Let's talk about nursing.

“Let’s talk about nurses and nursing, Jaded Julie. Nurses are my favorite people. This will be a giant leap from our recent discussions about difficult employees.”

“The last time we talked about nursing was back on December 3, 2007, when I told you about the nursing process. I thought you had forgotten all about us.”

“Me? Forget? Although I did sort of overlook my 50th wedding anniversary a few weeks ago.”

“Congratulations, Curmudge.”

“On my anniversary?”

“No. On surviving the forgetting of your anniversary.”

“Not a problem. To make up for it I sent my wife to Ireland, the land of her ancestors. So what do you want to teach me about nursing? As a nurse, you’ll have to provide the expertise for our discussion.”

“Naturally, Curmudge. If we had to depend on your nursing knowledge, our story would end right here. But more to the point, why am I going to teach you about nursing? I’ll bet that you are going to bend our conversation so that it relates to Lean. I’ll have to admit that applying Lean to nursing is likely to be quite different from implementing it in manufacturing.”

“You’ve got the right idea, Julie, as usual. Let’s start by characterizing the actors (usually actresses) in our scenario. Nurses clearly have some endearing as well as compelling professional qualities.”

“Of course we do. Let me count the ways. We are technically proficient, dedicated, compassionate, capable of hard work, sufficiently versatile to move into management or education, and charming in every way.”

“Hey, where did you get that ‘charming’ stuff, Julie? That wasn’t on my list.”

“Of course it wasn’t. I added it to describe me, Jaded Julie.”

“Well, if we are going to describe you, we’d better add feisty to the list. But that doesn‘t apply to all nurses. Is there anything else you’d like to add?”

“Back when I was starting out, I viewed my profession as a ‘calling’ and every day’s work a ‘mission.’ Hopefully most new nurses feel that way. However, as time passed my view of my profession hasn’t changed, but I’m not as starry-eyed about my daily work. I’ve seen too much waste and inefficiency. I guess I’ve just become jaded.”

“It’s interesting that you should choose that word, Julie. I sensed that you felt that way when we first met over a year ago. It may be the result of having to do too many ‘workarounds.’ I understand that nurses are the world’s best ‘workarounders’.”

“You’ve got that right, Curmudge. When I need something to care for a patient and the item isn’t where it’s supposed to be, I have to hunt for it. If I can’t find it, I devise a substitute or take a shortcut. These are all ‘workarounds,’ and shortcuts by some nurses might even compromise patient safety. Running down the hall to search for an urgently needed item may be good exercise for me, but it’s also one reason why older nurses migrate away from direct patient care.”

“If I were the patient, I’d prefer a workaround than having to do without something essential, but I surely don’t want to be the subject of an unsafe shortcut. It sounds to me as if the processes and procedures used by nurses would be ideal candidates for a Lean cultural transformation. If you did that, you could reduce your waste and inefficiency and minimize your workarounds.”

“You did it, Curmudge! Just as I expected, you sneaked Lean into our conversation. You are as predictable as you are forgetful.”

“Maybe so, Julie, but I didn’t forget that Lean is the reason for this blog’s existence. You might say that I worked our conversation around to Lean.”

“And my further prediction is that we are going to continue our discussion about Lean in nursing. Right?”

“Right, Nurse Charming.”

Affinity’s Kaizen Curmudgeon