Grand Rounds: Searching for meaning

Flo & Bo are pleased to be hosting Grand Rounds, the weekly carnival showcasing the best of the medical blogosphere, on June 23rd.

Since healthcare is abuzz with talk about "meaningful use" this week, send us something you think is meaningful, and we'll fit the pieces together.

Submissions welcomed until 10 pm (EDT) on Sunday, June 21. Send to: blynnolson at gmail dot com & include "Grand Rounds" in the subject line. (This will help me differentiate what's meaningful to you from what's meaningful to the people who seem to think I've won the lottery when I peruse the Spam file.)

Here's the e-prescription:

• name of blog
• URL of blog
• title of post
• URL of post
• blog (or post) author
• twitter URL (if you tweet)
• brief description of what makes your post or perspective meaningful

See you next week!

Happy Birthday, Miss Nightingale!

The name "Florence Nightingale" often makes a post-World War II "nurse-as-doctor's-helper" image spring to mind. But Nightingale, born in 1820, was a well-connected, highly political person who founded modern nursing using epidemiological principles, marrying her cutting-edge knowledge of science with the practical experience she amassed providing hands-on care.

To celebrate Flo's birthday--and send a final salute to nurses during Nurses Week 2009--here are few "then and now" reflections:

In 1859, ten years after beginning her career as a nurse Florence Nightingale publishes Notes on Nursing: What it is and What it is Not.

In 2009, President Barack Obama appoints Mary Wakefield, RN, PhD to serve as the Chief of the Health Resources and Services Administration (HRSA), an agency overseeing programs that bring health care to uninsured people, particularly in underserved areas of the country. Wakefield's agency will administer $2.5 billion to invest in health care infrastructure and train health care professionals.

Bo says, "Way to go!"

In 1860, Nightingale writes this about noise:

"Unnecessary noise, or noise that creates an expectation in the mind, is that which hurts a patient."

Today, YouTube (and Ameriquest) document the consequences of unnecessary noise in healthcare settings:



Bo says, "ROFLMAO." (Sorry, Flo.)

In 1860, Nightingale's Notes on Nursing says this about food,

"Every careful observer of the sick will agree in this that thousands of patients are annually starved in the midst of plenty."

A century and a half later, the U.S. Department of Agriculture reports 38 million people in our nation – 13.9 million of them children – live in households that suffer from hunger or live on the edge of hunger. The Food Research and Action Center provides education to a citzenry with increasing BMIs: Hunger and Obesity? Making the Connections.

Bo says, "Any program that removes recess from the school day to add more time for classroom instruction should be called, No Child Left Without a Big Behind."

In 1860, Nightingale challenges the conventional wisdom of her time saying,

"'What can't be cured, must be endured' is the very worst and most dangerous maxim for a nurse which was ever made."

In 2004, the association between patient outcomes, nursing care, and the conditions under which nursing is practiced is re-visited in a seminal IOM report, Keeping Patients Safe: Transforming the Work Environment of Nurses. "Coulda, shoulda, woulda" models of practice may join other cast-offs (like caps and bad shoes) as evidenced-based care, researched best practices, and patient-centric designs take hold.

Bo says, "Happy Birthday, Miss Nightingale!"

(If you don't want to wait until next year for more of Flo & Bo's wisdom, subscribe to this blog and follow along on Twitter!)

Can you hear me? Can you hear me now?

Welcome to the ongoing celebration of Nurses Week 2009, honoring nurses and nursing sensibilities. Today, it's all about hearing, and the good things that hearing makes easier, like listening and communicating.

Talking "patient safety" with nurses is like preaching to the choir, with the choir finally getting access to sheet music.

A few words about the valuable roles nurses play in making patients safe:




Finally, a look at standards and emerging best practices:

And a small musical tribute that says just a little bit about the important work you do:

Feel free to use the comments section to add suggestions to round out the playlist of songs celebrating nurses. Flo & Bo struck out in several genres, notably country and hip-hop. But hey, it's your party, you can cry if you want to.

Flo & Bo say "Hello"!

Happy Nurses' Week! Each day this week, Florence dot com, a real-time patient safety primer, is going to celebrate nursing sensibilities, recognizing the key role you play in making patients safe.

This patient safety blog is named for Florence Nightingale because I wanted it to reflect the kind of advocacy Nightingale did, advancing health and healthcare with a keen eye on the realities front line clinicians face. I hope you'll enjoy this week-long tribute to how you, the descendants of Florence, continue to make patients safe.

Florence Nightingale is often associated with the post-World War II "nurse-as-doctor's-helper" figure that populated novels, TV shows, and ads as baby boomers and Gen-Xers grew up. But this image was more about how women in that era were seen than about nursing, Nightingale-style.

I often use this picture when I speak, noting that nurses used to kneel down, pledging our intention to do good, right, and just things in our professional capacity. Most people laugh, readily identifying the most obvious things that have changed: that apron, that cap; that position, that hairstyle, and the fact that they're both women.

But while a deeply felt desire to "do right" by patients remains a stronghold of nursing, it's worth noting that pledges are now supported by emerging practices and norms, offering increasingly reliable ways for caring people to turn good intentions into desired outcomes.

I hope you'll visit every day in the coming week, find the tributes and take-aways helpful, then subscribe to Florence dot com. To appeal to your senses, here's what Flo & Bo have in store:

Thursday, 5/7: Can you hear me? Can you hear me now?
Friday, 5/8: Do you see what I see?
Saturday, 5/9: Something smells good
Sunday, 5/10: A touching tribute
Monday, 5/11: While it's sometimes tempting to eat the young, here's a better recipe
Tuesday, 5/12: Happy Birthday, Miss Nightingale!

Feel free to use the comment section. It's your party!