Why Florence Nightingale Never had to Address Quality Care
August 7, 2015
Florence Nightingale (1820-1920)
Florence Nightingale so reminds me of my first harp teacher. She was intolerant of error for any reason whatsoever. In fact, there were no words one could offer that would excuse a mistake. None whatsoever.
Nightingale was very clear. If a patient dies overnight who was not supposed to die, something was not seen, some clue missed.
And, the responsibility lay at the feet of the caregiver, whether nurse or physician. Basically, at the end of every lost detail or every error, is the life of a patient. Nothing less is at stake.
She focused more on nurses because the physician spent so little time with the patient. From Nightingale’s perspective, the ability to see detail over 24 hours was a foundational requirement for anyone who even thought about becoming a nurse.
So, quality care was built into her assumptions. In fact, there was no separation or distinction between good nursing practice and keeping the patient safe from harm.
Today, we have Quality Improvement Directors, Quality Improvement Coordinators, Quality Managers, and more. Safety is relegated to a department or C-suite role, with rules and policies flowing forth.
But the job begins and ends at the bedside. Seeing a problem and assigning the solution to another person is itself hazardous.
The buck stops at the bedside and the responsibility belongs to whoever is literally at the bedside.
Do you see anyone else around?
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