My friend has a small but wonderful garden. It has been the object of interest and devotion of she and her retired husband. The photo above is the beginning of what will become, some time later this summer, a tasty pear. The tree is stretched out along the side of the house. Last year, my friend 'severely' cut the tree back. Actually her husband, a gentle and kind man, said she "hacked it down". To both their surprise this Spring the tree was covered in blossoms and now those dozens of blossom are small fruits that will mature to produce a bounty of delicious treats in just a few months time. Perhaps if one is to be caught up in the pursuit of perfection is not the garden the place to put one's energy? Working there is the place where we mere mortals can reach for the Divine and do little harm.
For many decades I have been a member of various quality assurance committees. Every now and then someone will state that the quality 'bench mark" should be 100% for some care item or other. I inwardly groan. 100%? I am so often pleased if the health care system with all its participant people simply "do no harm". I do not believe 100% accuracy ( a form of "perfection") is maintainable....just ask Toyota.
This week, on two different days, two different staff nurses each gave insulin to a patient who had not eaten two meals prior receiving the drug. Fortunately no harm came to him because his wife was observant and as some of the nurses said "pushy" because she recognized hypoglycemia and demanded to know if her husband had eaten his meals. In this case, I applaud "pushy". I am now working with nurses to help them remember what they should have remembered from nursing school...regular insulin is fast acting with a rapid onset and peaks within one to two hours of administration. Is it searching for perfection to expect a clinician to remember basic facts? I put an insulin information chart in the med administration book along with the signs and symptoms of high and low blood sugar. There is a mandatory test on the subject of insulin in June. When the public will pay for a nursing home nurses to carry a patient assignment of say 6 to 10 people instead of 27 to 30 and every nurse cares passionately about doing his or her job to the best of his or her ability I will adjust the benchmark to something that approaches 'perfect' care...until then I aim for "do no harm".
For the record. The my usual benchmark is 98% and that is a cliff hanger!