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Chaos will reveal the ‘edgewalkers’ among us

In the midst of chaos, there is also opportunity.
Sun-Tzu

Let’s talk Chaos. Whether we like it or not, Chaos has paid us a visit and we, as health care leaders, would be wise to learn how to manage it in a healthy and productive way. Chaos is behavior within a system that appears disordered, confused, unpredictable yet, there’s actually patterns of order within the chaos! Remember the butterfly effect? The small and fragile butterfly flaps its wings in South America and the disruption to the atmosphere sets off a chain of events that causes a hurricane on the other side of the world. Essentially small and incremental changes in one part of a system can have vast effects in other parts and in the larger system

Think about it. Our current pandemic probably started with a small change in conditions on the other side of the world yet the impact is devastating to everyone across the globe including those of us here in the U.S. Also, consider the financial and economic systems that have been affected. The mind and spirit of most humans are challenged to reconcile the chaos we’re living in with the fact that small changes in behaviors and conditions brought us to today. So remember, I said there’s order in chaos. Chaos actually breeds innovation, usually out of necessity but nevertheless, we see the innovators emerge as heroes. The heroes among us will undoubtably be those closest to the front line of this pandemic. They’ll be the nurses, doctors, social workers, and leaders who walk the edge between two worlds: the world of chaos at the point of care where resources like masks are becoming scarce, where fear and anxiety are prevailing;  and then there’s the world of administrators creating guidelines and policies to dictate allocation of resources, process, and finances. This chaos is creating an order we’re just starting to be able to see. It’s an order that will ask the edgewalkers to walk the precipice between habit and change. The edgewalkers will create a new way of being in light of scarce resources.

Let me give you an example from the past to show how order and edgewalking are truly at work during the chaos of a pandemic.

Story

HIV/AIDs is an example of one of the most destructive global pandemics in history. The peak occurred between 2005-2012: 36 million people have died around the world. The edgewalkers during this pandemic were nurses, providers, researchers, and public health officials. Nurses were at the leading edge providing high-touch care in a time when we weren’t quite sure how the disease was transmitted nor did we know how to treat it. Nurses were influencers because we used touch and human presence to make our patients feel like human beings. Also, nurses led the charge to improve needle safety and technology. Every nurse and provider in today’s pandemic and in our everyday clinical world, have benefitted from the innovation that emerged during the AIDS pandemic… to make IVs, injections, and surgical procedures safer.  These edgewalkers blew up the vacuum of habit to create a world where HIV is no longer a death sentence and the health care team is no longer paralyzed with fear and anxiety to care for those with HIV.

So that brings us to today. Who will walk the edge of chaos to transform turbulence into innovation? Nurses are certainly on the forefront with calls to action over increased availability of PPE. Nurses from the ANA have been at the table with President Trump and with our congressional representatives to provide perspective and a call to action. I’ve also seen nurses gathering to sew masks guided by a multitude of YouTube videos on “How to Make a Face Mask.” This is a great way to show commitment to help arm our frontline staff but also, consider how technology is already ramping up. 3-D printers are cranking out masks and even ventilators. Hack-a-thons are going on worldwide to challenge tech companies to develop and “print” masks as well as valves for venturi masks. Residents at Massachusetts General are planning a virtual competition, CoVent-19, to develop a rapidly deployable ventilator within 90 days. Cool stuff in the midst of chaos.

The frenetic energy of today will result in an improved work environment for those who follow us. The next generation of nurses and providers will benefit from the innovation that’s emerging every day. They will also benefit from the lessons learned and will hopefully be better prepared for the next pandemic that will also most assuredly pay us a visit. Louis Pasteur is known for saying, “It is the microbes who will have the last word,” however I believe nurses are more famous for having the last word. Be an edgewalker! Take the turbulence in our world and transform it into innovation!

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