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NURS 517: FISH Philosophy

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Marissa Reynolds

on 4 August 2015

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Transcript of NURS 517: FISH Philosophy

FISH Philosophy
School of FISH
Binni Hagstrom, Marissa Reynolds,
Andrew Richardson, & Erinn Stampley
FISH Philosophy

Fish Philosophy
Integrating the FISH model as an organizational tool in the hospital.
The Current Problem:
Dissatisfaction with reorganization and revision of structure of hospital
Understaffed and unable to give quality patient care
Loss of morale
Lack of Teamwork

What is the FISH philosophy?
The Key Components:
What side will you wake up on this morning?
Ordinary day or Magnificent Day?
What difference will you make today?

Make work fun!
Bringing a positive attitude and knowing that play and work can coincide together
Emphasis is on teamwork and working with colleagues in a respectful manner and fun environment.

What is the experience you are giving to patients?
Quality Care vs Standard Care
Making the patient feel they received the best care
Make Someone's Day
Be There
Not limited to listening, keeping eye contact, but how teamwork is established and used to benefit the patient
The key question is: What is the mission for the patient as part of the interdisciplinary team in their healthcare?
Solutions & Outcomes
Patient, Practice, and Community involvement
Integration of the FISH Philosophy
Inter Professional team Involvement
Step 1- Solutions & Outcomes

Patient level
--Exit Interview
Practice level
--Communication of concerns
--Being Present at work
Community level
--Evaluate need for change and restructuring

(Staib, 2009)

Step 2- Solutions & Outcomes

Patient level
--Update patients on changes
Practice level
--Evaluate staff adaptation to change
--Choosing One’s Attitude
Community level
-- Community leader involvement

(Staib, 2009)

Step 3- Solutions & Outcomes

Patient level
--Patient Education Tools
Practice level
-- Initiate movement of model
-- Playing at work
Community level
--Social Media Outlets

(Staib, 2009)

Step 4- Solutions & Outcomes

Patient level
--Integrate Social Service
Practice level
-- Evidence Based Workshops
Community level
-- Advocate for local and national change

(Staib, 2009)

Step 5-- Solutions & Outcomes

Patient level
--Continue to develop new tools for education
--Make the Patient’s Day
Practice level
-- Reinforcement
Community level
-- Seek funding

(Staib, 2009)


Social Justice Advocacy
--Nurse-patient Advocacy
--Nurse-Nurse Advocacy
--Nurse-Self Advocacy

(Paquin, 2011)

Dobson Level of Advocacy

Practice level
Patient level
Community level

(Dobson, Voyer, Hubinette, & Regehr, 2015)
"We may all be different fish, but in this school we swim together!"
--FISH Philosophy

Chart House Learning. (2015, May 12). The Fish! Philosophy. Retrieved from https://

Davis, B. P., Clevenger, C. K., Posnock, S., Robertson, B. D., & Ander, D. S. (2015). Teaching
the teachers: Faculty development in inter-professional education. Applied Nursing Research : ANR, 28(1), 31-35. doi:10.1016/j.apnr.2014.03.003

Dobson, S., Voyer, S., Hubinette, M., & Regehr, G. (2015). From the clinic to the community:
The activities and abilities of effective health advocates. Academic Medicine, 90(2), 214-220. doi:10.1097/ACM.0000000000000588

Paquin, S. O. (2011). Social justice advocacy in nursing: What is it? how do we get there?
Creative Nursing, 17(2), 63-67. doi:10.1891/1078-4535.17.2.63

Ramteke, G. (2008, September 21). Go Fish!. Retrieved from

Staib, K. (2009). Why fish philosophy
works. Retrieved from http://www.workhappynow.com/2009/03/why-fish-philosophy-works/
Work Plan

Developed to help integrate the FISH model into practice on the units of the hospital during restructuring period, and as a tool to use in future employee orientations to new employees.

Stage 1: Planning and Decision Making
Hospital Administration, Unit Managers, Heads of Medical Staff, and Human Resources

Receive feedback from staff members regarding restructure process

Dissatisfaction of restructure process

Financial Assistance, Implementation of a structural change during an already occurring restructuring process

Stage 2: Create a Task Force
Unit managers, hospital administration, medical staff, human resources, and interested staff members on unit (RN, ancillary, housekeeping, PT, OT, etc)

Create a multidisciplinary integrative team as the task force for the implementation of FISH philosophy

Create a teamwork atmosphere with similar goals that can identify goals as a team to address concerns of staff

Difficulty recruiting staff members

(Ramteke, 2008)
(Ramteke, 2008)
(Ramteke, 2008)
(Ramteke, 2008)
(Chart House Learning, 2015)
Stage 3: Inform Staff
Who: Task Force

What: Spread the word that change is coming to the institution

Why: Create a buzz around a positive change that will be occurring during the reconstruction process

Barriers: Negativity from staff
Stage 4: Workshops
Task force members, managers, human resources

All staff members attend FISH workshops held by
FISH consultants and task force

Create change of culture in an integrative, teamwork

All staff members making change after attending
Stage 5: Be Persistent
All staff members

Uphold FISH philosophy in the organization

Change of culture to implement teamwork and interdisciplinary care as the fundamental objective of the organization

Upholding standards of FISH philosophy
Next Steps:
Next Steps:
Was the problem resolved?
Continue FISH philosophy?
Any Changes to the model?

Full transcript