Challenges to and resources for nurse inventors

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Published: 8 May 2019
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Prof Rachel Walker - University of Massachusetts, Massachusetts, USA

Prof Rachel Walker speaks to ecancer at ONS 2019 about her keynote address on nurse inventors.

She speaks about the challenges facing nurse inventors, innovators and entrepreneurs - including the lack of support for nurses to develop ideas, when they are already being asked to deliver more with less.

Prof Walker concludes by suggesting various resources to support nurse inventors, and encourages oncology nurses to recognise the innovative work that they are already providing.

We need nurse innovators, nurse entrepreneurs and nurse inventors now as much, if not more, than ever because the world we live in and the practice of oncology nursing is changing rapidly. Nurses are at the frontlines of all of that and nurses are also everywhere, not just in acute care settings and hospitals and infusion centres but out in the community doing home nursing. They’re in schools, they’re in prisons, they’re in all of these spaces where there are care needs and oncology care needs. So they are seeing in real time all of the both challenges and opportunities that are unfolding.

We heard this morning about the demographic shifts in who is receiving a diagnosis of cancer, both in the United States and in the world. Increasing numbers of aging cancer patients who bring their own complex life experiences and sometimes other conditions they’re managing and their strengths and resources that we are going to be caring for more and more in the community and at home as much as in the clinical centre. We have all of this omic science and genetic tests and precision medicine coming into play and changing the face of what is therapy. We’re trying to also continue to build the science that supports all of the supportive care, the behavioural interventions, the environmental modifications that nurses know help to support health and healing.

We have lots of things happening in the healthcare delivery space: we have mHealth and apps and consumer devices and wearables and sensors and all this data that are being generated. Translating all of that, making sense of it, figuring out what matters, what’s meaningful, are we paying attention to the right things and how do we explain it all to our patients, to families, to other members of the care team in a way that’s going to improve outcomes in what we do. All of that landscape is there and ready for nurse innovators to play a role in setting the agenda and also in identifying what are the problems we should be solving. Sometimes the problems we have been given as, ‘These are the challenges we’re addressing,’ aren’t necessarily the true problems that need to be solved.

So nurses can participate in just about every level of innovation from identifying the challenges to being the content experts on what things look like on the ground, what works, what doesn’t, to helping to drive the design process, iterating designs that work, figuring out what actually then works or doesn’t and then who else should be at the table and how do we get our patients’ voices as part of that conversation so that we’re not just talking about them, we’re talking with them and they are part of the team.

Are there any challenges that nurse inventors face?

Nurse inventors, nurse innovators, do face some structural barriers to having their ideas heard and fully supported and brought down that whole pipeline of innovation the way that some disciplines tend to… I see them having more support. So even at my own university in the College of Computer Science or in the Business School there are whole ecosystems to support innovation and people having ideas and then bringing them into reality. For nurses who are working at the bedside or in their day-to-day jobs, they already have so much they are being asked to do and often they’re being asked to do more with less. So that even if they have a great idea or even if they’ve made something work, they’re not given a whole lot of space sometimes to take the time or to put the extra energy that might be required into making that thing something more than the immediate solution that it was.

They’re also not necessarily invited to the table. I talked about in my talk how even hospital boards, which nurses are the main workforce of hospitals, less than 5% of them have nurses at the highest level of leadership. It’s even worse in the biotech sector and journalists don’t necessarily talk to nurses as the experts to lead the public conversation about what should be happening. So, as a result, nurses aren’t resourced and supported to bring their ideas into reality. Sometimes too because we all speak slightly different languages and have different sets of values the value proposition that the nurse is bringing is not seen for what it can do for a health system. So that’s something that we are trying to change and nurses are doing amazing work in that space. Like Barbara Glickstein and Diana Mason who recently replicated the study about nurse representation in the media and nursing innovation efforts, raising the platform and the profile of nursing in that space. But it’s still sometimes a bit of an uphill battle. Nurses, too, who have been at it for a while haven’t been encouraged historically to see themselves as having a right to be supported in really developing their ideas into inventions. So I would love if nurses could feel like they could take ownership of that in a way that works for them without also feeling like they have to take on extra burden in a world where they’re already doing so much. Hopefully we will continue to find creative ways to make that possible.

What kind of resources are out there to support nurse inventors?

There are a lot of resources to support innovation and specifically innovation in nursing. Which, again, nurses are probably already doing this, whether or not they’ve recognised they were. But if you have an idea one of the first steps, because it will probably look a little different for every person, is finding a champion for that idea and for you, as a nurse innovator, to be supported in developing that to the next stage. So in some cases some clinical centres have these innovation centres or patient innovation centres or resource and research centres where people are encouraged to bring their ideas and perhaps connect with a team, a whole team of people, who can help figure out how to make that a thing in the world. But not everybody has that so we also have organisations like ONS and the ONS communities, this online resource where you can crowdsource your ideas, you can send something out to the communities and people can reply from wherever they are. Because oftentimes there is someone out there who has tried to do something similar in the past. You can ask for mentors – we have some incredible nurse leaders who have really forged the path for the rest of us and who are very generous with their advice. We also have open source education platforms now that provide additional resources for nurses who want to innovate around design thinking or where to find, whether that’s funding support or a centre or resource to help develop your ideas. The Penn Nursing open source educational platform which is all about design thinking in healthcare and innovation: it’s a multidisciplinary resource but it’s being driven by nurses, including a very creative nurse, Marion Leary, who helped build that.

So we are going to see more and more these things coming on line and innovation being part of even our educational structures for nursing. If nothing else, if you’re a nurse who is on social media, nurse Twitter, I had not been a user of it really almost at all until just this past year but I find there too it’s like you have this whole hive mind of amazing people out there who will help you out when you put something out into the world and ask a question. You’ll sometimes just get deluged with responses of where to find a resource or someone else who is doing this thing that you should connect with. I love that, how we can connect with people now in ways that help us collectively change the landscape for nursing.

What is your take home message for oncology nurses?

My take home message is that nurses have a long and proud legacy of innovating and inventing and making things work in ways that ultimately make the world a better place, not just in terms of medical outcomes but this larger notion of what health could look like in the world and what wellbeing could look like in the world while living and while dying. We have such enormous creativity so I would like nurses to know not only that they can own that and they can claim that heritage and build on it and take these titles, not to just glorify themselves because I can’t think of almost any nurse who just is out there for themselves, but in the service of building a better system and of really highlighting places in our system that are broken and that nurse innovators can help to fix. So at the end of the day whether they’re taking on a new project or just continuing to show up for their patients and for their communities they are enough, they’re doing enough. You’re doing enough and hopefully the world will catch on.