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Nursing strike cost Allina Health $149 million

Last year was a tumultuous one for Allina Health in Minneapolis and its nursing staff. After a week-long walkout in June, Allina nurses went on strike in the fall as part of ongoing contract negotiations centered around the elimination of union-backed health plans. After a six-week strike, both sides finally reached an agreement that ended the strike and sent the nurses back to work.

As part of its 2016 earnings report, Allina Health reported that while revenue increased over the year, operating income dropped, thanks in part to expenses related to the nursing strike. Allina recorded a $30 million operating loss, a significant $179-million-dollar swing from the $149 million operating gain Allina posted in 2015. As part of its report, Allina cites a $149.3 million of strike expenses, which included hiring 1,400 replacement nurses to cover for the striking staff.

For more information on nursing strikes, check out the Strategies for Nurse Managers Reading Room.

Four easy ways to provide patient education

The responsibility of educating patients and their families often falls to nurses, from explaining procedures to providing discharge instructions. This can be one of the most difficult parts of the job, and your staff may have limited time due to staffing issues or an emergency situation. Here are some tips to help educate patients quickly and effectively:

Handouts are your friend: Patients are often given a lot of information all at once, and it can be hard for them to remember every detail, especially in a stressful hospital setting. Having notes and props ready for them can save time and prevent miscommunication, especially when discharging patients. Have your nurses write up the specific instructions and go over them with the patient; use highlighters to mark the most important information. There are a lot of resources and tools available (we have some here) about common procedures and practices that you can use as handouts for patients as well.

Stay concise but informative: Patients are probably only going to remember one or two learning points, so try to emphasize the most important takeaways and leave the rest for your handouts.

Test understanding: It’s important not to assume that your patient is well-informed about their own condition. Even if you think something is obvious, say it anyway! Once you go over the key points, make the patient repeat them back to you; it’s one thing to listen to an explanation, but quite another to have to explain it yourself.

Encourage questions: Even if a patient seems to understand, it’s important to leave time for questions. Ask if they have any concerns about medications or follow-up care; this will help prevent confusion going forward and negative health outcomes.

You can go here for more advice about patient education.

Trump: for every new healthcare regulation, two must be removed

On January 30, President Trump signed a new executive order declaring a “one-in, two-out” rule for healthcare regulations. Under the executive order, for a new healthcare regulation to be implemented two older regulations will have to be eliminated.

http://www.modernhealthcare.com/article/20170130/NEWS/170139994

“If you have a regulation you want, number one, we’re not going to approve it because it’s already been approved probably in 17 different forms,” Trump said during the signing. “But if we do, the only way you have a chance is we have to knock out two regulations for every new regulation. So if there’s a new regulation, they have to knock out two.”

http://www.nbcnews.com/politics/politics-news/trump-signs-executive-order-reduce-regulations-n714151

The order also sets an annual cap on the cost of new regulations and cuts the regulatory budget for fiscal year 2017 to zero. This means the only way to afford new regulations issued between now and September 30, 2017 is by repealing existing regulations.

While each agency will decide which regulations they think can be cut, the White House will ultimately decide which ones to gut. Regulations dealing with national security, foreign affairs, and the organization, management, or personnel of federal agencies are exempt.

Free Excerpt from HCPro’s new Critical Thinking book!

Avoiding Autopilot

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Rarely are we genuinely thoughtless—that is, without thought. But often we are not giving our thoughts much consideration. In today’s world, there is much distraction and sometimes we are guilty of distracting ourselves just to prevent our minds from focusing on the things that are most important (electronic devices proliferate and give us many opportunities to engage in mindlessness). So, to be genuinely able to think about thinking, we must avoid going onto autopilot.

Autopilot is the state of being where we are largely going through the motions, not thoughtfully engaged in the activities of life. It is when we arrive at our destination but cannot remember the traffic on our commute, or taking the last turn or even whether we stopped for the traffic signal or not—it happens to all of us, and that is autopilot. The key is in recognizing when it is happening and being willing and able to intercept your unconscious mind and instead coax it to be present in the real-life situation you’re living. It is learning to move our conscious mind from nowhere to now here—a subtle but essential difference!

Being present in the moment is the essence of mindfulness, and it is powerful! Mindfulness wakes us up to sensations we have been failing to notice. It reveals patterns in our activities that we’ve become blind to. It permits us the full engagement in the reality happening in front of us and even within us, silently, steadfastly, sacredly. Mindfulness may enable us to improve our health, connect more successfully to other people, enlarge our thinking, focus our perception, and even strengthen our intuition. Mindfulness is the polar opposite of autopilot!

To read more, visit the HCPro Marketplace

 

Tips for recommitting to nursing in the new year

The new year is often a time for retrospection and reflection, especially when it comes to your career. If you’re starting to feel burnt out on nursing but not quite ready for a career change, here is some advice to freshen things up in the new year.

  • Reflect on your past: Sometimes the best way to go forward is to look back. What drew you to nursing in the first place? Why was a career in nursing right for you? Think about the positive experiences you’ve had as a nurse that reaffirmed your career goals. Treat your next shift like it’s your first day; what excites you? What makes you nervous? Sometimes asking these questions can reinvigorate how you approach your work.
  • Connect (and disconnect): If you’re feeling down about your job, sometimes the best solution is to ask for help. Reach out to your peers and develop a support system to help yourself and others. If you think there’s something that could make you happier at work, talk to your managers about it; sometimes a small change can have a profound effect.

    It’s also important to let go sometimes. Being a caregiver, interacting with patients at some of the worst times in their lives can negatively impact your outlook and make your job even more difficult. Try to focus on the good you’ve done for patients and don’t take it personally when a patient struggles or suffers.

