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Nursing News HighlightsNurses Leading Innovation

Rachel Walker, PhD, RN, Wants Nurses to Tap into Their Innovative Spirit

Following her recent keynote at the 2019 ONS Congress, we sat down with nurse inventor and advocate Rachel Walker, PhD, RN, to get her perspective on how we can increase participation in the healthcare innovation space from nurses of all backgrounds and at any stage of their careers.

When IV fluid-manufacturing plants in Puerto Rico were disabled by the devastating hurricanes that struck the island in 2017, there was a critical shortage of IV fluids, such as normal saline, across the United States. Messages from her Puerto Rican nurse colleagues navigating shortages of critical supplies in the aftermath of the hurricane, and prior experiences running out of IV fluids in the ER tent after the 2010 earthquake in Port-au-Prince, Haiti, led nurse innovator Rachel Walker, PhD, RN, and a team of other nurses, students, and engineers, to begin developing a portable, self-contained system that purifies water and generates essential IV fluids on-site.

Rachel, a former rural emergency medical and disaster relief worker and an assistant professor at the University of Massachusetts (UMass) Amherst College of Nursing, was the first nurse to be selected by the American Association for the Advancement of Science (AAAS) and The Lemelson Foundation as an AAAS-Lemelson Invention Ambassador. Her passion for advocating for patients and nurses as leaders in healthcare innovation made her the perfect voice to kick off the opening ceremonies of the 2019 Oncology Nursing Society (ONS) Annual Congress as a keynote speaker with a speech that celebrated nurse inventors past and present and inspired oncology nurses to tap into their innovative spirit.

After introducing Rachel on the mainstage, Lynda Benton, Senior Director of Corporate Equity at Johnson & Johnson, who leads the Johnson & Johnson commitment to nurses, sat down with Rachel to learn more about her perspective on how nurses at every stage of their careers can better own their great ideas and make them reality.

Congrats on an amazing keynote at ONS 2019! How does it feel to be a celebrated nurse innovator and leader?
The ONS Congress was amazing- as an oncology nurse that organization truly feels like home for me. Being asked to give a speech on the mainstage at the Congress’ opening ceremonies was one of the greatest honors I could imagine ever receiving. After the speech, it was incredible to connect with so many oncology nurses from all over the world, who shared their own amazing and inspiring stories of nursing innovation. For instance, one nurse told me a story about how her fellow nurse colleague had taken care of a young child whose skin was so sensitive that the tape used to secure IV lines and medical devices caused tremendous pain. The nurse took the child’s baby blanket and fashioned it into a kind of garment for the child that would allow all the medical devices to be secured without causing discomfort. The nurse didn’t declare this garment as an invention – they were just trying to find a solution that would bring comfort to this child. That type of practical, person-centered, daily inventiveness is what inspires me.

During my keynote I shared stories of nurses throughout history who had been shut down or discouraged from pursuing great ideas but persevered - and I think those stories resonated with a lot of people in the room. Nurses like Mary Seacole, Dame Cicely Saunders, and Bessie Blount Griffin. Many nurses came up to me over the rest of the Congress to share their own experiences of not being “invited to the table” where decisions get made or hearing “no” to an idea for innovation they’d pitched. Several shared that they had always known their ideas and the needs they’d identified were important, but they hadn’t necessarily framed those ideas as innovations. In other words, they just saw what they were doing as part of their jobs as nurses. So having new language to name and claim what they are really doing – amplifying the voices of patients and communities and coming up with new ways to address those needs – can make a difference. Some said they planned to just start showing up to decision-making meetings they’d previously felt shut out of and to begin using that new language of invention going forward - especially when they hear the word, “no”! Now I’m excited for the stories I’ll hear at next year’s ONS Congress!
Johnson & Johnson Nursing is proud to consider you one of our key partners in advocating for greater nurse-led innovation and a stronger voice in healthcare for nurses. What does our partnership mean to you?
I really appreciate the platform organizations like Johnson & Johnson are giving to nurses and nurse innovators to raise the visibility of the critical work we are doing in the world and throughout history. Telling the stories of nursing – and not just famous nurses like Florence Nightingale but also some of the hidden figures behind breakthrough healthcare innovations that have changed our world, and who have persisted despite significant social barriers like colonialism, institutional racism, ableism, and sexism to innovate for patients. Platforms to communicate and opportunities to connect with resources and financial support for bringing nurse inventions into reality, like the Johnson & Johnson Nurses Innovate QuickFire Challenges, are key to opening doors to further opportunity and the amplification of nurses’ work globally.
How should nursing organizations and healthcare systems be thinking about innovation?
We must acknowledge that not every nurse has equal access to opportunities for their innovations to be recognized and supported. There are nurses all over the world who have incredible ideas to improve human health and better achieve health equity, but their circumstances simply don’t provide the time, resources, or platform necessary to bring these great ideas to life. These are nurses who are constantly managing to show up for their patients and communities and who make-it-work, despite challenges like chronic understaffing, financial hardship, caregiving demands, trauma and violence in the workplace, and lived realities of more insidious social forces like institutional racism and implicit bias. These nurses bring invaluable perspectives and ideas to the innovation space. If healthcare systems want to get serious about leveraging nurse-led innovation to improve health care and to achieve health equity, they need to be creating opportunities for these nurses – not just the ones who have advanced degrees or who can afford to volunteer their time off-hours. We need to create opportunities and space for nurses’ ideas to be recognized and supported, without adding further burden to what so many are already carrying.
What do you think are the biggest barriers to nurse innovation, and how can we overcome them?
I think one of the biggest barriers to translating and scaling nurse innovations- at the hospital bedside and out in schools, prisons, and the community- is that nursing workflows have not been designed with the innovation ecosystem in mind, in the ways that many engineers, computer scientists, and others are supported to pursue innovation. The list of what nurses are responsible for doing grows daily and nothing is ever taken away. If anything, nurses are being told to do more with less – less nurses, less time, less resources. Efficiency at any cost – including, often, the expense of the nurse’s own well-being. The research indicates nurses are experiencing high levels of moral distress, burnout, and turnover – in part, because ideals of how nurses should perform care don’t align to the reality of impossible staffing demands. Many of the tools and technologies nurses are told to implement - like clicking through the endless checkboxes of electronic health records systems- seem to rob them of the very ability to be present and attentive to the needs and dignity of patients. Most nurses are already working at 110%, trying to show up in the best way they can for patients and coworkers and communities, and when we say, “Go innovate!” now we’re asking them to do one more thing.

