IntroNurse-led innovation isn’t new. It began with the first recognized nurse innovator, Florence Nightingale, in the 19th century. That was over 160 years ago. Since then, nurses have been on the frontlines of every single health crisis and they’ve spearheaded significant breakthroughs in patient care, disease prevention, and medical devices.
Nurses have laid the groundwork for decades of innovation. In the following timeline, you’ll see how.Intro
1854Florence Nightingale, a Model for Nurse Innovation
Florence Nightingale became the model for how nurses innovate, thanks to her revolutionary hygiene practices during the Crimean War. After working in desperate conditions at the Army hospital in Scutari Turkey, Florence and her medical team improved its facilities from top to bottom. They cleaned the wards, set up a kitchen, and provided wounded soldiers with the first form of what’s now known as “quality care.”
As a result, far fewer patients died from hygiene-related diseases, prompting hospitals all over the world to formally adopt Florence’s practices — practices that are still used today.
1939Elizabeth Kenny and the Treatment of Polio
Like her predecessors, Elizabeth Kenny had no formal nursing education, but she would still be remembered for her breakthrough treatment of polio. When “Sister Kenny” (a name she earned in the Australian military) saw her first polio case, she had a hypothesis: that the patient’s limbs were stiff but not permanently paralyzed.
Unaware that stiff braces were the accepted medical treatment at the time, she used hot packs and encouraged gentle movement. This method re-taught patients how to use limbs that had been only temporarily paralyzed by the virus, revolutionizing the treatment of the disease.
1940sAdda May Allen, Inventor of Disposable Liners for Baby Bottles
Adda May Allen was a nurse at Columbia Hospital in Washington D.C. when she invented disposable liners for baby bottles. Realizing that babies often struggled to feed from traditional bottles, Adda created a disposable, collapsible liner that hospitals and moms at home could use once then throw away. It made it easier for babies to suck milk by eliminating the vacuum that traditional bottles created, working like a bag that closed in on its sides as a baby drank.1940s
1943Bessie Blount Griffin, Inventor of the Electronic Feeding Device
African American nurse, Bessie Blount Griffin, was also a physical therapist and a forensic scientist. But she’s best known in the nursing community as the inventor of the electronic feeding device. While working at the Bronx Hospital in New York, Bessie invented an electric self-feeding tube for amputees, which could transport individual bites of food to a patient's mouth. All the patient had to do was bite down on the tube and the food would dispense from an attached machine.
Bessie would later design a neck frame for injured or ill patients that could hold a bowl or cup close to their face as a "portable receptacle support."
1950sSister Jean Ward and the Treatment for Jaundice in Infants
Sister Jean Ward made a simple observation about sunlight that would lead to the most common clinical treatment for jaundice in infants. As Sister Jean was caring for newborns — during her time as head of the Premature Unit at Rochford General Hospital in Essex, England — she realized that sun exposure greatly reduced jaundice and its effects on the skin and liver.
This discovery led to neonatal phototherapy, a practice that safely and effectively treats the condition by exposing babies to artificial UV light.1950s
1954Elise Sorensen and the First Disposable Ostomy Bag
Elise Sorensen was the innovator behind the first disposable ostomy bag, which helps patients with post-surgery stomas feel more comfortable doing everyday things. Following her sister’s ostomy operation — a procedure that removes the end of the intestine through the abdomen, allowing waste to exit through a surgically-created stoma — Elise designed a new way to manage stoma leaks.
Instead of the metal capsules or fabric and rubber bags that were used at the time, Elise designed a disposable bag that was attached with an adhesive ring, a predecessor to the devices we use today.1954
1968Anita Dorr and the Crash Cart
As an OR nurse, nursing supervisor, and member of the U.S. Army Nurse Corps, Anita Dorr had a breadth of experience that she used to invent the first crash cart. After WWII, Anita went back to work as an ER nurse at Meyer Memorial in Buffalo, New York. There, after spending days carrying supplies back and forth, getting delayed every time there was an emergency, Anita leveraged her husband’s carpentry skills to invent the “Emergency Nursing Crisis Cart.”
Today, it’s more commonly called a Crash Cart. And they're so essential that nurses customize them to their professional needs and even personal tastes.
1980sThe Wong-Baker FACES® Pain Rating Scale
The Wong-Baker FACES® Pain Rating Scale — or happy to sad faces, as many know it — was created by Donna Wong and Connie Baker to help children communicate pain. As pediatric specialists, Donna and Connie worked with young patients to help them cope with illness or injury.
In the hope of creating an effective pain assessment tool, patients were asked to think back to their own experiences and draw facial expressions to show how they felt when they experienced different levels of pain. Each face was unique, but soon, a pattern developed, becoming the modern-day rating scale we use today.
