“Despite a very difficult work environment, they have found ways to bring remarkable energy, commitment and creativity to their work.” This quote describes Pike Place Fish Market in Seattle Washington. Wouldn’t this be a great description to have of every nursing unit in Wisconsin? Interestingly enough this does describe the environment of the Medical/Oncology units at Community Memorial Hospital in Menomonee Falls, Wisconsin.

The FISH! Philosophy is so called because it describes what observers saw at this fish market in Seattle. They had created a work place that focused on quality customer service while enhancing the lives of their employees and customers alike. Pike Place Fish Market states that “We interact with people with a strong desire to make a difference for them. We want to give each person the experience of having been served and appreciated, whether they buy fish or not”. This philosophy is described in the film called FISH!, which has become one of the best selling business videos in the world.

Approximately two years ago members of the Human Resources Department and the Education Services Department of Community Memorial Hospital teamed up and attended a conference called FISH! that introduced them to the philosophy. They were so impressed by the philosophy and the implementation of FISH! at Pike Place that they came back to the hospital determined to adopt FISH! at CMH. The concept was presented to the Continuous Quality Improvement Council for their approval and unanimously adopted. A plan was set in place to introduce the whole hospital to FISH!. This educational series was one of the best and most fun offerings at CMH. It was a great time to be part of the fun. Employees that attended it said, “This is Great! You can not let it die.” And so FISH! lives on at CMH.

The FISH! Philosophy can be summarized by 4 basic principles:

1. Choose Your Attitude – This concept revolves around the idea that your can choose to look for the good, or the bad, in every situation or environment in which you practice. That which you seek you will find. We see this often in our patients. Most of us recall the patient suffering in almost unimaginable circumstances. Yet that patient chose an attitude that made them one of the happier and peaceful patients on our watch.
2. Make Their Day – “To give is better than to receive” is the premise of this part of FISH! Find someone who needs a helping hand, or word of support. By adding that something extra to encounters with coworkers and patients, special memories that inspire and energize are made for all parties involved. If you ask most nurses about their most memorable moment in nursing many will point to a time when they were appreciated for a service rendered. The service rendered not only pleased the receiver but also the giver.
3. Be There - This is about focusing your attention and really listening to your customer. Don’t let distractions destroy the quality that is present in each moment. By “being there” a nurse can choose to prioritize and find the time to give to those that matter most. FISH! proclaims that going the “extra mile” in service to others is a way of not only serving but also giving you a sense of accomplishment. Burnout can be attributed to unsatisfactory completion of a service given to another person. Believing in this principle of giving wholeheartedly people may avoid burnout like we experience nursing.
4. Play – By attempting to find fun in the task at hand FISH! says that energy is added to the work environment. Our work is very serious making it difficult for many nurses to incorporate “play” into the very act of nursing. Given the important role that a nurse fulfills, having fun while at work can help to alleviate some of the stress. The challenge here is to find some sense of light heartedness that can involve our patients and be incorporated into the daily routine. A simple example might be giving a birthday cupcake and singing a happy birthday song to a patient.

The Medical/Oncology unit at Community Memorial Hospital fully embraced the FISH! concepts and adopted them. We were looking for creative ways to continue to improve patient satisfaction. When FISH! came along we saw a real opportunity to not only improve in the area of patient satisfaction but also in creating an energetic and appealing work environment for the staff.

Upon studying the material we went to work. We discussed FISH! at the Unit Based Council for planning and implementation. We understood that adopting FISH! meant more of an individual commitment as compared to a team commitment. Each member of the Third Floor Team wrote an individual goal that would address at least one of the FISH! concepts. During annual performance reviews each person presented his or her FISH! goal to the unit director.

As a team, our unit continues to discuss FISH! and develop creative ways to keep it alive and well. We have reminders throughout the unit such as FISH! mouse pads, fish lights and other fish decorations. We have even acquired a giant stuffed fish mascot named Mick Mackerel. Mick was acquired after intense negotiations ($.25) at a rummage sale by one of our employees who wanted to live out the PLAY aspect of FISH! Mick now resides full time on the Third Floor at the main nursing station.

Even though you may not be able to recruit Mick Mackerel, you can go to WWW.FISHPHILOSOPHY.COM, to find more information on the FISH! Philosophy. You will find resources that include useful books and videos. The web site also has a FISH! pond where your can read about other organizations and their improvements achieved by living the FISH! Philosophy.