RSSArchive for July, 2011

Are you a bully?

Do you have favorite nurses on your unit? Are there a couple of nurses who make you want to roll your eyes and sigh every time you interact with them?

While it’s to be expected you will have high and low performing employees on your unit, as well as personalities that you bond with more easily than others, nurse managers need to be careful how they deal with their feelings about their staff.

Nurse-to-nurse hostility is a well-recognized problem in the profession. Also known as bullying, lateral violence, horizontal hostility, or toxic behavior, the problem contributes to nurse burnout, high turnover, and poor patient safety.

Victims of horizontal hostility often report the behavior was ignored or condoned by managers, and in the worst cases, managers are the perpetrators. To ensure they are cultivating a healthy work environment, nurse managers must examine their own behavior and ask themselves whether they are doing enough to prevent toxic behavior. [more]

How to get started with a nurse residency program

Want to build a nurse residency program for new graduates but not sure where to start? Kendra Varner, MSN, RN, nurse residency program coordinator for the Kettering Health Network in Dayton, OH, and contributing author to Nurse Residency Program Builder: Tools for a Successful New Graduate Program, offers the following steps to get your started.

What’s the first step?

The first step is support. You need support from above if you want to start a successful program, so make sure you have someone who understands the return on investment who can champion the cause.  

Organizational culture is also important. The culture has to support nursing, education, etc. A culture that features low morale, quality, and job dissatisfaction are significant challenges as they tend to perpetuate themselves from one generation to the next (e.g., preceptors demonstrating poor attitudes and low quality care will result in new graduate nurses with the same behaviors). These issues must be addressed by nursing leadership.

If your organization struggles with low patient satisfaction and high nurse vacancy rates, then employee morale may be poor. It’s important to have a positive culture. A good clinical working environment and a nurse residency program will make employment at your organization highly desirable among new graduate nurses in the area. It takes a village to raise a child. The residency program belongs to the entire organization and its success or failure cannot lie with the program leader alone. [more]

Are you and your team on automatic pilot?

By Wendy Leebov, PhD

A couple of weeks ago, I was running a workshop on The Language of Caring and how to communicate in a way that builds trust and partnership with patients and families. As we worked our way through the seven skills, we reached the part where we examined what I consider to be one of the most important skills for patient-centered communication: “explaining positive intent.” This involves telling the patient (or other customer) how what you’re doing is for their sake. Often, we just engage in our activities with the patient without much explanation. We’re on automatic pilot and not thinking about how the patient or family member perceives what we’re doing. When we do explain, the explanation typically focuses on the activity: “Here’s what I’m doing.” Rarely, do we go beyond saying what we’re doing and articulate the benefit to the person with or on whom we’re doing it.

Thi [more]

Helping new graduate nurses over transition shock: Part 3-The “knowing” stage

Kendra Varner, MSN, RN, nurse residency program coordinator for the Kettering Health Network in Dayton, OH, wrote in the book Nurse Residency Program Builder,  that new nurses go through many experiences as they transition to become competent nurses. In the third part of a three part series, Varner describes the third stage.

Judy Duchscher elaborated on the concept of new graduate nurse shock by describing the transition process as a nonlinear “Process of Becoming” a nurse (Duchscher, 2008). This process has three stages: doing, being, and knowing.

With positive role transition, graduate nurses experience a renewed confidence, sense of calm, purpose, and optimism during the “knowing” stage. Transition recovery may vary from eight to eighteen months (Duchscher, 2008; Williams, 1999). According to Bridges (2009), the new beginning follows “the timing of the mind and heart”. New nurses are still moderately stressed, but able to accept the new role and cope with the responsibilities with new energy. Primary support relationships will shift to nursing colleagues; intimate relationships will crystallize. Comparing themselves with nursing students and more recent graduates, new nurses note their own progress with satisfaction. Emotionally committed to the new reality, graduate nurses may begin working toward personal career goals, as well as explore new opportunities and roles within the organization.