Changes. . . .

Donna Mason isNurse Manager, V

For correspondenServices, 1314 –TN 37232-7240;

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August 2007 33:

Donna Mason, RN, MS, Nashville, Tenn

As I sit in a class called Advanced Stroke

Life Support and listen to all the new changes in stroke

care, I ref lect on how medicine continually changes. Prac-

tices that once were unheard of are now routine in today’s

nursing world. In the early 1970s I was taught by my men-

tors that a stroke was one of the worst death sentences

to quality of life that could be delivered to a patient and

his or her family. Their future was one of bedpans, bed

baths, constant care, and a permanent loss of quality of

life. In the year 2007, if caught early enough, one can

see a patient’s stroke dissolve before one’s very eyes. I am

amazed by medical advances and how frequently and rap-

idly practices change.

There has been a great deal of research and change

in patient care during the past 35 years. Taking a trip

down memory lane, I remember when we gave everyone

D50W and thought it was the right thing to do for brain

tissue! How about those MAST trousers? They were going

to change the world of trauma and shock resuscitation.

President of the Emergency Nurses Association andanderbilt Emergency Services, Nashville, Tenn.

ce, write: Donna Mason, Vanderbilt EmergencyVUH, 1211 Medical Center Dr, Nashville,E-mail: donna.mason@Vanderbilt.Edu.

07;33:307-8.

0

7 by the Emergency Nurses Association.

.2007.06.018

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I remember one of our cardiologists in the early 1980s

being called a radical physician and a ‘‘quack’’ by other

physicians for suggesting the use of thrombolytics in the

care of a patient with an acute myocardial infarction. Have

we not changed a great deal over the years?

Change is difficult to accept and has been since the

beginning of my nursing career. How many times have

you said, ‘‘Why can’t things just stay the same? Why

do they have to change?’’ I have said those words myself

as a staff nurse, educator, and manager. (Remember those

American Heart Association changes to ACLS, BLS, and

PALS every 4 years?) But then I think about all the lives

that have been saved, the disability that has been avoided,

and the good outcomes that we see for patients, families,

and their loved ones. A single presentation of a ‘‘good’’

change seems to make the discomfort of change less diffi-

cult to accept.

In recent literature one can read about ‘‘change fa-

tigue.’’ With the inception of the Internet, information is

automatic and constant. With every new research study,

we alter our practice to make improvements for our pa-

tients. With that constant change comes the discomfort of

learning new policies, procedures, and practices to deliver

better care. It seems as if every new program or initiative

that someone reads about and wants to implement requires

more change. Leaders of nursing are no different. We all

want to be the best and deliver excellent care. This causes

change, and thus discomfort or stress.

The management of change is critical to our patients.

Good direction, good communication, and good gover-

nance are key to helping everyone understand and accept

new practices in nursing. We all must embrace change and

help each other communicate how the evidence shows it

JOURNAL OF EMERGENCY NURSING 307

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is best for our patients, their families, and our emergency

nurses. I believe we can step back and ensure that we have

all the steps in place so that change is made in the cor-

rect manner, with good communication and with proven

good outcomes.

I am grateful that change helps patients. I am sad that

nurses have to accept constant change and feel the accom-

panying frustration, but we have each other for support.

We have each other for understanding. We have each other

to see that change often is best for patient care.

308 JOURNAL OF EMERGENCY NURSING 33:4 August 2007