My husband and I recently entertained guests from out-of-town. One of the fun things we did was visit Powell’s City of Books in Portland. Powell’s on Burnside is the largest bookstore in the world, a reader’s Paradise. Rooms of books sprawl from floors of multiple staircases, like levels of heaven. It is so big; the store provides maps for customers, like Disneyland. If you visit Powell’s, allow at least two hours. Like making a painting, you never finish going through Powell’s, you just reach interesting places to stop.
Of course, I bought some books while we were there. Three came from the Pearl Room, where the art books are shelved. In the Gold room, I found a copy of American Pastoral by Philip Roth. I’ve meant to read Philip Roth since I read Night Studio, a memoir by Musa Mayer about her father, the artist Philip Guston. The two Philips were friends, as painters and writers often are. That is not why I bought American Pastoral. I bought the novel because I’m reading books from the Books to Read Immediately list in How to Read like a Writer, by Francine Prose. An award-winning author, Prose teaches writing the way my instructors at Pacific Northwest College of Art taught painting: study the work of the best, and imitate what they did.
It sounds so simple: study masterpieces. This kind of observation is about getting inside the artist or writer’s head, understanding the choices they made, and why each decision contributes to the masterpiece. The next step is to take that why and store it like a tool in its box, until an opportunity for use presents itself.
That sounds simple too, except that the trick, the magic, the craft, only occurs if one wields the tool in a fresh, new way. Restating something said before needs to reveal a unique voice. That is what makes the work a piece of art: craft and a unique voice.
As I meandered through the rooms of Powell’s, it occurred to me that craft and unique voice are often missing in nursing innovation. How many times are manufacturers of IV tubing and connector systems replaced in a hospital? That is not innovation; it’s changing vendors because the current vendor contract has expired and the hospital is shopping for a new one. Real innovation is finding ways to improve, for instance, staffing in a damaged economy. It is seeing old ideas in a fresh new way. Hospitals move slowly towards change, as if lumbering freighters pulled along by tugboats in a busy harbor. Nurses resist change too. For instance, we complain about understaffing, and about losing hours (pay) when hospital census is low. Not enough nurses leaves a unit under staffed, but too many nurses means not enough working hours for everyone. Dilemma is part of the business of health care. Problems have answers; dilemmas are ongoing and need management.
Reduced paychecks due to lost shifts were particularly painful when I was a single mother with a mortgage. After awhile, the vacation paid leave dried up too. I needed cash. Therefore, I became agreeable to floating from PICU to related units, like NICU and general pediatrics. It wasn’t always comfortable going to an unfamiliar unit and taking patient assignments, but I found if I went with an open mind, spoke up about what kind of assignments were appropriate for my skill level, and won over a buddy or two from the unit, floating wasn’t that bad. I took CE courses in NICU subjects, including NALS and improved my skills. That improved my comfort level and patient safety. Social networking the old school way, I made friends in the units where I floated, and rarely lost a shift of work. Each new skill embellished my résumé; adding to my marketability. It’s a good tactic for nurses wanting to look experienced, instead of just aging, to employers.
Hospital administration plays an important role in successful floating experiences for their nurses. It is critical that they understand it takes more than a body with a pulse and a stethoscope to care for various patient populations. Years ago, I attended a meeting organized by the hospital. Its administrators asked nurses what would encourage us to float. I pointed out that while I was able to sustain a critically ill child on life support; if floated to labor and delivery I could reason that a slow heart rate on a fetal monitor was probably not a good thing, but all I would know to do about it was scream for help. The administrators listened, and created float area “bundles,” limiting the departments nurses are asked to float to by related acuity and skills. The tugboats helped navigate the freighter in this case.
I am grateful to have a career that provides so many opportunities for work. In this economy, nursing is one of the few jobs with any security at all. It also provides opportunity for creative souls.