Health Care System

The (nursing) revolution will not be televised: Part II

/ Carey S. Clark, PhD, RN, AHN-BC, RYT, FAAN / 4 Comments

“If we do not change direction, we are likely to end up exactly where we are headed”- Chinese Proverb.

In one of my previous postings, I mentioned that the nursing revolution would not be televised; in other words, our own revolution begins with an evolution of consciousness about nursing and our practices. I do believe, just as our esteemed nursing theorists Jean Watson has stated time and again, that caring is the essence of nursing practice, and yet we have continued as nurses to generally practice in institutions and organizations that do not know how to value and support the caring- healing capacities of nurses, despite the fact that our patients make clear time and again are of the utmost importance along their healing journey.

We are each, as individuals and nurses, in need of awakening to our own personal path of caring and healing. If we are to be able to share caring and healing with others on a meaningful basis, we have to be on a caring-healing journey for ourselves individually and collectively.

In order to create change in our profession and move toward greater acceptance of caring-healing nursing practices, the change needs to come from within each of us. I have some students who state things along the lines of, “What is the use? I can change myself and yet this will not effect the institution where I work”. And this is where they are wrong. I have seen time and again nurses who move toward changing their consciousness and engaging in their own self-care and healing endeavors, and they then go on to create meaningful changes in their lives and their practices. Others find the courage and strength through self-reflective practices  and increasing stress resilience to realize that they are serving a dysfunctional system and they opt to leave their place of employment. By increasing our personal stress resilience and creating new brain pathways, we can open up to creative solutions to workplace problems and we can walk into our own issues instead of running from them or remaining stagnant.

Stress resilience helps us to create a personal revolution toward peace, ease, and well being. The following is a video by Joan Boryenseko on transformational experiences of healing, awakening, and consciousness evolution. Here she walks into the process of witnessing our emotions and the process of witnessing, forgiveness, and grief.

As we undertake the revolutionary steps of transformation to change our personal and nursing consciousness toward peace, we will notice a reduction in aggression and an increase in compassion, caring, love, and tolerance- the qualities needed to support the creation of healing environments in our healthcare systems and facilities. As our personal and professional consciousness evolves and shifts, we begin to move toward a better understanding of the unity of all human beings and species and even to the larger cosmos.

So what prevents us from taking the steps toward personal and professional revolution through consciousness transformation? Below is a video by Eckhart Tolle that briefly described the movement toward consciousness transformation and moving beyond fear.

I am open to hearing your thoughts here and in the next installation, I will present ideas on the steps toward walking into peaceful revolution and transformation in part III.

The (nursing) revolution will not be televised: Part I

/ Carey S. Clark, PhD, RN, AHN-BC, RYT, FAAN / 3 Comments

Nursing is in need of a revolution. A revolution of thought and a revolution of how nursing is learned and practiced. Now seems to be a “good” chaotic moment in time and history for the revolution to begin and perhaps to expand: as our healthcare systems become less well funded, less well-staffed, and as more and more of the population (in theory) begins to seek healthcare due to “Affordable Care Act”, the stage for change and growth have been set. I do predict that some major changes are ahead for nurses and our roles in healthcare, and if we as a profession and as individuals do not create our own revolution in nursing, the revolution will be dictated to us by others.

Dovetailing on my last post about nursing and the media, I feel confident in stating that the nursing revolution will not be televised. The following is video-recording of Gil Scott Heron’s work on the revolution not being televised:

What Gil Scott Heron really meant he explains here:

We as nurses can learn a great deal from this song and the revolution of the civil rights movement to begin to plan how we each can and must forge a plan to change our minds, our consciousness, to move toward the right page, and find the right note as Mr. Heron encourages us to do. Each of us has within us the power to create the environment and practices of nursing that best serve our patients, our colleagues, and ourselves on this human journey of life, healing, and love.

And it begins within; we cannot televise the changes in our consciousness that we create, but we can begin our own efforts focused on healing and creating stress resilience practices that support us in moving toward others, instead of remaining in fight-or- flight mode and running from ourselves and others. We can each create a personal brain bio-psycho-neuro-immunological (mind-body-spirit) revolution movement that can change the face of healthcare as we empower ourselves and others toward healing and supporting our evolution of consciousness personally and professionally.

