General Discussions

Breaking Down Walls in Healthcare

By Alene Nitzky, PhD, RN, OCN
General Discussions - Discussions
2 replies
Reaching outside your comfort zone can be empowering and satisfying. I’m a nurse entrepreneur. Over the past year, I wrote a book called Navigating the C: A Nurse Charts the Course for Cancer Survivorship Care. A key premise in the book is that being inside an organization can lead to missing out on what others are doing outside when it comes to meeting cancer survivors’ needs. 

I have learned how important it is for clinicians to be aware of what's happening outside of their offices and exam rooms. Nurses and physicians get swept into the whirlwind of the workplace, simply getting through each day's tasks. When this happens, the clinicians becomes survivors, just barely surviving their workloads, yet attempting to provide needed services and care to cancer patients and their families in their times of great vulnerability.

I have tried to reach out to physicians in my community to let them know about my programs, a bi-monthly hybrid exercise class/support group for cancer survivors, which I offer free of charge. I wanted to let them know about the benefits for their patients, answer their questions or concerns around it, and ask them to refer their patients. As a professional, I wanted to let them know what I offer, that I will be attentive to any concerns or contraindications to activities, and their patients will be safe. I wanted to convey to them that I am a resource in the community for their patients once they complete treatment.

In that outreach process, I discovered there is an obstacle to exchanging information from outside to inside an organization’s walls. There is a gatekeeper--often staff members at the front desk who screen out anyone who might take the physician’s time. Even a chance to schedule a short block of time months in advance is met with resistance. 

I have wondered, is it really a lack of time? Could it be ego, fear, apathy, or arrogance? Do they think there is nothing outside of their safe zone that could possibly be of value? Is it burnout, from running themselves ragged, maxed out with their patient loads and regulatory demands?

More than one secretary suggested that the way to get their attention is through food. They told me if I wanted to provide a catered lunch or meal for the physicians then they might come in, but there was no guarantee. I am not a pharmaceutical company with a budget allocated to entertaining physicians when I am a solo, small business owner. I’ve heard from other business people that they tried that and only one doctor came in and half-listened while he texted on his cell phone, meanwhile over a hundred dollars of catered food went to waste.

“What’s in it for me?” may be the modus operandi here. I used to be one of those nurses barely surviving twelve hour shifts so I could go home and collapse. I didn’t want my work life infringing on my personal life when I was so exhausted, and the fatigue spilled over into my days off--and I wasn’t being compensated for that.

When we are so stressed out that we don’t have time to find out what else is out there while we’re at work, we shortchange our patients by not giving them the full range of options. For example, not every patient wants to come back to a clinical setting for rehab, and not every patient needs rehab. Some would be better served by community-based providers whether for recovery or other support.

The solution, I think, is systemic. When professionals don’t have time and their administrators don’t see the value of time to interact with outside professionals in the community who can provide needed resources for their patients, the patients suffer. In the workplace, it is important to reserve time to step back, look at the big picture of being part of the community that surrounds the organization, and connect with it, instead of being walled off.

As professionals, we owe it to our patients to be refreshed, fully present at work and prepared to use the full extent of our knowledge, skills, education, and energy to their benefit. If our workplace is compromising what we bring to the patient-nurse relationship, then we need to examine our workplace policies and question our leaders. It is important that nurses and other healthcare professionals have time and energy to interact with community providers outside of the workplace so they are not isolated, and can offer a full range of options to their patients.





 
Mar 21, 2018 7:34:36 pm
In any unit or clinic I beieve we are at risk of only doing things one way, the way we've always done them. In recent years we have had to use some travel nurses in our clinic and aside from the hands on help a suprise benefit was having our status quo questioned. In survivorship I wonder if the same princilple applies. What are others doing, what works, what doesn't and what unique ideas do people outside of our insular units have to offer.
Apr 30, 2018 4:39:39 pm
Exactly. I agree that it's always good to have an outside reality check from time to time. New ideas are good, and it's important for us to get outside of our usual environment to get a fresh view.
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