1. Bean, Kathy B. PhD, RN, CGRN, APRN, BC, Editor

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I love to listen to music, and some of my most meaningful growth experiences have come from inspirational music. Recently, I was listening to a song I've heard many times before, but this time, I really heard the words. The song communicates how often we hear words that are not truthful and emphasizes how critical it is to listen instead to the voice of truth because that voice tells a different story-one that we need to hear and respond to!! I suppose I must have been unknowingly struggling with this issue, because the message of this song really hit home with me.

Figure. Kathy B. Bea... - Click to enlarge in new windowFigure. Kathy B. Bean, PhD, RN, CGRN, APRN, BC, Editor

I think most people struggle with moments of discouragement and doubt, but it seems to me that more and more of my colleagues are struggling with these experiences in both their professional and personal lives. In my practice environment, patient census has been fluctuating so much that many have not had steady work despite their full time employment status. As a result, some nurses have left our institution for other opportunities, and now that our patient census is back up, nurses are struggling to deliver care with minimal staffing resources available. In addition, more and more work is required by the hospital accrediting bodies. Staff verbalize their struggles just to focus on meeting the minimal requirements of all these bodies-forget trying to go above and beyond!! For an overachieving discipline like nursing, this tension causes frustration and discouragement.


It is easy to lose hope and feel helpless in this type of practice environment. Patient care is more complex than ever before. We are challenged daily to learn new technology and medications, meet quality safety standards, and document increasingly detailed information. Patients are more informed and, as a result, have more questions, which require more of our time to answer. Frustration, hopelessness, and exhaustion would be easy to embrace. But the voice of truth tells a different story!!


Now more than ever, as nurses, we have an opportunity to impact the work environment by demonstrating what is most important to care delivery and prioritizing how we spend our time. Because of the national Magnet Recognition Program(R) and state-initiated efforts, such as the Nurse-Friendly(TM) Hospital designation in Texas, many hospital administrators finally understand how critical it is for nurses to actively shape and control their practice environment. Many of the care burdens that have been handed to staff nurses time after time are beginning to be carried by nurses who are hired specifically to focus on these special initiatives, such as monitoring and impacting patient safety initiatives or generating and using nurse research. This allows a fair distribution of workload and taps the expertise of nursing without burdening the staff nurse and bringing down quality of care.


As a professional nursing organization, SGNA has been actively involved in developing national guidelines and standards to support and protect the gastroenterology nurse. The 2006 position statements "Minimum Registered Nurse Staffing for Patient Care in the Gastrointestinal Endoscopy Unit" and "Standards of Clinical Nursing Practice and Role Delineation Statements" are examples of how SGNA members have worked to shape our practice environment.


The Certification Board of Gastroenterology Nurses and Associates (CBGNA) develops and administers a certification program that recognizes the special knowledge and understanding of gastroenterology nurses. This recognition demonstrates to the public as well as our multidisciplinary colleagues the value nurses place on using knowledge and gaining recognition for their expertise in delivering and managing care.


I think nursing's voice of truth acknowledges our challenging work environment but speaks to how highly capable nurses are at analyzing this dynamic and stressful environment and responding with creative, useful strategies for meeting patient and nurse satisfaction. Few of us will ever have the luxury of working in a stress-free healthcare environment. Few of us will ever experience a "comfortable" workload with the "idealistic" opportunity to spend unhurried time with our patients and their families. We are, instead, pushed to turn procedure rooms quickly and efficiently, discharge patients within a "standard" time frame, or transfer them to an in-hospital setting quickly in order to keep the work flow moving. We must troubleshoot problems with expensive equipment and products, while tracking down physicians who are late for their scheduled patients and procedures. We must meticulously monitor quality processes and avoid unwanted outcomes. All while delivering care with a positive, optimistic attitude!!


Despite these overwhelming challenges, I believe our voice of truth says we can and will use this opportunity to advance nursing's reputation and recognition by actively creating a win-win environment for patients and nurses. It is critically important that we actively participate in our regional and national organization. We should quickly volunteer to be part of any task force or work group in our practice setting that engages nurses in problem solving through leadership, creativity, and dialogue.


Meaningful change doesn't usually happen when things are going well; instead, those leaps ahead come from the efforts of those who persisted through the tough times to have their voices heard and to direct initiatives promoting positive change in response to the turmoil of the moment. I hope as individuals and members of the nursing profession, we will stay focused and committed to advancing our discipline during this time of opportunity. Stay committed. Be a leader. Contribute to problem solving. Actively negotiate positive change. Listen to your voice of truth.