1980sA More Human Standard of Care for AIDS Patients
In the early 1980s, nurses Cliff Morrison and Alison Moed Paolercio did what few other people in the U.S. would have dared: establish a new standard of care for patients in the country’s first dedicated AIDS unit. HIV/AIDS was an epidemic that also brought with it an epidemic of hysteria, fear, and marginalization. When the disease was spreading faster than information could be obtained, nurses at San Francisco General Hospital defied medical conventions to treat “untouchable” patients with a truly innovative approach to care.
In Wards 5B and 5A — wards specifically dedicated to HIV/AIDS — nurses put themselves at personal risk to stand beside patients as they faced painful symptoms and, oftentimes, death. It revolutionized hospital care at the time in the US and around the world, and proved instrumental in gathering data that transformed the disease from a fatal prognosis to a manageable condition.
2003Safer Patients and Fewer Errors, With Color-Coded IV Lines
After over 30 years of nursing experience, Teri Barton-Salinas and her sister, Gail Barton-Hay, put their observations into a unique innovation: color-coded IV lines. Noticing that there can be a number of hazards using clear, indistinguishable intravenous lines — let alone multiple lines, in some cases — Teri hypothesized that using different colors would make the insertion and removal process much easier.
ColorSafe IV lines now allow nurses to more quickly and accurately identify a patient’s IV, especially in emergency situations when every second counts.2003
2016Rebecca Koszalinski and the Speak for Myself-Voice app
Throughout her career, Rebecca Koszalinski has been helping the speech vulnerable communicate. Mostly recently with her Speak For Myself-Voice app. Building on her background as a clinical instructor, researcher, assistant professor, and app developer, Rebecca created the Speak For Myself-Voice app. It helps disabled patients, such as those diagnosed with cerebral palsy, clearly communicate in clinical situations, like when they’re left unattended and find themselves in an uncomfortable position.
As a result, Speak For Myself-Voice is now in the hands of those who need it most, so there can be open and effective lines of communication between friends, family members, healthcare providers, and the most vulnerable patients.
Find the Speak for Myself-Voice app in the Apple App Store.
2018Johnson & Johnson Nurse Innovate Quick Fire Challenge
In the spotlight of National Nurses Week, nurses Abby Hess, Lauren Wright, and Tram Pham became the first awardees of the Johnson & Johnson Nurses Innovate QuickFire Challenge. When Abby first started working as a nurse in the pediatric post-anesthesia care unit (PACU) of Cincinnati Children’s, she heard a valuable piece of advice: Kids who fall asleep fighting, as they’re given anesthesia, often wake up fighting.
To make that process easier, she and her team created a breathing-controlled video game using anesthesia masks that provided a more engaging way to help kids practice being induced before surgery.
Halfway across the country, Lauren and Tram were researching how to prevent dysbiosis — a disruption in the gut microbiome that affects over 4,000 babies a year. They learned that increasing breast milk consumption can establish immunity, so they turned to overcoming a common breastfeeding barrier: nipple confusion.
To make sure babies who are used to being bottle-fed can return to the breast, they invented the Natural Nipple, which 3D prints the shape of a mother’s nipple.
Learn more about the Natural Nipple.2018
2020Nurse Innovation in Real Time, to Fight COVID-19
From medical grade masks to new, color-coded methods of communication, nurses like Ellen Smithline and Jessica Latham, have been on the front lines, developing innovative responses to COVID-19. After 35 years of nursing — including first-hand experience with Ebola, SARS, and emergency care — Ellen paused her PhD program to work as an isolation tents nurse manager in communities hit with COVID-19.
There, she put her crisis training to work by collaborating with her ground team to create a laser-cut shield from a single sheet of flexible plastic that can be worn over an N95 mask, curbing the need for goggles. No assembly required.
Likewise, Jessica used her years of experience as an ICU educator to create “Code Cards” that helped pass important messages within her Covid-19 ICU quickly and effectively. Once the pandemic started to create more stressful conditions in her unit, Jessica’s team needed a way to keep the code team informed and those outside of the room unexposed. Within an hour of identifying the problem, they created laminated "Code Cards" with the most common medications and procedures, ready for use across ICU areas.
Meet 10 nurses pioneering COVID-19.2020
Because it’s not just about developing a new gizmo or gadget. It’s about creating new models of care, safety practices, more efficient processes — and even innovations that tackle social challenges to improve patient outcomes.
What Makes Nurses Innovators?
