Nursing's Failure to Thrive


Published: 22 November 2016

We don’t fail nearly well enough or often enough in nursing.

I don’t mean here, the spectacularly dangerous and life-threatening failures of a Francis Report, or of connecting a man’s urinary catheter to his oxygen supply or bathing an elderly patient in bleach. I mean the kind of failures that result from trying something new, of thinking around corners, of entrepreneurial or intrapreneurial creativity. Sometimes these ways of trying something new or coming at age-old, seemingly intractable problems from a different angle seem so clear, so obvious, so worthwhile that we wonder why no-one has tried them before.

This ignores the reality for so many nurses who work in cumbersome, bureaucratic organisations, whether they be a hospital, health service or even a University. For these nurses and their ‘leaders’, the idea of trying something new that may not work is anathema. We have become so procedurally-driven and risk averse in healthcare that we have almost equated the idea of trying something new that doesn’t work (this first time around), as being synonymous with personal failing, incompetence, stupidity, or even lack of professionalism. In the minds of some, it seems that a new initiative that doesn’t work equates to poor project planning, faulty thinking and a ‘waste of resources’.

In such a risk-averse climate, who would even contemplate ‘rocking the boat’ by going out on a limb to try something new?

Every built-in incentive in our ‘system’ is geared to reward inactivity, maintaining the status quo and not taking any risks at all. Promotions and kudos are given for keeping ‘business as usual’ ticking over, or for reorganising structural deck-chairs, not for disruptive innovation, not for taking radical new approaches to the myriad of health problems and issues that seem to have been part of our health landscape for as long as any of us can remember.

Look at the recent ‘We got this’ video produced as part of a new campaign to ‘change the script’ of nursing. The intentions are wholly laudable. If ever a public image needed a makeover it is nursing. However, if you apply the ‘Gruen Test’, it hardly bears thinking about what Wil Anderson and the team would do with this video. No current media cliché stone is left unturned, from the oh-so-serious black and white photography, to the cod-poetic voiceovers and the almost unworkable hashtag of #wegotthis, which can’t even stand out from the hundreds of other #wegotthis hashtags on twitter or online. The only mystery is why the nurses filmed weren’t given handwritten placards to hold up as they spoke, but maybe Bob Dylan already had the last word on that.

So is this a failure that should never have seen the light of day? Not at all!

Just because the initial video didn’t work doesn’t mean that subsequent ones won’t. Because attempt #1 to change the script about the story of nursing and nurses almost certainly won’t work, is no reason not to learn from this, to take the best lessons, and to work them into even better campaigns in the future.

If you are not failing properly then you are not learning. It’s a lesson that nursing and healthcare still struggle to grasp.

Philip Darbyshire
Follow Philip on twitter @PDarbyshire
Philip is a Director of Philip Darbyshire Consulting Pty Ltd
and a Professor of Nursing at Monash University School of Nursing & Midwifery


Portrait of Philip Darbyshire
Philip Darbyshire

Professor Philip Darbyshire is internationally recognised as a leader in nursing and healthcare research and service development. The Australasian College of Health Service Management called Philip: “the ‘go-to’ person for hospitals and healthcare organisations who want research and evidence-based practice demystified and moved out of the ‘too-hard basket’ and into the hearts and minds of clinicians who will use it make a real difference”. For 13 years, he led one of Australia’s most successful practice-based research departments at Women’s and Children’s Hospital in Adelaide, described by the Australian Council on Healthcare Standards as, an “example of excellence in research leadership”. Philip is a professor of Nursing at Monash University and an adjunct professor at the University of Western Sydney. See Educator Profile