Episode 3: Recognizing Ethics

This transcript was generated automatically. Its accuracy may vary.

Cara Lunsford

Oh, hey, nurses. Welcome to the Nurse Dot podcast. Giving nurses validation, resources and hope. One episode at a time. So today on Nurse Dot podcast.

Bonnie Barnes

I often talk about the fact that when we got together and created the Daisy Foundation, it was over a very liquid dinner. And that refers to both the tears and the wine that were flowing that night.

Cara Lunsford

Joining us today, Bonnie Barnes, Bonnie and her husband Mark co-founded the Daisy Foundation in 1999 following the death of Mark son Patrick from an autoimmune disease. They have spent the last 23 years leading the foundation that is dedicated to honoring and providing meaningful recognition of extraordinary compassion at nurses. The Daisy Award is the gold standard of nurse recognition internationally.

I'm your host, Cara Lunsford. Registered nurse and VP of community at Nurse dot com.

Oh, okay. Bonnie, being on with you is passive. Lee even better than being on with Brené Brown, which is a personal dream of mine.

Bonnie Barnes

Knowing Brittney, I am really honored, but it's that Bebe thing, you know?

Cara Lunsford

Oh, my God, I can't even believe I didn't make the connection. Bonnie Barnes and Brené Brown. It is the Bebe thing.

Bonnie Barnes

That's amazing.

Cara Lunsford

Well, I've known about the Daisy Award for as long as I have been a nurse, which is about 16 years. Some of my closest friends, including one of our past podcast guests, she was a Daisy Award winner. And so I want to start off just by sharing with our listeners today what was your passion behind starting the Daisy Foundation and what do nurses mean to you personally?

Bonnie Barnes

It would not be honest for me to tell you that at the moment that we started the Daisy Foundation, we had this wild passion for who nurses are and what they do. I can tell you that we had an incredible experience with nurses that really got our attention and nurses to whom we were deeply grateful for how they had carried us through the worst eight weeks of our lives.

But I often talk about the fact that when we got together and created the Daisy Foundation, it was over a very liquid dinner. And that refers to both the tears and the wine that were flowing that night that we were with Patrick's wife, Tina and Mark and I started talking about what we would do in Patrick's memory. It took some time for us to come to really understand what was behind the care that we experienced from Patrick's nurses that we were grateful for, but we didn't truly appreciate all that went in to creating these extraordinary human beings until we started really delving into this work.

And I have often said that it's nurses who have created the Daisy Award because it was nurses and nurse leaders who took us by the hand and helped us understand the education, the skill, the critical thinking, what the role really is that we didn't see at the level that we were seeing it at in our bedside experience. What leadership was about.

I mean, we learn so much from nurses. We always say it's nurses who created the Daisy Foundation and who drove our passion and drive our passion every day, because every day we learn more about who nurses are and what it takes to really be a nurse. And it's not only what nurses acquire in their learning and in their expertise, but it's also who they are as human beings.

How can you not love these people?

Cara Lunsford

Right.

Bonnie Barnes

Right. So the passion just built.

Cara Lunsford

You know, I think you and I both share this passion, right, for the nurse community. What drives us forward is how do we keep these people doing the work that they love? And a big part of that is appreciation.

Bonnie Barnes

Nurses become nurses because of who they are as people I know better than I. You don't do this for the money and you don't do this for the great lifestyle and the work life balance and all those things that other people do things for. You do this because of who you are and the caring, caring qualities of your soul.

And what we at Daisy are every day working to do is reminding nurses of that, of who they are and why they became nurses. Because when you tie back to the purpose of what nurses do and the impact that nurses have every day, that's uplifting. That's going to keep you doing what you were doing because it's got meaning.

How many of us get to do work that's truly meaningful? I can tell you, having spent 30 years working in advertising agencies, not so much. Right. Not so much. I did a lot of nonprofit work, which I loved, and I had a very successful, wonderful career, which I loved. But nurses get to have such meaning and purpose in their lives.