There are over 4 million nurses in the US, and over 20 million nurses in the world, which means there’s the potential for over 20 million nurse innovators. Many of those nurses are at the bedside every day, understanding patient concerns, patient care challenges, and identifying the gaps. But why are nurses so primed for innovation?
Maybe it’s because they’re critical thinkers who when presented with a problem get creative with solutions and look at the problem from multiple angles. Or maybe it’s their tenacity and care. They’re constantly assessing situations and trying every approach, even non-pharmacological ones.
To weigh in, here are a few of those nurses on what makes every nurse an innovator at their core.
Healthcare is challenged by complexity and ambiguity. Nurses bring a collective, connective and collaborative point of view that has the capacity to bring intentionality to product, policy, and process.
Nurses are natural innovators because we have the ability to empathize with a problem more than most. Seeing a problem that directly affects a patient tugs at our heartstrings, and we want to solve it for the betterment of patient care.
We, as nurses, have been told to think in a linear process — but thinking differently is a huge asset and attribute. You not only need the confidence to bring your ideas forward, you also need to be okay with failure. And you have to be okay with iteration and trying things multiple times.
As a nurse innovator, you are starting to think out of the box and how to incorporate the changes you want to see into real life practice. The advice I have for them is to persevere, don’t give up, and continue, because you will end up making a difference with your design and with your device.
Divergent thinking, or thinking nonlinearly and exploring many possibilities instead of a single solution, is a cornerstone of innovation. And it encourages curiosity and creativity, both of which are essential for developing something truly novel.
Many healthcare settings and even a number of healthcare organizations prefer to do only what’s tried and true, until a near miss occurs. But this is where nurse innovators can shine. Nurses are already natural problem solvers after all. So by using divergent thinking as you ideate, you’ll also be able to anticipate problems instead of simply addressing them.
Divergent thinking can result in ideas that may feel risky to implement. Which is understandable, when you consider the healthcare industry as a whole. There, risk is often viewed as a negative term and risk-taking behavior is widely avoided. In fact, few nurses voluntarily visit the risk management office.
But that’s also why it’s important to develop a certain tolerance for taking risks. Risk is inherent to innovation you just need to mitigate it. Generally speaking, nurse innovators have a higher ability to manage it, because they’re solution-minded and take a bolder approach with experimentation, often introducing new solutions.
As you develop an idea, plan for the risks that may come up: Identify and document potential setbacks, so you can find an alternative solution when one is needed. And educate your peers on all possible outcomes as you encounter them.
Teamwork and Collaboration
Even the greatest nurse innovators never work in a silo. Because both nursing and innovating truly take a team. Bringing an idea to life — whether it addresses patient needs, the needs of their families, workflows, or how to make everyday practices more efficient — requires research, testing, and vetting. And these require different points of view, too.
While it’s easy to assume that healthcare innovation should be done by people like nurses physicians, pharmacists, and physical therapists, it should also include statisticians, engineers, software developers, and business leaders who have industry insights that healthcare staff are less familiar with. By diversifying who you work with, you can identify blind spots in your design thinking to help your ideas grow.
There are medical skills, which include hands-on training, and there are entrepreneurial skills, made up of financial, operational, and strategic know-how. Both are equally important. Because when you learn the business of healthcare, you learn the skills you need to sit at the boardroom table.
The most effective nurse innovators have a sharp knowledge of healthcare trends and their implications for other healthcare workers, patients, and processes. They also understand the system at large, and can identify both opportunities and obstacles within how it works today. So as you develop your own solutions, think through a multi-step strategy that outlines the successes you hope to achieve and how they could inform trends in the future.
Design Thinking for HealthCreated by innovators at the University of Pennsylvania School of Nursing and the Rita and Alex Hillman Foundation, this online platform teaches nurses a new framework to help them tackle the complex challenges they see in their practice.
"The Nurse's Guide to Innovation"How do you build a more innovative culture? How can you develop an innovator's mindset? These are just a couple of the topics covered in The Nurses Guide to Innovation. Written for nurses, nurse leaders, and other clinicians, it serves as a how-to guide for healthcare workers with an entrepreneurial spirit.
"The Rebel Nurse Handbook"Made up of stories from over 40 nurse leaders, innovators, and entrepreneurs, The Rebel Nurse Handbook reveals the winding paths that every nurse has taken to help improve themselves, their patients’ care, and the healthcare system of today. From demanding a seat at the table of healthcare innovation to lobbying on Capitol Hill, it will share how Rebel Nurses have changed proactive care through real research and policy application.
The Innovation Roadmap: A Guide for Nurse LeadersCo-written by nurse innovator, Bonnie Clipper, this book serves as a jumping off point for other nurse leaders who are looking to introduce the spirit and practice of innovation to their organizations.