Smart Nursing in the

time of the Global Pandemic

Maria Virginia M. Santos-Abalos MD FPOGS FPSGE FPIDSOG MBA
 2020:
“Year
“Let of the
us never Nurse
consider &
ourselves
finished nurses… We must be
Midwife”
learning all of our lives.”
in celebration of the
200thFlorence
birthdayNightingale
of
Florence Nightingale
 September 2019

“Cycle of panic & neglect when it

comes to pandemics. We ramp up
efforts when there is a serious
threat, then quickly forget about
them when the threat subsides.
It is well past time to act.”
2019-2020: COVID 19 Pandemic
 Frontliners
Dedication & Commitment
 Nursing in the
Global Pandemic

The Nurse as an
The Nurse and
Innovator-
Technology
Educator-Leader

The Nurse:
From Silence
to Voice
1
Nursing in
the Global
Pandemic
The virus that killed 40 million people worldwide
As the flu brought society to its knees,
nurses stepped up as the
first line of defense.

FLU Doctors realized that

“good nursing care was the
best predictor of outcome.”
 EQUAL OBLIGATIONS
Provision 2: “ the nurse’s primary commitment is to
Code of the patient”
Ethics for Provision 5: “the nurse owes the same duty to self as
to others” + loved ones
Nurses With
Nurses must continually care for critically ill
Interpretive infectious patients, often under extreme circumstances
Statements incl:insufficient resources
uncontained contagion
2015  Must be supported by the systems/organizations
in which they provide care
Healthcare Worker Hospital Administration Government

Deliver care on moral Provides safe environment, Government support

grounds basic needs, PPEs, *control of the pandemic
Maintain professional operational protocols *rights of healthcare worker
integrity
 SE LEFT B EHIND
NO NUR

NURS E S a r e ONE
The FILIPINO

RESPITE IN THE MIDST OF CRISIS

 Even heroes need rest.
Healthcare workers are not
expendables.
Nor can the government
RESPITE IN
THE MIDST assume that there will always
OF CRISIS be a fusillade of heroes who
August 4,
2020
will fight its war.
 RESPITE IN THE
MIDST OF CRISIS
August 4, 2020

The political indiscretion leading

to the rise of Covid 19 cases should
be halted so that everyone can
REFLECT REVIEW REASSESS
RE-STRATEGIZE & REPLAN
The government and Frontliners will never stop
healthcare workers should working.
be partners in the fight Their loyalty is to their
against Covid 19 pandemic profession’s nobility.
 This pandemic Still, nurses were
challenged the able to capitalize on
nurse manpower their power to
to the extreme. maximize their
efforts to combat the
pandemic.
A pandemic amplifies the sources of
emotional distress and worker burnout
Key Public Health Concern
Sustaining an adequate healthcare workforce
• Quantity (adequate numbers)
• Quality (maximized clinician resilience)
‘

To provide SAFE CARE

to LARGE VOLUMES of patients
under CHALLENGING CONDITIONS
 Patient Safety & Quality Care
in the Pandemic
HEALTHCA
RE Burnout
PROVIDER:
Duty-readiness
Second-Victim
Well-being
Syndrome
 Nurses are
renewable
resources with
substantial
value, but not
when they are
burned out.
 Key Drivers of Burnout and Engagement

Workload
& Job
demands
BURNOUT ENGAGEMENT
Exhaustion Meaning Vigor
Organiza in work Dedication
Cynicism
tional Work-Life
Inefficiency Culture &
Absorption
integration
Values
Workload & Job demands

Rude superiors & co-workers Energy-

Dysfunctional system draining
days
Suggestions not acted upon
Workload & Job demands
Staff-friendly culture

Team collaboration
High-performance team
Energy-
enhancing
Suggestions acted upon
experience
Nurses are one of the most
trusted professionals
within the hospital.
They build positive
relationships with our
patients and function as
our ambassadors.
2
The Nurse
as an
Innovator,
Educator,
Leader
 25 Nursing
Trends we expect
to see in 2020
 Holistic Care
Integrative & holistic health:
healthcare delivery models
Ensures care for
patient as a whole
Higher education
Become the norm for RNs
Education leads to better
patient outcomes

Specialty Care
Greater demand for higher Nursing
levels of practice
Geriatric Care will be a
Trends
highly sought-after specialty
in 2020+
Why go for further
EDUCATION?

33
 Nursing
Trends
2020+

Nurses’ inclusion in
hospital board will be
greater

1. Why go for further EDUCATION?

The key to unleashing the
organization's potential to
excel is
putting that power in the
hands of the people who
perform the work.

