Dan Keller RN MS's blog

Exploration of the concept of missed nursing care was pioneered by Dr. Bea Kalisch, RN, of the University of Michigan. Her 2006 paper in the Journal of Nursing Care Quality, Missed nursing care: a qualitative study is a classic in the field.

She identified nine elements of regularly missed nursing care:

Something that was made endlessly clear to us in nursing school was that upon completion we would still "know nothing".  That is, the real training would not happen until we were hired, and it would be at the hospital's expense.  We could expect several months of limited productivity before we would be able to function fully as autonomous professionals.

What is patient acuity?  Why do we need to know it?  Conceptually, it's a measure of how much care a patient requires.  We need to know it because in order to do effective nurse staffing, we must know how much work each patient represents for each nurse.  We need a metric.

The longer I use NurseMind in my nursing work, the more its value to me grows.  What makes NurseMind's value grow?

1. Personalization (it becomes tuned to the way I work)
2. Connectedness (others use it and we talk about it)
3. Prestige (colleagues use the shifts and protocols I create)
4. History (my work experience records accumulate and yield valuable diaries)
5. Mastery (I'm good at it)

Presence.  When you've got it, you're at your professional best. You walk into your patient's room and from the first step all your senses are trained on what's there.  A whiff of C-Diff, perhaps, or that unmistakable pitch to the cries that mean kidney stones.  All your experience and judgment is in action.  This is what it feels like to be a truly great nurse, the kind patients hope for and doctors trust.  Can we be that kind of nurse?  Can we do it consistently?  How do we get there?  What are the obstacles?  How can we overcome them?