Nursing is changing, healthcare is changing, and so is everyone in it.
You are experiencing it every day at work, and in the ways you work.
Understanding the source of these changes can give you insight into what is happening around you and to you.
The primary source of change in healthcare currently is Healthcare Reform, and it’s changing nursing.
As you recall, in 2010, Healthcare Reform expanded access to millions of patients, which prompted the Institute of Medicine (IOM) report on the Future of Nursing to define how nursing could rise to these challenges.
The IOM recommendations included:
- Nurses practicing to the full extent of their education and scope
- Improving and expanding nursing education; setting new standards
- Nurse leaders to participate with physician and other leaders in redesigning care
- Workforce planning and policy making to be based on an improved information infrastructure
These high level changes have now translated into changes at the bedside:
- Rapid roll outs of technologies
- Rigid compliance with clinical standards
- Tightening parameters of medications
- Nurse – patient engagement to deepen to meet patients’ expectations
- Patient discharge improvements to reduce readmission rates
- Nurse education standards rising
- Pace of on the job training rising
Nurses are familiar with change, but not at this pace.
The reality is that the rate of healthcare changes has outpaced the available bandwidth for nurses. Well-intentioned leaders and nurses are on a fast treadmill, and it’s not likely to slow down.
The science of change shows us how to make changes effectively. Nurse leaders cannot apply the principles widely and consistently enough at this point.
Under stress, we hold on to old mindsets, which includes these Myths of Change:
- Education changes behaviors
- Successful change is a matter of finding the right solution
- Successful change depends on having enough motivation or willpower
These are myths. Change requires more than knowledge, motivation and will power.
Change requires not only our minds and environment to align, but it requires a change of heart, literally. For individuals’ behaviors to change, their hearts have to be aligned with their minds.
It’s great when an organization and its leaders roll out changes with successful attention to the nurses’ minds and hearts, along with needed environmental adjustments. But this ideal is rarely consistent in healthcare organizations with our current rate of changes.
Change is always personal. The way you practice is always personal.
Therefore, each of us has a role in being aware of change dynamics. When changes are constant, we can create our own stability by growing self-awareness of our thoughts, mindsets, feelings and responses.
This is a process worth developing. It doesn’t right everything, but it does reduce distractions and stress levels, and allows focus on priorities to return.
Nurse mindfulness is non-meditation mindfulness. This is an active and direct process of nurses noticing, of purposely searching for new information. It’s a process that can be applied to anything, anywhere and anytime. Noticing and observing, non-judgmentally, what you perceive in your thoughts, feelings and surroundings create distinctions. These distinctions lead to new mindsets; your world starts to look and feel different. It’s a new way of being.
Or the alternative is simmering in the sea of changes, like the frog in slow boiling water.
Heath,C. & Heath,D. (2010). Switch. New York: Broadway Books. Langer, E. (2014). Mindfulness. Philadelphia, PA: Ca Capo Press