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A Legacy Lives On: Tim Porter-O’Grady

Monday June 28, 2010
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Florence Nightingale’s energy, vision and activism live on in many of today’s nurses, some of whom have become legends in the profession. Nurse.com profiles several exemplary nurses from a variety of backgrounds who reflect the scope of Nightingale’s influence, including their thoughts on the link between Nightingale and current practice.

Tim Porter-O’Grady, RN, DM, EdD, ScD(h), FAAN, is senior partner, Tim Porter-O’Grady Associates Inc., Atlanta

Does what you do make a difference? That’s the question Tim Porter-O’Grady says is most important for nurses today.

“We’re in a value-driven age,” Porter-O’Grady says. “So the issue is whether what we’re doing demonstrates value or impact. What is better because of what we do? The evidence is the goodness of fit between what we did and what we got. People make the mistake of thinking accountability is about responsibility, which focuses on the work. Real accountability asks, ‘Did the work matter?’”

Porter-O’Grady runs a consulting firm whose clients are hospitals and healthcare organizations in the midst of clinical service transformations. He began his career as a nurse in a hospital neurological unit and soon became a charge nurse. After earning a master’s degree in nursing administration, he became a chief nursing officer, then joined a large healthcare organization in Atlanta to implement a shared governance system.

“Once I started writing about it, people started asking me to come to their institutions to help them,” Porter-O’Grady says. Shared governance, which helps nurses oversee and regulate the practice of nursing, challenges traditional behaviors and roles, though Porter-O’Grady says the best-performing institutions have adopted it.

“Shared governance has had a huge effect,” Porter-O’Grady says. “Now when a nursing student is graduating, he or she will ask an employing organization if it has shared governance and Magnet designation. The two together demonstrate an expectation of excellence.”

Porter-O’Grady says he approaches everything he does from the viewpoint of a nurse.
“Even when we’re working with boards, policies and governance, we’re working from the perspective of the nurse, the one perspective that lies at the center,” he says. “Nursing drives the culture at a hospital. If you want something to happen, engage nursing.”

Porter-O’Grady says a part of his mission is to help nurses understand where they fit into a 21st-century system of healthcare.

“There is a new paradigm, a new framework for healthcare that is completely altering our understanding of services provided and the way they are provided,” he says. “The nurse must be able to know today the kinds of shifts and adjustments in both practice and profession that will be necessary to thrive tomorrow.”

Porter-O’Grady has co-led the implementation of the new master’s and PhD programs in health innovation, the systematic study of the ways in which change affects patients, providers and entire health systems. He believes healthcare reform will open thousands of doors for nurses.

“The nurse is right at the point of service,” he says. “Almost everybody in the hospital who deals with the patient has to cross the path of the nurse. He or she can answer the question, ‘Is it all coming together?’”

Porter-O’Grady believes although this role for nurses hasn’t been adequately valued in the past, hospital administrators will see its significance in the future. But first, he says, nurses must recognize their responsibility, much as Nightingale did.

“Nightingale’s principles haven’t changed; only the practice has shifted,” he says. “She called us to create a safe space for patients, and that still would be her commitment. We have an obligation to speak and act as though we are Nightingale in our time.”

See related stories:
A Legacy Lives On: Antonia M. Villarruel http://news.nurse.com/article/20100628/NATIONAL02/100628004/-1/frontpage
A Legacy Lives On: Mary D. Naylor http://news.nurse.com/article/20100628/NATIONAL02/100628006/-1/frontpage
A Legacy Lives On: Margaret L. McClure http://news.nurse.com/article/20100628/NATIONAL02/100628007/-1/frontpage
A Legacy Lives On: Loretta Ford http://news.nurse.com/article/20100628/NATIONAL02/100628008/-1/frontpage
A Legacy Lives On: Linda Burnes Bolton http://news.nurse.com/article/20100628/NATIONAL02/100628009/-1/frontpage

Cindy Conover Dashnaw is chief copywriter at BohlsenPR in Indianapolis.Send a letter to editorNTL@gannetthg.com or post a comment below.