Well, the other day, I proved myself wrong. I pulled together a policy that had been chewed on by at least six nurses and probably three physicians for a period of roughly five months and still hadn’t been brought to conclusion or completion.
Now for those of you who don’t work in healthcare, you’re probably thinking, “What is she talking about? You mean all these professionals can’t get their heads together and figure out how to write a policy any more efficiently than that? And we’re trusting our lives to these people?”And, you might be justified in thinking that but, in their defense, in this particular matter, they were working against 50 years of practice history (the way we’ve always done it) and at least a one-inch-thick stack of literature offering somewhat contradictory evidence on how we need to change our practices. In addition, there had been an “incident” one that required the attention of the hospital’s liability lawyers which, in and of itself, puts everyone on edge.
So, now we get to my part in all this.
First, I took the work document everyone else had been mulling over and re-wrote it. In doing this I made the language throughout the document consistent and removed all the abbreviations that would certainly have confused someone relying on this document for guidance.
Then, I circulated my draft to the top four or five folks who I knew had a vested interest in seeing this project finished. They gave me feedback and offered constructive criticism.
Finally, I built an algorithm for the new practice (a flow chart of the preferred process steps we want clinicians to now follow) for the interested parties to review.
Right away I got a piece of feedback from someone I didn’t expect I’d even show it to – our new DNP (Doctor of Nursing Practice) who saw that the new protocol asked for a daily abdominal x-ray. She indicated that while the radiation dose from such an x-ray was quite minimal, it would be even better if we could eliminate that step. Her wisdom was to investigate whether the ultrasound imaging machinery we use for bladder scanning might afford us the safe, effective verification we wanted without the need for x-rays.Now, I’m not sure yet if we can incorporate what she has recommended, but I certainly am going to find out. This would be splendid for several reasons:
- The patient avoids the radiation
- The nurse doesn’t have to chase down a physician order for x-rays
- The physician can simply count on the nurse to use the ultrasound machine to accomplish the work without involving the cost or complication of the imaging (x-ray) department.
Even more importantly, it occurred to me that personally showing this document – still in draft form, mind you – so rapidly to so many clinicians, and especially the DNP, gave me very rich input in just a day or two. Far more information than we had been able to pull together in the previous five months.
Now, are we done yet? No.
We’ll get the key players to sign off on the new process next week. We’ll run a pilot for at least two weeks or maybe a month, to see if we’ve got all the details down with sufficient clarity that even a novice would know what to do. THEN, we can publish it as a policy and roll out the instructions to the various departments who will need to change their behavior in order to accommodate the new practice.“So what?” you ask.
The so what is this. . .
- I got to do something I really dread AND found I could enjoy it!
- I found highly engaged colleagues who, when I asked them to focus on and review the work, did so willingly and with insight.
- I got feedback that was targeted, innovative and highly helpful.
- I found clinicians eager to map out a better way to get the intervention accomplished and with the least possible danger to the patient (there’s always some danger, especially when the patient’s care is highly complex).
So I went home at the end of the day totally amazed that the one chore I simply hate doing, brought me, on this day, the kind of job satisfaction that many other elements of my work consistently do.
Who knew that is policy writing and revision could actually be fun?
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