HCHD Nurses Reclaiming Higher Ground

Every morning, Ben Taub Hospital medical intensive care nurses get together before they go on duty at 7 a.m. to "reclaim higher ground." They take a few minutes before they clock in to touch base with each other and with themselves. They spend some quiet time preparing for what they know will be a busy, hectic, and stressful day.

Dr. Mary Holt Ashley, vice president of nursing at Ben Taub, recognizes this type of interaction as a growing phenomenon across organizations. "As the health care environment has changed, we find that we are being asked to do our work faster, better, and sometimes with fewer resources," she says. "While organizations re-engineer and redesign business processes, they often overlook an employee's need to regenerate."

That is why Dr. Ashley led a group that studied Reclaiming Higher Ground: Creating Organizations That Inspire the Soul by Lance H. K. Secretan (Macmillan Canada). Secretan's theme is that business approaches, such as re-engineering, focus on process redesign that is personality driven, the exterior, but the "soul" of the organization and its employees, the interior, has not been part of the equation. Dr. Ashley explains that this missing piece has been noted in companies and institutions across the country and that people have begun to ask, "If re-engineering is the answer, what is the question?"

The question for the Ben Taub MICU nurses was how do you keep "soul" in your unit and maintain your own peace through the demands of the busy ICU. "It gives me focus," says R.N. Janet Rose. "Some days, when things are hectic and everything is going wrong - instead of lashing out at coworkers or patients - pause, take a deep breath and refocus on the spirit that we generated in our morning session."

"The group began with just one or two of us," says Tina Vaz, R.N. Now as many as 12 nurses come together for a few minutes each morning to inspire each other, provide grounding, or even give a little "attitude adjustment" when it's needed.

Dr. Ashley adds that because nurses are viewed as the comforters and the caregivers we tend to overlook their own need for comfort. Losing a patient, for example, is something a health care professional never gets used to, but knowing you have coworkers who understand and who will take time to help you through the difficulty is the hallmark of an organization that inspires the soul. "The nurses in the MICU certainly seem to be a close-knit, cooperative group, and it reflects in the positive comments we receive from patients," Dr. Ashley says. "And this is no surprise to me because they have connected their daily work activities with a sense of meaning and purpose."

Recognizing that stress is an internal reaction to an external event, the nurses recall Secretan's lesson of focusing on you and not me, of supporting people and not managing things, and celebrating strengths instead of dwelling on weaknesses. In this way, they redirect the natural internal focus to an external one.

"This grassroots effort is spreading throughout the Hospital District," Dr. Ashley says. "It underscores our mission of providing quality, compassionate health care."

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©2006 Texas Medical Center

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