We at Daisy are here to just keep that spirit of why you are a nurse. Front and center every day.

Cara Lunsford

The work that nurses do is very meaningful. It is very impactful. It can change people's lives. It's also very ethical. We definitely follow a pretty strict standard of ethics in our practice, which is why I think that the new award by the Daisy Foundation around ethical practice is so, so important. Can you tell us a little bit more about this new award, Bonnie?

Bonnie Barnes

Sure. Thank you for asking. We are very excited about this. And frankly, we know it's going to take a little bit of education. So thank you for giving me the forum to talk about what's very important to us. So, as you know, we created the Daisy Award thinking that we'd say thank you to nurses in all ten hospitals around the country.

And we go back to doing what we were doing before Patrick died. And we feel better. When Daisy really started to get embedded in organizations, we started seeing different application of the Daisy Award, a team award for nurses who are working together to to do something special for a patient or a family member nurse leadership, which we've had great emphasis on this year to honor those people who are creating the environment where all this great care goes on.

The Daisy nurse Leader Award nursing faculty for nurses who who become educators to inspire the nurses who are going to provide all this great compassionate care in the future. So on and on, we have all these different applications of the Daisy Award. Well, during the pandemic, as we read the nominations stories that were coming in for our Daisy honorees, one of the things that struck us was a different tone of decision making that was being honored when there were some really tough calls that nurses at the bedside, clinicians as well as leaders were having to make that were really tapping into their values of who they are as people.

And the more we read about the advocacy that was going on and the nurses who were taking a stand, the more we thought, how do we shine a light on what nurses do without even thinking about it? That is in keeping with their integrity and their and their ethical values. And then we learned about the RNA code of ethics and thought, Oh my gosh, this sounds like a really great connection for us.

So as happens with everything we do, we were in touch with one of the leaders in ethics, and that's Dr. Cinda Rushton at Johns Hopkins, and she's on the board of the and a Council of Nursing of Nursing Ethics and Human Rights. I said, Cinder has been on my mind for reading all these incredible nominations. Nurses are doing work right now.

That is so even more incredible than what they were doing before. I think there's a recognition in here. What do you think? How do we shine a light on ethical practice and ethical leadership and send a lit up? Just lit up. She said, you are absolutely right. We could really help inspire more understanding of the ethical values that go into nursing practice and leadership every day by recognizing it and making it part of our overall DAISY program.

So we went to A&E and with Cinda at hand, one of our fabulous board members, Stuart Downs, who has got tremendous focus on nursing ethics and has done a lot of writing and work in that area. And he helped us understand and lo and behold, we are now in January introducing, although it's already on our website, but we're now announcing the new Daisy Award for Ethics in Practice and Leadership.

And it's important for our health care partners to understand that this is a way for nurses to be encouraged to practice to their values, to their integrity, because when they do that, that helps to offset moral distress. When they get to do what they know is the right thing to do. And we're here to support that for.

Cara Lunsford

Coming up after the break.

Bonnie Barnes

A nurse leader said to me, you know, how do you make the decision about which patients you give those contract nurses? Do you give them? Do they get all the COVID patients or do they get any of the COVID patients? How do you decide, Oh.

Cara Lunsford

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Oh. Today on the dot spot we welcome Dr. Stuart Downs, DNP nursing Administrator and a member of the Board of Directors for the Daisy Foundation. I asked Dr. Downs to provide just a few examples of the ethical challenges that nurses face in their practice today.

Stuart Downs

I think about the nurse leader who had to take bold action relative to maybe some staffing dilemmas that he or she faced during the pandemic as they were trying to ensure and compromised here. Also during the pandemic, I think about that nurse leader who was bold enough to disallow visitation despite the many requests, maybe to make exceptions to the rule.

