Why “going it alone” doesn’t work in health care!

Why “going it alone” doesn’t work in health care!

By Irene Andress, Chief Nursing Executive
 
At Michael Garron Hospital, nurses play a key role in problem solving – applying their knowledge and skill at the frontlines and at the system level. Recently, I’ve been intrigued to revisit nursing theory in guiding our practice especially as it relates to the complex and ever changing needs of those we serve – our patients and families.
 
I encourage you to look at models like the AACN Synergy Model for Patient Care. Developed in 1990’s, refined by Hardin, 2005, and rooted in the critical care setting, the core concept suggests that “synergy” results when the needs or characteristics of the patient/their circumstance matches the nurses’ core competencies.
 
At its core, successful models of care connect the right care provider with the priority patient need which considers how family and community contribute to the nurse – patient caring relationship. In our hospital, given our patient acuity and need, the Synergy theory is foundational to our care delivery model.
 
As the largest body of health care providers at MGH, nurses are situated in the care setting in many diverse roles from the bedside to the boardroom, working within great teams and in partnership with other clinical and corporate professionals.
 
I’m incredibly proud of the accomplishments and achievements of many of MGH’s nurses: from Daisy Award winners to Nightingale nominees and recipients. Nursing is present in the details and when we get those details right, our patients and the broader health care system wins.
 
There’s an African proverb I know that says, “If you want to go fast, go alone. If you want to go far, go together.”
 
Let’s face it, in health care, it’s a marathon, not a sprint.
 
And the truth is, no one person or professional – or category of nurse – has all the answers to solving all that ails the system. Our organization and broader health system works when we all work together, problem solving collaboratively with the interest of the patient and their family at the forefront.
 
As nurses, we must also remember we are one profession, many faces.
 
Yes. This is Nursing. And this is the MGH way.
 
I’d like to share a special video that highlights some of the important work that nurses – in partnership with other professionals – engage in that’s helping to improve the safety and quality of care we provide.
 

Happy Nursing Week!
 
Join me on Twitter @IreneAndress

One profession, many roads taken

One profession, many roads taken

By Irene Andress, Chief Nursing Executive
 
IreneGrad
Time flies.
 
Next year, it will be 30 years since I graduated from Ryerson University’s School of Nursing. So much has changed. Nurses today no longer wear the white, starched uniforms and caps of yesteryear. More importantly, nurses today are more educated, highly skilled and knowledgeable.
 
They have to be. Health care is changing at a dizzying pace.
 
Last week, I saw this incredible expertise, skill and knowledge when I shadowed some of the nurses and nurse practitioners on Michael Garron Hospital’s respirology and oncology unit.
 
Have a watch.
 

And I realized in their varied titles, all nurses share one goal: to use their skill, knowledge and expertise, partnering with patients and their families as they move through their health care journey.
 
Spending time with nurses every month- shadowing them on the units- not only gives me a connection to the front lines, but also allows me to realize the breadth of this great profession.
 
There’s a saying I came across the other day by a fellow named John Le Carré:
 
“A desk is a dangerous place from which to watch the world.”
 
And so I make it a priority to learn about the nurses who work here and see the profession from their eyes. Looking back now to my own career, I never imagined I would leave the bedside to influence patient care from an administrative lens as Chief Nursing Executive.
 
But within the nursing profession, there are many roads taken:
 
All around MGH, nurses like Maria Janes, Nadia Raymond, Mikki Layton and Laura Istanbulian manage care directly at the bedside;
 
Nurses like Sandra Dickau and Jane Harwood manage programs and patient units;
 
Nurses like Gaye Bell manage patient relations;
 
And nurses like Kirsten Martin manage clinical decisions related to planning the new redevelopment.
 
We’ve taken many different paths, but in actuality, we nurses are all guided by the same beacon calling us to our destination – that of the patient. Nursing really is one profession, many faces.
 
Nurses working as a team are a formidable force – we’re even stronger when we work together toward a common vision. When we’re aligned, we truly have a great opportunity to shape and influence the entire health care system.
 
We are one profession, many faces and I’m proud to lead the nurses at MGH – patient partners and advocates for the highest quality of care.
 
Happy Nursing Week.
 
Join me on Twitter @IreneAndress

Dispatches from the Frontlines: Ensuring Safe Transitions

Dispatches from the Frontlines: Ensuring Safe Transitions

By Irene Andress, Chief Nursing Executive
 
Andress_justin
 
Years ago when one of my hockey-playing twin sons, Justin, was very young, he underwent surgery to repair a hernia. As a mom, I had a lot of fears. How would he react under anesthesia? Would there be complications? Would his recovery be uneventful?
 
I know many of you can relate. I’m a nurse, but Mom first.
 
And during those moments waiting for him to come out of surgery, I remember feeling vulnerable, helpless and scared. Pain shows up in a lot of different ways for different people.
 
When I first saw Justin in the Post Anesthetic Recovery Room or PARR, I knew he was in a lot of pain. He was writhing and reeling and climbing over the rails. It was scary to watch. Even with clinical knowledge, I struggled to make sense of what was going on. I relied on the expertise of the nurses and physicians.
 
I also relied on their knowledge and skill to communicate what I needed to know as Justin transferred from the Operating Room (OR) to PARR and then to the unit. Seven years later, Justin does not remember trying to climb off the stretcher.
 
A few weeks ago, I visited PARR – this time to shadow Jessy Thomas, a highly-skilled RN of more than 15 years of experience. I saw how she used the Eight Rights of Medication Administration to minimize the chance of medication errors, performed independent double checks on a number of processes to ensure safety and kept her patient comfortable during her stay in PARR.
 
