I have always been inspired by The American Nurses Association’s Code of Ethics. The first code says: “The nurse practices with compassion and respect for the inherit dignity, worth, and unique attributes of every person.”

In 2017 I was doing some research to prepare for a 15-minute podium presentation. This presentation was going to be at a leadership event with ~250 leaders in attendance. I was new to that hospital and had not worked in a hospital or with a Women & Infant service line for a few years. I was shocked, disappointed, and dismayed when I can across so many articles in the lay media – such as USA Today, ProPublica, NY Times, and others – speaking to the increasing rates of maternal morbidity and mortality. Historically, healthcare professionals would read about morbidity and mortality in peer-reviewed journals and periodicals. My perception was that the problem was so significant that the general public felt a sense of obligation to highlight and amplify it.

I remember crying as I read story after story of preventable deaths. At that moment, I wondered what I could do. How can I be a part of the solution? The words “not on my watch” popped in my head. Of course, that’s what I can do! Within my locus of control, as I have oversight for the Labor & Delivery, Mother/Baby, and Neonatal Intensive Care units, I can lean into ensuring that preventable deaths don’t occur. I thought through what would be necessary to create buy-in, support, and compliance with a statement like “not on my watch,” and then it occurred to me… A hashtag could be a means to further amplify this commitment, as well as make it a call to action for other nurses. So #notonmywatch was created.

Here are the tenets:

• Treat everyone with dignity and respect

• Listen to and believe women

• Provide evidence-based care

• Use shared decision-making

• Advocate for all birthing people

After my 15-minute “TedTalk” in 2017 (and that’s really how I formatted the presentation), I was humbled by the engagement, tears, and standing ovation that I received. One of the attendees offered to make t-shirts with the hashtag. Several women talked to me about their birth stories and how frightened they were. It was clear to me that this hashtag was timely and needed. I shared the hashtag more broadly with my entire leadership team and then together we started the hard work of reimagining how we cared for the birthing community. I reached out to some creative friends to create a logo, then got some t-shirts made, and then recorded a short video to announce and launch the hashtag and call to action. My professional home, the Association of Women’s Health, Obstetrics and Neonatal Nurses (AWHONN) posted the video on their website and the rest, as they say, is history.

The hashtag has been used over 20,000 times, I see it on shirts and jackets when I attend professional meetings. What I love most about this movement is when I hear from the birthing community how they felt seen, heard and safe. This is now my life’s work, to mitigate trauma, disrespect and preventable morbidity and mortality.

Who’s with me? #notonmywatch