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Florence In My Time

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How would Florence change the nursing team in my hospital?

Specializes in ED,Tele,Med surg, ADN,outpatient,homecare,LTC,Peds. Has 32 years experience.

Florence Nightingale as CNO?

Florence In My Time

The Nursing Unit was abuzz with the news! There was a new Chief Nursing Officer (CNO).

Her name was Florence Nightingale.

“Have you seen her?”

“No, but I heard there is a Nursing Meeting with Breakfast tomorrow from 7 am - 9 am so that the incoming and outgoing shifts can meet her tomorrow and next week Tuesday!”

The next day the nurses were surprised at the breakfast! Fresh fruits, oatmeal, freshly baked bread and cheese and of course hot coffee, tea and hot chocolate!

Florence turned out to be a practical, data-driven but compassionate leader.

She talked about her work during the Gulf War and the issues nurses faced from understaffing, lack of supplies, the cluelessness of the rest of the team about the nursing role. The nurses found themselves nodding as she accurately portrayed their issues. She broke the group into smaller groups for brainstorming sessions about the Covid crisis and the nurses' suggestions on handling the issues.  A group of nurses came up with a system to monitor the PPE, and equitable distribution based on a WhatsApp group for days and nights nursing teams. The Nurse Managers were also part of that group. Another group decided to monitor patient outcomes related to staffing ratios. Yet another team of outspoken nurses volunteered to be on Zoom meetings when discussing the hospital’s Covid recovery plan. It was a productive meeting. The nurses left the meeting feeling rejuvenated and it was not just the non-greasy breakfast! Finally, they were really part of a team!

Utilizing the nurses' feedback from the bedside, Ms. Nightingale used the data and showed not just positive patient outcomes but an increase in patient satisfaction scores, a decrease in rehospitalizations after a safe nursing discharge, Nurses' retention scores, a decrease in mortality due to Covid for patients and staff. There was a designated 24/7 hotline number for staff to call if any kind of crisis,  a “calm down room for all staff ” in every wing and Ms. Nightingale involved the Nurse’s union to set up these resources.

Nurses were encouraged to bring their ideas for a better workflow to the table and were listened to. At the same time, they were expected to be professional at all times, dress in uniform and be on time. Slackers were taken to task and “a three times you are out” rule was instituted with the approval and support of the union! More and more nurses wanted to come and work in this hospital. The CNO was looked upon as an innovative leader and role model. Her Nurse Managers took the lead in understanding the data and showcasing the skills of their unit Nurses! It was the ripple effect.

One of the initiatives that the nurses came up with was a liquid diet for the covid patients that were easily digested and helped them recover faster. The hot coffee and tea truck rolled through at 10 am and 4 pm. This change in diet correlated to speedier recovery for many patients and also became a cost-effective measure that saved the hospital a ton of money. This model was then adopted by other hospitals effectively.

All these initiatives had the backing of the CNO and empowered the nurses. I am happy that Florence is now in my time!

Nurse, leader, wife, mother and writer!

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4 Comment(s)

Hoosier_RN, MSN

Specializes in dialysis. Has 28 years experience.

Then the CEO and CFO told Florence "sorry, budget" and all of the other BS that nurses at every level hear everyday. I know I sound like a negative Nancy, but I'm trying to be realistic Rita

I do like the idea of liquid diet for covid patients, but with short staffing, who's going to transport and serve?  

Flo as our CNO sounds great, but d/t corporate greed that exists at the C"x"O levels, wouldn't happen. She'd be walked out, legs cut out from under her. Or resign due to the stress of fighting the good fight. Or worse, buy into the greed and become one of them. I don't think I'll ever see it in my working years, but there's always hope

spotangel, DNP, RN, NP

Specializes in ED,Tele,Med surg, ADN,outpatient,homecare,LTC,Peds. Has 32 years experience.

I hear you Hoosier!

We actually implemented the liquid diet  in our hospital and dietary brought it to the floors instead of lunch trays. Pt's ate much more compared to when they got a solid diet and regained some strength.

 I think Flo can make a case with her data on better patient outcomes which translates to money in the CFO/CEO's eyes. She knew how to pitch and wouldn't rest till she got it done. With the nurses backing her---the power of many would be on display!

 She was selfless and fearless and we can all learn from her!

hppygr8ful, ASN, RN, EMT-I

Specializes in Psych, Addictions, SOL (Student of Life). Has 19 years experience.

On 6/18/2021 at 10:39 AM, spotangel said:

I hear you Hoosier!

We actually implemented the liquid diet  in our hospital and dietary brought it to the floors instead of lunch trays. Pt's ate much more compared to when they got a solid diet and regained some strength.

 I think Flo can make a case with her data on better patient outcomes which translates to money in the CFO/CEO's eyes. She knew how to pitch and wouldn't rest till she got it done. With the nurses backing her---the power of many would be on display!

 She was selfless and fearless and we can all learn from her!

She was also continually frustrated by the fact she was dependent on men to implement her ideas. When she put toward the idea of cleaning the wards at Scutari she was shot down by the military (male) hierarchy and was told if she wanted the hospital cleaned she would have to do it herself. 
 

She was extremely critical of nurses who didn’t rise to her standard of perfection and had no tolerance for work she saw as sub-standard. When she opened the Nightingale school she constantly lamented the lack of qualified candidates. She was looking for people who had the same selfless desire and Devine calling the she possessed.

When looking  at her life and alternating episodes of boundless energy followed by profound lethargy that left her bed ridden coupled with her claim the God revealed her path to her may have been evidence of a mental illness such as bi- polar disorder. 
 
No doubt she was a remarkable woman especially considering the paternalistic Victorian ideals of how a woman should act but she would not have accomplished all she did without the help of male benefactors.

I will come back and cite my source later as I am typing this on my phone.

Hppy

spotangel, DNP, RN, NP

Specializes in ED,Tele,Med surg, ADN,outpatient,homecare,LTC,Peds. Has 32 years experience.

I agree that she was not a saint and not very tolerant but then how many of us can relate to that!

Some more information on her.

In 1857, around a year after returning from the Crimean War, Nightingale suffered a severe collapse, now believed to have been caused by a flu-like infection called brucellosis. For much of her subsequent life, she was racked with chronic pain, often unable to walk or leave her bed ).Like many of today’s PTSD sufferers, she isolated herself from social interactions, in her case by punishing herself for almost 30 years with what amounted to virtual self-imposed imprisonment. In all likelihood, Nightingale had not one, but four different disorders, all at least loosely inter-related—bipolar personality disorder, Crimean fever (brucellosis), post-traumatic stress disorder (PTSD), and terminal, senile dementia (Alzheimer’s disease).She died non compos mentis at age 90 of “old age and heart failure.”

 

Just goes to show that it's her abilities that defined her and made her stand out! Her mark on Nursing elevated our profession to where it is today. During the pandemic, Nurses shone because the world got to stand still and see what we actually do! Proud to be a nurse and part of a legacy of trust and care. It's up to each one of us to show the world that Nursing is not just a science but an art too!

Peace! 

(https://www.sciencelearn.org.nz/resources/2901-florence-nightingale-a-pioneer-of-hand-washing-and-hygiene-for-health