Unified in Hope: The dangers of the Us VS Them approach to solving large systems issues in healthcare.

Security is not the absence of threat, but the presence of connection.?

As a bedside nurse looking for solutions to a global problem, I often find myself speaking in front of large groups of nurses who are visibly frustrated with our care delivery system that is leaving many patients in harms way. Looking to place blame; because they have done all they can humanly do to avoid letting system issues fall through the cracks to their patients,? they are likely to challenge systems and administrators.?

I have found in my years as a nurse, often while working in difficult middle management positions, that the pathway forward has to be one of cohesiveness. We have to work hard to understand each other’s roles and responsibilities. It is the same as when we are training Security, Nursing and Providers together as we often do for #TACT.? We take this opportunity to reconnect with each other sharing the the same core value of wanting to save lives.

The same goes with the collaboration that MUST exist between bedside clinicians and the C-suite. So today, I thought I would spend some time giving you tips and tricks you can use to help bridge the gap at your facilities and rebuild trust.?

The only way forward is together.?

My favorite population to speak to is Students and New/Novice nurses (learn more about nursing learn about the Novice to Expert theory here by Patricia Benner https://nursing-theory.org/nursing-theorists/Patricia-Benner.php ). I tell them all the time, they saw us on the news wearing trash bags and still signed up to get the Guinness World Book of Records hardest Undergraduate degree. To me, they are the true heroes. Their stories are inspiring and they have a degree of altruism that is often not found in other non-healthcare professions. I have found that the same goes for those that have accepted the challenge to lead these huge healthcare organizations. They have the business and organizational management tools to navigate one of the most complicated industries that exists. When frustrated bedside clinicians and healthcare professionals start to complain to me about all the system issues that they face, I often say this;?

People leading healthcare organizations do it because they do want to make a difference. They could be off running fortune 500 companies where work- lifestyle balance is beautiful, but they tough it out in healthcare because they care. We must learn to work together towards solutions that will secure the future of healthcare.?

Organizations are large, corporate entities that have to make revenue to survive. I often compare them to large cruise ships. They have to navigate the turbulent waters of reimbursement, legal, regulatory compliance, staffing issues, media…etc. They also were formed on models that have not been able to adjust in a timely manner. Even if you have one member of a revolutionary team, they are often in an uphill battle. The competitive nature of business is sometimes negative for the innovation that needs to be forefront in healthcare.?

Most clinicians do not understand business.?

As the most resistant to change in all of corporate America, healthcare workers are often only seeing the negative results of a change. Decisions made for the betterment of the entire organization, can often result in a unintentional decrease in the quality and/or delivery of care. These decisions are often made for sustainability and are made far away from the bedside, in boardrooms full of people that are tasked to look at healthcare as the business it is.?

We need those people to be successful.

That is why I wanted to create a solution that was innovative enough to connect both worlds but have one goal, create a safer healthcare system for all of us. I quickly realized that in order for us to create a meaningful culture shift to one of safety, we had to help organizations build a foundation of trust. Trust goes both ways. I know to have validity in healthcare this solution would need to be research backed, and rapidly deliverable due to faced paced, understaffed world we live in. It would require not only World-Class experts, but I wanted it to enhance each organization's ability to reconnect to their employees. The CEO wants to know that his staff is well trained to keep the house safe, and all employees; even the line cook at the cafeteria, wants to be sure that the organization is providing a safe environment for them to continue caring for those who need it most.?

I believe in a safer healthcare system.?

The one thing that keeps all of us from cashing in our certificates and selling luxury real estate, is that desire to help others. Organizations have an obligation to provide a safe workplace per Federal Law (OSHA). View the following OSHA statement here. https://www.osha.gov/workers . Though there is insufficient research (YET...working on that) to prove that building a well designed Workplace Violence Prevention Program will lead to increased retention and recruitment, many experts believe it will. By making your organization known as a safe place to work, major culture shift will happen and it all starts in the Break Room.

Here are my top tips to get that done using the OSHA reference as a guide.

The only way we secure our systems is by standing together against violence, building trust and supporting innovations that work.?

