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The Culture of Nursing
THE BACK PAGE
The Culture of Nursing Vallire D. Hooper, MSN, RN, CPAN “Culture is the process by which a person becomes all that they were created capable of being.” Thomas Carlyle1
when appropriate, this care was actually provided in a very timely, yet unrushed manner.
THE DISCUSSION OF “cultural competence,” diversity, and the care of vulnerable populations has been a predominant theme of many discussions and editorials in this and other ASPAN publications during the past year. Much of this discussion has focused on encouraging our membership to expand its horizons and to provide better care to the diverse patient populations that we are now encountering, as well as to recognize and to respect differences in our patients and coworkers within our own working environment. The purpose of this discussion has been to closely examine external issues affecting the care of and relationships with both our patients and coworkers. I would like to take some time, however, to explore the internal aspects of the culture of nursing.
Our emergency room visits involved a moderately sized hospital in Statesville, NC, and a very small hospital in the Banff National Park in Alberta, Canada. The visits involved minor, orthopedic sports injuries, and quite frankly, I expected to be somewhat ignored, and to have to wait FOREVER! Granted, our timing must have been impeccable, but in North Carolina, my daughter (in full, grubby, soccer attire) presented to the local emergency room with a grossly dislocated and possibly broken left pinkie. We were sent straight through triage, were assessed by a nurse and the emergency room physician, x-rayed, and the bone splinted in less than 2 hours. Every member of the staff was wonderful, but the nurses were especially attentive, caring, and professional. Knowing we were from out of town, they also went out of their way to make sure that we had directions to the local pharmacy, local eateries, and then back to our hotel from their facility. The emergency room visit in Banff for my daughter’s broken wrist was equally pleasant and efficient. Interestingly, an emergency medical technician and emergency room physician conducted all of our initial triage and examination, and we did not encounter a nurse until we got our dis-
Kaminski2 defines culture as “a deep core structure within any group of people that is expressed through the members’ knowledge, beliefs, values, convictions, morals and laws.” The culture of nursing blends the art and science of the discipline in a unique combination to provide safe, compassionate care to both patients and their families. I have had the great fortune of experiencing several very positive personal encounters with the nursing cultures within various hospital units in different states (and countries) within the last year. These encounters involved emergency room visits with my daughter, and a weeklong hospitalization of my mother. All of these experiences, however, were amazingly positive in nature, which I must admit, was very surprising. In every situation, we received safe, high-quality nursing care, and
Vallire D. Hooper, MSN, RN, CPAN, is a Perianesthesia Consultant and a Clinical Assistant Professor for the School of Nursing at the Medical College of Georgia, Augusta, GA. Address correspondence to Vallire D. Hooper, MSN, RN, CPAN, 10 Park Place Circle, Augusta, GA 30909; e-mail address: [email protected]. © 2006 by American Society of PeriAnesthesia Nurses. 1089-9472/06/2102-0015$32.00/0 doi:10.1016/j.jopan.2006.03.001
Journal of PeriAnesthesia Nursing, Vol 21, No 2 (April), 2006: pp 149-150
149
VALLIRE D. HOOPER
150
charge instructions. Once again, however, those nurses made sure that we thoroughly understood our care, and had all of the supplies and contact information necessary to survive the rest of our vacation in comfort. In addition, they provided recommendations for interesting “nonskiing” activities to fill the rest of our vacation time! My most positive nursing encounter in the last year, however, would be my mother’s weeklong hospitalization for nonrefractory atrial flutter this past summer. She spent the better part of a week on the telemetry unit of a local hospital with heart rates running anywhere from 130 to 200 bpm. She had been hospitalized in this same hospital, on this same floor, almost 10 years earlier, and while the care at that time had been adequate, the consistency of quality and nursing attention left much to be desired. This same hospital, however, applied for and received Magnet recognition last year, and I must say, the improvement in the nursing culture was palpable! Unlike other hospitalizations, during this encounter, we actually saw the assigned nurse almost every hour. They managed every aspect of my mother’s care, addressing the science of the technology and hemodynamic medications while also providing the artful reassurance that both she and her family members so desperately needed. While no hospitalization is pleasant, I must say that this was an extremely positive experience, and all of that was due to the nursing “culture” in that hospital.