In future postings, I will discuss a bit more about how this is possible and the amazing tools that we have at our disposal to make this revolution a reality.

Dream of a Healing House & Feminist thought in nursing

/ Peggy L Chinn / 4 Comments

Toady I posted on my own blog a “reprint” of the “Dream of a Healing House” that appeared in 1989 in the now-defunct journal Nursing and Health Care.  For those who have become familiar with the NurseManifest project, you will immediately recognize that the dream, and the feminist ideas that I wrote about then are also part of the foundation of the NurseManifest project.  It seems like a discouragingly long time since I first wrote this article, and of course it is even much longer since others have conceived of similar ideas.  But, those of us who have been and are inspired by the ideals embedded in NurseManifest possibilities thankfully never give up the dream!

What prompted me to get permission to “reprint” the dream was a request, by email, from a school in Australia that was facing a routine accreditation review of their curriculum, and in the documents that they had on record describing the curriculum there was a reference to a “dream of a healing house” that was not cited, but that folks involved with the program believed to have been published by me at some point along the way!  They were contacting me to see if this was the case, and if so, where was it published.  I still do not know what their curriculum materials contain, but of course I provided the information they needed and urged them to keep working to make this a reality!

This kind of connection continues to pop up regularly with the NurseManifest project – someone somehow hears about or sees the web site, and either emails or comments when we meet about how much the web site means to them.  So far we have done no promotion, and I wonder what might happen if we were to find more ways to let folks know we exist?  But regardless, I am so very glad that the ideas are “out there” as part of a much wider and deeper trust that we can make a difference!

If you have had experiences that affirm the possibility that our ideals can, or actually are coming into action, please share here!  Just share a comment about what you have experienced, and let’s build a “log” of things that affirm our conviction that the ideals can be real!

To Challenge and to Cooperate

/ Peggy L Chinn / 8 Comments

Most readers of this blog are already aware of the IOM/Robert Wood Johnson report on the Future of Nursing that was issued in October of 2010.  You may recall my post about the report last June – in fact, there were 16 replies to that post – a record for this fledgling blog!  The replies were thoughtful and brought to the fore exactly what is most badly   needed in nursing – challenges about not only the report, but the assumptions underlying it.  So I would like for us to focus once again on this initiative, not simply because of the terrific discussion it raised on this blog, but because it is generating a substantial degree of action.  Part of the action component is built into the funding plan that accompanied the original report, which actually strengthen the possibility that something will come of it!  But of course the action components need to be watched closely.  The challenge for me, and I suspect for many others who entered the discussion in June, has to do with a fundamental question: “Who benefits?”

During the August conference of INANE (International Academy of Nursing Journal Editors) in San Francisco, the 130+ nursing journal editors and publishers heard a presentation by Susan Hassmiller, the Senior Advisor for Nursing for the Center to Champion Nursing in America.  In response to her presentation, the group decided to initiate a coordinated effort across as many nursing journals as possible, to further the possibilities for the achievement of the report’s recommendations.  So far, the INANE web site has a listing of editorials and resources that have appeared in various nursing journals over the past year or so; in the spring of 2012, many of the journals will carry focused messages about the report, articles, and other content that provides evidence and resources for their readers in moving forward.  I would encourage folks to browse this list … it is impressive, and many of the editorials are well worth looking up and reading.  Also, if you want to see Susan Hassmiller’s presentation from the INANE conference, you can find it here (scroll down to the Friday 8:00 session).

