Nurse risk management

For those of us who wake up every morning, put on our suits and ties and head off to our risk management jobs only to spend the day thinking about fat tails, ISO3 1000 or business continuity, compared to the risk management that nurses perform everyday, we are nothing but a bunch of well paid prima donnas.

Because in nursing there is pretty much one rule: Don’t kill your patient.

Before putting on my French cuffs and Cole Haan shoes I have the pleasure of waking up every morning to the beautiful face of a recovery room nurse. And while there are perks to going to work in your pajamas (read: scrubs), I will gladly take my starched collar because while I am staring at Excel and PowerPoint, she’s doing some pretty amazing and often gross stuff including wiping asses. (To learn more about this, read Theresa Brown’s new book, “Critical Care” where she writes  how nurses often sit around with other nurses over lunch and explain how “I’m really in the shit today”.)

And unlike our corporate world where we worry about trying to classify risks into appropriate risk categories (market, credit, operational or reputation), nurses are often classifying poop by its “colour, consistency, constancy and smell.” Nursing is a world where liquidity risk has an entirely different meaning.

Earlier in my career, I used to run daily VaR (Value-at-risk) reports and hope that there wouldn’t be a limit breach because sometimes tracking down and getting a sign-off from the Managing Director was such a pain. When I read about the real pains that Brown’s chemo patients have to deal with including “mouth pain, nausea, vomiting, rashes, breathing problems, infections, cardiac trouble or nerve pain”, I am a little ashamed.

I also had a brief stint in internal audit once. There, one of my managers liked to remind us that this was audit and we weren’t saving lives. Having read about Brown’s experiences administering chemo and heard those of my honey in the recovery room, I implore you to remember that nurses actually do save lives.

Let’s try to remember that while our risk management skills and functions are important to the success of our clients, organizations or regulators, compared to what nurses do day in and day out, what we do is really not that important.

2 thoughts on “Nurse risk management

  1. Just about everything about risk management in healthcare facilities is “different”. Which is weird…because so many of the people who get the job of designing a hospital treat it like just another building.
    The infrastructural requirements of hospitals make them a lot like educational campuses, and so they’re actually ideal places to roll-out sophisticated technology-based security systems, but you need to take a whole bunch of non-intuitive things into account when you’re planning security for healthcare.
    It’s like you need to get the people who design systems for hospitcals to take the Hippocratic Oath…”first do no harm”…because you can do an awful lot of harm if you get the security systems wrong. You can’t delay a crash team while someone looks for their access card, you can’t lock-down the doors when the security staff are pursuing someone who’s just snatched a baby. You can’t let people with mental disorders wander around…but you also can’t leave them burn to death in a fire!
    Even the physical positioning of devices makes a difference to the impact on life-safety…but where are the standards and guidelines…? How do you know who are the real experts…?
    Of all the places in the built environment where users will justifiably circumvent the security systems if they feel they don’t work, hospitals are probably the most significant – and as a result of the penny-pinching, non-fit-for-purpose design approach we see all the time, they’re also probably the most common.

  2. Just about everything about risk management in healthcare facilities is “different”. Which is weird…because so many of the people who get the job of designing a hospital treat it like just another building.
    The infrastructural requirements of hospitals make them a lot like educational campuses, and so they’re actually ideal places to roll-out sophisticated technology-based security systems, but you need to take a whole bunch of non-intuitive things into account when you’re planning security for healthcare.
    It’s like you need to get the people who design systems for hospitcals to take the Hippocratic Oath…”first do no harm”…because you can do an awful lot of harm if you get the security systems wrong. You can’t delay a crash team while someone looks for their access card, you can’t lock-down the doors when the security staff are pursuing someone who’s just snatched a baby. You can’t let people with mental disorders wander around…but you also can’t leave them burn to death in a fire!
    Even the physical positioning of devices makes a difference to the impact on life-safety…but where are the standards and guidelines…? How do you know who are the real experts…?
    Of all the places in the built environment where users will justifiably circumvent the security systems if they feel they don’t work, hospitals are probably the most significant – and as a result of the penny-pinching, non-fit-for-purpose design approach we see all the time, they’re also probably the most common.

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