Transcript of my speech from Nurses Take DC 2018

I am honored to have been asked to speak here today, thanks to the Nurses Take DC organizers for the invitation. I want to make this short but not sweet. There is no sugar coating why we’re here. I want to suggest some ways to kill two birds with one stone in our own communities- back home, wherever we all came from.  We can solve the nursing shortage AND create safe staffing for patients by living up to our values around nursing care. But first, I want to tell you a story.

When I left my hospital job they didn’t give exit interviews. They didn’t care what their nurses thought of working there- what experiences led to their leaving- or how they might have done better to retain that nurse. There’s a lot of talk coming from above about shortages and retention, but no action. You’d think they’d want to find out how to keep us around- right?  How can you expect to retain employees if you don’t find out why they are leaving? 

Well I finally got my exit interview. Six months after I left, completely by chance, I ran into my old CEO- I was coming out from my mammogram- and ran into him in the hallway at that exact moment. I grabbed his ear (so to speak) and we went out in the parking lot and that’s where I had my exit interview.

I had to explain to him the difference between a leader and a ringleader. Because that’s what management was at the hospital- ringleaders. And you know some of our professional organizations use that same style of leadership. They have so little respect for us, value nurses so little, that we are just another production unit… it’s such an inconvenience that we cost money to train and replace. Gets in the way of profit. 

When leaders don’t act in our interest, and their actions don’t match their words, it’s time to get new leaders!!

These hospitals are built with mortar mixed with blood, flesh, sweat and tears, even lives, of patients, and also nurses and physicians. (If you don’t believe me- watch Dr. Pam Wible’s documentary- Do No Harm- about physician suicides- but physicians aren’t the only healthcare professionals who kill themselves.) We work ourselves to bone-deep exhaustion while executives sit in their suites, dining at nice restaurants and playing golf at 5-star resorts at their ACHE meetings. They have second homes, while we get second jobs to make ends meet since our nursing job doesn’t earn us a comfortable living.

They ask us to be responsible for the lives and safety of our patients, and document everything so they won’t get penalized, while we can’t even go to the bathroom, eat lunch, or finish two nurses’ work in one 12-hour shift. Every time we are understaffed, we are doing the work of two nurses. Or more.

They have no idea what they are asking of us. Have you ever had an executive shadow you for an entire shift? Have you ever tried asking them to?

So…The million dollar question is NOT, “Thank you sir, may I have another?”

It is, “How do we solve this mess?”

I don’t know why so many nurses sit behind the nurses’ station whining about work but never do anything about it. I know I’m preaching to the choir here. The point is, we have to do more. Let’s make nursing a career worth keeping!

So here’s what I want each of you to do, myself included.

I want you to go back to where you came from and convince at least one of your colleagues to get off their butt and do something about safe staffing- grow a pair, say something, step out of their comfort zone and take a risk. Then…

I challenge each of you to have three conversations this year, out of your comfort zone. I want you to talk with that nurse colleague, and a physician, and with someone in administration, preferably an executive. I want you to find common ground with them as a human being and have a conversation. Break the ice by asking them, what is the most difficult part of your job…  Let them know you’re interested in what they have to say. And then… creatively propose a way to start solving the problem of safe staffing. Together. Follow through. Commit.

When we have those conversations, there are a few points I want you to take away, remember, and use.

1.     There is a difference between safe staffing to avoid sentinel events and staffing that is adequate to improve a patient’s health after being hospitalized or being treated in a healthcare facility.

2.     Today’s nursing jobs are not the equivalent of a regular desk job. They shouldn’t be compensated like a desk job. Hour for hour, we put in a lot more work and have a lot more responsibility than your average paper pusher. It beats us up, physically, emotionally, spiritually. 36 ≠ 40! Think about that.

3.     Nurses need to be able to do our jobs without sacrificing our physical or mental well-being. We need to see that we’re not stuck forever with only lateral options for career moves. We need to know that by advancing ourselves, we don’t have to sacrifice our integrity.

4.     Keep your intellectual curiosity alive- don’t rely on dumbed-down, pharmaceutical and hospital industry-funded continuing education for all your career needs. They won’t help you go above and beyond. Strive to grow personally, strive to grow beyond the scripted, measured, limited status quo that keeps us stuck.

We hear a lot about VALUE-based care these days, it’s one of those favorite buzzwords that the scripted bots of the healthcare industry love to hear rolling off their tongues. But healthcare won’t be successful unless those who deliver the care have human qualities to care. And exhausted, burned out, chronically understaffed nurses can’t care. Let’s start using value and care as verbs instead of nouns. How about if we VALUE nurses so we can CARE?

But most important of all- let's get back to value- each of us should think about what we value. We’re here for patient safety. We can’t live our values if we’re not authentic. When we know who we are, what we value, and why, we are grounded, and are less likely to be swept away by the strongest gust. 

If you take nothing else away from this rally, resolve to define your values around your work. Why did you become a nurse in the first place? What’s your number one priority as a nurse? Live and work in accordance with those values. Encourage your fellow nurses to do the same.  Moral distress is not good for your health, or your patients’!

Patients and nurses alike, each of us only gets one life for sure. Let’s make sure each of us can live it fully.  Thank you.