1. Mee, Cheryl L. RN, BC, CMSRN, MSN

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Summer is a wonderful season to relax and reflect-to back away from daily responsibilities and recharge your batteries. What better way to contemplate how to improve nursing practice than an off-site retreat from work?

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As you care for patients, you learn what works and what doesn't. But in the rush of daily activity, you rarely have time to think through problems, let alone propose solutions or pick your colleagues' brains. And staff meetings are too short and detail-driven for solving complex problems.


An off-site retreat can be invigorating. On an assigned day, staff nurses-who should be paid for a normal workday-go to an informal setting such as a park or country inn, wearing casual clothes and ready to brainstorm.


At our editorial retreats, we start with continental breakfast and a few fun activities, such as a trivia quiz, to break the ice. Guided by an agenda, we then tackle issues that have bedeviled us in recent months. We all enjoy the break from our routine and return to work energized with new ideas.


As we've learned here at Nursing, planning is critical to a retreat's success. To prepare for a nursing retreat, the nurse-manager or other designated team leader should invite each nurse to propose topics for the agenda. To encourage frankness, she can talk privately with each nurse or set up a suggestion box.


In The Dance of Change, author Peter Senge and colleagues suggest these familiar images for a framework:


Barking dogs: Important and urgent issues that concern everyone.


Nonbarking dogs: Very important-but not urgent-"to do's."


Sleeping dogs: Issues whispered about in the corridors that must be confronted for positive change to occur.



After the nurses identify their own barking, nonbarking, and sleeping dogs, the team leader can then establish priorities and set the retreat agenda. A positive outcome is more likely when each nurse understands that the meeting will be a "safe" environment for constructive ideas.


Impossible, you say? Maybe not. Work with colleagues to convince your managers that a retreat requires minimal investment and can lead to enormous payoffs. If an off-site meeting simply won't work, monthly hour-long sessions between shifts can be useful if everyone keeps a strict focus on prompting improvement.


Remind your nurse-manager that answers to problems in your practice area often lie in the grass roots, and ask how staff nurses can play a role in developing solutions. Start the initiative this summer, and you and your colleagues could be leading change in the fall.


Cheryl L. Mee, RN,BC, CMSRN, MSN


Editor-in-Chief, Nursing2006.