We need to make the value proposition of giving nurses the time and resources to be meaningfully involved in the development, evaluation, translation and scaling of their innovations clear to employers, policy makers, industry and the public. And we need to support involvement in innovation programs in ways that don’t just endlessly add onto nurses’ responsibilities without first making space. This will likely require capturing and clearly communicating the value of what nurses are already doing and the myriad intangible but critically important outcomes of appropriately supporting us to practice the art and science of our profession. Because nurses are already innovating – we always have, we always will. But our systems and structures make much of this work invisible to the public and to gatekeepers of power – including budgetary and staffing power – who are in a position to fundamentally change the system and make it more sustainable.
What next steps should nurses be taking to bring their ideas to life?
The landscape and the next step is probably different for every nurse, but one way to start is by finding a champion or a mentor who has gone down a similar path before, and who can help guide next steps. If nurses are located in large hospitals or academic settings, these resources may be readily available in places like innovation and research centers. But if not, nurses can also look to professional nursing organizations like ONS, ANA, Sigma Nursing, or SONSIEL where other nurse members can provide this type of support – even at a distance. Professional meetings and online nursing communities on social media are another way to make such connections. Nurses should never feel they are alone in this – there are so many of us ready to support and cheer on our colleagues!

Usually when nurses come up with something we just want our idea to help people. So we readily share our ideas with the world. Which can be great, but learning about protections such as invention disclosures, licensing, and patents can also help nurses to avoid certain, unintended consequences of innovation, like having their ideas implemented by others in ways that are ultimately more harmful than helpful. Often medical centers and universities have “tech transfer offices” where people with expertise in this – like lawyers and patent experts- can provide support for navigating the complex world of intellectual property.
How can fellow nurses be inspiring each other?
Nurses inspiring and celebrating each other was what I experienced at ONS. I had a number of retired or semi-retired nurses – do nurses ever truly retire? - come up to me and thank me, saying that they’ve been doing this work and advocating for more recognition for nursing forever and they’re so glad that the next generation of nurses will carry the torch.

Historically, nurses have not been socialized to take credit for their innovations and even today there’s a perception that it is frowned upon. But nurses are vital storytellers and should tell the world about the impact of nursing and what we are capable of. This isn’t about tooting our own horn- by owning what we are doing and amplifying that message to the public and to policy makers, we are advocating for our patients and making visible all the ways that nurses are healing and transforming broken systems. If we just keep these stories to ourselves, we will continue to prop up systems that aren’t necessarily serving us or our patients, which perpetuates inequity for both our profession and the people we serve.

I also want to highlight that every nurse has the innate capacity to solve problems and bring ideas to the table. I want nurses to know that their ideas – their lived experiences – are valuable wherever they are, whatever their job title, whatever initials are next to their names. You offer a critical perspective as a nurse, you count, you should be heard, and you have a right to claim the identity of nurse innovator. Thank you for all that you are doing.

To stay up-to-date with how Walker is advocating for nurses, follow her on Twitter: @UMassWalker.

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