“Personal Perspectives” provide a space for practitioners and patients to offer their personal views about any aspect of enhanced recovery. “Personal Perspectives” do not necessarily reflect the views of the ERAS Collaborative in general. If you would like to contribute your personal perspective, please contact the Project Manager.
ERAS – Ongoing Quality Improvement Changes to Surgical Care
By Deborah Bachand, RN, BA; formerly Manager of Quality Improvements for Surgical Services at Island Health and Member of BC Enhanced Recovery Collaborative Advisory Panel
Change. I love words, and I’ll bet that many of you are tired of that one. The Oxford English Dictionary tells us it is an old word with Celtic origins; that it can be used as a noun, and a verb both with and without direct objects, that an altered form is also an acceptable adjective.
I have seen a lot of change in my 40 plus years of nursing – mostly good and mostly beneficial to people – our patients. Some changes I have disagreed with.
I disagreed with the move to the BSN program, which purports to train bedside nurses with limited access to the bedsides of real patients. I disagreed with the ‘primary care’ nursing model, which broke down the bonds of teamwork and in my opinion made a hard job harder. But I came around. And then I recently sat in on a local forum where our university community met with the nursing professional standards body to discuss what to do about nurses coming out of the current BSN programs, none of whom at that table considered ‘practice ready’. And most of us are aware of, or have been embroiled in the conflict between health authority administrators, staff, managers and nursing unions over the change back to team nursing – aka CDMR – Care Delivery Model Redesign.
Change is difficult but as someone once said: Change is inevitable – resistance is futile. We can’t undo the changes to university degree nursing or the changes brought about by resource stresses in health care but we can change the way we deliver care to ensure that patients are getting the best we can provide based on statistical evidence, carefully measure outcomes, and by being attentive to the needs of our patients and their desire to get back to life as they knew if before they heard the words “you will need surgery”.
By now you may all be wondering what this has to do with ERAS. Reflect for a moment on ERAS as the new change for surgical care – spreadable, sustainable. Think about how we can never go back to the way things were.