RSSArchive for March, 2008

Build an engaged team!

If asked, we’d all agree that we want to manage an enthusiastic and engaged team! That’s a tall order to fill, but it isn’t impossible. Here are a couple of quick-fire ideas to get started towards fostering engagement:

Try to identify one learning opportunity for each of your staff.
This doean’t mean that everyone has to attend an expen$ive conference. How about cross-training, one additional departmental responsibility, or a self-study project? A primary characteristic of engaged employees is the feeling of being challenged.

Offer 5 times more praise than correction.
Admittedly, this can be a challenge when considering a low achieving performer. Try to take note of any incremental progress, demonstration of positive behaviors or even a wonderful sense of humor that enables his/her peers to have a few minutes of stress relief!

What ideas do YOU use to foster engagement?

Filling the pockets of retention

By Lydia Ostermeier, RN, MSN, CHCR and Shelley Cohen, RN, BSN, CEN

When it comes to retaining staff, sometimes the hardest part is finding the dollars to drive your efforts. Too often, managers are unsure about the resources and support available to them when they budget for retention.

One of the first questions to ask yourself is, “What is my greatest resource to obtaining funds?” Whether you are determining the resource most likely to provide you with funding or the people most able to play a supportive role in validating the need for retention budgeting, the identification of these valuable sources is a key step toward monetary resources.

Here are some tips to keep in mind when working toward acquiring retention funds:

  • Always combine your budget request with ideas and plans that do not require funding, such as employee retention committees
  • Determine alternative methods of communicating retention tips, such as a monthly email sent out to managers
  • Listen to your staff to find out what things are really important to them; you don’t want to spend money on things that they do not value
  • Make a strong business case to your executive team, including the increased cost of turnover that would occur without retention efforts

If you are lucky enough to receive some specific funding for retention programs, build them in to a special general ledger in your budget so that you can keep track of your spending. And if you don’t succeed the first time, try again with a different angle. For example, it is not only important for retention of staff, but it may also help with recruitment as well; talk about the potential recruitment benefits.

If you are still not able to secure the funds that you need, take a look at your current programs, benefits, and perks. Are they all still important to your staff? Is there something that you can give up to reinvest the funds in something more worthwhile?

Many other strategies are taking place at hospitals nationwide, and communicating successful efforts is a retention strategy in itself. What have you found to be your most successful methods of gaining funding for retention efforts? How were you able to get the budgeted resources you needed to keep your nurses happy and by the bedside? To respond with questions or comments, just click on the comments link and let your voice be heard.

Who is accountable to the cost and use of patient supplies?

Are you finding yourself spending more time with a budget sheet, calculator and bottle of Tylenol these days? If you answer yes, that makes you normal as a Nurse Manager. With all your fiscal responsibilities do you ever wonder how much accountability staff should have?

Of course, their first response will be, “you make the big bucks you should take care of the money stuff. I’m here to take care of sick people and be a nurse, not an accountant”. Sound familiar to anyone? You might be wondering, where is Shelley going with this? Think about your role as a manager as it relates to sound fiscal practices in your department. With that in mind, how do you see your role as it relates to holding staff accountable from a fiscal perspective?

Have you wondered what goes on in the mind of the staff nurse when he/she reaches for supplies? You may be hoping they are calculating the cost to purchase the item vs the amount you are actually reimbursed. But, let’s be real here, after all a good professional blog prides itself on reality. When I work my prn shifts as a staff nurse and I am in need of a supply for a patient, my thoughts are (in order of priority);

Do I remember where this item is stored?

  • Will the item actually be there on the shelf?
  • What is going on with my other patients while I am in the supply closet?
  • When can I finally get to the bathroom (ok, maybe this is a number 2 priority)?
  • What time is lunch?

Can you put yourself in the position of your staff as they make selection decisions related to supply use? How can the manager educate and coach staff to lead to a more fiscally realized use of supplies? If the nurse needs one sterile 4×4 for a procedure and they have the following to choose between, how do they make their decision?

Option 1 package with 2 4×4’s
Option 2 package with 4 4×4’s

Some staff will select the item based on which one they see first. Another staff person may consider/rationalize the following;

If a liter of irrigating solution costs the same as a 250cc bottle, maybe the same applies to other supplies.

What do you think your staff consider as they make decisions about selecting supplies for their patients? How have you educated staff to details regarding costs vs reimbursement? If you had the opportunity, what would you implement that would hold staff more accountable to areas related to the costs of providing health care?

Retention tips!

Here is a quick idea that costs only about 2 minutes of time: Even though you may have thanked an employee at work for something they did “above and beyond”, take the time to call them at home after their shift to thank them again. It’s preferable for you to make the call from your home instead of your office. You may be surprised how far this small gesture can go!

When I originally sent this idea out to managers and administrators in our organization, our COO called me at home! I was not there to receive the call, but he left me a wonderful message saying how much he appreciated the retention ideas I sent out and how much he valued my position within the organization. WOW. I was floored!

