Listening is a tremendous strength, a gift, not given to everyone, but essential when caring for patients, managing staff, and even helping family members through illness and difficult times. My friend, classmate, and colleague, Nola, taught me much about listening.

How do you perceive the care you were given? A simple question posed by Nola Della-Monica found that patients and nurses had different perspectives about feeling cared for. Nola's research in this area led her to develop and test a new tool in 2008. Nola synthesized qualitative studies to develop a new concept or midrange theory informed by students, nurses, patients, and families. This work allowed her to develop and test a new tool that captured the essence of caring in the Nurse Caring Patient Scale.1

I was fortunate to witness this work; I listened and learned a great deal. Caring is many things, and at times, the definition changes as our patients' needs change. Sometimes it is competence and knowledge; other times, it is a quiet presence or a small act of kindness. Difficult to measure and quantify, but essential to help us define and measure how we are doing.

Nola continued to bring her listening skills into her work as an assistant professor of nursing at Emmanuel College in Boston. She asked students to take one on-line course from the Institute of Healthcare Improvement (IHI) Open School and share their impressions with the class. Students responded with enthusiasm and asked to have the courses added to the curriculum.

Nola listened to the students and realized the value the courses and integration with IHI would bring the students saying, "Quality and safety bring us back to the basics of nursing, the things that we should care about," "It's about giving the best patient care."2

Nola started using the courses, which includes a module on person- and family-centered care, realizing it taught caring as a core value.

"We see Institute of Medicine reports, and it's so disheartening to think that we have strayed so far from our core of caring," Della-Monica says. "Personal care and, with it, opportunities for assessment are rare in hospitals today. I often wonder if we spent even 5 or 10 more minutes with a patient, how often would we stop 2 to 3 extra days in the hospitals due to nosocomial infections or other events?"3

Adding content to an already full curriculum is a daunting task, requiring buy-in from faculty and administration. Nola shared feedback from the students; suggesting requiring all 16 courses for the basic certification. The curriculum team decided to give students 3 semesters to complete all the courses, with a plan to consider integrating the IHI Open School Quality Improvement Practicum, a new course that walks students through how to set up and execute a quality improvement project.3

Currently, students completing a master's degree in nursing from Emmanuel are required to earn a IHI Open School Basic Certificate as part of the Advanced Roles in Professional Nursing course. Emmanuel is 1 of more than 200 schools around the world that have integrated the IHI Open School courses into their curricula.3 Thanks to Nola, it is one of the first nursing programs to require certification.

Dr Nola Della-Monica lost her battle with cancer last month. Much too soon, as she had much to do, but her work will continue. In her memory, may we all listen to the voice of students, nurses, patients, and families.

Kathleen Ahern Gould, PhD, RN

Adjunct Faculty

William F. Connell School of Nursing

Boston College

Chestnut Hill, Massachusetts

References