Lead from where you work

Next week we implement the first round of changes in what is the most significant, transformative process our health region has undertaken in two decades.  Those of you working within sites and programs shifting in this first phase of clinical consolidation are already experiencing the disruption change of this scope entails.

While it's fair to say that change and the stress that accompanies it aren't exactly new in our world - no one chooses nursing if they're looking for a predictable workday - this is a lot to process. It's difficult and it's got a lot of people asking why we're doing it.

So how do we respond? How do we talk to each other, and most importantly to our patients, about what's happening and why?

Here's what I say as a colleague: The status quo wasn't serving anyone - not patients, not staff. Our wait times, our lengths of stay, our need to transfer patients between sites to get the care they needed, we struggled with all of these things. And because the system didn't work for us, we worked around it, which is inefficient and exhausting. Imagine channeling all that energy towards patient care that happens when and where it should. Imagine staffing patterns that make sense, predicated on grouping patients of like need and acuity, and implementing standardized models of care that ensure both consistency of care and the reliability of processes that support it.

And how do we talk to our patients when they express concern, even fear, about all these changes?

Here's what I say as a nurse: What would we tell a patient who expresses concern, even fear, about anything involving their care? We'd acknowledge the concern - these are big changes, and it's stressful. We'd remind them of the goal - here's the outcome we're looking for. We'd tell them our plan - that along the way some things will work and some things won't, and that when they don't we'll use what we've learned and we'll try again. We'd admit we don't have all the answers - we're making decisions based on what we know today, but we'll know more in a month, in a year, and we'll adjust our approach based on what we learn. And we'd tell that patient, unequivocally, that we are here for them, and that we always will be, because that's what all this is about. As professionals we will listen to patients, support them and each other through the changes. Please engage in the changes with the best interest of patients in mind. "Lead from where you work." It's about creating a better system for all.

We've been working in our respective silos for a long time, pushing separate agendas towards separate goals. This is different. This time it's all of us as a health region, pushing in the same direction. And I'm betting we'll find the pushing a lot easier because our goals are shared.  

Yes, these changes are real, and significant, and tough. It's natural to be anxious about that, but if we feed that anxiety in ourselves, and particularly in our patients, we feed negativity and fear, and diminish our opportunity to heal a health system that has needed fixing for a long time.

Remember that clinical consolidation is not a reflection of the quality of care our staff and physicians provide. I'm well aware of how hard staff are working to ensure the health and wellbeing of our patients. This is about creating a system that works, for all of us. The new reality won't be perfect, but the old one wasn't either. Let's talk about that, to each other and to the people who count on us most. We can create a more responsive health care system, and we will, together.

Links

Caring about Models of Care

Organizational Change Management Reference Sites:

Workshop: Navigating change in your workplace

Winnipeg Critical Care Nursing Education Program: Next intake begins January 2, 2018. Deadline for applications is November 9, 2017