AN OPEN LETTER
Thanks to Olga Yakushev, Betty Rambur, and Peter Buerhaus.
ABSTRACT. Nurses make decisions about the use of costly resources in countless care delivery settings 24 hours a day. Consequently, nurses are inseparably connected to not only the quality and safety of care, but to the cost of care as well. This article is Part 1 of a 5-part series on ‘value-informed nursing practice’. It describes the concept of value-informed nursing practice as ’practice that focuses not only on outcomes, but also on the cost of care’ - a new way to envision nursing practice*1 1
Dear Peter et al,
I read your article in Nursing Outlook with deep interest and strong enthusiasm. In my opinion, ‘value-informed nursing practice’ is exactly the right direction for nursing to be taking post-COVID. It is an exciting example of implementing disruptive change in order to destroy dysfunctional staffing systems.
During my life-long experience of practice innovation and leadership development, the staffing/workload issue has always been front and center of every practice model, innovation, or development, driving either staff resistance or acceptance.
I have thought hard and deeply about the mind-sets that control so much of the experience of nursing practice in hospitals. Ever since reading about mental models in Peter Senge’s work, I saw how mental models re: staffing negatively impacted the experience of hospital nursing 2. In my decades of experience with practice innovations that have staffing implications, the power of the collective mind-set has been stunning. Equally stunning, however, is the disruptive impact COVID has had in breaking down and destroying these mindsets.
A key to ‘value-informed nursing practice’ is nurses’ ownership of resource distribution for the care provided on a shift-to-shift basis. What value-informed practice provides is consideration of choices about care activity priorities having efficacious outcomes. COVID handed us a destructive force powerful enough to shatter mental mindsets and create a process for assuring high quality care within a framework of cultures that lean into advances in humanization.
1. “Valued-informed nursing practice”: What it is and how to make it a reality. Nursing Outlook Vol.70 Number 2 March/April 2022 pg., 2011
2. ?A Brief Compendium of Curious and Peculiar Aspects of Nursing Resource Management. CREATIVE NURSING., Vol 15 Number 2. pg 61
