The End and The Beginning: Nurses Week and the RWJF INQRI Program

Words are powerful.  They inspire us to act, to change, to make the world a better place.  Today, may I choose mine carefully. 

— Me

The only thing I know that is more powerful than words is the work of the great profession I belong to.  Today, I firmly state that I believe the work of nursing is some of the most critical for individuals, families, communities, and countries around the globe.  This week I want to pay tribute to a nursing organization that believes it is in its final stages, but really this organization has merely sparked the beginning of a movement… a movement of evidence as to the importance of the work of my profession.

In 2005 the Robert Wood Johnson Foundation decided to take action on evidence about the importance of nursing found during the I.O.M.’s quest to stamp out health care errors and begin supporting the investigation of the importance of what nurses do.  Out of the discovery of the ‘To Err is Human’ project, the INQRI was born.  Lead by Dr. Mary Naylor, Dr. Mark Pauly, and Dr. Lori Melichar, the program was designed to investigate evidence of the importance of the nursing profession, to link everyday actions by bedside nurses to the improvement of patient outcomes, and to strengthen healthcare through interdisciplinary research. What the program did, in retrospect, was even more profound.  By funding 40 different interdisciplinary research teams investigating the importance of nursing actions for patients, the program has laid the groundwork for future nurse scientists everywhere to learn from and act upon.

One of the Most Important Trips of My Life

Just prior to nurses week I had the greatest privileged of my nursing career, when I was invited to sit and drink in the important lessons learned from the INQRI program at their final meeting in Washing D.C. April 26th and 27th.  Check out the highlights of the entire INQRI program at their blog.  Being present at this event changed me, through broadening my outlook on nursing research and giving me much to ponder about the questions left unanswered even in my own practice.  I could go on for paragraphs about what learned, but I will summarize in a few short bullets:

• The work of nursing within healthcare is critical and is increasing as time progresses.
• Nursing needs more evidence.  This evidence needs to be immediately usable to all practitioners at all levels of the profession and not just highly scholarly or theoretical.
• The INQRI program funded over 40 projects that used robust measures and truly interdisciplinary teams to measure the impact of nursing.  Results from these research projects will continue to be published and impact nursing, healthcare, and patients for years to come.
• Interdisciplinary teams are critical to moving beyond ideas of a single profession’s scope of practice, keeping the patient and outcomes the center of everything, and they are key to pushing valuable evidence out to more than only the nursing profession.
• Nursing needs to emphasize the importance of engaging in research to all levels of practice, and not just the academic institutions or persons with the highest degrees within the profession.
• Nursing research is difficult because it involves real people, multiple factors within the profession such as staffing, time, technology, and an ever changing healthcare system, small amounts of funding,… but still research needs to be done and we must find a way to overcome barriers.
• By simply developing and executing the INQRI program for six years much important information was learned about measuring interventions, working with multiple sites, engaging patients and nurses at all levels, and dealing with and overcoming barriers.
• What nurses do matters, and to prove that and be heard, we must have more evidence.
• There are still gaps in knowledge about the impact of what nurses do and the impact of our practice on patients.

This week I want to say to all of the nurses who have given days, weeks, years to this profession and to your patients… THANK YOU! I also want to say thank you to the Robert Wood Johnson Foundation for placing a priority on the health of people and for putting your faith in nursing as a critical part of that priority.  Finally, I want to say thank you not only to Dr. Naylor, Dr. Pauly, and Dr. Melichar for giving years of time and effort into strengthening the nursing profession and improving health outcomes, but also to the numerous people behind the scenes who made the INQRI a success and brought information and knowledge to an entire profession, people like Heather Kelly and the many teams of funded researchers, bedside nurses, and patients who made this new knowledge possible.  Without each of you, nursing would not be at this great door of hope and opportunity that you have opened.

To all nurses everywhere, I challenge you as the INQRI program is ending, that you do not let the spirit of this program die.  The INQRI has opened the door to stronger evidence and now we must walk through it, no matter where we are or at what level we practice.  We must be the change we want to see for our patients and change begins with sound evidence.

Goodbye to one of the greatest programs in nursing history.

Hello to a new dawning of scientific curiosity and inquiry, or rather INQRI, in nursing.

Happy Nurses Week to all who made both possible.