RSSArchive for January, 2009

Achieve accountability when working with physicians

We have many opportunities to work with physicians. It may be in caring for a specific patient or group of patients, or we may work with them on a project or team. Working with physicians to achieve accountability is no different from working with anyone else. We want to get physicians to do what they say they are going to do. We want them to make commitments and keep their commitments, as explained in the video below.

We can use the same tools used in all accountability situations, and one which is to frame the conversation.

Framing an accountability conversation is how you “set the stage” for what is expected. Often, you don’t achieve the results you desire because the expectations were not clear or each party had different expectations. Framing allows you to define what you expect.

Framing is when you ask the physician to listen and process in a positive way. It creates the listening opportunity for you to speak into. It creates one common mindset in the conversation and enables participants to do the correct work.

You can easily fix the random mindset in a conversation or meeting by asking people to be a certain way, to do a specific kind of work, and to be open to the possibility of accountability. In a group, framing sounds like this:

  • I ask us to focus on our vision of improving our patient satisfaction scores by five percentage points in six months
  • I ask us to listen to the presentation for opportunities we can pursue to make progress on our goal
  • Please be prepared to make commitments at the end

You can do the same thing in a one-on-one conversation with a physician. For example, let’s say you are caring for a patient in pain. You contact the physician and use the SBAR technique (situation background assessment recommendation) to communicate the patient’s condition. You confer with the physician about how reasonable pain control can be achieved, and the physician gives you an order for pain medicine. You commit to the physician that you will give the medication as ordered and you will call the physician in three hours if the patient’s pain has not improved (pain level < 5) for further orders. The physician agrees with the plan.

Everyone wants to do the right work and to contribute. All we have to do is ask!

What methods have you used to gain commitments from physicians at your facility?

Get nursing research underway at your facility

Research is a high-focus area in nursing departments across the country. It is highly emphasized in the 2008 ANCC Magnet Recognition Program® Application Manual, which was released in October. In the new manual, the 14 Forces of Magnetism are now structured under 5 Model Components. Nursing research falls under Component IV: New knowledge, innovations, and improvements, and Component V: Empirical outcomes. Specifically, nurses are expected to conduct research projects. [more]

For nurses, now is the time to hold each other accountable

With Tuesday’s inauguration of President Obama, there is an atmosphere of hope and of new ideas that will move us toward improving our economy and planet. His inaugural speech focused on many different areas, including “a new era of responsibility” and accountability. As we move into this new era of accountability, it is important for all of us to look at where we need to step up to the plate. [more]

Budget-friendly gifts and retention gems

Tighter spending may be in your hospital budget’s forecast with the state of the economy, but recognizing and rewarding staff shouldn’t take the backseat. Creating and environment where nurses feel appreciated, valued, and that they are making a positive affect on patient care is key to improving retention. And, there are several low-cost gifts for any occasion to help you celebrate your nurses’ success, thank them for a job well done, or just let them know you’re thinking about them. [more]

Dealing with verbal abuse

It’s inevitable that some of your decisions will be unpopular. However, you are not a manager to win a popularity contest. If you made the decision with thought and consideration and not as a reaction to an event, it should be understood and accepted in time. If you make staff understand the rationale behind and unpopular decision (or any decision, for that matter), they will be more likely to keep rowing in the same direction as you are. [more]

Hone your hiring skills

by Shelley Cohen, RN, BS, CEN

Selecting new staff to add to the team is one of the most important roles nurse managers play in relation to recruitment and retention, yet their interview skills are typically lacking. In order to improve the interview and hiring process, nurse managers must be educated and provided with the right resources: [more]