JONA Volume 44, Number 3, pp 125-126 Copyright B 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
THE JOURNAL OF NURSING ADMINISTRATION
MAGNETA PERSPECTIVES
Leading Unplanned Change Jeanette Ives Erickson, RN, DNP, FAAN The article presents reflections on how Magnet principles help nurse leaders through unplanned change using the 1-year anniversary of the Boston Marathon bombings and the response at Massachusetts General Hospital as an exemplar. A
Always expect the unexpected. This simple truth permeates the daily life of every nurse leader. Being able to effectively respond to unplanned change is one of the key Sources of Evidence (TL 5)1 of the Magnet Recognition Program and an essential skill for today’s transformational leaders. More and more, nurse leaders are helping to guide organizations through periods of unplanned change through effective communication, adaptability, coordination, and the ability to remain grounded. Central to managing unplanned change is preparation. Emergency preparedness drills and clearly articulated policies and procedures are vital. Even core values and the organizational mission and vision come into play. Everyone knows what’s expected of them and is empowered to do what’s right for patients, the organization, and the community. At the Massachusetts A
Author Affiliation: Senior Vice President for Patient Care and Chief Nurse, Massachusetts General Hospital, Boston. The author declares no conflicts of interest. Correspondence: Dr Ives Erickson, Massachusetts General Hospital, 55 Fruit St, BUL 230, Boston, MA 02114 ([email protected]). DOI: 10.1097/NNA.0000000000000037
JONA Vol. 44, No. 3 March 2014
General Hospital (MGH), we work every day to create that environment. On April 15, 2013, we were put to the test. Nurse leaders throughout the city, including at the MGH, were confronted with unprecedented challenges when 2 bombs exploded at the finish line of the Boston Marathon. As the world knows, 3 people were killed, and hundreds more suffered horrific injuries. Victims were sent to a number of area hospitals; more than 30 critically injured trauma patients were brought to MGH. While shock and panic gripped the city, a purposeful calm permeated the halls of MGH. Nurse leaders worked with others to rapidly identify patients who could be discharged or transferred to other units to make room for incoming wounded. Nurses utilized all facets of their role as integrators, navigators, coordinators, communicators, and care providers. As nurses, we focused on the emotional impact of this mass casualtyVnot just on patients and families, but the entire MGH community. We collaborated with colleagues in social services, the chaplaincy, employee assistance, and other departments to support the teams caring for victims and families. We comforted staff whose loved ones and colleagues had been at the race. Highly effective leaders develop high-functioning teams that remain calm and focused at all times. In the aftermath of the bombings, we were able to draw on the spirit of collaboration that exists at MGH. Intraprofessional teamwork is a fundamental philosophy of care here. Driven by Magnet ideals, our culture is to communicate, work together, and trust each otherVqualities that proved invaluable when disaster struck. Because we embrace the Magnet values of professional autonomy, patient- and family-centeredness, collaboration, evidence-based practice, respect, ethical decision making, knowledge development, and
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Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
innovation, nurses feel empowered and supported in their practice. On that terrible day in April, that level of engagement was captured in the words of our emergency department nursing director, Mary Fran Hughes, RN, who said, ‘‘Every nurse at MGH is a leader. I think we demonstrated that today by immediately identifying what needed to happen and proactively doing everything possible to help.’’ Nearly a year after the bombings, that level of leadership is evident in every facet of hospital life, from raising awareness about the diverse community we serve to implementing innovative solutions to bring care delivery to a new level. We’ve learned that the culture of teamwork, patient- and family-focused care, and professionalism is truly embedded in the MGH community. We’ve learned the importance of being ‘‘attuned’’ to the emotional impact a crisis can have on everyone. People need time to process catastrophic events, so creating an environment of ongoing support is essential. We, as leaders, recognize the importance of disaster train-
ing, including drills and simulations. We realize that the world is constantly changing. Cell phones have changed the way we communicate; images and information can be shared instantly. We need to incorporate these technological advances into our disaster response plan. MGH has installed televisions in nurses’ and physicians’ lounges and digital communication boards throughout the hospital so everyone can stay abreast of rapidly unfolding situations. As we approach the 1-year anniversary of the Marathon bombings, there remains great pride in the Boston community for how we came together that day to care for the victims, families, and for one another. At MGH, there’s heightened appreciation at being part of this great institution and a renewed commitment to our mission. I’m reminded of the legacy our dear colleague, Keith Perleberg, RN, former director of Quality & Safety, coined in the phrase, ‘‘Excellence Every Day.’’ He meant it as a call to action to work together to give our patients our best in every moment. He would have been very proud of us on April 15, 2013.
Reference 1. American Nurses Credentialing Center. 2104 Magnet Application Manual. Silver Spring, MD: American Nurses Credentialing Center; 2013.
