Four basic rules for engaging direct-care nurses in quality improvement

To engage direct-care nurses, nurse leaders need to follow four basic rules:

1. Be transparent with your staff at all times

2. Make accountability for improvement at the unit and staff nurse levels

3. Give your staff the tools to succeed

4. Continually reward and recognize improvement

Here is a more in-depth look at each of the four basic rules. [more]

RWJF senior advisor for nursing honors 100th anniversary of Florence Nightingale’s death

Susan Hassmiller, PhD, RN, FAAN, senior advisor for nursing at the Robert Wood Johnson Foundation, is spending her summer vacation doing something extraordinary. She is not spending her days soaking up the sun, or taking a cruise to Alaska. Instead she is traveling in Europe, learning about the life and work of Florence Nightingale.

Throughout Hassmiller’s journey across Europe, she is blogging about her experience. Her trips marks the 100th anniversary of Nightingale’s death. [more]

Preserve the Image of Nursing: New TV series jeopardizes nursing image

For years, nurses have been battling how the nursing profession and nurses are portrayed in the media. Having to go against the nursing stereotypes on display in programs such as “Grey’s Anatomy” and “House, M.D.” makes the job that much harder, as patients and families are familiar with the popular television shows.

Now, nurses will have to add another television show to the list that puts their image in jeopardy. MysticArt Pictures has issued a casting call for the new “sexy docu-series” called “Cali Nurse.” According to the casting call, the show is looking for “gorgeous” young females (ages 21-30 only) who will experience “comedy, romance, and fun” and are all about “big hearts” and “dates with McDreamy.” [more]

Eight Ways to Drive the Complaining Patient and Family Member Nuts

One of my favorite activities is facilitating patient and family focus groups. What I love about focus groups is that I always learn something!

I’ve consistently found that patients and families are very sensitive to how they are treated when they complain and very articulate about the experience. If there’s one thing I’ve learned well it is “What drives the complaining patient and family member nuts?”

Listed here are the highlights. Consider sharing this list with staff throughout your organization so that people avoid some of the pitfalls of dealing with complaints.

1. It drives patients and families nuts when we get defensive. If we take complaints personally and say things like “I only work here” or “It’s not my fault”, we make matters worse. We need to keep calm, stay objective, and avoid judging, acting superior or making excuses.

2. It drives customers nuts when we coldly cite “policy” as our reason why we can’t do what the customer wants. Statements like “I’m sorry, but that’s the way we do things here” or “It’s our policy” infuriate patients and families, because it seems we care more about protecting ourselves than serving their needs. We need to somehow give them at least one option in line with policy or find ways to bend rules when we know we’re acting in the patient’s and organization’s best interest. And when the rule can’t be bent, we can at least listen intently and, with sincere regret and caring, explain how the rule exists for the sake of the patient. Why is there no smoking? Not because “it’s our policy.” Instead, “For the health and safety of all of our patients and staff, there’s no smoking.” [more]

Should nurses be the ones to help patients stop smoking?

Not being a nurse, I’ve never really thought about what happens when patients are admitted to the hospital and they are smokers. However, this is something that nurses and healthcare providers have to deal with all the time, and a recent survey says that many are not offering patients any help with quitting.

The survey, published in the July issue of Nicotine & Tobacco Research, finds that nurses and healthcare professionals often do not provide information to help patients kick the habit because they feel they lack of training in smoking cessation interventions and that it is not part of their professional responsibilities, among other things. [more]

Nursing reviews change across the country

Everyone has to undergo a performance review, including nurses. At some facilities, it can take place annually, maybe every six months, or even every other year. Nurses may be asked to fill out a 10-page form that helps their managers score qualities such as “leadership” or “respectfulness.” Or maybe the nurses don’t have to fill out a form, but rather have an electronic system tracking every project they do, and if a task is not completed on time, the information is logged into a performance system.

No matter the case, many organizations are changing the way performance reviews are conducted to separate top performers from underachievers. According to Hewitt Associates, 10% of managers and 11% of other employees are now judged solely on the results they achieve, as opposed to a combination of hard figures and additional behavioral characteristics. [more]

Charge Nurse Exemplary Roles: The Icing on the Cake

Charge nurse is a term that has been around since the early 1980s and has often been used interchangeably with other terms, such as unit supervisor or shift supervisor. Charge nurses are accountable to the organization, direct care providers, and patients. They must be sufficiently trained in regulatory requirements such as The Joint Commission’s standards, and they must be adequately familiar with and trained in organizational policies and procedures so that the delivery and coordination of patient care meet organizational expectations.

Aside from the traditional roles charge nurses hold, here is a list of a few of the exemplary roles they also take on:

Educators: The educator role is more than just acting as a resource for the patient care staff. Charge nurses who develop skills as an educator can help bring the patient care team to another level by assisting with staff orientation, equipment, and procedural in-services, updating team members about new clinical practice changes, and helping plan for new education programs based on needs assessments. [more]

President Obama thanks nurses for their commitment

On June 16, President Obama spoke in front of more than 1,000 cheering nurse delegates and RNs at the biennial American Nurses Association (ANA) House of Delegates to thank ANA and nurses for all their hard work and commitment in the journey to passing healthcare reform.

“Nurses are the beating heart of our healthcare system,” said President Obama in a press release from ANA. “Because you know our healthcare system so well, that is why you have become such fierce advocates for reform.” [more]

Seven strategies to prevent nurse burnout

In a recent post, I discussed the issue of nurses being double at risk for a heart attack. This statistic comes from a study conducted by Danish researchers (the full study can be found here) and was conducted over a 15-year period. In addition to this finding, a British study tracked 6,000 workers for 11 years and found those regularly working more than 10 hours per day had a 60% higher risk for heart disease than those who only worked seven hours daily.

A recent column on HealthLeaders Media discussed seven strategies to reduce nurse burnout that I want to share here.

The strategies come from a study conducted by Milliken, Clements, and Tillman in a 2007 study called Nursing Economic$ (free login required). The study says to prevent burnout, organizations need to employ a nurse-centered stress management program AND an executive support system. Too often, stress reduction programs fail because they aren’t relevant for bedside nurses or because bedside nurses do not receive support for such programs from leadership.

The following strategies were found by this study and others to be effective:

1. Stress reduction classes: Offer live classes and computer-based sessions about self-care stress reduction techniques. Be sure to tailor the sessions so they make sense for busy staff nurses. For example, a session filled only with strategies that aren’t applicable to the nurse environment won’t be as helpful as one that includes easy-to-implement techniques such as deep breathing that can be performed during a quick meal break. Encourage nurses to participate by raffling off gift certificates for massages.

2. Create a space for relaxation: Social support has been shown to reduce the effects of stress, and senior leadership can help foster opportunities for nurses to interact by providing a place for them to meet. The break room can be more than a place to scarf a quick sandwich and managers should encourage staff to take breaks together when possible to build a sense of community.

3. Mentor and buddy programs: Having someone to vent to and engage in joint problem-solving can mitigate the effects of stress. Encouraging mentor and buddy programs also boosts nurse engagement and helps in long-term retention and professional development. [more]

Facebook posts could cost five California nurses their jobs

A few years ago, hospitals did not have to worry about patient information being posted on the internet, as social media sites such as Twitter and Facebook were not as popular as they have become today. Tri-City Medical Center in CA may be wishing for the days before computers, as five nurses’ jobs are in jeopardy and a sixth will be disciplined for allegedly posting patient information on Facebook. [more]