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3 Favorite Nursing Trends of 2013

 |  By Alexandra Wilson Pecci  
   December 17, 2013

Some nursing leadership trends emerged quietly this year, but are nonetheless provocative for how they force us to think about nursing and how they force nurses to think about themselves as caregivers and healthcare leaders.

Nearly a year ago, I played fortune teller. With the help of ANA president Karen Daley, I predicted the top nursing issues for 2013, forecasting that the safety of nurses, the rise of APRNs, advancing nurse education, and increasing emphasis on care coordination would dominate the consciousness of nurse leaders. Indeed, those topics were, and continue to be, among nursing's most important, overarching issues.

But in reviewing the past years' worth of nursing columns—I wrote 49 of them—some other trends have emerged, too, ones that challenge the way we think about nursing and, maybe too, how nurses perceive themselves. Here are my picks for the three most compelling under-the-radar nursing trends of 2013.

1.Empower Nurses; See Results
Ask nurses whether they think their hospitals' patient safety programs are actually effective, and you might be surprised by the answer: Only 41% of nurses describe the hospital they work in as "safe." And barely more than half (57%) believe that the patient safety programs in their hospitals are effective, a survey of 900 practicing registered nurses by the ANA and GE Healthcare found early this year.

But those hospitals that do ask for nurse input on patient safety are rewarded with innovative, empowered nurses. "The best ideas are not coming from the C-suite when it comes to care delivery," says Maureen White, RN, MBA, NEA-BC, FAAN, senior vice president and chief nurse executive of North Shore-LIJ Health System.

White's hospital was selected this fall to participate in the American Association of Critical-Care Nurses' Clinical Scene Investigator Academy to "empower bedside nurses as clinician leaders and change agents." The best ideas, White says, are "coming from front-line staff."

Many hospitals are recognizing this and taking action. Baylor Health Care System has in place ASPIRE (Achieving Synergy in Practice through Impact, Relationships and Evidence), a voluntary professional-development program that awards cash bonuses to bedside nurses who complete it.

Among the projects is one from a clinical transplant research nurse at Baylor Research Institute, which developed a low-health literacy education module that used pictures to help patients with cirrhosis of the liver better understand their condition. It's a great example of how nurses can instigate valuable, significant change. The best ones don't wait around to be given an opportunity; they create it.

2. Nurses as Change Agents
The trend that intrigued me most this year was that of bold, inventive nurses challenging the status quo of their profession, pushing the boundaries, and being "positively deviant."

Positive deviance in nursing—bending or tweaking rules or guidelines in the interest of improving patient care—was examined by Jodie Gary, Ph.D., RN, assistant professor of nursing at the Texas A&M University Health Science Center College of Nursing, in the American Journal of Nursing. "It's departing from any sport of policy, procedure, [or] routine… intentionally but honorably, using some sort of creativity," Gary told me, and it's doing so with the intention providing patient-centered care.

I've written about two examples of nurses who are breaking the mold to create new models of patient care: Nancy Bergstrom, Ph.D., RN, FAAN, whose research has called into question 50 years of standard pressure ulcer prevention, and Sharon Schindler Rising, CNM, MSN, whose "disruptive designs" include the Centering model of group healthcare.

But my absolute favorite column of the year was about a program from MIT's Little Devices Lab called MakerNurse, a nationwide hunt for DIY, "MacGyver nurses" who are creating new devices and workarounds to fix healthcare problems and improve patient care.

3. Making Nursing Safer and Healthier
This year was a landmark for nurse safety, thanks to the national interdisciplinary standards for safe-patient handling released by the ANA and its partners in April. The standards advocate, among other things, an increased use of technology, such as ceiling lifts to assist in moving, lifting, and repositioning patients.

But it wasn't just nurses' physical safety that got attention: Their emotional wellbeing was considered too, by shining a light on nursing's "dirty little secret:" The hard-to-deal-with topic of nurse-on-nurse bullying and verbal abuse. Not only did the phenomenon come under scrutiny, nurse leaders were warned again to stamp it out or risk losing good nurses.

Research backs this up: A study of newly licensed registered nurses finds that nurses who are verbally abused by nursing colleagues report lower job satisfaction, unfavorable perceptions of their work environment, and greater intent to leave their current jobs.

It wasn't just negative nurses who got my attention this year. I also wrote about the nurse who founded Pet the Pooch, a program that teams the Hospital of the University of Pennsylvania with the Pennsylvania Society for the Prevention of Cruelty to Animals. SPCA staff members bring shelter cats and dogs to the hospital about once a month to give doctors, nurses, and other staff a chance to reduce their stress by interacting with the animals.

Here's to a brand new year of nursing leadership stories to tell.

Alexandra Wilson Pecci is an editor for HealthLeaders.

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