Watch Jessy in action below.
 

As you all are aware, when we transfer our patients from OR to PARR and then to a unit, the critical information about their health must be passed on safely and effectively. For a safe transfer we must make use of the tools that we have to ensure that we’re giving the right information to the right person at the right time. This guarantees that there is no gap in the continuity of care. We must make sure that the critical information about the patient is communicated clearly and effectively to the next care provider – complete documentation that uses checklists, face-to-face communication and sometimes the telephone.
 
Over the next month I challenge you to reflect how you help transition patients safely. How you use the 2 Patient Identifier and other tools to ensure safe transitions.
 
As a provider, you can’t know for sure what your patient is going to remember from their experience in hospital. But what you can do is ensure that you’re using your knowledge and skills to keep your patients safe and comfortable. They will always remember – and thank you.
 
Join me on Twitter @IreneAndress.
 

All eyes are on us

All eyes are on us

By Irene Andress, Chief Nurse Executive
 
I still get flashbacks.
 
When I was a fledgling nurse, just out of school, I did a placement at a long-term care home. The morning started like any other and I was assigned to help a patient with their morning hygiene. Everything was in place, including a steel wash basin at his bedside table.
 
Then it happened.
 
I don’t know what I said or what I did, but I vaguely remember seeing a flash of silver coming down toward my head. I ducked out of the way. Just in the nick of time.
 
My patient had tried to hurt me with that heavy washbasin.
 
It’s a memory I’ve tried to forget over the years. And for many reasons I didn’t tell anyone. I was scared and embarrassed. I had no one to tell. But recently, as we prepared TEGH nurses to be part of a print feature in the Toronto Star (that’s scheduled to be in print on Saturday) and a national documentary on workplace violence that’s set to air this Saturday on Global TV’s 16X9, I was forced to confront my past.
 
Did you know that, according to the stats, compared to police and firefighters, health care providers, particularly nurses, have a higher risk of being assaulted at work? I’ve spoken to many nurses as they described being choked, hair pulled and tackled to the ground. Has it always been like this? Like me, have we hidden this reality?
 
Today, I’m proud to be a nurse at TEGH. We have a zero tolerance for any form of violence and we encourage staff to speak out and report it.
 
We’re a national and provincial leader in the prevention of workplace violence.
 
In partnership with our union leaders from ONA, we’ve implemented a comprehensive violence prevention program that includes extensive hands on training for staff and patient flagging. Part of our successful workplace violence prevention rests in the capable hands of our security team.
 
And I saw this firsthand as I shadowed Ortney Brown, security agent. Our security agents are valued and appreciated constantly by the staff of TEGH. Their expertise, communication and responsiveness is outstanding.
 
On behalf of nurses and the staff at TEGH, thank you!
 
Spending time with Ortney was a privilege. In his quiet, yet confident way, he continually reminded me of the importance of teamwork, caring for each other and taking a stand for the kind of community we want to work in.
 
We all have a role to play in living our values… of being excellent in what we do, of caring for each other and our community and of respecting our workplace and our colleagues.
 
Join me on Twitter @IreneAndress


Irene Andress, CNE, shadows security agent Ortney Brown. Watch now!

If your Dad was in that bed, what would you like us to know?

If your Dad was in that bed, what would you like us to know?

By Irene Andress, Chief Nurse Executive
 
Like so many of you, I’m a proud East Yorker. And Toronto East General Hospital is my community hospital.
 
It’s a constant that has been here for most of my life’s major milestones: I was born here, my kids were born here and my mom received compassionate care in her last days here, within these walls. And despite being in the big city, TEGH has always had that small-town, everybody-knows-your-name kind of feel, where my doctor could be my neighbour.
 
Through my lifetime, our community has grown, my family has grown, yet our hospital has retained that same “family-like feeling.” It’s this sense of familiarity that’s so comforting to me – especially when a loved one is here, receiving care.
 
As Chief Nurse Executive, having a family member in one of our beds always reminds me about the importance of getting to know the person and understanding their story. And when they can’t tell it – because of age, dementia or another reason- we work with the family to help them tell it. When a family member was recently admitted, I knew they were in good hands. Still, I worried whether the information I told one nurse would be passed along to the next.
 
At the bedside, critical information is relayed from one care team to another during bedside shift report when nurses change shifts. Recently, I saw this in action and had the opportunity to shadow one of our nursing teams led by Shanda Samuels, an RN on B3.
 
As I watched my loved one transition from the emergency department to the unit to surgery and back, it gave me incredible peace of mind knowing that nurses and other care providers acknowledged the information I gave them. They wrote it down. They confirmed and asked me about it. I felt like I was a member of the care team – like my input mattered.
 
And feeling like I mattered matters a whole lot.
 
This information gives those caring at the bedside the tools they need to anticipate the patient’s need. It’s often the difference between a ho-hum and a great patient experience. Communicating with and involving the family during transition points provides opportunities to make care safer, reduce the risk of an adverse action and ultimately improve the patient experience.
 
As our hospital continues to evolve and we gain an increasingly louder and more influential voice in the Toronto teaching hospital community, keeping that “family feel” is important.
 
It distinguishes us.
 
It starts by making our patients and their families feel at home and part of the care team. And it starts by listening and asking, “What would you like us to know about your dad?”
 
I’d love to hear from you. Let me know what you think @IreneAndress