Communication With Nurses

imagesCAATJSWMThe key to life safety compliance is education. Relating better to caregivers will open their eyes about the important of Life Safety Code® (LSC) requirements.

The situation with nurses not observing LSC provisions is near universal in hospitals. The solution has to start with safety and accreditation professionals because the nurse’s main focus is often on patient care. The LSC isn’t a regulation that nurses generally worry about—there are plenty of issues in their jobs that are more immediately pressing.

For example, nurses like to keep patient care items nearby (e.g., parking blood pressure cuff machines in corridors outside patient rooms) instead of having them stored 30 feet away in a utility room. Although items parked in corridors is generally a legitimate violation of the LSC and Joint Commission standards, if you voice your objection nurses may nonetheless feel you are policing them. Rather than taking a hard-line stand on compliance, a more open approach will get the desired results. 

Steps to Open Lines of Communication

Use the following tips to win over nurses:

  • Go onto the units and job-shadow nurses for a few hours. Tell them, “I want to get to know what you do better.” You’ll learn nurses may need to take all of their patients’ blood pressure every two hours, which is why they want the blood pressure cuff devices nearby.
  • Schedule times to sit down and talk to the nurses, either individually or in group meetings. This approach is time-consuming because the goal is to reach every nurse in the facility. Years ago, I carried out a similar effort as a safety officer at the hospital where I used to work, and it took a total of six months to talk to all the nurses. This involved coming to the hospital on weekends and at 2 a.m. on the overnight shift.
  • When you talk to nurses, don’t wear a suit. Appearance plays a large part in the success of the interaction. You don’t want to dress like you’re someone’s boss.
  • Avoid mentioning LSC terms and related jargon. Words such as “Life Safety Code,” “standards,” “laws,” and “rules” will drown out your message. Don’t use these buzzwords because caregivers will tune you out right away.
  • Relate life safety to nursing work. After learning what activities nurses undertake as part of patient care, explain that life safety compliance has a similar goal. Tell them, “I want you to consider other examples in the environment that keep your patients safe.”
  • Use visual examples to drive the point about life safety provisions home. For example, explain that an 8-foot corridor needs to remain clear because in a fire, nurses may need to push 40-inch-wide hospital beds down that corridor. Those beds almost never roll straight and could occupy up to 6 feet of the corridor, especially if IV pumps, heart monitors, and other equipment are attached to the patient. The remaining width of the corridor needs to stay clear for other nurses, security officers, and firefighters who are trying to get onto the unit to assist. As a nurse moves a bed, if he or she encounters an item blocking the corridor, that item will need to be moved out of the way and stored somewhere. This could take 30–60 seconds to accomplish and may mean the difference between life and death for the last person trying to get out.
  • Show nurses the closest locations of portable fire extinguishers and fire alarm pull stations. There’s a good chance caregivers will pass by the closest location for these items and delay response because they simply don’t realize the devices are there. Encourage nurses to talk to each other about the locations of extinguishers and pull stations to maintain awareness.
  • Confirm that nurses know where to relocate patients during an evacuation. Sure, most nurses understand that if an alarm goes off in their unit, they may need to move patients to the nearest safe smoke compartment, which begins after a double set of smoke barrier doors. But not all double doors that close on alarm are smoke barrier doors. Show nurses the exact locations of adjacent smoke compartments so they know where to relocate patients.
  • Ask nurses whether they’ve ever been involved with a fire. If you’re talking to a group of nurses and you encounter one who has responded to a blaze, that nurse’s recounting of the event will support your cause.

Time Is the Major Investment

The above approach will take time but shouldn’t cost you much money. Getting leadership support is important, particularly if you run into a nurse who butts heads with you about efforts such as keeping egress corridors clear. You can further convince nurses to help you with LSC compliance by assisting them with nagging projects, such as hanging a bulletin board that’s been lying around for weeks. By fixing little things, you can buy trust.