutes).
4. I did not have a strong enough relationship with my clinical director to support my project. Well, to put it mildly, we hate each other. So my latest pearl project wasn’t going to go anywhere if it was going to ride on this crazy woman’s back. I should have known that.
So I’ve learned some good lessons. First and foremost is that I presently lack the sort of intimate understanding of people (specifically nurses) to assess their needs, assess their desires to get these needs met, and to meet them.
Probably more training is involved. I’m not sure how much more I’ll do. I’m not of the mindset to be a consultant (and have earned a new respect for good consultants). I think I could go out and learn it, but I’m not sure the information would ever be properly financially reciprocated (this happens a lot in nursing; it drains intelligent and innovative minds out of nursing; it makes it more likely you will die in a hospital bed due to the bad clinical judgment of an unimaginative and unintelligent nurse).
My next project is more commiserate with my skills as a former teacher. I’m working on learning/behavioral objectives for our nurse extern program. If you’re a teacher, I’m thinking something along the lines of the SOLs (Standards of Learning) used in grade school. Sort of a Bloom’s Taxonomy but for people trying to be nurses. Wish me luck.