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This series takes a deeper look into the stories appearing in The Rebel Nurse Handbook, which features inspiring nurses who push the boundaries of healthcare and the nursing profession. This installment focuses on Nicole Lincoln’s work as an innovator and her mission to inspire others to become innovators as well.
“Nursing has bestowed gifts upon me which I can never pay back: independence, joy, pride, self-esteem, and purpose.”
When Nicole Lincoln decided to embark upon a nursing career, she had to power through a variety of hurdles to reach her goal. While pursuing her baccalaureate degree in Boston, she balanced pregnancy and childbirth with school, but a more serious challenge arose when her home life was afflicted by domestic violence. Forced to take refuge at a homeless shelter for women and children, Nicole managed to find subsidized housing in an apartment closer to her classes in Boston. In this new place, she found a true mentor through Catholic Charities, on which she leaned until she graduated with her BSN.
Nicole’s first nursing position was at a state hospital in 1995, during the height of the AIDS crisis. Three years later, she began work at Boston Medical Center in an intensive care unit, where she is still employed. In 2011 she felt a calling to further her education: “I wanted to be a part of innovating the evolution of the nursing profession. The recent wave of technology and advancements were monumental. Change was the only thing you could count on in medical care.”
Having attained her higher degrees as a Critical Care Nurse Specialist and Family Nurse Practitioner, Nicole became a nurse educator at Boston Medical Center and embarked on her innovation journey.
She began by investigating safety events that were occurring in the units. She worked with the front-line nurses, quality improvement specialists, and healthcare engineering students to evaluate their problems and devise solutions. One of Nicole’s most successful projects was the implementation of SAFETY (Stand at the Bedside – Assess your patient – Falls or other safety risk? – Explain the plan of care – Try to involve the patient in the plan of care – Y time for questions/clarifications), which she describes as “a standardized bedside nursing handoff with my cardiac interventional floor who had experienced serious medication errors on their unit.” As a result of their early projects, her nursing team reduced the fall rate by 76% and achieved a 25% reduction in medication error during the pilot periods.
In response to these successes, the hospital actively encouraged innovation among nurses and worked to further foster interdisciplinary cooperation between doctors and nurses. Nurses became key members of quality improvement committees, and a spin-off from “Shark Tank,” known as “Nursing Tank,” was formed to encourage nurses to create and share innovative ideas. By the end of “Nursing tank,” Nicole notes, “we had 70 ideas of which 10 were funded to move forward by the board of trustees.”
As the mission to innovate progressed, residents formed workgroups with nurses to improve communication, and physicians collaborated with nurses on Boston Medical Center’s patient safety publication, OK to Proceed. Nicole notes, “There have been major strides in the reduction of the preventable harm index and mortality observed to expected ratio. This can only be done when all members of a team feel they have a significant voice.”
Mindful of her own early experiences, Nicole is also deeply committed to helping women who are struggling to move ahead amid social, economic, and other obstacles. In addition to mentoring nursing students and graduate students from local universities, she participates in a number of initiatives, including Boston Medical Center’s hiring program for RNs with Associate degrees and Certified Nursing Assistants (CNAs). Described by Nicole as an opportunity for “nurses who come from diverse backgrounds, are single parents or economically challenged to get started making an income faster,” RN hires at BMC are given five years to complete their BSN and receive tuition reimbursement, and CNAs are also eligible for tuition reimbursement.
Among her many activities to help nurses move forward in their careers and as innovators, Nicole also serves as a faculty member with distinction at the Boston University and BMC Leadership Academy, is a founding member of SONSIEL (Society of Nurse Scientists, Innovators, Entrepreneurs, and Leaders), and speaks professionally to “hopefully inspire nurses to believe in their ability to be leaders of change and innovation. “
Nicole’s tips on how to bring innovation to your unit:
- Form a Unit Based Council to support Local Improvement
- Share ideas with peers for improvement
- Identify workarounds that are broken elements of the system that can be fixed
- Identify waste
- Identify solutions to problems
- Engage peers in innovation ideas
- Improve workplace teamwork
- Embrace change
- Work with others on the multi-disciplinary team (join committees or improvement projects)
- Take a course on innovation or creativity (That’s what got me hooked!!)