Another example that comes to mind in the clinical practice setting would be a clinical nurse who is faced with the ethical tension of handcuffing a patient to a bed. Maybe during the laboring phase of delivery, or that nurse who courageously disclosed an error to the patient or a family member. This is bit a few of the situations for which nurses and nurse leaders advocate on a daily basis and remain true to who they are as an ethical leader and an ethical nurse.

Cara Lunsford

So creating awards and creating recognition is a way to help nurses to understand that what they're doing is right. Sometimes we're very gaslit in this industry. We can we can experience a lot of gaslighting. True, right?

Bonnie Barnes

Yeah.

Cara Lunsford

When someone comes in and says you are right, what you and your team did, that is the right thing to do. Well.

Bonnie Barnes

Actually, as you know, the Daisy Awards chosen by a team of nurses, a committee that is is there to really identify the best of the best out of the Daisy nominations.

So even better, when the organization the nurse works for supports them by recognizing their ethical practice, their ethical leadership, telling them that when they stood up and did the right thing, they were noticed and it mattered and they were valued. That's what we really hope that this recognition will provide to the leadership of organizations to to demonstrate their support for the role nurses play.

Cara Lunsford

I'm so excited about this award. I know I've said this already, but I really think that this award is going to make a huge impact. It's a statement that we are making to hospitals about the importance of valuing ethics and really acknowledging and seeing how the work that our nurses and anybody who's working in patient care, you know, the ability to do that gut check.

Right. Because like you said, I don't remember the code of ethics word for word. It's been a long time since I had to read it. But I will tell you that I'm very in touch with my gut. And when something doesn't feel right, I immediately check in and go, All right, I can either turn a blind eye and not do the difficult thing of having to stand up and make change.

Bonnie Barnes

And make change. And don't you think that clinicians do this every day? They just don't think about the fact that it's an ethical practice? I think you just naturally think this way and do it this way. And what we want to do is make sure that that nurses realized, wait a minute, I am doing something that's ethically appropriate and that and I'm being supported in doing it.

And I think that it's a there's an awareness issue. One of the things that we learned in some of our research several years ago as we were examining the relationship between Daisy is meaningful recognition and compassion fatigue. We did a qualitative study that helped us understand what it was that emotionally recharges nurses. And one of the things was all about becoming self-aware and being aware of a difference you make when you don't know you were making a difference is emotionally satisfying.

It elevates compassion, satisfaction. And I think this is very similar. You become aware of something you don't even think about. You don't even realize you're making an ethical statement. You know, hopefully that you did the right thing. But but, but by shining a light on it, recognizing it, it's going to be even enhanced and its value to you as a nurse.

Cara Lunsford

It's empowering, right? It's this empowerment because what you're doing is you're arming people with this knowledge that what they're doing is in line with something that they actually agreed to do when they got their license. They made this vow right to always practice ethically. And that there is a code of ethics that they could take to any administrator, to any leader, to any institution and say, look, now I'm realizing that what I did, maybe I thought it was just my gut instinct and that's valuable.

But you know what? There's something here to back this up. Look at my code of ethics. Look at how this lines up with what I agreed to do as a licensed nurse.

Bonnie Barnes

Yeah.

Cara Lunsford

And that's what you're giving them. You're giving them that validation. You're empowering them with this information and this knowledge about their practice so that they can speak intelligent early to their institutions about why they are asking for the things that they are asking for or why they feel strongly about a policy that needs to be implemented or needs to be honored.

Maybe a policy that just needs to be honored. It already exists, but somebody's trying to break it. For our listeners who are maybe asking themselves right now, well, I think that I work for I think I practice ethically. I, I really think they're thinking about a time right now where ethics has strongly come into their practice, which really is every day.

But then there's those moments that really stand out. Are there any moments specifically that stand out to you of an example of ethics of something someone's done?

Bonnie Barnes

I think there's a lot of these examples. So, for example, let me give you a leadership one, particularly during the time of the pandemic when there were a lot of contract nurses coming in, a lot of travel nurses coming in. I think there was a tremendous amount of angst about that and making sure they knew where the light switches were and and how to practice and all that.