So my question for readers of the Nurse Manifest blog: can we both challenge and cooperate?  I fully agree with many of the challenges that came forward in our discussion in June, including skepticism about the source of the report, and the fact that the report’s recommendations are in fact what we might call “lame.”  However, the cold hard truth is that the recommendations of the report, which of course should already be reality, are far from real.  If we were to achieve the report recommendations as reality, do we not have a better outlook for achieving not only the fundamental goal of better health care and better nursing care, but also the ideal of seeing nursing at the center of health care policy-making.  If we simply sit on the sidelines and challenge the report, then we isolate ourselves from the places where mainstream change might be possible.  If we simply cooperate with the report without questioning some of the assumptions and directions, then we ourselves may all too easily be drawn into an abyss of the status quo.  So bottom line, to me, there is no simple way forward.  But I favor moving forward, challenging ideas and actions where possible to be heard, and with as much cooperation as possible with those who follow a more mainstream path than many of us follow!

Continuing to look at the Nurse Manifesto

/ Carey S. Clark, PhD, RN, AHN-BC, RYT, FAAN / 6 Comments

As summer progresses, I continue to think about the demand for change in the healthcare profession and nursing. The Manifesto provides us with a unique tool to begin the change process, and a foundation for the call to change.

Here is another quote from the document that may be of interest to examine with some depth:

The situation we find ourselves in has been created from an array of forces. While economic issues have helped create a situation in which nurses cannot practice nursing, we, as nurses, have participated by remaining silent. Our professional sovereignty is threatened. The health of global humankind is at risk. It is now time to ask ourselves, who benefits from the situation as it now exists? As long as we know that the current situation inhibits the fullest expression of nursing’s highest values, and that people who need our care are not receiving the best we can offer, we know that we, and those we serve, are not benefiting. If nurses are to significantly contribute to a mission of caring for people and communities, we must find our voice, acting now to create situations in which our values come to the center and from which we can realize our best intentions.  (Cowling, Chinn, & Hagedorn, 2000, paragraph 3).

I have to agree that healthcare is big business here in the USA, a place where democracy, free enterprise, and capitalism have created a healthcare system which profits in the billions of dollars every year. For more information on the profit status of insurance companies, I found this link helpful and easy to follow: http://www.huffingtonpost.com/2011/05/14/health-insurance-companies-make-record-profits_n_861946.html.

As nurses we have in many aspects blindly given over our practice to the regulating agencies and facilities where we work. Instead of as a profession deciding the services we can and will provide, which includes enacting our core values of caring and presence for those on a healing journey, we have chosen to allow our practices to be largely dictated to us. I believe that the high rate of burn out among nurses, and the great professional exodus of many new nurse graduates, is related to the inability to enact a caring-healing presence at the bedside.

So how is that we find our voice in order to create the type of transformative change that is so desperately needed in our healthcare system? While I believe joining a professional nursing organization is a place to start, I think we have found that having over one hundred specialty organizations in nursing has in some ways defeated our ability to come together and create a single strong voice. The American Nurses Association also has it challenges with membership and creating true, meaningful action. As the largest number of healthcare providers in the USA, a clear strong united voice and resultant action that demonstrates how our values can be realized in the healthcare system.

I think partnering with patients offers the profession a lot of hope for the future. As patients demand more access to complimentary and alternative modalities, nurses are the ones who could be enacting these interventions. Patients also know the importance of a caring presence at the bedside as they journey through suffering and the healing process. Patients are also some of our greatest teachers, as they remind us over and over again of the importance of nursing and the urgency of the need for loving kindness and caring in our professional actions. The rewards of nursing are indeed encapsulated within the patient-nurse transpersonal experience, and we have failed on many levels to support one another in explicating, teaching, supporting, and enacting the intricacies of this process.

I also believe that there is great hope for the future: each of us has the power to enact and create the kind of nursing practices we envision. Many of my students have found that by changing their views of themselves and the world, and begin to take action in creating change in how they practice nursing. With an emphasis on self-care and holism, the students often find themselves empowered to begin to solve workplace issues. They begin to return to the sacredness of their work, and enact their own healing journeys.

I suppose the questions remains in how to continue to reach the many, many nurses who are suffering in oppressive work situations. How can we best support and empower these nurses to take back their practices, and accordingly allow for our true nursing values of caring, compassion, empowerment, and patient advocacy to emerge?

Reference:

Cowling, R., Chinn, P.L., & Hagedorn, S. (2000). The Nurse Manifesto.
Retrieved June 27, 2011 from http://www.nursemanifest.com.