Vicki Dreger, MSN, RN, MA, CNOR, CNL
"A ship in harbor is safe; but that is not what ships are for." — William Shedd
"I know God won't give me anything I can't handle...I just wish He didn't trust me so much." — Mother Theresa
The first post in this series referred to the CCI homepage: "Being certified reflects your leadership within the surgical and healthcare communities. Your credential is a personal commitment to higher standards that inspires credibility and confidence with patients and peers in your workplace." Leadership–and role modeling–have benefits. There are costs as well, though.
Have you ever experienced either aspect? The benefit could potentially be financial, with promotion and increased salary. However, most benefit is personal. CCI’s White Paper, "Bridging the Gap Between Patient Safety and Healthcare Provider Competency" proclaims that "as the complex healthcare delivery system dynamically evolves, personnel should remain the focus as the most important resource in the delivery of safe and quality patient care" and asks the question, "How can you contribute to the envisioning, dialoguing, and innovating the future of the healthcare system for safe patient care?" Although systems and environments are important in creating a Culture of Safety, it is the personal response of each individual healthcare professional that affirms whether there truly is a Culture of Safety.
The current national and international economic crisis demands more productivity with decreasing reimbursements. To stay afloat, there can be an unspoken pressure to hurry, and cut corners. Those same steps that could be skipped can be pivotal for patient safety. How do you respond to the pressure? Do you resort to abbreviated assessments, and skip even the basics such as patient identification? During a Time Out, do you follow each detail, such as checking antibiotic to be given, comparing consent to actual schedule, and recheck the patient I.D.? Or, do you “assume” that each person has done their part and that all is in order?
The true cost of leadership can affect relationships. While others, for their own reasons, may want to simply proceed and keep the schedule running, clarifying any discrepancies can be seen as a waste of time. A nurse with a strong surgical conscience, who points out breaks in sterile technique which might require reprepping and redraping, can put a crimp in the smooth flow of a scheduled room. What is more important? Seemingly more contented coworkers/superiors, or, true patient safety? This coincides with, does your practice match policy, and vice versa? How do you reconcile those discrepancies?
Ultimately, addressing these matters requires assertive communication and questioning. Some, for whom questioning can interfere with smooth operations, may object in various ways (condescension, power plays). This can be draining for a conscientious certified Operating Room nurse, or any other team member. Is the benefit—intended patient safety—worth the cost? This is a personal decision, and different for each one. For a true leader, though, there is only one choice: being a patient advocate.
