Marisa’s Rehearsal for Real Life As A Nurse
Improv is really fun, visual and powerful,” says Sherry Belanger. “No one can watch it and not be influenced!"
From the moment the national project was launched in Toronto, Sherry believed that Improv Prototyping would be an effective way to work on a serious challenge: reducing infections on her hospital unit.
Sherry Belanger is a nurse who serves as a patient care coordinator on 4-East at Kelowna General Hospital (KGH) in British Columbia, Canada. She is the energetic project manager of a core group working to stop the transmission of super bugs (antibiotic resistant organisms include MRSA, VRE, and C-difficile) that cause stubborn infections.
KGH was part of a demonstration project to prevent infections in five hospital sites across Canada that concluded in 2011. [see Superbug Prevention Plus Enduring Cultural Change story]
Sherry knows better than anyone, the behaviours that spread superbugs are resistant to change. Many ideas coming from outside the unit are not sustained.
Anything imposed on my staff—new policies, laminated posters or free Tim Horton coffee coupons—will not work well. If it does not come from them, follow through will suffer.
Within three weeks of returning from the national kickoff meeting, Sherry and her team had staged Improv Prototyping scenes on a unit and with the senior leadership team. Their debut with leaders was a big hit. Sherry recalls, “We wanted to get leaders talking about superbug prevention. My manager and her director were very supportive.” Their playfulness unleashed serious attention, energy and momentum beyond expectations.
Literally and figuratively, they were ready to act their way into safer practice. The team had visited units and groups across the hospital. Discovery and Action Dialogues were often used to generate local conversation and action. With the goal of discovering challenges specific to each unit, they generated “the material” for Improv Prototyping. For example, on a drug rehab unit a scene dubbed “Mr. Munchie” was developed. Unit personnel wanted to help patients with infections safely visit the communal kitchen.
An improv skit called “Speaking Truth to Power” made a real difference for one student nurse named Marisa. The core team had recently worked with a group of second year nursing students. Improv Prototyping was used to help people remind others about safe practice, particularly when the person you are reminding holds a more powerful position.
Sherry recalls the scenes, “We asked for volunteers and 2 students stepped up to do the acting. Along with a member of our core group they acted out 2 scenes. Scene 1: A student nurse is in an isolation room with a patient, when a physician enters without isolation gear on, carrying the patient chart. The physician is very over bearing and brushes off the student. Scene 2: A replay of the scene with the student nurse inviting the physician to step aside (away from the patient), helping the physician get into the isolation gown.” A lively group debrief followed the two scenes.
Three weeks later, the same group of second year students was doing part of their clinical rotation on Sherry’s medical unit. A physiotherapist stopped Sherry in the hall and let her know how impressed she was that a student had stopped a physician who was entering an isolation room. Just like the improv scene, a physician was rushing into the room without donning a gown or gloves while carrying the patient chart.
Sherry, as always, followed up, “I went to find the student and let her know she was doing a fantastic job. Her name is Marisa.
She said, ‘I didn’t even have to think about what I was going to say it just came out. I might not have stopped him if I hadn’t seen the improv. I realized that it is everyone’s responsibility to speak up to stop the transmission of super bugs.’
While the physician did not comply after her attempt to stop him, Marisa was not intimidated. Sherry was delighted to hear Marisa’s take on the experience, “When it comes to safety, there should be no hierarchy. We should all do our part to protect ourselves and our patients. We shouldn’t be less important because we are students.”
Sherry was delighted. Capturing the imagination of everyone is central to making progress with superbugprevention. The story spread throughout the hospital like wildfire. To succeed, everyone from doctors to room cleaners need to change their habits and routines. Marisa inspired many others to speak truth to power. Just as important, Marisa developed the real-life confidence to do the right thing.
Sherry served as leader of a core group that managed the prevention effort within her unit and across hosptial departments. To coodinate action and attract cross-functional participation, the group employed Social Network Webbing.