But a nurse leader said to me, you know, how do you make the decision about which patients you give those contract nurses, Do you give them do they get all the COVID patients or do they get any of the COVID patients? How do you decide another leadership example that this listener Slater talked to me about was that CEO called her one day and said, so-and-so is in the hospital with COVID, we are shut down with, you know, no roster, no visitors and all of that.

But how do we where I've got this, you know, legislator who has fathers in the hospital, he wants to come visit. I don't want you to let him in. That's a real ethical problem, isn't it? Because the rule has been policy's been set for a reason. And just because somebody is in local and influential legislature legislator does not mean that that person should be allowed to possibly bring risk to patients.

And importantly, staff of the hospital. So those were a couple of specific things that happened and covered. There are lots of times when you just have to know something isn't right and whether you know, whether you can really repeat the code of ethics from the A&E by heart or not, your integrity is is everything. And as I said earlier, I think when our integrity is attacked is when we go into this area of moral distress or even worse, moral injury.

And that's what is is making nurses rethink if they're in the right career. And we don't we don't ever want them to challenge themselves about that. We want them to have complete security, that they are supported and appreciated and valued for their brainpower as well as their compassion, because it's the combination of those two things that nurses magically bring together.

Obviously, it's not so magical because you all do it brilliantly, bring together and make for this extraordinary profession.

Cara Lunsford

Any time we had a nurse that was at the hospital who was getting awarded with the Daisy Award, it was such a huge thing. I say it's like the Academy Award of Nursing Awards. First of all, it's a beautiful award. I mean, it's just beautiful. What what was your inspiration around just the creation of the statue?

Bonnie Barnes

Well, actually, the statue we never intended to have it be the award, although we've heard many people talk about it that way. But our intent was simply a gift. Let me tell you a quick sidebar story. And it actually happened in Los Angeles when we first started the Daisy Award march. And I thought about what are the things we want to give to nurses?

It wasn't about money. We don't have money. But what we have is a spirit of recognition and admiration for this beautiful profession of nursing. So we had very simple things. We have a certificate when we first started, and we still have that. We put into a frame that we bought at Costco. We would send our hospitals a box of the frames that we bought at Costco.

We had a beautiful Daisy Award pin and we thought, Wouldn't it be great to give nurses some time for them to go have a wonderful dinner and a massage at a great spot in their local area and, you know, to take care of themselves and to have a night to celebrate with a loved one on us. So I spent in the early years or so, a lot of time negotiating with restaurants and stars in each of the cities that had our our our program.

And by the way, we weren't in a lot of cities at the time, you know, L.A., San Francisco, New York, whatever. And I would find a great place, great places, and negotiate that mark and I would pay for half and the restaurant would give us a 50% discount so that it was a good deal. And then we would make this all available.

None of the daisy honorees ever wanted to go have a massage or go to dinner, and yet I was spending all this time negotiating with restaurants and spots. And one day Mark looked at me and he said, You got to stop doing this. It's nobody's taking advantage of it. What's the value? What's the purpose of doing it? And I, you know, didn't want to just cut it off thinking I'd take it away from nurses don't want to do that because every time we talked about it, people would up and, oh, boy, you know, but then they wouldn't go.

So we were in Los Angeles at Northridge Hospital and talking to the chief nurse. And I said, you know, what do you think? If we were to stop offering massages and dinners and we were walking down the hall and she stopped in the hall and she said, Honey, don't you get it? It's about the recognition. Those things don't mean anything.

It's about the recognition. That was a huge epiphany, just huge. So coming back to your question about the sculpture, when we discovered this beautiful design, it was meant to be a gift, not an award, because it's really about what happens in those moments when the whole team is surrounding a nurse, when that nurse's story of extraordinary care is being told, when the C-suite is there to celebrate with the team.

