RSSArchive for October, 2017

Excerpt: Dealing with the cyberbully

October is National Bullying Prevention Awareness Month, highlighting the dangers of bullying in all settings. The following is an excerpt from Ending Nurse-to-Nurse Hostility: Why Nurses Eat Their Young and Each Other by Kathleen Bartholomew, RN, MN that explores the dangers of cyberbullying in the nursing unit.

Facebook boasts more than 1.86 billion monthly users worldwide, with more than 40% of Americans logging in every single day. In 2007, Twitter reported 5,000 tweets a day; and in only six years, tweets jumped to more than 400 million. Ten years later in 2017, we tweet 6000 tweets per second. (Zephoria) Without a doubt, we have entered the digital world:

  • Fifteen nurses received letters of warning from their State Board of Nursing after they were reported by their nurse executive for “liking” a derogatory comment that one nurse posted about a husband who was uncaring and unsupportive during childbirth. They did not heed the first warning.
  • A nursing student was dismissed from the program after taking a picture of herself holding an unidentified placenta and proudly commenting how thrilled she was to assist at her first birth.
  • A group of nurses who were friends started a conversation on Facebook which included several disparaging comments about a nurse they didn’t like, as well as remarks on the safety of the organization’s staffing levels.

We talk to each other on online chat rooms in casual conversations that feel so real we forget that no discussion in this virtual world is ever private. Every one of the nurses in the above situations had no idea that they were violating professional ethical guidelines by breaching confidence.

As social networking becomes more integrated into our daily lives, the boundaries between social conduct and professional misconduct are becoming increasingly difficult to navigate.

—Rose Sherman, EdD

While it is generally accepted that we cannot speak about our patients, even anonymously, many nurses do not realize that it is also not professional to speak about a coworker. According to the National Council for the State Board of Nursing policy on Social Media, any online comments posted about a coworker may constitute lateral violence; even if the post is from home during non-work hours. Communication modes for cyberbullying include: instant messaging, email, text messaging, bash boards, social networking sites, chat rooms, blogs, and even Internet gaming.

Nurses often fail to realize that deleting a comment does not erase it. Talking about coworkers is unprofessional and contrary to the standards of honesty and good morals (moral turpitude). Depending on the laws of a jurisdiction, a Board of Nursing may investigate reports of inappropriate disclosures on social media by a nurse on the grounds of:

  • Unprofessional conduct
  • Unethical conduct
  • Moral turpitude
  • Mismanagement of patient records
  • Revealing a privileged communication
  • Breach of confidentiality

Guidelines for nurses victimized by cyberbullying

  • Save all evidence. Copy messages or use the “print screen” function. Use the “save” button on instant messages.
  • First offense: Ask to speak to the person in private and bring a copy of the evidence. Use the D-E-S-C communication model.
    • Describe: “I was on Facebook yesterday and my friend sent me this post because it was about me.”
    • Explain the impact: “I was really surprised because I had no idea that you didn’t like working with me, or that that was the reason you switched weekends.”
    • State what you need: “No one is perfect. Next time could you come to me privately and let me know if you are having any issues so that we can work together to resolve them?”
    • Conclusion: “I am willing to learn how we can be more mutually supportive of each other for the sake of our relationship, our team, and our patients.”
  • Document the conversation and the outcome.
  • Second serious offense: Report to manager (if not serious, try a mediated conversation).
  • Third serious offense: Report to the chief nursing officer.

Manager guidelines

  • Verbalize that no bullying or hostility of any kind will be tolerated, including online.
  • Set the expectation that all staff are responsible for monitoring their virtual world. Don’t assume the parental or vigilante friend role.
  • Educate staff on standards and policies, and provide examples.
    • National Council of State Board of Nursing Guidelines
    • Hospital/organizational policy (including use of hospital computers, cell phones, etc.)
    • Review common myths. Use case studies from NCSBN YouTube.
  • Be supportive of online targets and take derogatory online comments seriously.

 

Source: National Council for the State Board of Nursing: www.ncsbn.org/2930.htm

The 2017 Nursing Salary Report

HCPro recently conducted a survey among 291 nursing professionals in the healthcare industry regarding their work experience, environment, salary, and benefits. The results show that while careers in nursing careers are more varied and higher paid than ever, nurses are working later in their career and the age gap is growing.

A majority of the respondents were over 50 years old with over 10 years of experience. Respondents had a wide variety of education background, job titles, and salaries. While salaries overall are higher than ever, most respondents say that wages have not increased in the past year, and that benefits for many positions are lacking.

Click here to download!

 

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Guidelines for the critique of nursing research articles

The overall goal of a research critique is to evaluate a study’s merits and its applicability to clinical practice. A research critique goes beyond a review or summary of a study, and it carefully appraises a study’s strengths and limitations. By evaluating a study’s component parts, the critique should assess objectively a study’s validity and significance.
Several guidelines for the appraisal of evidence—in the form of meta-analyses, systematic reviews, and clinical practice guidelines—have been published in print and online. In addition to nursing research textbooks, several published guidelines for how to review single research studies can help nurses in their journal club endeavors. The following resources specifically target the critical appraisal of research studies:

  • Critical appraisal tools developed by the Critical Appraisal Skills Program, (suitable for all types of studies) NHS Trust-Public Health Resource Unit. (www.caspinternational.org)
  • Critical appraisal worksheets in the EBM Toolbox, Center for Evidence-Based Medicine at Oxford (www.cebm.net).
  • Users’ Guide to Evidence-Based Practice. Site maintained by the Canadian Centre for Health Evidence (www.cche.net/text/usersguides/therapy.asp). (Originally published in the Journal of the American Medical Asociation.)

The level of discussion at the initial journal club meetings will depend on the facilitator’s knowledge base. Nurses who have completed graduate-level research courses will be able to guide the group so that all questions can be answered and discussed. It may not be possible, however, to have a registered nurse with a master’s degree serve as a facilitator for every journal club. If this is the case in your organization, consider limiting how many journal clubs meet to ensure adequate mentorship. Another choice is to have baccalaureate-prepared nurses serve as facilitators and understand that, in the beginning, certain questions may pose a challenge to the group. In that case, the group should agree to discuss as many of the questions as possible and to skip over questions they find difficult. The facilitator can then follow up with someone who can clarify the difficult areas of the critique. With experience, educational sessions, and mentoring, nurses’ knowledge and confidence levels will continue to increase. Evidence-based practice, like any new skill, takes practice. Journal clubs are a great way to learn the skills necessary to evaluate the evidence and to decide whether it’s applicable to specific practice areas.

Source: Evidence-Based Practice Made Simple