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Pockets of Excellence – How Great Nurses Naturally Create Military Squad Camaraderie and Tactics

Travel nurse positions nearly always come with a requirement of one to three years of experience.  Travel nurses are the calvary, hit the ground running quick reaction force, and when you find the right one, they create a pocket of excellence.  Recently, I listened to a podcast called The Business of Healthcare Episode 113 by the University of Texas at Dallas (link below) where Dr. Eric Bricker is speaking about the economics of successful health systems and the pockets of excellence concept, which crossed right into what I knew in my past roles in military and law enforcement. 

Pockets of excellence are those environments which bring out the best in those around them.  A nursing floor can be a pocket of excellence, while the next level over may not be.  Pockets of excellence of places where teams thrive, revive, mature, and they are contagious. 

Bricker had some exceptional commentary and thoughts; for example, when we look at the healthcare system in the United States it's too big to take and steer to actionable solutions; but, when you focus on creating pockets of excellence they have a way of spreading.  This gets me thinking…. How do you create one?  Who creates one? 

In the military there is a concept of 1 up and 2 down in leadership.  Simply, be able to do the job 1 level above you and 2 levels below you to have an adaptable fighting force.  If your squad leader goes down, the team leader can fill in; the next highest ranking squad member then becomes the team leader.  If the machine gunner goes down, the squad leader can drop down 2 roles into that spot in a pinch knowing every inch of the weapon and what to do with it.

Nurses are always teaching and always learning.  To quote Florence Nightingale, “Let us never consider ourselves finished nurses. We must be learning all of our lives.”  Nurses are advocates and teachers of and for their patients as well.  The day to day of floor nursing is learning from your peers and growing in comfort and confidence.  By teaching those around us we create a better team; suddenly, in a span of a few months a nursing floor is akin to a 1 up/2 down combat team; which, is what you need when you’re under siege on the floor that day, week, or whole month. 

Teachers and mentors are the “who” that create pockets and learners that seek and absorb this knowledge bolstered by the right environment create the how and this becomes cyclical, cultural, and caring. 

An astonishing 17% to 30% of newly licensed registered nurses quit the profession within the first year and 30%-57% by their second year according to an article published by Healthleadersmedia.  Regular one on one meetings are identified as being critical to establishing strong relationships with new nurses and guiding them through struggles commonly identified as organizing, prioritizing, and feeling poorly prepared for the work environment.  This is the teaching part and why experienced nurses are the keystones to the creation of a pocket of excellence and less experienced nurses feeling valued and guided the other half. 

Iron Medical seeks to create pockets of excellence and hire those who support those efforts in the areas we serve.  Mentorship, teaching, and finding those who you can bounce and idea, situation, or learn from is critical to long term satisfaction, team success, and individual growth.  As we stand up as a unique nurse staffing team, we will do so with mentorship and building a community that is its own contagious pocket of excellence at our core.  More to come, stay well! 





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