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JONA Vol. 44, No. 3 March 2014
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
THE JOURNAL OF NURSING ADMINISTRATION
MAGNETA PERSPECTIVES
Leading Unplanned Change Jeanette Ives Erickson, RN, DNP, FAAN The article presents reflections on how Magnet principles help nurse leaders through unplanned change using the 1-year anniversary of the Boston Marathon bombings and the response at Massachusetts General Hospital as an exemplar. A
Always expect the unexpected. This simple truth permeates the daily life of every nurse leader. Being able to effectively respond to unplanned change is one of the key Sources of Evidence (TL 5)1 of the Magnet Recognition Program and an essential skill for today’s transformational leaders. More and more, nurse leaders are helping to guide organizations through periods of unplanned change through effective communication, adaptability, coordination, and the ability to remain grounded. Central to managing unplanned change is preparation. Emergency preparedness drills and clearly articulated policies and procedures are vital. Even core values and the organizational mission and vision come into play. Everyone knows what’s expected of them and is empowered to do what’s right for patients, the organization, and the community. At the Massachusetts A
Author Affiliation: Senior Vice President for Patient Care and Chief Nurse, Massachusetts General Hospital, Boston. The author declares no conflicts of interest. Correspondence: Dr Ives Erickson, Massachusetts General Hospital, 55 Fruit St, BUL 230, Boston, MA 02114 ([email protected]). DOI: 10.1097/NNA.0000000000000037
JONA Vol. 44, No. 3 March 2014
General Hospital (MGH), we work every day to create that environment. On April 15, 2013, we were put to the test. Nurse leaders throughout the city, including at the MGH, were confronted with unprecedented challenges when 2 bombs exploded at the finish line of the Boston Marathon. As the world knows, 3 people were killed, and hundreds more suffered horrific injuries. Victims were sent to a number of area hospitals; more than 30 critically injured trauma patients were brought to MGH. While shock and panic gripped the city, a purposeful calm permeated the halls of MGH. Nurse leaders worked with others to rapidly identify patients who could be discharged or transferred to other units to make room for incoming wounded. Nurses utilized all facets of their role as integrators, navigators, coordinators, communicators, and care providers. As nurses, we focused on the emotional impact of this mass casualtyVnot just on patients and families, but the entire MGH community. We collaborated with colleagues in social services, the chaplaincy, employee assistance, and other departments to support the teams caring for victims and families. We comforted staff whose loved ones and colleagues had been at the race. Highly effective leaders develop high-functioning teams that remain calm and focused at all times. In the aftermath of the bombings, we were able to draw on the spirit of collaboration that exists at MGH. Intraprofessional teamwork is a fundamental philosophy of care here. Driven by Magnet ideals, our culture is to communicate, work together, and trust each otherVqualities that proved invaluable when disaster struck. Because we embrace the Magnet values of professional autonomy, patient- and family-centeredness, collaboration, evidence-based practice, respect, ethical decision making, knowledge development, and
125
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
innovation, nurses feel empowered and supported in their practice. On that terrible day in April, that level of engagement was captured in the words of our emergency department nursing director, Mary Fran Hughes, RN, who said, ‘‘Every nurse at MGH is a leader. I think we demonstrated that today by immediately identifying what needed to happen and proactively doing everything possible to help.’’ Nearly a year after the bombings, that level of leadership is evident in every facet of hospital life, from raising awareness about the diverse community we serve to implementing innovative solutions to bring care delivery to a new level. We’ve learned that the culture of teamwork, patient- and family-focused care, and professionalism is truly embedded in the MGH community. We’ve learned the importance of being ‘‘attuned’’ to the emotional impact a crisis can have on everyone. People need time to process catastrophic events, so creating an environment of ongoing support is essential. We, as leaders, recognize the importance of disaster train-
ing, including drills and simulations. We realize that the world is constantly changing. Cell phones have changed the way we communicate; images and information can be shared instantly. We need to incorporate these technological advances into our disaster response plan. MGH has installed televisions in nurses’ and physicians’ lounges and digital communication boards throughout the hospital so everyone can stay abreast of rapidly unfolding situations. As we approach the 1-year anniversary of the Marathon bombings, there remains great pride in the Boston community for how we came together that day to care for the victims, families, and for one another. At MGH, there’s heightened appreciation at being part of this great institution and a renewed commitment to our mission. I’m reminded of the legacy our dear colleague, Keith Perleberg, RN, former director of Quality & Safety, coined in the phrase, ‘‘Excellence Every Day.’’ He meant it as a call to action to work together to give our patients our best in every moment. He would have been very proud of us on April 15, 2013.
Reference 1. American Nurses Credentialing Center. 2104 Magnet Application Manual. Silver Spring, MD: American Nurses Credentialing Center; 2013.
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JONA Vol. 44, No. 3 March 2014
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