James M. Kouzes
Nursing faculty positions will become more attractive

Nursing
Trends
2020+

2. Why go for further EDUCATION?

Nursing
Trends
2020+
 Nursing
Bi/Multilingual nurses Trends
2020+
will be more valued

3. Why go for further EDUCATION?

4. Why go for further EDUCATION?

Cross-
training in
different
specialties
offers
versatility in a
world of nurse
 Nurses are highly
trained healthcare
professionals

Nurses don’t
‘merely’ follow
doctor’s orders

5. Why go for further EDUCATION?

 Doctors Nurses
are trained to are oftentimes
diagnose, treat, the primary
and prevent caregivers for
illness patients.

Nurses don’t ‘merely’ follow doctor’s orders

 Nursing
Trends
2020+

Online education programs will

increase in popularity

6. Why go for further EDUCATION?

3
The Nurse
and
Technology
Digital health
technology

KEY ENABLERS
to optimize health
systems & improve the
quality of care
 MOBILE
HEALTH
Patients are more active in
consuming information & researching options
 Changes may be
disruptive
threatening
A Threat to the
Human Element
LEGACY
STRUCTURES,
Generational JOBS, &
Divide BELIEFS,
Data and
Security Threats
but they are
INEVITAB
LE
 82% of
nurses
believe that
technology
positively
impacts
patient care
 Positive Impact on
Nursing Shortage Decreased Human Error
e.g. portable monitors e.g. automated IV pump

Improved Accessibility
with EHRs

Technological innovation in the medical field ensures that nurses

have an easy time keeping each patient safe and comfortable. 
4
The Nurse:
From
Silence
to Voice
 Framework for Safe Psycholo-
and Reliable Care gical Accountability
Safety

Psychological Safety Teamwork &

Communica-
Ask questions “I can speak tion

Be respectfully critical up freely

Ask for feedback about my Negotia-
tion
Suggest innovations concerns”

https://www.safeandreliablecare.com/blog/2016/11/29/s-r-sociotechnical-framework-ihi-minicourse
 Top 3 Reasons why Employees don’t speak up

Fear of being viewed Feeling they don’t have Feel organization’s

negatively; enough experience; hierarchy is
Appear disruptive Look stupid & intimidating /
incompetent unsupportive
The Silent Treatment Specific concerns that Poor communication is
shows how nurses’ often result in a deadly, esp in critical
failure to speak up decision to not speak care settings
when risks are known up: (ICU & ORs,
undermines the dangerous shortcuts, the result is
effectiveness of current incompetence, catastrophic harm and
safety tools. disrespect even death.
SILENCE KILLS
Seven Most Crucial Conversations for Healthcare

Poor Lack of
Teamwork Support
Broken Incom-
Rules petence

Disrespect

Microman
Mistakes agement

57
Nurses are PATIENT
ADVOCATES
 Nurses are PATIENT
ADVOCATES

VOICE is a non-negotiable
prerequisite of advocacy.

Advocacy usually
• requires some kind of RISK and
• deals with some kind of
CONFLICT
 Clinical nurses and managers need to teach
others how to treat them with respect.
TWO-CHALLENGE RULE
Empowers all to “stop the line” if
they sense or discover an essential
DESC SCRIPT safety breach
Constructive approach to
conflict: Describe, “CUS” ASSERTIVE
Express, Suggest, STATEMENT
Consequences
I am Concerned, Uncomfortable,
This is a Safety issue
PSYCHOLOGICAL SAFETY
61
 Team members explicitly give
permission to hold
each other accountable across a flat
hierarchy
 Just
Understanding
Cultur Risk and Human
e Behavior
• Test for Intentions &
Behaviours
Console
• Test for adherence to
Duties
• Provides guidance on
consequential actions
Coach
Punish 63
SILEN
T NO
MORE
Nursing is anchored in a
CARE NARRATIVE
(kindness & compassion)

Nurses should be cast for their

PROFESSIONAL ACUMEN
(knowledge, judgment, and skill)
that makes them an effective
FIRST LINE OF DEFENSE against
medical errors and injuries.
Taking the time to wash your
hands before you examine a
patient

Making sure that the proper OR

equipment is available during
surgery
Acts of
Team does debriefs and time- CARIN
outs G
INSTITUTE OF
MEDICINE:
Nurses have been AHEAD OF
THE CURVE on safety
practices
Nurses should have a
GREATER ROLE in shaping
health care delivery
 SILENT
NO
MORE
non-negotiable
prerequisite of
advocacy
 To the world, we may be
ordinary people, but to our
patients ,
we are heroes.
“What we do in life
echoes in eternity”.

Gladiator , 2000
We decide our destiny
The physician is in the forefront
We need to adapt, or we will perish
To the world, we may be ordinary
people, but to our patients ,
we are heroes.