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Integrity: Staying the Course, Even When It's Difficult

By: Julie Williamson

April 8, 2020

Author’s note: This article is an abbreviated version of the Hot Topics cover story that will be published in the May/June 2020 issue of PROCESS. Be sure to read the full article (which offers more strategies and suggestions for navigating difficult situations that often arise in the SPD) when the issue hits your mailbox next month.

Integrity is a highly-sought quality, and for good reason. It’s defined as “being honest or having strong moral principles’ or a ‘firm adherence to a code of especially moral values,” and those who possess it and display it consistently are considered “sound” and “incorruptible.”

As much as each of us lists integrity as a prioritized quality for ourselves and others, the reality is many of us slip up over the course of our careers and personal lives – or, at least, are tempted to do so. In healthcare and, certainly, in the realm of Sterile Processing, pressures mount on a daily, hourly and even minute-to-minute basis, which can lead to unrealistic expectations and demands, and a desire to get things done quickly to stay afloat. But it’s important to always remember that even a momentary lapse in integrity can spell big trouble for employee and patient safety. It could even mean the difference between life and death.

No one said reaching and consistently maintaining that essential trait is easy, however. In fact, most would agree that, especially, in the ever-changing, high-stress healthcare environment, it can be downright difficult. We may not realize how a rushed process or other questionable action can lead to devastating consequences. We may not want to correct a co-worker who performed a step incorrectly – so we look away or swallow our words. We may not want to explain to a boss that the practice they just taught counters the IFU or best practices – and we likely wouldn’t find it comfortable to inform a surgeon, nurse or other customer that their request for expedited instrument turnover can’t and won’t be met because it would put the patient at risk. But we must.

As Sterile Processing Director Marjorie Wall, MLOS, CRCST, CIS, CHL, CSSBB, and IAHCSMM Board of Directors member explained, “We are all human and make mistakes. Through open communication and education, we can be better.”

Stand up, speak up

SP professionals and their healthcare customers share a mutual goal: to deliver quality service that sets the patient on the receiving end of the instrumentation and frontline care with the best odds for a positive outcome.

Still, to no fault of one’s own, undue pressure can pop into the picture that can hamper the ability to reach that goal: a missing or malfunctioning instrument discovered when the patient is already on the table; a higher-than-normal procedure volume that leads the surgical team to push, sometimes aggressively, SP professionals to turn instrument sets around more quickly (and some SP professionals to cave to the requests for fear of angering the surgeon); instrument damage caused by poor practices in the OR, SPD or other department; a colleague who rushes a process or skips a step because they’re tired, unfocused or eager to move onto a less challenging task, and the list goes on.

Fostering a culture of integrity and teamwork involves overcoming fear, gaining confidence and ignoring one’s inner voice that may say, ‘who am I to question?’

“Often, people are scared to speak up because they are worried about retaliation, feel like it’s not their place to say anything, or are burned out and just don’t care anymore. We need to remember that all of us are here for the patient. Our jobs are to help patients. We need to remember that,” said Wall. “If a technician sees someone doing something unsafe, they need to stop the line and speak up. Management can be brought to help facilitate the conversation, if needed.”

Lisa Wakeman, DrPHc, MBA, CRCST, CIS, CHL, MBTI, CS Education and Quality Coordinator for IU North Hospital in Carmel, Indiana, reminded that teachable moments are spontaneous. By choosing to connect with someone, we can seize an opportunity that may otherwise be missed.

“All too often, we let these moments pass by because we are focused on conquering the task at hand, and we lack the mindset it takes to engage with a peer to help them learn. When noticing a team member either taking a shortcut or doing the wrong thing, common responses are to let something we observe slide because it’s easier and faster to simply take care of it ourselves and avoid the confrontation,” she explained, adding it may be tempting to later complain about it behind that person’s back, which only makes the problem worse.

“It takes extra time to stop what we are doing and constructively teach something, and we stretch outside of our comfort zones when we choose to make a moment count,” noted Wakeman. “We can inspire others toward positive change when we take initiative to demonstrate that we trust and value one another enough to grow together. Showing someone a better technique, process, method, or skill while explaining the rationale helps them put the reason behind best-practice into context.”

Being open to ideas and willing to take constructive criticism when our own actions are called into question is equally important. Wakeman urges more veteran employees to recall what it was like when they were a newer technician, and to understand that a lot has changed over the years. “Even seasoned professionals may not have had newer information put into the right format for them to accept and adopt a newer method. If you want to teach someone, you have to be open to being teachable yourself,” she noted. “There is always something to learn in Sterile Processing. With an iron-sharpens-iron mentality, we can foster a culture that is open to growth and improvement.”

Julie Williamson is IAHCSMM's Communications Director.