by Bonnie Eissner
Running a hospital well or badly has life or death
consequences. Wei Liu, Ph.D., and Susan Zori, D.N.P., know this all too well
from their long experiences as hospital nurses and their more recent pursuits
as academic researchers.
Prior to joining the Adelphi faculty as an assistant
professor in the College of Nursing and Public Health, Dr. Liu worked for more
than a decade as an emergency room nurse in China and Australia. Dr. Liu became
fascinated by the complexities of how nurses, doctors and pharmacists
communicate across their various disciplines in order to dispense medications.
What does it mean, for example, that doctors make medication
decisions at the central staff station, away from patients’ bedsides? Or that
they make their medical ward rounds when nurses are absent? What is the impact
on patient care when doctors, nurses and pharmacists conduct separate staff
meetings?
Through interviews with and observations of doctors,
pharmacists, nurses and patients, Dr. Liu documented patterns of communication
and miscommunication in medication management at a major metropolitan hospital
in Melbourne, Australia.
As a nurse in a separate ward at the hospital, Dr. Liu was
able to establish credibility and rapport with the professionals and patients
she was studying, to the point that they allowed her to videotape their
clinical interactions.
Dr. Liu’s ultimate goal was to improve patient safety at the
hospital. In addition to publishing papers based on her research, she took her
findings back to the hospital professionals. In focus groups, she shared her
data and a DVD she produced and encouraged discussion. Her aim, she said, was
to “have them look at their own practices to see where the communication gaps
might be and how we could improve our interdisciplinary communication and then
improve our patient safety.”
Dr. Zori, a clinical assistant professor at Adelphi’s
College of Nursing and Public Health, has practiced nursing for 40 years, many
of them as a nursing director at prominent hospitals in New York City and on
Long Island. During decades of overseeing teams of nurses, she grew curious about
why some teams exuded positive energy and excelled while others seemed
disgruntled and performed less well. She suspected that the nurse managers’
critical thinking abilities and attitudes played a significant role.
In an often-cited study of nurse managers and their staffs,
Dr. Zori and her colleagues validated this hunch. Nurse managers who scored
high in seven categories of critical thinking disposition, ranging from
open-mindedness and inquisitiveness to truth seeking and cognitive maturity,
had staffs who felt better about their work and, as a result, were more likely
to provide safer and more effective patient care.
Dr. Zori has since been testing ways to boost the critical
thinking skills of up-and-coming nurses. Working with administrators at North
Shore LIJ Health System’s Center for Learning and Innovation, for example, she
created a critical thinking class for nurses in the system’s fellowship
program. From journals that the nurses kept, Dr. Zori observed that many had
become more attuned to the importance of being inquisitive and analytical in
their work.
In her classes at Adelphi, Dr. Zori encourages critical
thinking by emphasizing case studies and interaction. “For me, it’s constantly
challenging myself to find a way to get [students] to critically think and to
be creative and interactive so that they’re not just learning information,
they’re applying it to real-life situations,” she said.
This article appeared in the Spring 2015 issue of Erudition.