  • Commit to the new: Even though it doesn’t always feel like it, taking on new challenges can be a great way to energize your career. Seek out new experiences and opportunities; take the frustrations of the day and channel it toward learning a new skill or pursuing additional training options. Reflecting on your weaknesses can be difficult at first, but identifying them and working towards improvement can be satisfying and build you confidence.

    Another great way to embrace the new is working with nursing students or new nurses. They bring energy and enthusiasm to the job, and becoming a preceptor or informal mentor can be a great way to grow your own enthusiasm while furthering your career.

For more articles about avoiding burnout and developing your career, check out the Health & Wellness section of the Strategies for Nurse Managers Reading Room!

Nurses are once again named the most trusted profession

For the 15th year in a row, the Gallup’s annual honesty and ethical standards poll has named nurses as the most trustworthy profession.

Released last week, the Gallup poll shows that 84% of respondents said they rate nurses’ ethical standards and honesty as very high or high. Pamela Cipriano, PhD, RN, the president of the American Nurses Association, said that trust plays a vital role in the relationship between nurses and their patients, and because nurses are at the frontline of healthcare, they offer a unique point of view to their patients and the facilities they serve.

Healthcare professions took the second and third rank as well, with pharmacists receiving a positive rating and medical doctors receiving a 65% rating.

Read more here.

Virtual reality a potential solution for pain management

This year has seen the release of multiple virtual reality (VR) headsets aimed at the home consumer. As they are becoming more affordable, hospitals and companies are researching the benefits in a healthcare environment, and the early results are positive.

Cedars-Sinai Medical Center and Children’s Hospital Los Angeles are conducting studies using the software, and the early results are positive. Cedars-Sinai researchers found that 20 minutes of using the VR software reduced patients’ pain by almost 25 percent; patients had an average pain score of 5.5 out of 10 before the VR experience and an average score of 4 after using the software. The researchers say this is a dramatic reduction, and not far from the effect of narcotics. At Stanford Children’s Health, they speculate that VR can be valuable for helping children get through tedious or uncomfortable procedures, such as physical therapy or imaging studies.

Though providers are cautiously optimistic about the possibilities, there are still some hurdles to overcome. It is difficult to find developers who want to target medical issues, because of the unclear path to profitability. One startup company, ApplieVR, is building a library of content designed to help patients “before, during, and after medical procedures” It’s also important to determine when the technology can helpful and when it can’t; some patients won’t respond to the applications as well as others, and researchers are careful not to oversell the value of VR at this early stage.

For more information, check out the MIT Technology Review article.

Do you think VR might replace Opoid use eventually? Let me know in the comments!

How nurses can reduce patient anxiety

Nurses face challenging patients and their families every day, but understanding the causes of patient stress can reduce the patient’s anxiety and ultimately make your job easier.

Healthcare can be confusing and distressing for many patients. Being admitted to a hospital for any reason can be one of the more stressful events in a person’s life. Because of this, it is important to remember that anxiety is the root cause for many conflicts in healthcare settings; so a difficult patient or family member isn’t necessarily a rude or ornery person most of the time, they may just be experiencing symptoms of anxiety.

The first step in mitigating a patient’s anxiety is to introduce yourself and explain your role in their treatment plan. Explain everything you are going to do and why you are doing it. Patients are inexperienced in healthcare procedures, and it can be easy to take your knowledge for granted. Come armed with hand-outs and as much information as you can; the more knowledgeable the patient feels, they more comfortable they will be.

Next, it is important to listen to your patient and take their needs seriously. Active listening techniques, such as asking open-ended questions, taking an interest in their lives, or checking in on their feelings, can be a vital lifeline to someone suffering from anxiety. Check in with them often, and give them a venue to voice their concerns.

Instead of instructing the patient to relax, demonstrate it! Your demeanor can have a profound effect on a patient’s emotional well-being, so staying cool and collected can relax them in turn. Consider using relaxation techniques like breathing exercises to help them cope with anxiety.

For more tips, click here.

Nurses file for collective action over lunchbreak dispute

Nurses at Methodist Health claim that the hospital docks lunch pay for breaks they aren’t able to take.

Robert Straka, a nurse at Methodist Health in Dallas, filed a collective action lawsuit in August against his employer. The issue in question is the hospital policy that dictates that nurses should be allotted 30 minutes every shift to take an uninterrupted break. He argues that nurses are still expected to care for patients during their break, and would often get pulled away to perform duties. Straka filed on behalf of almost one thousand nurses across Methodist’s five facilities.

Meanwhile, Methodist argues that this is not the case, and questioned the plaintiff’s interpretation of the rules. They’ve requested that the charges be dropped in a response sent last week. The judge in the case has mandated that each party meet and produce a report next month, that would outline settlement options and hopefully come to a resolution.

Do you get a dedicated lunch break in your hospital? Send me an email at kmichek@hcpro.com and I’ll share the results (anonymous, of course) with your colleagues.
Read more here.

Allina and nurses agree to end strike

The Minnesota Nurses Association (MNA) and Allina Health have reached an agreement after months of negotiations and weeks of striking.

Last week, we reported that Allina nurses were about to enter their second month on strike after another round of failed negotiations. This week, the two sides finally reached a tentative resolution that should end the nurse’s strike.

Health care coverage had been a sticking point in negotiations; Allina wanted to transfer nurses away from their nurse-only insurance policy onto the more cost-effective corporate plan. The new agreement states that nurses will be moved off their current insurance by 2018, but the company has agreed to make additional contributions to HRA/HAS accounts in the next four years. The MNA representatives believe that this will protect nurses from any future benefit reductions.

Although the rank-and-file nurses still need to vote on the proposed terms, this deal is backed with the unanimous endorsement of the MNA, unlike the previous deal.