Here is the full transcript of Rebecca Love’s talk titled “Nurse Innovation: Saving the Future of Healthcare” at TEDxBeaconStreet 2018 conference.
Listen to the audio version here:
TRANSCRIPT:
The Crimean War and Florence Nightingale
It was the year 1854 and the British government was entrenched in a bloody battle called the Crimean War. Florence Nightingale served as a volunteer on one of the floors of the wards where the soldiers were brought after they had been injured on the battlefield. Unlike women of her generation, she had been educated, and what she witnessed inspired her to pen a letter to the British government in which she wrote, “If you had wanted to create a place worse than hell, you have thus succeeded.”
For what she saw around her was that the soldiers were not dying from the injuries they sustained on the battlefield, but were dying from the death, disease, and infection that seemed to follow the physician from the bedside to the bedside to the bedside, as he did not wash his hands nor sterilize his medical equipment.
Conventional medical practice of the time believed that if you could not see it, it did not exist, and that germs were simply a figment of one’s imagination. But Florence Nightingale knew something was fundamentally wrong, and without the support of her physician colleagues, she implemented a policy of hygiene and sanitation among her support staff.
She had to be meticulous in her documentation, in her notes, and her follow-up, to prove that washing one’s hands and sterilization of medical equipment not only decreased rates of death and disease, but the centuries-long conventional medical practice had been wrong. Florence Nightingale challenged conventional medical practice.
She challenged the status quo to found nursing. And she officially led medicine out of the dark ages of practice and forever fundamentally changed the future of science, history, and medicine with the establishment of the profession of nursing. Today, there are nearly 19 million nurses worldwide and 4 million in the United States, making up roughly half of the U.S. healthcare workforce.
The Role of Nurses in Healthcare
Every day, nurses stand on the front line between life and death of patients, handling hundreds of thousands of dollars of highly complex medical equipment, technology, and medications to keep a patient alive the many hours a day a physician is not by the bedside. Every clinical interaction begins with and ends with the nurse, and nurses are the end user of nearly every medical product on the market.
However, nurses are rarely, if ever engaged in the decision-making process of which products are to be brought forth into the healthcare system. I can’t tell you the number of times as a nurse new products were rolled out that were supposed to decrease our workload but actually made more work for us.
Let me give you an example, something like this stethoscope. Only kidding, they really didn’t give us that stethoscope. But many of the devices that they rolled out had a similar impact onto our workflow. Let me give you an example.
When I was a floor nurse, our hospital decided to roll out this new device to help us with communication. So we took this device, put it around our neck, and off onto the floor we went. Suddenly, this device started screaming at us, “Dr. Smith is on the phone, your blood products are ready, the IV is beeping in room 16, your new admission is here.”
By the end of the first week, we had all taken this device off and put it at the front desk, explaining to our manager that had not at all helped our workflow, but significantly complicated it. Eventually, the hospital brought back out this company to work with us on the design of the product. But from that moment forward, I wondered what if they had engaged with the nurse at the beginning of the design process? How this would have driven down healthcare costs and increased productivity.
Nurses as Innovators
Because the truth is, nurses are natural innovators, and they know where all the inefficiencies are in healthcare. Research studies show that nurses do 27 workarounds per shift, and are in 36 different places over the course of an hour. That means nurses are innovating in a highly inefficient healthcare environment 27 times a shift.
They’re MacGyvering the medical devices and the products on the hospital floor to better serve the needs of their patients. The challenge is, workarounds are not considered a good thing in nursing. They’re not recognized as innovation. They’re seen as skipping over policy and procedure.
Unlike places like Google or Amazon, where employees are rewarded for identifying inefficiencies and fixing them, nurses run the risk of losing their jobs. So instead of driving forward innovation, coming up with new ways to deal with the inefficiencies they see around them, nurses keep them secret. And we keep living the definition of insanity, which according to Albert Einstein, is “to do the same thing over and over again and expect different results.”
The truth is, we must embrace a culture of innovation whereby frontline workers can bring forward their innovation. For innovation is the moment between stagnation and progress. Innovation is the impossible, the unseeable, the unbelievable, the unattainable until it is the possible, the believable, the attainable, the seeable. We must cultivate programs and environments that support those who want to drive forward innovation as opposed to environments that keep supporting insanity.
The Power of Hackathons
And I have one idea. Hackathons. And I think it’s time I tell you a bit about my story. For it wasn’t very long ago that I didn’t know what a hackathon was or how that one weekend would change my life.
A few years ago, I was a struggling nurse entrepreneur and a friend of mine, also an entrepreneur, said, “Rebecca, you should really attend this health care hackathon.” I had never heard of a hackathon, so he explained.