Newsletter - Bartlett Regional Hospital

Excellence in Nursing
Advocating for patients and the nursing profession
It is a busy day on Bartlett’s medsurg
floor. Each nurse on duty is
responsible for at least half-a-dozen
patients, and, on this day, most of the
patients are very sick. That there are
very sick patients in a hospital may seem
self evident, but their prevalence is a
fairly recent trend—a result of increasingly
prompt discharges and a high percentage
of day surgeries. These days, the
patients who spend time in a hospital
are far sicker and often need much more
attention than the average patient of a
generation ago. It all adds up to more
demands on the time and attention of
med-surg nurses.
This day, one patient is particularly
needy—an elderly woman with mild
dementia suffering from hypertension
brought on by Type II diabetes, a condition
that will put her at risk for serious
infection if bed sores develop. The
patient, who has been admitted because
of breathing problems and low blood
oxygen, is also suffering from anxiety
attacks, not uncommon for people who
can’t catch their breath. Her heart has
been weakened by a lifetime of smoking,
and she also has urinary issues. Her
frequent trips to the rest room put her
at risk for falls. Such a patient needs the
full attention of her primary nurse.
A patient with such a complex array
of needs draws on multiple hospital
resources. In addition to physicians,
nurses, and nurse assistants, other professionals,
such as pulmonary therapists,
pharmacists, physical therapists,
nutritionists, and discharge planners
will need to be consulted. “Most people
don’t realize how much goes on behind
the scenes,” says Sarah Hargrave, RN.
“This is a complex, multi-disciplinary
system.” One way of addressing the present-day
challenges of patient care, she
explains, is by instituting the modern,
research-based professional practice
model known as Shared Governance.
“In a Shared Governance model, frontline
nurses come to the table with nurse
managers to shape nursing policies and
practices,” says Hargrave, who is the
facilitator for Bartlett’s Shared Governance
initiative.
Simply put, shared governance provides
“stakeholders,” in this case nurses, the
means to change their practice.
The Nursing Department
[at Bartlett Regional
Hospital] is launching its
shared governance plan....
Shared governance brings
a commitment from all
aspects of nursing —staff,
specialists, managers and
administrators — to share
in both the rights and
responsibilities and to be
accountable for nursing care
in their facility.
— Excerpt of a statement by Nancy
Davis, RN, MS, President, Alaska
Nurses Association, that appeared in
the organization’s June 2011 “Alaska
Nurse” newsletter.
The efficiency of any complex system,
Hargrave points out, can benefit by the
implementation of new technology or
streamlining a process. “We’ve all witnessed
improvements in making travel
arrangements,” she says of the transition
from the time-demanding process of
making reservations then getting tickets
at airline counters, to the scheduling
flights on-line, then downloading boarding
passes from a website. How to introduce
such process changes to improve
patient care is the focus of the Shared
Governance process now in its first year
at Bartlett Regional Hospital.
“The heart and soul of nursing is patient
care,” says Susan Thompson, RN, who,
along with Margie Fisher, RN, co-chairs
the Coordination Council for Share
Governance. Thompson, who previously
served as an ER nurse for 15
years, is House Supervisor for Bartlett.
“Shared Governance is about elevating
the profession, with the ultimate goal
always to improve patient care,” she says.
“We believe that the professionals most
knowledgeable and best suited to do that
are the bedside nurses.”
According to Fisher, the shared governance
process seeks to increase quality
nursing time spent at the bedside and
improve the professional peer review
process for nurses. “With the senior
leadership and the board, we have support
for doing this,” Fisher says. “We
were given a budget, by which we were
able to get materials that didn’t have to
come out-of-pocket. Instead of upper
management telling us what to do, they
are saying, Hey, you are the front line staff —
do it.”
Thompson agrees that the administration
has provided strong support. “They
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