This year’s Nurses Week theme focuses on safety – “Culture of Safety – It Starts with YOU.” Immediately many of us think of patient safety, and that’s as it should be – patients come first. We know that hospitals can be hazardous to patients because of nosocomial infections, medication errors, slips and falls, increased stress because of lack of sleep. Because of our around-the-clock presence, nurses have always been the sentinels, shepherding our charges towards discharge with no complications.
The ANA defines a culture of safety “as one in which core values and behaviors — resulting from a collective and sustained commitment by organizational leadership, managers and workers — emphasize safety over competing goals.” That’s a great concept but not one that every hospital has put into practice.
Staffing, of course, has to be key – how can nurses fulfill one of our most critical functions – assessing and monitoring patients – if there are too few of us to be able to spend time with patients? How can we prevent pressure ulcers and promote return to strength and mobility if there are too few of us to safely assist patients to ambulate? Patients who’ve been in and out of hospitals – the “experienced” patient – know that nurses are the key to recovery. I unearthed this from an AJN
article published in the 1970s:
The patients were then asked what they felt was the most positive aspect of their experience on the intensive care unit as well as the most negative. Thirteen responded that the most positive aspect was “knowing that the nurses were there every minute”; 10 answered simply, “nurses.”
But a true culture of safety has to include our own individual commitment to safety. The 12-hour shift has come under fire as evidence is mounting that it’s not the best solution for nurses or for patients. (We’ve covered the issue in AJN
in a March 2014 news article
as it relates to fatigue, and also in the AJN blog, Off the Charts
.) The shifts often extend to more than 12 hours, often without breaks; and some nurses may pick-up extra shifts, working four or five straight days of 12-hour shifts. I don’t work in a hospital but in an office, yet when I’m on deadlines and working 10-12 hour days, my brain is fried after four days and I know I’m not thinking as clear as I should be. I’d be afraid to have that kind of fatigue and have to give medications and make critical decisions with lives at stake.
We know nurses have been involved in auto accidents (In the February 2014 issue of AJN
, we reported
on a nurse who was killed on her way home) and involved in near-misses on the drive home from long shifts – my sister, a former NICU night nurse, always put the car in park when she came to a stop light after she found herself falling asleep and coasting through an intersection on her way home.
So for this Nurses’ Week, make a commitment to safety – your patients’ and your own.