Making a Difference

“Curmudge, I’ve seen you reading a lot of books on Lean and management. They don’t seem to be the type of book that old geezers read between shuffleboard games. Who buys these books, anyway?”

“The books are written for top management, Jaded Julie. I suspect they are purchased by managers on the way up, MBA students, and one—as you irreverently said—old geezer. The contents of these books should be valuable for middle managers and even for the folks in gemba. It’s too bad that their exposure to the authors’ ideas is so limited.”

“Maybe we can help, Curmudge. If we discuss some of the books’ more important concepts, it might inspire the middle managers who read this blog—all five of them—to implement the authors’ teachings. Let’s start with Quint Studer’s Hardwiring Excellence (1).”

“Good idea, Julie. Studer felt that three things were so important that he put them on his book’s front cover. ‘Employees want three things: (a) They want to believe the organization has the right purpose. (b) They want to know that their job is worthwhile. (c) They want to make a difference.’”

“Having the right purpose shouldn’t be too difficult for a hospital, especially if its mission statement is clearly articulated by top management. (Articulated! Curmudge is putting words in my mouth.) And it should be easy for those of us performing direct patient care to recognize that our job is worthwhile. However, we all must help people such as housekeepers and cafeteria workers to appreciate their own importance. The housekeeper is ‘protecting the patient from a nosocomial infection.’ It’s like the janitor at the Johnson Space Center who said his job was to ‘help put a man on the moon.’”

“Convincing a person that she is ‘making a difference’ may fall more on the individual than on management. One might ask, ‘making a difference between what and what?’ As seen by an inpatient, the difference might be between you, Jaded Julie, and a nurse in another hospital or the nurse on the preceding shift.”

“That, Curmudge, sounds like the personal brand that we were talking about a few weeks ago.”

“It’s that and more, Julie. A nurse can make a big difference to the patient by fully and effectively implementing the Nursing Process, as you described to me back on December 3, 2007. Of course, a nurse’s workload must allow her to spend the necessary time with the patient. Hopefully that will result from Lean initiatives conducted in his or her unit.”

“Curmudge, I remember reading an article by Sandra Nettina on ways that a nurse can make a difference (2). Because the nurse is the member of the care team who is closest to the patient, she should become the patient’s advocate. The nurse’s assessment should be holistic and include understanding the patient’s mood, support system, and concerns. That will allow her to better represent the patient’s interests. In addition, she should listen to the patients, help solve their problems, and teach patients to be their own advocates.”

“That certainly sounds like the Nursing Process as it should be practiced. I hope our nurses have time to do it.”

“Here is a quotation from Nettina’s paper that needs to be shared. ‘I provide hands-on care for all of these patients, none of which I had ever met before. They bared their souls to me, shared the most intimate details of their lives, and admitted their fears and failures to me, a nurse. I listened to them and gave them my understanding and compassion. They touched my soul and I hope I touched theirs.’”

“Julie, if that isn’t ‘making a difference,’ I don’t know what is.”

Affinity’s Kaizen Curmudgeon

(1) Studer, Quint. Hardwiring Excellence. (Firestarter Publishing, 2003)
(2) Nettina, Sandra M. Nurses: The Perfect Patient Advocates. http://www.medscape.com/viewarticle/503902