I've come to realize a fairly universal truth: Nurses are experts at "making do." Perhaps this ability stems from being so busy that shortcuts and improvisation become a way of life. There's little time to jump through the requisite hoops to get what's really needed. It brings to mind the age-old saying, "We've done so much for so long with so little, we are now qualified to do anything with nothing."

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When all is said and done, patients typically get what they need, tasks get accomplished, and no one misses a beat. So, then, what's the problem? It all looks too easy. The casual observer won't notice. And the problem will persist because it's not obvious. Nurses have done so well "making do" that when it comes time for budgetary decisions, product upgrades, maintenance, or even staffing enhancements, there's no evidence trail to show that a particular problem even exists.

Of course, not everyone's quiet. A few courageous ones stand tall and take on the problems at hand. They're often rewarded with paperwork, committees, policies, politics, and bureaucracy to navigate. This obstacle course can knock the wind right out of the sails of the most enthusiastic nurse, causing that person to think twice about getting involved when the next "opportunity" arises.

So, what's a nurse to do? It's a complex world with hoops to jump and barriers to break down. But nurses on the front lines are in the best possible position to raise the red flag when issues need to be rectified, particularly those that involve patient or staff safety.

And don't overlook improvements that could make work more efficient and enjoyable for everyone. So much of our time is spent at work-why not strive for the very best work environment?

Formally document your concerns and your suggestions. Seek out your resources and your allies, including educators, advanced practice nurses, and nursing leaders. When needed, involve other disciplines. Consult the literature and discuss ideas with trusted colleagues. Few things that are worthy are easy, but the results can be well worth the effort. Though we might need to pull a few tricks out of the hat now and again, never be satisfied with just "making do"!!

Until next time-

Linda Laskowski-Jones, MS, RN, ACNS-BC, CEN, FAWM

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Editor-in-Chief, Nursing2011 Vice President, Emergency, Trauma, and Aeromedical Services Christiana Care Health System, Wilmington, Del.