1. Schaffner, Marilyn PhD, RN, CGRN

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As I write this column, this is the week the 44th President of the United States, Barack Obama, took the oath of office. As he started his role as Chief of Staff, the United States is undeniably in one of the worst economic times since the Great Depression, with a budget deficit of $1.5 trillion and more than 10 million Americans out of work (Webb, 2009). With the sluggish economy, no doubt patients and communities will depend on nurses more than ever.


The cost of caring for patients continues to rise. Serious health problems such as obesity, hypertension, asthma, depression, diabetes, and so forth often go untreated and increase the cost of providing care once patients seek our assistance. This has required an exploration of methods to deliver care in a more efficient manner, with a focus on quality of care.


The population continues to age and will age dramatically between 2010 and 2030 (Department of Health and Human Services [DHHS] Administration on Aging, 2008). In fact, by 2030, the population of those 65 years and older will be twice as large as it was in 2000, growing from 35 million to 71.5 million (DHHS Administration on Aging). We must increase our repertoire of strategies to face the complex care of older adults.


Should the characteristics of our "today" cause us to fear tomorrow? Fear breeds doubt. Hope breeds anticipation of a better tomorrow. The strong foundations of nursing were set in the late 19th century by Florence Nightingale. Florence Nightingale believed in the power of nursing. She also believed in the ability of statistics to convey the truth. To have healing powers, we must consider and employ the things we know as nurses. We must convey our story with evidence.


We begin to convey our nursing story by demonstrating care of self. The message is simple. There are some tips I want to pass along. Many of these tips are not new, yet nurses always seem to be "nursing" others and many times put ourselves last. By doing so, we have less to give our patients.


Let us start with tips for you, a human being:


* Work hard but know how to rest and get plenty of it. According to the 2008 National Sleep Foundation (NSF) survey, more than half of those polled said that they get less sleep on workdays and 18% said that they get 2 or more hours less (NSF, 2009). Less sleep can mean less for your patients.


* Make reading a habit. Read to stay abreast of changes in healthcare. Read for pleasure. Reading can nourish your mind, soul, and profession.


* Savor a good meal. Eat slowly. Eating slowly helps you delight in the flavors, textures, and smells of your food. It provides time for socialization. Eating slowly can have weight control and digestion benefits.


* Surround yourself with good friends. Good friends are there when you need them the most. They do not question your wisdom or lack thereof. Good friends increase your enjoyment of life.


* Volunteer in your community; it is the ultimate experience of democracy. You may vote in elections once a year, but when you volunteer, you are voting every day about the community in which you want to live (Howard, 2008).



Tips for you, the nurse:


* Eliminate work-arounds that infringe on safe patient care. Adopt the mantra: "I have time to be safe."


* Learn from your mistakes, turning hindsight into foresight (Hendricks, 2008).


* Tell your story. Everyday share the good things about your day to at least one person.


* Help one another. The feeling at the end of a long day filled with good teamwork is one of true accomplishment. You will find your work will be more rewarding and pleasurable.


* Break old habits. Take time for meal breaks away from the unit. A unit at Massachusetts General Hospital in Boston decided to adopt "one hour off-unit meals"-1 hour away from the unit without adding extra staff (Stefancyk, 2009). Although they are still analyzing the effects on patient care, I can assure you that nurses will not be the only ones who benefit.



Tips for nurses as a collective whole:


* Assist developing products and services around quality and safety to ensure nurses have the tools needed in their organizations (Herrin, 2009).


* Participate in coalitions that address the role of regulation in the industry and work to ensure that regulation adds value to the delivery of patient care (Herrin, 2009).


* Work with academia to develop curricula that integrate quality and safety education (Herrin, 2009).


* Stand together and let it be known; there is a continuing nursing shortage of professional registered nurses who are the single largest group of healthcare professionals in the country (Webb, 2009). Let it be known that we are critical to the delivery of high-quality, life-saving, preventive, and palliative healthcare across all settings, geographic areas, socioeconomic factors, and cultures (Webb, 2009).



In these challenging times, let us not be divided by fear but united by hope. You are but one pebble in the sea, but never underestimate the ripple effects of what you do today on someone's tomorrow. Thirty-six years ago, our association emerged because of one nurse, Marna Schirmer, with a goal of making a difference for gastrointestinal nurses through information sharing, education, and collaborative development of guidelines. Let us thank the nurses who have gone before us, providing us with a basis for our hope for tomorrow.




Department of Health and Human Services Administration on Aging. (2008). Statistics on the aging population. Retrieved January 23, 2009, from[Context Link]


Hendricks, J. (2008). The up side: Quotes from today's positive thinkers. Guideposts, LXIII(9), 16. [Context Link]


Herrin, D. (2009, January). Rising above immediate challenges: Quality at the core. Voice of Nursing Leadership, 7, 3. [Context Link]


Howard, P. (2008). The up side: Quotes from today's positive thinkers. Guideposts, LXIII(9), 16. [Context Link]


National Sleep Foundation. (2009). 2008 Sleep in America Poll-Summary of findings. Retrieved January 23, 2009, from[Context Link]


Stefancyk, A. L. (2009). One-hour, off-unit meal breaks. AmericanJournal of Nursing, 109(1), 64-66. [Context Link]


Webb, J. A. K. (2009, January). Preparing for a new era. Voice of Nursing Leadership, 7, 12. [Context Link]