Nursing's non-negotiables for re-starting cancelled care
In honour of International Nurses Day this week, I wanted to share some of the key lessons learned by nursing leaders and their colleagues during the Covid-19 outbreak—they're ones I hope we'll continue to remember and leverage going forward to make our systems stronger.
1. Nursing can push the rest of the care system to get comfortable with risk.
Across many of these conversations, we talked about the need for nursing leaders to signal to teams that some risk is OK, and that failure shouldn't always be hidden because it's a powerful learning tool.
We also talked about capturing success from new ways of working to really ensure that these approaches stick for the long-term. Many CNOs said their preparations for Covid-19 led to the fast implementation of strategies that had been under debate for years. For example, one leader shared that, after years of wrangling, one meeting with her clinical colleagues was all it took to accept that, without criteria-led discharge, they would collapse, and so it's now been embraced by all.
Another leader talked about having been able to significantly increase the work done by nurse-prescribers at a level that was previously 'not accepted' by other clinicians. Again, I wish it didn't take a pandemic to expedite these opportunities, but let's celebrate and publicise them to ensure they stick.
2. As the frontline, nursing is uniquely positioned to help assess which crisis-borne "innovations" are the right ones to keep around.
We talked through a very simple set of three questions to help CNOs and their teams make that call:
- What is the innovation in plain and clear terms? If you can't get to clarity here, maybe you need to stop the conversation until someone can!
- How is it disrupting the delivery of care? In other words, what's the ROI/evidence?
- Does policy inhibit or incentivise adoption? If it inhibits, why? And if current policies cause friction—as outlined in the graphic below—is that necessarily a bad thing or can we learn from it?
3. Going forward, nurse leaders must wear two hats.
Because of the pandemic, nurse leaders have had a major role at the strategy table, helping design and implement every element of each country's response to Covid-19. But we've long heard from CNOs frustrated by not always having the chance to operate consistently at a system strategy level. The pandemic has forced that to change quickly—and hopefully for good.
Last year, we developed a simple tool to help CNOs to, first, think about the balance between leading the nursing organisation and leading at the system level, and how they want that balance to fall out for them. And second, to identify any barriers to making that shift and ways to overcome them. Below, I've included the two-part framework in the hopes that it might be helpful for nursing and other leaders.
Covid-19 weekly webinar: What you need to know in 30 minutes
Every week Advisory Board's Vidal Seegobin will lay out in 30 minutes the most important Covid-19 developments for global health care leaders, based on what's happening around the world. If you make time for only one call each week to stay up to date on the pandemic, this is the one. We're hosting two sessions per week to accommodate members around the world.