Transforming Nursing Services through Appreciative Inquiry

Introduction

The Nursing Association of Nepal (NAN) embarked on a groundbreaking initiative to enhance the quality of nursing services and improve nurse well-being across the country through the “Nursing Now” campaign. To achieve these goals, Dr. RC Lamichhane was commissioned to conduct Appreciative Inquiry (AI) training for nurses. This initiative involved 14 training events held in 14 different cities, impacting 2000 nurses. This report delves into how Appreciative Inquiry helps increase the quality of nursing services, enhances nurse happiness and well-being, and inspires nurses to adopt AI in their careers and services.

Appreciative Inquiry: An Overview

Appreciative Inquiry is a strengths-based approach to organizational development and change management. Unlike traditional problem-solving methods that focus on identifying and fixing issues, AI emphasizes recognizing and building on existing strengths and successes. The AI process is structured around the 5-D cycle: Definition, Discovery, Dream, Design, and Delivery. Each stage of this cycle guides participants to uncover what works well, envision an ideal future, design the necessary changes, and implement strategies to achieve their goals.

Discovery: Uncovering Strengths and Positive Cores

The Discovery phase of AI training encouraged nurses to identify and appreciate their strengths and the positive aspects of their profession. By sharing and reflecting on their success stories, nurses gained a deeper understanding of what they do well and how their contributions positively impact patient care and the entire hospital’s reputation.

Inspirational Success Stories

During the training, many inspirational success stories and their root causes, as well as the positive cores of the nurses and the nursing profession from all over the country, were discovered. These stories showcased the dedication, resilience, and innovative spirit of nurses in providing exceptional care despite limited resources.

Success Story:

1. Quality Care: A nurse from a rural area shared how she provided excellent care despite having limited resources. By focusing on her skills in patient communication and community engagement, she made a significant impact. Her story showed how Appreciative Inquiry helped her see the value of her work, leading to greater patient satisfaction and trust in the healthcare system.

• Emotional Strength: A nurse working in a high-stress emergency department shared how AI training helped her build emotional resilience. By focusing on her successes and strengths, she developed coping strategies to manage stress. This resilience enabled her to provide high-quality care even in the most challenging situations.

3. Community Health Initiatives: A nurse leader shared how her team implemented a community health initiative focused on maternal and child health. By leveraging their strengths in community engagement and education, they successfully reduced maternal and infant mortality rates in their region. https://www.youtube.com/watch?v=zFXOOzgfUDc 

• Empowering Nurses: A group of nurses in a large hospital developed a new patient care protocol. By being involved in the decision-making process, they felt empowered and valued. This sense of autonomy improved their job satisfaction and happiness.

• Enhancing Patient Care: A nurse working in a pediatric ward shared how AI training improved her interactions with patients and their families. By focusing on positive communication and empathy, she created a supportive environment that enhanced patient satisfaction and outcomes.

• Meaning in Service: A nurse from a remote village shared how AI training helped her realize the profound impact of her work on the community. By connecting with the meaningful aspects of her job, she found greater fulfillment and happiness in serving her patients.

Positive Cores and Nurse Happiness

The positive strengths found during this phase were connected to the nurses’ happiness. Recognizing and celebrating their achievements created a sense of pride and accomplishment. This is crucial for keeping their spirits high and ensuring job satisfaction. This emotional uplift helped nurses manage job pressures better, leading to improved mental health and well-being.

Dream: Envisioning an Inspirational Future

In the Dream phase, nurses were encouraged to envision their ideal future for the nursing profession. This phase involved creative thinking and imagination, allowing nurses to dream big about what could be possible if they fully leveraged their strengths.

Provocative Dreams

Based on the discovered strengths, positive cores, and success stories, nurses developed inspirational and provocative dreams. These dreams included better working conditions, advanced training opportunities, and greater recognition for their contributions.

• Dreaming of Advanced Training: A group of nurses from an urban hospital dreamed of establishing a specialized training center for nurses. This center would provide advanced training and professional development opportunities, ensuring that nurses are equippedwith the latest knowledge and skills to provide high-quality care.

• Innovative Patient Care Models Inspired by their strengths and sucess, a team of nurses designed a new model of patient care that integrated technology and patient-centered approaches. They dream for implementing electronic health records, telemedicine, and community health outreach programs.

Strategies for Translating Dreams into Action

The dreams were not just abstract ideas; they served as a foundation for developing practical strategies. Nurses collaboratively developed plans to achieve their envisioned future, focusing on leveraging their strengths and positive cores.

Design: Creating Practical Strategies

The Design phase translated these dreams into actionable strategies. Nurses collaboratively developed plans to achieve their envisioned future, focusing on leveraging their strengths and positive cores.

Innovative Patient Care Models

Inspired by their dreams, nurses designed new models of patient care that integrated technology and patient-centered approaches. They developed strategies for implementing electronic health records, telemedicine, and community health outreach programs.

Delivery: Implementing Action Plans

In the Delivery phase, nurses put their plans into action. This phase emphasized continuous learning and adaptation, ensuring that the strategies developed were effectively implemented and sustained over time.

