“I think there's more to this hobbit than meets the eye” ~ Gandalf, The Grey
My daughter “HD” is known to her friends as ‘hildow’ or to me as my ‘Hobbit Diva’. She always has a way of bringing things home for me. She has challenged my career decisions ever since I left the ICU bedside. To her what I do ‘now’ is nebulous and meaningless. For her saving real lives is what matters. I can recount the many times she has asked me if “indirectly helping people with activities of daily living is as significant as direct intervention/life saving measures? “ I can’t answer that question. My passion has and always will be direct intervention; however, keeping people safe at home abates the inevitable direct interventions.
Yesterday while chauffeuring HD to one of her many activities, she asked one of her profoundly dreaded questions; “What are you most passionate about, people or standards?” I didn’t answer her; I had to think about that for awhile.
The College of Nurses of Ontario (CNO) assists nurses in providing safe, effective and ethical care by developing and setting standards for the profession. Those regulated Standards of Practice legislated through the Nursing Act 1991 http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_91n32_e.htm and the RHPA 1991 http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_91r18_e.htm have guided my professional life. I have always practised safe effective ethical care according to the CNO practice standards and guidelines and applicable legislations. So HD even while I was in direct care delivery I practiced according to standards.
On the other hand Accreditation Canada's sector and service-based standards help organizations assess quality at the point of service delivery. They are based upon five key elements of service excellence: clinical leadership, people, process, information, and performance. While my current work focuses on these serviced-based standards, my patient outcome goals remain steadfast...SAFE, EFFECTIVE and ETHICAL care.
So HD, patients or standards? Without standards, safe patient care is inexistent. "Would I rather enforce compliance to standards or feel the pulse of a patient?" I think you know my answer. I’d rather nurture my patient but for now I’m doing that by ensuring that standards are adhered to and patient care outcomes are met. Believe it or not, it’s another way of saving lives. It will never replace the feel of a pulse, breath or smile. Thanks for reminding me why I do what I do.