1. Receive Workplace Violence Safety and Health training in a language that you understand?

Let’s start by looking at the definition of language.

Do you understand the vernacular of a bedside nurse? What is the demographic of the employees in your organization? What are they watching? Where are they getting their perception of culture from your organization?? A simple # search of #nurselife will yield some very cynical, sarcastic memes about lateral violence, patient generated violence and staffing crisis issues.?

But what if you could change the narrative?

You can! In fact, we need you to. There are many of us on LinkedIn Life that are trying to influence healthcare to shift in a way that is not only sustainable, but also supports the organizations as they shift. But we cannot do it without the support of the organizations themselves. Organizations have the platform of all the currently employed nurses, and by bringing in UPLIFTING Nurse Influencers, leveraging AI Generative and new Marketing trends (specifically social media) we are able to change the perception New and Novice Nurses are getting from “we the people” media.?

TRY THIS:?

Start a TikTok campaign about what you are doing specifically to reduce violence in your organization.? (Follow Ascend HR Corp | HR Maximizer for all your HR video content tips! Rollis Fontenot III is the GOAT.)?

2. Work on machines that are safe.?

Safe patient care delivery is a well-oiled machine. Most of the time, the mechanical issues and misfires do not end in patient harm because of those that are at the bedside. We all have to remember we can use as much tech as possible to avoid mistakes, but humans are still providing care to humans. And it’s those intuitive skills that come with the human experience that save lives.?

TRY THIS:?

Take a look at all the reported incidents in the last month on one unit. Look at time of day, staffing levels, patient volume, patient severity, and patient payment demographics. I recommend starting in the ER. See what you find. I can probably guess that you will see areas of “stressed” systems leading to increased violence. (Then call me, and we can strategize what content to produce to?FIX IT. )

3. Right to refuse to work in a situation where you would be exposed to a hazard.?

We cannot leave patients who are in crisis or exhibiting challenging behaviors. No clinician will reasonably do that. But, we do have to keep in mind that those clinicians are also responsible for MULTIPLE patients. We have to have EVIDENCE-BASED protocols that will lead us to ensure no healthcare workers find themselves in harm's way UNPREPARED to deal with that behavior. Yes, there are appropriate interventions for behavioral anomalies. Do we have enough research to know exactly what works when? No. (not yet! Working on that too) But we have some of the top experts in the world trying to figure it out.?

TRY THIS:?

Initiate Safe Zone training. Use this link to get a FREE demo video and printable simulations on how to use our Scene Safety Resource for New Nurses and those on orientation. (Would be great for students too!?)

4. Receive required safety equipment and training & 5. Free from toxic chemicals.?

We know the issue with PPE is a thing. For someone like me, who had to re use masks it is a triggering topic. I understand in the pandemic with a mass influx of patients and we were not prepared for it, but we are all sounding the alarm about Workplace violence and there is not a big push for PPE. I think because it is an overwhelming thought about how we could possibly afford to give every employee bullet proof material and every nurse protective scrubs?

TRY THIS:?

Build your own?TACT Response Kit. Much like a Rapid Sequence Intubation Kit, this model, developed by the team at TACTBook, is a collection of recommended medications and materials to keep on a Behavioral Health Unit/Labor and Delivery/ ER. I think it is an IMPERATIVE part of the BHERT Response model. Sometimes, we just have to help the patient stabilize rapidly and we will have to assist them in their compliance. This can take a combination of seclusion for HCW (healthcare worker) safety, application of puncture proof/stab resistant/ blunt force trauma blocking Protective PPE from a vendor such as @BitePro (Check it out here. Contact me for special discount offers ) physical restraint (I recommend Safer Handling for the least restrictive, effective option on the market), chemical restraint and emotionally regulated negotiation skills. Please remember to include actual PPE to protect from bodily fluids.?

I believe we can create a safer environment to provide care, but we have to work together to do it. The Us VS Them mentality is only detrimental to those we are tasked to care for.

As always, please reach out anytime to see how we can best support one another. Send me an email at [email protected]

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