Continuous Improvement and Learning

AI training emphasizes the importance of continuous improvement and learning. By regularly reflecting on their experiences and adapting their strategies, nurses can ensure that their initiatives remain effective and sustainable.

Linking Positive Cores with Quality of Services

The AI process helped nurses develop greater emotional resilience. Reflecting on and celebrating their achievements fostered a sense of accomplishment and pride. This emotional boost equipped nurses to handle the pressures of their jobs more effectively, contributing to better mental health and well-being.

Importance of AI to Promote Nurses’ Happiness

1. Creating a Positive Work Environment

According to the training participants, AI training fosters a positive work environment by emphasizing strengths and successes. This positive focus helps mitigate the stress and burnout commonly associated with the nursing profession. When nurses feel appreciated and valued, their job satisfaction increases, which in turn reduces stress levels.

• Creates Positive Atmosphere:  A nurse leader shared her belief that this training can help all nurses to create a more positive and supportive work environment. By recognizing and celebrating small wins, nurses can boost the morale of their team. This positive atmosphere can reduce stress and burnout, leading to higher job satisfaction.

2. Building Emotional Resilience

The AI process helps nurses develop greater emotional resilience. Reflecting on and celebrating their achievements fosters a sense of accomplishment and pride. This emotional boost equips nurses to handle the pressures of their job more effectively, contributing to better mental health and well-being.

• Emotional Strength: A nurse working in a high-stress emergency department reflected on how AI training can help her to build emotional resilience. By focusing on successes and strengths, nurses can develop coping strategies to manage stress. This resilience enabled them to provide high-quality care even in the most challenging situations.

3. Fostering Supportive Relationships

AI promotes supportive relationships among nursing staff. The emphasis on collaboration and mutual respect creates a support network within the workplace. Nurses are more likely to share their challenges and seek help from colleagues, reducing feelings of isolation and stress.

• Support Networks: In one training event, nurses formed support groups to share experiences and offer mutual support. These groups can provide a safe space for nurses to discuss their challenges and find collective solutions. This support network can improve their well-being and reduce the sense of isolation.

Application of AI to Promote Quality of Services

1. Enhancing Patient Care through Strengths-Based Approaches

AI helps nurses connect with the meaningful aspects of their work. By focusing on the positive impact they have on patients’ lives, nurses find greater fulfillment in their roles. This sense of purpose and accomplishment leads to higher job satisfaction and happiness.

2. Empowerment and Autonomy

AI empowers nurses by involving them in the decision-making process. When nurses feel that their opinions and contributions are valued, they experience a greater sense of autonomy and control over their work. This empowerment is crucial for job satisfaction and overall happiness.

3. Positive Patient Interactions

A positive and happy nurse is more likely to create a positive atmosphere for patients. The nurturing and supportive environment cultivated through AI training enhances patient-nurse interactions, leading to better patient experiences and outcomes. Nurses who are happy and fulfilled in their roles provide higher quality care and are more compassionate and attentive to their patients’ needs.

Future Scope of AI for Happy Nurses and a Happy Nursing Profession

1. Sustained Professional Development

AI has the potential to sustain and enhance professional development in nursing. By continuously engaging in AI practices, nurses can regularly reflect on their achievements, identify new strengths, and adapt their practices to meet evolving healthcare needs.

• Continuous Learning A nurse leader envisions a future where AI is integrated into regular professional development programs. By continuously learning and adapting, nurses can stay at the forefront of healthcare innovation and provide the highest quality care.

2. System-Wide Implementation

The success of AI training in the Nursing Now campaign suggests that AI can be implemented system-wide to promote nurse happiness and quality of services. By adopting AI at all levels of the healthcare system, from individual practices to national policies, the entire nursing profession can benefit.

• AI in Healthcare Policies A healthcare administrator envisions a future where AI principles are embedded in national healthcare policies. By promoting strengths-based approaches at all levels, the healthcare system can support nurse well-being and enhance the quality of patient care.

3. Research and Evidence-Based Practice

Continued research on the impact of AI on nurse happiness and quality of services is essential. Evidence-based practice can guide the implementation of AI and demonstrate its benefits to healthcare stakeholders, leading to wider adoption and support.

• Research and Innovation: A nursing researcher envisions a future where AI is the subject of ongoing research and innovation. By gathering evidence and sharing best practices, the nursing profession can continually improve and adapt AI to meet the changing needs of healthcare.

Conclusion

The “Appreciative Inquiry Training to the Nurses” conducted by Dr. RC Lamichhane during the Nursing Now campaign has demonstrated the transformative potential of AI in promoting nurse happiness and improving the quality of nursing services. By focusing on strengths, celebrating successes, and envisioning a positive future, nurses have been empowered to enhance their well-being and provide higher-quality care. The future scope of AI in nursing is promising, with the potential to sustain professional development, implement system-wide changes, and advance evidence-based practice. By embracing AI, the nursing profession can create a positive and fulfilling work environment, ultimately leading to better patient outcomes and a happier healthcare workforce.

https://www.youtube.com/watch?v=6YJK8dlsbcg