I believe that the culture of nursing, in all specialties, is built on a foundational belief that the profession should do, and provide “all that we are capable of being.”1 I have been fortunate to experience that full dedication to safe, quality care and patient satisfaction in my last personal encounters with nursing care; however, I realize that this positive experience is often not the standard. So what is it that promotes this culture of care? The common theme in our emergency room visits were adequate time and staffing. We were fortunate, however, in that our visits happened to fall during nonpeak hours. The prominent feature in my mother’s hospitalization was a facility with Magnet accreditation, the focus of which is superiority in quality patient care and nursing excellence.3 Does a Magnet accreditation equate to higher quality nursing care? I think so. Do you have to hold this accreditation to provide Magnet level care? Absolutely not! Safe, quality patient care and enhanced patient satisfaction starts with the individual nurse, and then the individual unit. We all have the drive; it is just a manner of working together to enhance the process. It is my belief that every perianesthesia unit is “Magnet” capable. It is just a matter of setting the appropriate goals and developing a plan to attain them. The culture of perianesthesia nursing is ever transforming. Make it your goal to maximize your potential and “be” all that you are capable of, and more!
References 1. BrainyQuote. Thomas Carlyle quotes. Available at: http:// www.brainyquote.com/quotes/quotes/t/thomascarl156163.htm. Accessed March 1, 2006. 2. Kaminski, J. Editorial: Nursing informatics and nursing culture. Is there a fit? Online J Nurs Informatics [serial online].
October 2005;9(3). Available at: httw://eaa-knowledge.com/ ojni/ni/9_3/june.htm. Accessed March 1, 2006. 3. American Nurses Credentialing Center. Benefits of Magnet. Available at: http://www.nursingworld.org/ancc/magnet/ consumer/benefits2.html. Accessed March 1, 2006.
The Culture of Nursing Vallire D. Hooper, MSN, RN, CPAN “Culture is the process by which a person becomes all that they were created capable of being.” Thomas Carlyle1
when appropriate, this care was actually provided in a very timely, yet unrushed manner.
THE DISCUSSION OF “cultural competence,” diversity, and the care of vulnerable populations has been a predominant theme of many discussions and editorials in this and other ASPAN publications during the past year. Much of this discussion has focused on encouraging our membership to expand its horizons and to provide better care to the diverse patient populations that we are now encountering, as well as to recognize and to respect differences in our patients and coworkers within our own working environment. The purpose of this discussion has been to closely examine external issues affecting the care of and relationships with both our patients and coworkers. I would like to take some time, however, to explore the internal aspects of the culture of nursing.
