RSSAuthor Archive for Administrator

This post was compiled by members of the Strategies for Nurse Managers staff.

Connecting technology with nursing education

By Janet M. Phillips, PhDc, RN, Associate Instructor, Indiana University School of Nursing

In February, a colleague and I will be discussing the new technology that is available for nurse educators on an audioconference.

Many of you have likely already started bringing technology into your classrooms, and you might have encountered bumps along the way. What have been some of your difficulties in using technologies in education, and how have you resolved them?

Looking to charts for a few chuckles

Documentation is a serious business. It demonstrates excellent patient care and can be your saving grace when legal issues occasionally rise to the surface. But sometimes, a chart can make you laugh. From entries as bizarre as a patient refusing an autopsy to a woman being numb from her toes down, you can find some funny stuff on a chart. A friend sent us this list of 25 gut-busters and we had to pass them along. Enjoy.

And, in case you were wondering, these were (allegedly!) taken from actual hospital charts.

1. The patient refused autopsy.
2. The patient has no previous history of suicides.
3. Patient has left white blood cells at another hospital.
4. She has no rigors or shaking chills, but her husband states she was very hot in bed last night.
5. Patient has chest pain if she lies on her left side for over a year.
6. On the second day the knee was better and on the third day it disappeared.
7. The patient is tearful and crying constantly. She also appears to be depressed.
8. The patient has been depressed since she began seeing me in 1993.
9. Discharge status: Alive but without permission.
10. Healthy appearing decrepit 69-year-old male, mentally alert but forgetful.
11. Patient had waffles for breakfast and anorexia for lunch.
12. She is numb from her toes down.
13. While in ER, she was examined, x-rated, and sent home.
14. The skin was moist and dry.
15. Occasional, constant infrequent headaches.
16. Patient was alert and unresponsive.
17. Rectal examination revealed a normal size thyroid.
18. She stated that she had been constipated for most of her life, until she got a divorce.
19. I saw your patient today, who is still under our car for physical therapy.
20. Both breasts are equal and reactive to light and accommodation.
21. Examination of genitalia reveals that he is circus sized.
22. The lab test indicated abnormal lover function.
23. Skin: somewhat pale but present.
24. The pelvic exam will be done later on the floor.
25. Patient has two teenage children, but no other abnormalities.

Are there any others you’ve stumbled upon during your time as a nurse? Feel free to add your own comment–and share the laughter.

Create a nurturing nursing environment

By Rosa Belgard, MS, RN, Presbyterian Hospital of Dallas

The challenge of retaining the best nurses at the bedside is universal in the nursing profession, so it is crucial to offer nurses an environment where they can gain new skills, contribute to improving patient care, and feel like their job makes a difference. If you offer such an environment, nurses will not only stay, they will prosper and flourish.

Choosing and developing an environment where bedside nurses are held in high esteem, receive frequent recognition, and are compensated appropriately must be an individual process every healthcare organization, and the biggest challenge is developing an environment that meets your needs.

How are you working on creating this environment for your nurses? What are your biggest challenges in developing, maintaining, and supporting a clinical ladder or career advancement program? How have you addressed these challenges?

Give your nurses a holiday e-card

In search of a simple way to let someone know you are thinking about them this holiday season? Just want to give a quick “thank-you” for all the hard work they do?

Here’s a quick and easy way to do it: Send some fellow nurses a holiday card here.

Make a necklace of conscious moments

by Diana Lang, relaxation expert

I like to think of life’s momentous experiences like beads on a string. Those moments that are important, valuable, or rare are like beautiful colored beads that we lovingly thread onto this string of beads. Each bead symbolically represents a moment, an experience, a special person. As life goes on, a gorgeous necklace of our lives is created, full of these moments that have meant something to us.

This little metaphor is a way to imagine making our lives more conscious. By recognizing these moments more often, we become more fully alive to our experience. It is easy to see how a marriage or a birth of a child would be a bead on our string, but what about today? What about right now?

One of the ways I make my moments conscious is by using my breath. When I awake in the morning or go to sleep at night, I take a conscious breath. In between daily rituals like my morning tea or meditation, or taking a walk or going to the grocery store, I take a breath to establish myself in the place where I am.

This is one of the most valuable tools I have. I use it all day long. Between every client and every class, between every activity in my day, I take a conscious breath. These aware moments then are indelibly written in my consciousness. They become part of me. They are beads on my string.

