System Change – Discussion Response

1. Nurses routinely outperform other occupations, earning the title of most trusted profession for decades. Nonetheless, the nursing voice remains absent in the public sphere, with little representation in governments and boardrooms. Healthcare can only improve and get better over time when positive change takes place within its ranks. As change agents, it is important that nursing leaders take up and spearhead new policies and procedures for change to improve patient care and nursing as a whole. Nursing leaders are classic examples of change agents. A “change agent is the individual responsible for delivering the implementation strategy, and is thus largely responsible for fidelity to the intended strategy and its ultimate success in achieving desired organizational changes” (Alagoz, et al., 2018, p. 2). One example of a nurse leader who spearheaded and implemented change is, AnnMarie Walton, MPH, BSN, Ph.D. AnnMarie noticed the increase in Hispanic males being diagnosed with leukemia and dying in their early years. She carried out a study and spearheaded research that has led to policy changes in North Carolina, where the state now mandates compliance with NIOSH recommendations for the safe handling of hazardous drugs, especially in the farms and fields. I believe she was able to conduct and push her work into policy through understanding the political playing field in her community and having a good network and communication with those in decision-making roles. She was able to influence those who could effect a change on current policies or programs. She then influenced the persons in decision-making roles to change the current policies to accommodate the change she desired.
Some of the driving forces that led to the change included the increase in the diagnosis of new Hispanic young male farmers with leukemia, along with the increase in fatalities for this population in her community. This pushed Ann Marie to use her skills as a good communicator to aid in the process. It is important that any change agent understand the most effective manner of communication to best communicate with those who need to be influenced for policies to be enacted.
Ann Marie faced very little opposition when she was trying to initiate change to improve and change policies in her community due in part to the fact that, this was a problem that was affecting a lot of the community at random, and the solution benefited the community in such a positive way.
Reference
Alagoz, E., Chih, M. Y., Hitchcock, M., Brown, R., & Quanbeck, A. (2018). The use of external change agents to promote quality improvement and organizational change in healthcare organizations: a systematic review. BMC health services research, 18(1), 1-13.

2. Not all nurses begin their career thinking of becoming a leader or spear heading a change, but there is no shortage of leadership in nursing. Strong leaders are needed for any transformation or big changes to be realized in healthcare system. Mary Breckinridge was a nursing leader that spearheaded a change that has affected healthcare policies up till today. According to Shampo & Kyle “The most important contribution Mary Breckinridge made to nursing was her work as a pioneer in nurse-midwifery and in the development of modern nursing services in rural communities” (1999). She was a horse bicker nurse and a midwife, riding through the rough mountain terrain and during bad weathers to care for women and children. She got her midwife training in England after World War 1 and came back to America. She founded the frontier nursing services (FNS) in Appalachia, Kentucky, the poorest county in the country back then. Mary introduced the first modern comprehensive healthcare system in America. She promoted the growth of district-wide nursing centers and hospital facilities in southern Kentucky and provided professional services for primary nursing care and midwifery.

According to Carter “Fourteen years after FNS began its work, its founder, Mary Breckenridge, started the Frontier Graduate School of Midwifery, sending its graduates all over the country to assist underserved communities” (2018). Mary Breckinridge traveled on horseback where she surveyed and gathered information from women and noticed that they lack prenatal care, with few roads and no physicians. She believed that children’s healthcare should begin in the prenatal period. She had now opened the frontier nursing services to care for the children in remote rural areas of Kentucky, after experiencing the death of her two children at an early age. The FNS lowered the maternity mortality rate in Leslie County, Kentucky from the highest to the lowest in the country and below national average. The baby delivery service was only $5, but during the depression when money was scares, they will take manual labor or chicken in exchange for their services, no family was ever turned away. Their resourcefulness help build the frontier school. She sent midwives from frontier to the rest of the country to help train others in the process of delivering babies.

There is still an online non-profit Frontier Graduate School of Midwifery that trains nurses and midwives worldwide. In 1982 she was inducted into American Nurses Association’s Hall of Fame for her contributions to nursing profession in children and women health.

Reference:

Carter, E. (2018, September 20). The forgotten frontier nursing done in wild places. U.S. National Library of Medicine. Retrieved November 16, 2021, from https://circulatingnow.nlm.nih.gov/2018/09/20/the-forgotten-frontier-nursing-done-in-wild-places/.

Shampo, M. A., & Kyle, R. A. (1999). Mary Breckinridge—pioneer nurse brings modern nursing to rural environment. Stamp Vignette on Medical Science, 7(12). https://doi.org/https://doi.org/10.4065/74.12.1312