Our emergency room visits involved a moderately sized hospital in Statesville, NC, and a very small hospital in the Banff National Park in Alberta, Canada. The visits involved minor, orthopedic sports injuries, and quite frankly, I expected to be somewhat ignored, and to have to wait FOREVER! Granted, our timing must have been impeccable, but in North Carolina, my daughter (in full, grubby, soccer attire) presented to the local emergency room with a grossly dislocated and possibly broken left pinkie. We were sent straight through triage, were assessed by a nurse and the emergency room physician, x-rayed, and the bone splinted in less than 2 hours. Every member of the staff was wonderful, but the nurses were especially attentive, caring, and professional. Knowing we were from out of town, they also went out of their way to make sure that we had directions to the local pharmacy, local eateries, and then back to our hotel from their facility. The emergency room visit in Banff for my daughter’s broken wrist was equally pleasant and efficient. Interestingly, an emergency medical technician and emergency room physician conducted all of our initial triage and examination, and we did not encounter a nurse until we got our dis-
Kaminski2 defines culture as “a deep core structure within any group of people that is expressed through the members’ knowledge, beliefs, values, convictions, morals and laws.” The culture of nursing blends the art and science of the discipline in a unique combination to provide safe, compassionate care to both patients and their families. I have had the great fortune of experiencing several very positive personal encounters with the nursing cultures within various hospital units in different states (and countries) within the last year. These encounters involved emergency room visits with my daughter, and a weeklong hospitalization of my mother. All of these experiences, however, were amazingly positive in nature, which I must admit, was very surprising. In every situation, we received safe, high-quality nursing care, and
Vallire D. Hooper, MSN, RN, CPAN, is a Perianesthesia Consultant and a Clinical Assistant Professor for the School of Nursing at the Medical College of Georgia, Augusta, GA. Address correspondence to Vallire D. Hooper, MSN, RN, CPAN, 10 Park Place Circle, Augusta, GA 30909; e-mail address: [email protected]. © 2006 by American Society of PeriAnesthesia Nurses. 1089-9472/06/2102-0015$32.00/0 doi:10.1016/j.jopan.2006.03.001
Journal of PeriAnesthesia Nursing, Vol 21, No 2 (April), 2006: pp 149-150
149
VALLIRE D. HOOPER
150
charge instructions. Once again, however, those nurses made sure that we thoroughly understood our care, and had all of the supplies and contact information necessary to survive the rest of our vacation in comfort. In addition, they provided recommendations for interesting “nonskiing” activities to fill the rest of our vacation time! My most positive nursing encounter in the last year, however, would be my mother’s weeklong hospitalization for nonrefractory atrial flutter this past summer. She spent the better part of a week on the telemetry unit of a local hospital with heart rates running anywhere from 130 to 200 bpm. She had been hospitalized in this same hospital, on this same floor, almost 10 years earlier, and while the care at that time had been adequate, the consistency of quality and nursing attention left much to be desired. This same hospital, however, applied for and received Magnet recognition last year, and I must say, the improvement in the nursing culture was palpable! Unlike other hospitalizations, during this encounter, we actually saw the assigned nurse almost every hour. They managed every aspect of my mother’s care, addressing the science of the technology and hemodynamic medications while also providing the artful reassurance that both she and her family members so desperately needed. While no hospitalization is pleasant, I must say that this was an extremely positive experience, and all of that was due to the nursing “culture” in that hospital.
I believe that the culture of nursing, in all specialties, is built on a foundational belief that the profession should do, and provide “all that we are capable of being.”1 I have been fortunate to experience that full dedication to safe, quality care and patient satisfaction in my last personal encounters with nursing care; however, I realize that this positive experience is often not the standard. So what is it that promotes this culture of care? The common theme in our emergency room visits were adequate time and staffing. We were fortunate, however, in that our visits happened to fall during nonpeak hours. The prominent feature in my mother’s hospitalization was a facility with Magnet accreditation, the focus of which is superiority in quality patient care and nursing excellence.3 Does a Magnet accreditation equate to higher quality nursing care? I think so. Do you have to hold this accreditation to provide Magnet level care? Absolutely not! Safe, quality patient care and enhanced patient satisfaction starts with the individual nurse, and then the individual unit. We all have the drive; it is just a manner of working together to enhance the process. It is my belief that every perianesthesia unit is “Magnet” capable. It is just a matter of setting the appropriate goals and developing a plan to attain them. The culture of perianesthesia nursing is ever transforming. Make it your goal to maximize your potential and “be” all that you are capable of, and more!
References 1. BrainyQuote. Thomas Carlyle quotes. Available at: http:// www.brainyquote.com/quotes/quotes/t/thomascarl156163.htm. Accessed March 1, 2006. 2. Kaminski, J. Editorial: Nursing informatics and nursing culture. Is there a fit? Online J Nurs Informatics [serial online].
October 2005;9(3). Available at: httw://eaa-knowledge.com/ ojni/ni/9_3/june.htm. Accessed March 1, 2006. 3. American Nurses Credentialing Center. Benefits of Magnet. Available at: http://www.nursingworld.org/ancc/magnet/ consumer/benefits2.html. Accessed March 1, 2006.