That's really what that meant, that the Daisy Award was about in our hearts, we found this beautiful sculpture and thought, wouldn't that? It's a great symbol of the unique relationship between patients and nurses and the bond that happens in with great care. So we brought that in.

Cara Lunsford

It's gorgeous.

Bonnie Barnes

Yeah. As things happen with Daisy, everything's got a story and now we uncover this little community of artists in Zimbabwe from whom we now are buying 20,000 pieces a year and supporting this incredible community of artists entirely. And through their economic and political breakdown in Zimbabwe, this community of artists is able to support hundreds of people in their families through the money we send them by fairly paying for these beautiful pieces of art.

Cara Lunsford

All of that just makes it even better.

Bonnie Barnes

I know it's a great story and you see you can see on the website, on our website, Daisy Foundation board, we have a video of two of the artists sitting in the middle of nowhere, Zimbabwe carving this big piece of gray rock and turning it into that beautiful image of the relationship nurses and patients have with each other.

Cara Lunsford

Tell me a little bit about that process of how do you nominate somebody for this?

Bonnie Barnes

Well, there's a lot of information on our website, Daisy Foundation board where and our team, we have a team of 20 some odd, wonderful program directors and managers who are the people who really interfaced with our 5500 plus health care partners to help them make their programs the best it can be. So we will work with everyone who wants to bring the Daisy Ethics Award into place to help them understand what criteria they could be using and how to solicit nominations, just like they solicit nominations for the Daisy Award or the Leader Award or whatever else we have.

And then to take it into the committee that chooses nurses using those specific criteria that are based on nursing ethics and practice and leadership. So our team is prepared. We have brought in everybody we need to teach them to help them understand the reason for this program, for them to understand, to be able to then educate our partners on how to bring it to life.

It's very similar to what we do for nurses who are doing extraordinary acts of compassion.

Cara Lunsford

That's wonderful. So are we thinking that this is going to go live in 2023 or what's when when are we going to see this magnificent award?

Bonnie Barnes

Well, it's a funny story. It is. We said we were going to launch it and announce it in January of 2023, but we got all of our materials together. Our team is so fast. We got all of our materials together. So it's up on our website. Now, if you go to the search box and you just look for ethics, you'll find a whole pages of information about it and even though it says Coming soon and we had material about it at the NCC Magnet and Pathway to Excellence Conference, we'll have it at the Sigma conference coming up.

So, yeah, we're talking about it now. It's on the website. Anybody can start it whenever they're ready. But our big announcement will will be in January. It will be sending out more marketing materials at that point.

Cara Lunsford

Well, I am so excited that we got to be some of the first people to broadcast this. We just launched this podcast, but already our first episode is doing really well. It's on all the platforms everywhere you get your podcast and we are just so excited to be able to put all the energy and resources that we have over at Nurse dot com to just push this out to everybody that we know.

Is there anything else you want to share with our listeners that I haven't touched on?

Bonnie Barnes

Well, I want to share with you, Cara, how much we at Daisy appreciate our partnership with Nurse dot com Any time we have something to say Nurse dot com has been just wonderful in helping us get the word out. We are you are a fabulous media partner but now being able to share and have this kind of conversation with you, I don't know if you could tell I'm taking some notes on some of the ways that you describe the ethics award that really I think will make our presentation of it even stronger and more clearly defined.

So I want to say thank you to you and the nurse dot com team for all you do for Daisy and for the incredible investment you make in us and being able to help help us get our message out.

Cara Lunsford

It is a true honor and privilege. And I know I can say that on behalf of everyone over at Nurse dot com and myself.

Bonnie Barnes

Thank you so much for this opportunity.

Cara Lunsford

It was a pleasure. I'll see you soon.

Bonnie Barnes

You bet.

Cara Lunsford

So if you were a nurse who enjoyed this episode and you have an idea for future episodes, you can connect with me by downloading the nurse dot com app. See you there.