A conscious breath is a physical/spiritual acknowledgement of the moment. My inhalation and exhalation establish me in the new moment I am in. When we use the breath like this, life becomes a living meditation, seamlessly connecting the dots of our experience, one to another, like beads on a string, and soon we have a collection of moments that is an acknowledgment that this life, and everything in it, is sacred.

Breathe your life in deeply. Live your life completely. Recognize that this moment, right now, is special and add it to your life’s string of magical moments.

For more information on Diana, visit her Web site at

Your job is a job–not your life

by Pat Maguire, RN, MN, CNAA

It’s the time of year when everything has a tendency to get chaotic–either the budget year is ending and you are worried about your final numbers, or you are putting the final touches on next year’s financial plan and are concerned that your requests may not be approved. The newly licensed nurses are nearing the end of orientation and some feel they aren’t competent to fly solo. One of your expert nurses is contemplating a transfer to a critical care unit and someone who behaves like “poor pitiful Pearl” most of the time has been in your face one more time about her seniority and expectation that she will be off Christmas and New Year’s Eve and day.

You’ve only held your position for a year or two and the stress of the 24-hour accountability and responsibility is starting to take its toll. Where do you turn for support? How do you manage the daily conflicts that tend to pop up regardless of the effort you put into modeling collaboration and teamwork?

Several years ago, a wise colleague who’d seen it all helped me through a particularly tough time. She asked me if I knew what my trigger points were. What made me vulnerable to a self created “pity party?” What part of the chaos did I own? Was I willing to step up to the plate just as I expected my staff to? Wow, those are pretty intense questions, especially if you are willing and able to do some soul searching before you flip back into high gear and try to solve world hunger.

What was the last novel or mystery book you read? What about your friends and family, when did you do something fun with them? Have you had any “retail therapy” lately? How about professional publications–either clinically focused journals or management texts–do you have a favorite? There are so many that offer a world of insight about your team and more importantly, about you and your style. I have found three publications to be most useful:

  • Michael Henry Cohen’s What You Accept Is What You Teach
  • Jim Collin’s Good To Great
  • Carly Fiorina’s Tough Choices

I pick one up whenever I’m down and learn something new about myself each and every time.

Commit to lifelong learning. And at the end of every day, pause and think about the things you did that made a difference for your patients, your staff, and your colleagues. Keep a journal and for heaven sake, don’t be critical and say, “I didn’t do anything.” You and I both know that isn’t true. Above all, be true to yourself. Don’t compromise your values. Know who and what your resources are so you can seek them out whenever the need presents.

The bottom line is make time for yourself every week–both personally and professionally. And never forget, your position is intended to be your job–not your life.

Self-Care 101 for Nurses

by June Marshall, RN, MS, CNAA, BC

Most of us are really good at taking care of others. We’re also great at giving advice about maintaining healthy balance in our personal and professional lives, but how good are we at walking the talk? I dare to say that as nurse leaders, most of us do not practice what we preach.

Employees look to us as role models. It’s tough to mentor nursing staff in the area of healthy work/life balance if we don’t have balance in our own lives. Have you put off exercising regularly because of an impending deadline or because you’re simply too tired after long hours at work? Do you eat at least five servings of fruit and vegetables daily? Do you drink at least 6-8 glasses of water each day? Do you take some time each day to relax and do something you really enjoy? Do you get enough uninterrupted sleep at night? Do you often feel tired? Just think about what kind of role model you are.

How healthy are our work environments? Direct patient care is physically demanding and psychologically stressful. Do we offer adequate time for nurses to have rest periods at work? Do we provide the same healing environments for nurses that we provide for patients? How good are we at providing flexible work schedules to accommodate needs of mature nurses who have difficulty still working 12-hour shifts? How creative are we in offering employee wellness programs where direct care nurses can actually participate?

Take a few moments to assess your unit or department. Have a discussion about self care at your next staff meeting. Make self care a priority. Ask for staff input and develop an action plan. Then implement it and evaluate your progress. Make self care and the care of your staff a priority. Try a few simple actions to improve the care of your unit/department:

  • Use humor. Find something to laugh about with your staff each day.
  • Assess the mature nurses’ needs and create flexible scheduling options for them.
  • Designate a quiet place where nurses can go to relax and get away from the stresses of work for a few minutes.
  • Have a massage therapist come to the unit to give short massages once a month.
  • Limit work hours. Avoid overtime except in a crisis. Take vacation time!
  • Look for the positives each day. Recognize staff accomplishments. Focus on praise rather than problems.

And last, but certainly not least, practice what you preach!