If you’ve tried this idea, or are thinking about it, drop a comment on the blog and let us know how it goes!

Groundbreaking study seeks to uncover truth about new grad nurses

As new generations of nurses enter the workforce, questions abound. What influences a new graduate’s job choice? How long do they expect to stay? Why do some of them want to leave? Professors Christine T. Kovner, PhD, RN, FAAN, and Carol S. Brewer, PhD, RN, are spearheading an in-depth study to find answers to some of these critical questions. And thanks to a recent $4.1 million grant, in addition to $1.9 million in earlier funding, from the Robert Wood Johnson Foundation, the research is now funded into 2015.

“There is a lot of information floating around about new graduates,” says Kovner, who has been at New York University since 1985. “But, in my opinion, there is no solid, systematic research.”

Already, that is changing.

The study, which tracks more than 3,000 nurses from 35 states, touches on a variety of topics including workplace experience, relationships with managers, and violence against nurses. Some early highlights from the first few years of the study include:

  • About 66% of newly licensed registered nurses (NLRNs) worked a 12-hour shift
  • Poor management was cited as the top professional reason for leaving a first job
  • About 62% of NLRNs reported at least one incidence of verbal abuse
  • 27.2% of NLRNs who had worked at least 13 months in nursing had already left their first job
  • Nearly 60% of NLRNs reported they were satisfied or very satisfied with their jobs
  • 41% of NLRNs planned to stay in their first jobs for less than three years
  • The median income for NLRNs was $45,000
  • The most important work characteristics to new RNs are “the ability to do the job well” and “being rewarded fairly for the work”

What are your impressions of these early study findings?

For more information on the study, visit or for more of this article, click here.

Frequently asked questions about blogs

What is a blog? A blog (short for Weblog) is a Web site where you post thoughts, articles, and ideas on an ongoing basis. New posts show up at the top, so visitors can read what’s new. Then they comment on it. The posts can be broken down into categories and topics for easier navigation.

For more information, watch this video.

What is a blogger? A blogger is someone who posts an article on a blog. (Email the blog editor at for more information on how to become a blogger on this site.)

What is the benefit of a blog? You can network with peers, gather new insight, and share stories and successes. More specifically, on our blog, you can learn about new ideas, programs, and best practices at facilities across the country, get some tips to help you in your daily life, or share some advice or an opinion with others in the nursing industry.

How can a blog help you, specifically, in your job? Our blog is filled with valuable articles, insight from others in the nursing industry, and links to other items of interest. Because your time is tight, we try keep posts short and to the point. Feel free to share any of the information you find with peers or employees or post your comments on a particular topic with others who visit the blog.

What is the difference between a blog and a discussion board? The idea is basically the same: People can read what has been written and add their own comments. However, a discussion board usually begins with a single idea or question. A blog begins with a longer post, something that typically portrays a certain idea or opinion. Then, people can comment on that particular topic.

How do I comment on the blog? It’s easy. Click on the headline of a post to go to that particular post. Scroll down and click on “Add comment.” Then, simply fill out the fields and click “post.”

How do I comment on a comment? The same way that you’d comment on the blog.

Can anyone comment on a blog? Yes. The blog is open for anyone to comment on any topic they wish.

Getting another chance . . . thanks to robots

By Charlene Gordon, RN, Emergency Preparedness Manager at Huntsville (TX) Memorial Hospital

Ever have a patient go bad and just wish at the end of the day you could get a chance to replay it and fix what went wrong?

I just got done with a three-day WMD (weapons of mass destruction) course that had a robot for a victim. And this guy was so real, it was scary.

“The guy” was a manikin that blinked, had pupils that were reactive to light, and emitted pulses from every place a real person would. He made different heart sounds and different lung sounds (from rales to wheezing to rhonchi) while his chest rose and fell. He had an IV site that takes into account which drug you are pushing, how much you are giving, and how fast you are giving it! He responds by computer to all your interventions, including reading an exact Oxygen saturation to see if you are bagging correctly. (Don’t push the versed too fast!)

Crashing him is okay . . . just re-boot and start all over again. With this one, you can play it again. And, what a learning experience it was!

It would have been awesome for just basic assessments or regular ACLS (advanced cardiac life support), but this guy put ER nurses, ICU nurses, floor nurses, respiratory techs, and paramedics through their paces for a WMD treatment roundtable. We treated chemical emergencies, including viral and biological illnesses that were bad and getting worse.

The real beauty of the course was that several of the nurses have been around the emergency/ICU block a few times and were pretty sure this class was going to be a dud. They were one wound up bunch of nurses after three days. They loved it! This guy is spooky real and it really feels like he is dying, but unlike ACLS, where you alone have to answer, the group cooperates just like a real crashing patient.

The class really helped to prepare us to understand these complicated patients during a critical time where hesitation or a wrong choice could mean life or death for them. I just wish every nurse and all healthcare professionals could take this course every year. This was a great experience!

Don’t you wish you could get another chance sometimes?