Embrace History and Become a Leader of Change

Abstract

EDUCATORS ARE NO EXCEPTION. While history was not my first love — probably due to boredom from memorizing facts, names, and battles — I became passionately hooked when I discovered lived history during an English history class in college. I also love mysteries, and historical medical mysteries best of all. Consider the true story recounted in Holly Tucker’s Blood Work: A Tale of Medicine and Murder in the Scientific Revolution (W. W. Norton, 2011). Blood Work tells of a conspiracy and a sensational trial that delayed the use of blood transfusions for more than 150 years. The story begins in Paris in the mid-1600s, when hot oil was the treatment for wounds. At this time, philosophers were debating the nature of the soul. Since it was believed that animals did not have souls, animals were often used for medical experiments, including blood transfusions. However, peopled feared taking on the characteristics of the animal whose blood they were given. Sheep, perceived as pure, were the animal of choice. Jean-Baptiste Denis, one of several scientists to experiment with transfusions, was determined to make a name for himself. He had treated a feverish young boy with lamb’s blood in 1667, and found a sponsor to stage a transfusion on one Antoine Mauroy, a former valet who frequently frightened people. The transfusion, an experimental cure for mental illness, was painful, and Mauroy died the next day. Denis was charged and tried for murder and eventually acquitted. The court case documents that Mauroy had, in fact, been administered arsenic before the transfusion took place, possibly by enemies of experimentation and scientific progress. Although Denis gained his freedom, the murder succeeded in putting an end to further exploration of blood transfusions and work on other potential findings, such as blood typing, for more than a century. Parallels exist today among those who oppose the rapid wave of change in the practice and education environments. We see this trend in the media, when sensational “human stories” lead to opposition to change. For example, on a recent radio talk show, a physician from the United Kingdom railed against nurses, stating that physicians had to order water because patients were dying of dehydration. According to this physician, inaction by nurses was the result of socialized medicine. Stories of the human experience hold our attention and sway our beliefs, attitudes, and actions. Some proposals being considered for so-called entitlement programs, such as Medicaid and Medicare, are frightening. And they are accompanied by much hostility. The human harm potential is staggering. Nevertheless, I am encouraged by the strength and determination of leaders across disciplines, who have joined together to repair and redesign our faulty health care system. Some of the players are hospitals, politicians, educators, and private funders, but most dominant are nurses, regardless of setting. Nurses are changing how they work, the way they interact with team members, and the way they treat clients and coworkers. Incivility is now named and not tolerated. Systems that contribute to errors are studied, and reforms are instituted. The effective nurse of tomorrow must hone skills to create, manage, and evaluate environments of change. Today, we have the opportunity to improve the public’s health through ways that nurses know well. Although nurses have long been restricted by their employment settings and, unfortunately, by nurse practice acts, things are changing. But we must be wary. Often when rapid change occurs, and leaders do not emerge, the vacuum is filled by some who, while well intentioned, lack the breadth and depth of the nurse’s education and experiences. As nurse educators, we must embrace change, incorporating in our curricula the knowledge, skills, and complex learning experiences that prepare us, along with our students, to thrive in a transformative work environment. And it is vitally important to remember our history. There was a day when nurses taught all new mothers how to care for infants and provided information on cost-effective, proper nutrition. There was a day when complications from care in hospitals were minimal, and when school children received routine physical examinations by nurses. Are we determined to lead change with confidence and learn from our history...for such a time as this? NLN NLN