#TBT: Happy National Nurses Week — Posts on #Lean and Nursing

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Republished from 2018. Since it's again Nurses Week or “Nurses Month” in some circles. It seems like bad form for the American Hospital Association to also declare this exact same week to be “Hospital Week.” Let the nurses have their week. Better yet, give them the support they need instead of a few free pieces of “thank you” candy. See this Reddit post about “Insulting Nurses Week Gifts.”


This week is National Nurses Week. Nurses are highly skilled and, too often, are underappreciated.

Lean should be one of the best things that has ever happened to nurses. In a truly Lean environment, we wouldn't be understaffed. Nurses wouldn't get blamed and punished for systemic problems. Hospitals and the broader healthcare system would break down silos and barriers to care. And nurses would be treated respectfully by everybody in the system at all times.

This post is a collection of some of my favorite blog posts and podcasts about nursing and Lean here in this post.

First, here is a compelling book that I've read that might serve as a “virtual gemba walk” of sorts for those of you not working in healthcare:

The Shift: One Nurse, Twelve Hours, Four Patients' Lives

There's an unfortunate, judgmental, blaming 1-star review of the book that rips the author, a nurse:


“… glad i have much better oncology nurses than this one. first of all, she doesn't take care of herself so that she can function competently in this demanding profession. riding a bike to work in the dead of winter to take on a 12-hour shift, then not eating a decent meal all day or not at all. glucose to the brain takes a back seat to trying to please your co-workers to the detriment to your own health – dumb, ignorant and dangerous to your patients. no wonder she gets bronchitis and is off work for a lengthy period of time. her diatribe does no good to all the hard-working nurses, pa's, doctors and np's, and wouldn't help anyone to have respect for those in the medical profession. one positive to this book is that it makes me appreciate my medical staff so much more.”


Um, does the reviewer think nurses WANT to work a 12-hour shift without getting proper breaks? These are systemic problems, leading to fatigue, mistakes, and patient harm.

Another Amazon customer replied to the review:


“That is the life of a Nurse…we don't get meals, we don't get enough sleep, we are constantly stressed, we don't drink enough water, or see a bathroom but once or twice a shift if we're lucky. We adapt, our bodies learn to deal with the lack of calories and hydration.

In nursing school we are told what the expectations are and this profession is not for the faint of heart or those who would rather be pampered. We are smart, sharp, and our brains also adapt to lack of nutrients and rest. But we are human, and we do get ill…a hospital is a living, breathing germ factory and no one is safe from the exposure.

So it's easy to blame the Nurse here (and believe me, it's a daily occurrence from patients, coworkers, and doctors), but the fact is that we are human, and we get sick and sometimes it really knocks us down. And just so you know her life is like every other nurse out there…this is not a unique situation…not by a long shot. The only way things would ever change (that we get enough breaks, meal breaks, bathroom breaks, etc) is if the hospitals actually staffed at a safe level. You learn to make do with what you have and that very often means, your needs always come last, if at all. I hope you will reconsider your harsh words of judgment.”


For those of you who DO work in healthcare, are you able to go shadow a nurse for an entire shift? Are they tired, stressed, fatigued? Are they having to “make do?” Or are they working in a system that sets them up for success?

Here are the blog posts:

Again, thanks to all of our nurses for what they do.


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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.

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