Three Simple Changes To Transform Our Disease-Focused Healthcare System

My friends, this pandemic will change our nursing profession forever. And while the spotlight is on our healthcare system, a disease-focused model, we have a once-in-a-generation opportunity to change everything for the better.

In fact, there are three simple changes you can make in your practice right here, right now, that will prevent our failing, reactionary model from continuing to be our norm. I promise that these three changes will fundamentally alter the entire way that you work and practice.

So today, I’m talking about exactly what you and all of us nurses must do to ensure that we never go back to the failing system we’ve been propping up for decades.

In case you don’t know me, my name’s Peter Giza – a registered nurse, board-certified nurse coach, and co-founder of the Nurse Coach Collective.

Welcome! I’m so happy to have you with me today.

Before we dive into today’s conversation, I want you to know that my love and support goes out to our frontline workers. I’ve been holding you in my meditations every day, praying for your safety and for the health of our population.

In fact, I think one of the more difficult things to balance is speaking about the enormous suffering that’s happening presently while continuing to be hopeful about the future.

But here we go.

Our Chronically Ill Healthcare System

Over the past few months, we’ve been experiencing an acute exacerbation of a chronically ill healthcare system. COVID-19 has shone a spotlight on the innumerable shortcomings inherent in our disease-focused healthcare model. Shortcomings that have existed for far too long and that cannot continue to exist anymore.

At the best of times, nurses are constantly asked to do the impossible. Our time with patients has been hijacked by computer documentation, medication administration, and care coordination that consumes nearly 75% of our time at work.

I’m not negating the hard work you put in every single day. Nurses save lives, period.

Yet 90% of all healthcare resources – money, time, and energy – 90% of that is wasted on managing chronic diseases. Wasted. And I say wasted not because the sick don’t deserve to be cared for and healed, and not because you don’t put your heart and soul into your work… but wasted because we know there’s a better way to do it.

We know that 4 out of 5 cases of chronic disease are preventable and reversible through lifestyle coaching. Imagine how different your life would be if we allocated just half of those enormous resources – more than 1.5 trillion dollars and millions of healthcare professionals – to focus on getting to the root of disease, instead of feeling like we’re drowning in a sea of disease.

What if 80% of cases we see in the hospital simply went away because we were focused on helping people in a way that was congruent with science, best practice, and what we know in our hearts to be right? How much could be different for us?

And this isn’t wishful thinking – it’s a matter of sustainability and creating a new reality for ourselves.

New Shift, Same Problem

We nurses cannot continue to prop up a wasteful, flawed medical model. A model based on the sunk-cost fallacy, which describes our tendency to throw good resources on a burning fire. The sunk-cost fallacy states that just because we’ve already spent an enormous amount of resources on something, doesn’t mean we should continue shoveling resources at it just to maintain a failing status quo.

The first time your car breaks, you fix it. But the 20th time it breaks in a year, you’re better off selling it and buying a new one.

You see, more than 3 trillion dollars annually goes towards managing chronic diseases. And managing them ineffectively, at that. Let me put that in perspective for you. That’s more than the entire stimulus package that was passed to prop up the American economy in the wake of Coronavirus.

And nurses know this better than anyone – managing these chronic diseases turns every shift into groundhog day – we give meds, chart incessantly, and break our backs just to wake up the next day to a new shift but the same problem.

Our altruism has been pushed to the max – we give and give while hospitals take and take. You want to do a great job, but they give you another box to check. Another policy to implement. Another patient under your care. Oh, and you’re expected to do all of that in the exact same length of shift as before, or else you risk disciplinary action for staying late to document.

So it’s no wonder that we are experiencing moral injury at an unprecedented scale in the medical profession. We know – both scientifically and in our hearts – that we could be practicing in a way that’s congruent with the entire reason we became healthcare pros in the first place – to help people truly heal and get better.

So once the COVID-19 pandemic comes under our control – which it will because we have so many smart and talented medical professionals working their asses off and risking their lives to ensure that happens – let their sacrifice not be in vain.

Let’s Create A New Reality

Earlier, I told you there were three changes we need to make as a profession, on an individual and systemic level. Three changes that will prevent this failed system from continuing to abuse our altruism and decimate the wellbeing of us nurses and our patients.

These three changes are to slow down, remember how powerful you are, and to take action.

First, slow down. Many of you have been furloughed. Use this time to reflect on how you want to serve as a nurse. There are hundreds of thousands of jobs out there, and the wellness paradigm is just beginning to take root. For those of you who have been in the midst of a war zone, take a much-needed break. Decompress. Talk about your experiences openly and with candor, and heal. Let’s all take a collective deep breath and reassess how exactly we want to move forward.

Second, remember how powerful you are. You are the lungs that breathe life into the health of this nation. Never forget that. There are hundreds of thousands of jobs out there for you. You deserve respect, a safe working environment, and fulfillment from the care you provide.

And third, take action. Be fiercely loyal to yourself and your values. Speak up at all levels and create change. Connect with colleagues who get it. And wherever you are, right now, take one tiny step towards creating the practice you deserve and the health your community needs.

Because if we can all make a choice right here, right now, to commit to these three changes – to slow down, remember how powerful we are, and to take action – we don’t need to wait for things to transform. The Wellness Model begins right now.

So tell me what your tiny step is. In 1-2 sentences, what actions are you willing to take to make the wellness model our new status quo?

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