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From where I stand….. October 20, 2011

Posted by mariemanthey in Leadership, Professional Practice, Thought for today.
Tags: , , , ,

This is the ‘best of times and the worst of times’ for nursing.   As I travel around the country, I see and hear about nursing departments that are delivering the highest quality nursing care humans have even received.    There is a peak of highly personalized, humane care focused on the individual being delivered, which provides opportunities for true healing to occur.   A level of care we could only dream about years ago.   Care that is highly competent, highly holistic, and highly personalized.   And in these places, nurses truly experience a level of joy that enriches and energizes their whole lives.

And then down the street ….or at the other end of town, there is another place, where the workplace culture is toxic, staff are angry and fearful (the same thing?) and patients are viewed as sources of trouble, annoyances to be dealt with, etc.

In other words, the contrasts between good and great hospitals and the worst ones is sharper than ever.    And the finding that my colleagues and I see over and over again is that the difference is in the culture and in leadership.   In other words “the protoplasm is the same”.

And of course, a whole huge chunk in between these two extremes.   The good news is the bad ones can change.   The bad news is they have to see that the problem is leadership and culture… and BE WILLING to change!

I’m curious what those of you working today think about these observations.   Are you working in one of the best or one of the worse?    Have you had a family member in one or the other?    The best or the worse of times.


1. mkoloroutis - October 20, 2011

Dear Marie,

Thank you for naming this phenomenon so clearly. Leaders bring out the best in people when they lead toward a higher purpose. And we are able to do our best work in an environment of honesty, trust, respect, and continuous and visible support. I think that at the core of the toxic organizations you are describing is a fear-based mentality that originates with the positional leaders. Such organizations tend to be compliance focused rather than focused on human caring and commitment. Many people in such environments become automatic and disspirited and begin to simply do what they can to get the tasks done. To cope, they also begin to objectify, label, and distance themselves from the human caring aspect of practice. So it is no surprise that patients become objectified and are seen as being in the way rather than our reason for beig.
It is miraculous to me, however, that even within these toxic environments individual physicians, nurses, physical therapists, social worker, pastors, and many others continue to give their heart and soul to their patients, continuously moving beyond the toxitity and cultural obstacles.
Your message is a wake up call–you have once again, named the elephant in the middle of the room — it is a call for us to take leadership and influence the development and design of organizations that are devoted to the highest level of humane and compassionate patient care. We can get there by creating environments in which nurses, physicians — all clinicians can thrive and practice with dignity and proficiency. An environment in which the complexity and mystery of clinical care is recognized and support of and respect for the caregivers is a driving force.

2. healthcare decision makers - February 21, 2012

Thank you for your honesty

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