MakerNurse is searching nationwide for nurses who are creating new devices and workarounds that fix healthcare problems and improve patient care.
Nurse-made solution to an infant's back problem. |
My daughter was born with a rare neural tube defect that made her spinal cord protrude into a softball-sized lump on her lower back. She was healthy otherwise and surgery could wait a few months, but being discharged from the hospital presented a more immediate problem: How could a newborn with a large, delicate sac containing her spinal cord safely ride in a car seat when she wasn't even supposed to lie on her back?
Enter the innovative nurse who used a twisted hospital blanket and medical tape to fashion a donut that fit around the lump and cushioned her back.
"I bet that never got published," says Jose Gomez-Marquez, director of Little Devices Lab at MIT. "I bet nobody got an award for that little solution."
He's right. I don't even know that nurse's name. She rolled the blanket, taped it up, saw that it fit, and went on with her day. But her quick-thinking invention helped my daughter safely ride in her car seat for almost four months. And it didn't cost us a penny.
This kind of creativity happens a lot in nursing, but it's often quiet, unheralded, and anonymous. And it stays stuck on the ward where the nurse is working, almost never seeing the light of day outside the tiny little sphere where it was invented.
"They never got that positive reinforcement," Gomez-Marquez says of such creative nurses.
Gomez-Marquez wants to change that. That's why MIT's Little Devices Lab, with support from the Robert Wood Johnson Foundation, has launched MakerNurse, a nationwide hunt for these DIY, "MacGyver nurses" who are creating new devices and workarounds to fix healthcare problems and improve patient care.
MakerNurse isn't an incubator for ideas. Instead, it aims to "study nurse making in hospitals and identify ways to better support inventive nurses," according to the website. It wants to collect images and stories about these kinds of inventions, talk with nurses who are doing this kind of work, and help them in their endeavors. And it also wants to give these nurses recognition they deserve.
"They don't even do it because they wanted to be creative…they did it because they wanted to get the job done," Gomez-Marquez says.
Some nurses do commercialize the products they develop in the line of work. But MakerNurse isn't really about commercialization. In fact, it's about imparting value and recognition on things that don't get patented or commercialized.
"The concept of making and fabricating is different," Gomez-Marquez says, adding that the MakerNurse program has nothing to do with intellectual property protection.
"I think that's one of the main things that we're going to be imparting," he says. "It's about changing that dynamic between what is considered innovation in the clinic."
Gomez-Marquez says the program will ask nurses, "What are you hacking in the clinic, and how can we help you do more of that?" For six months, MakerNurse will collect and share examples of "medical making" from the nurses who are doing it every day.
But "first we have to find it," Gomez-Marquez says. Then, the program will visit hospitals, talking with nurses, and having coffee and pizza sessions to "understand where they are and what makes them tick."
The program will also let these nurses know that what they're doing "isn't just an outlier activity." Part of that, Gomez-Marquez says, is trying to encourage nurses and nurse leaders to eliminate certain jargon that's used to describe such making.
For instance, Gomez-Marquez says the term "workaround" can be problematic because it implies that there's no better solution. He also takes issue with the term "positive deviance."
"It's such a patronizing approach that says 'you broke the rules, but thank God it had a positive outcome… but we'll study you as an outlier,'" he says.
The point of all this haggling about semantics? It's about showing that these "inventive fabrications" are worthy and important in their own right, that they're more than just a last-ditch workaround, or the result of a nurse taking a chance and happening to get it right.
He also hopes that nurse leaders will be supportive and encouraging of inventive nurses, pointing to the paradox that, "The nurses who are making things like [my daughter's] donut are not the ones who are in charge." And a rush to crack down on the rules can sometimes stifle innovation.
Such nurse innovation was commonplace in the early part of the 20th century, Gomez-Marquez says, pointing to a write-in section of the American Journal of Nursing in which nurses would share ideas, tips, and tricks about things like making medical devices or modifying furniture.
But "around 1950-something we just see a cliff, all of a sudden it dropped," Gomez-Marquez says. Although he's not sure why such innovation ground to a halt, Gomez-Marquez believes it could have something to do with the rise of evidence-based medicine, which always asks for data. And in the case of on-the-spot inventions like my daughter's donut, data doesn't exist.
But if nurse making can once again take off, Gomez-Marquez says he has "a feeling it can help in driving down healthcare costs." He again point to the donut example, saying a custom-made orthopedic donut would have cost $300. Not to mention that it would have taken way too long to create; we needed it immediately.
Gomez-Marquez is urging DIY nurses to get in touch with MakerNurse.
"Our doors are open," he says. "Please send us emails and call us."
Learn more at MakerNurse.org.
Alexandra Wilson Pecci is an editor for HealthLeaders.
