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Privacy and social media in the nursing unit

We all consider our privacy to be sacrosanct, a cocoon in which we wrap ourselves to feel safe and in control. We value our personal space and believe that others have an obligation to respect our wishes in regard to what is commonly known and what we wish to keep private.

Your role as a manager means you have become the “Privacy Police.” It is your job to protect the privacy of your staff, the hospital, your patients, and yourself. This juggling act is made more difficult by the fact that privacy is a very fragile commodity these days, and we have far less influence than we had previously thought. Large leaks of personal data in the online environment have made privacy a matter of public commentary and personal challenge.

The word “privacy” has been part of our lives back to our earliest moments of awareness, when we were told that “some things are private” or “do not talk about that at school; it is private.” However, as we swept into the 21st century, the term “privacy” began to take on a new meaning or perhaps to lose its meaning entirely. Invasive social media and the unrelenting celebrity-chasing paparazzi have somewhat neutralized the concept of privacy, making it largely a word with diminishing relevance in today’s world. Yet, on your unit, the idea of privacy remains important and fundamental to your staff and patients.

We consider privacy to be freedom from unwanted invasive scrutiny. Young people today hear about hacking and high-level release of private information, and they accept it as a natural part of life. Privacy has become relative to the degree of interest in your business and your ability to keep others out of it. Your young nurses were raised in a world calling for more transparency with decreasing value on personal privacy; these are often the values they bring to your unit when they are hired.

As a manager, you are faced with a boatload of privacy rules and regulations that fall to you for enforcement. You must ensure that your unit protocols are protecting personal health information largely driven by the Health Insurance Portability and Accountability Act of 1996 (HIPAA; U.S Department of Health and Human Services, 2015). HIPAA applies to all healthcare personnel and providers. Your manager role means you must ensure your nursing staff understands and complies with rules about documentation, photography, telephone release of information, and the media’s need to know.

You can help your staff understand release of patient information, for example, by identifying who is nonessential and who is on a “need-to-know” basis. Make sure they understand the boundaries and then ensure that they adhere.

You also need to help Boomers grasp how social media really works. Many of them get on sites in order to keep up with younger family members. They may not understand the insidious seepage of information based on the link provided by these sites. Your younger nurses might provide information to the more senior members, helping them understand the full impact of such platforms as Facebook, Twitter, and others. But do not assume that everyone just naturally knows the privacy limitations on your unit; annual review of current privacy standards is a good time to emphasize how this information helps protect the hospital as well as the individual nurse from legal repercussions.

Frank, open conversations about the right to privacy can move it from a gray area for social media followers into a priority for all activities on the unit.

Source: Managing the Intergenerational Nursing Team

Nurses file for collective action over lunchbreak dispute

Nurses at Methodist Health claim that the hospital docks lunch pay for breaks they aren’t able to take.

Robert Straka, a nurse at Methodist Health in Dallas, filed a collective action lawsuit in August against his employer. The issue in question is the hospital policy that dictates that nurses should be allotted 30 minutes every shift to take an uninterrupted break. He argues that nurses are still expected to care for patients during their break, and would often get pulled away to perform duties. Straka filed on behalf of almost one thousand nurses across Methodist’s five facilities.

Meanwhile, Methodist argues that this is not the case, and questioned the plaintiff’s interpretation of the rules. They’ve requested that the charges be dropped in a response sent last week. The judge in the case has mandated that each party meet and produce a report next month, that would outline settlement options and hopefully come to a resolution.

Do you get a dedicated lunch break in your hospital? Send me an email at kmichek@hcpro.com and I’ll share the results (anonymous, of course) with your colleagues.
Read more here.

Allina nurses go back on strike

Allina nurses enter their second month of striking after voting “No” the most recent contract proposal.

The nurses at Allina Health hospitals in Minnesota began contract discussions in February, and eight months later, Allina and the nurses have yet to settle on an offer. Allina Health’s 4000 nurses walked out for a week in June to start negotiations, and have been striking since Labor Day.

The dispute started when Allina wanted to eliminate the nurses’ union-backed health plans, with high premiums but low deductibles, and replace them with their corporate plan, saving the company $10 million per year. Both sides have agreed to move all nurses by 2020, but the nurses want input on the plans to ensure they get quality healthcare.

Allina made a new contract offer on Monday, and the nurses voted to reject this latest offer and continue the strike. The Minnesota Nurses Association reports that the offer was largely the same that they rejected in August, while Allina insists that their offer was fair and addressed many of the concerns raised by the unions.

This is set to become the longest strike in state history, and the Star Tribune reports that the strikes have cost Allina more than $40 million dollars so far.

For more information about nurse labor disputes, check out these articles from the Strategies for Nurse Managers’ Reading Room:

Ask the Experts: Nurses strikes

Why do nurses join unions? Because they can

A Simple Interprofessional Accountability Technique

Listening, validating and asking for a commitment

From Team-Building Handbook: Accountability Strategies for Nurses, by Eileen Lavin Dohmann, RN, MBA, NEA-BC

accountability scenario

When working with a group, I assume that people are rational and logical.

So, if I want them to do something, I just need to explain it and they’ll do it. When I don’t get the results I am seeking, I tend to think “Oh, I must not be explaining it well. Let me try it again.”

It’s taken me a long time to realize that what I was hearing as “not understanding me” was often someone’s polite way of telling me no. So, now when I find myself explaining the same thing to someone for the third time, I stop and ask the person what he or she is hearing me request. If I can validate that the person is hearing me correctly, I ask for the commitment: yes or no.

Validating… and asking for a yes or no

We can hold ourselves accountable, but holding other people accountable can be much more difficult. Consider this nurse-physician scenario and ask yourself [more]

Free Download: Job Description Update Confirmation

As promised, you can now download the very practical and simple tool  I mentioned in last week’s post (Not My Job: The legal perspective on updating job descriptions). I’ve created a Word file of the standard job description update letter, which you’ll find here. Don’t let its simplicity fool you; this is useful tool for legal risk reduction.

downloadicon2About the Word file: You can customize it to include your organization’s logo, address, and such. Use it as a simple way to document that your staff members understand changes in responsibilities and duties included in their job descriptions.

When you incorporate new practices or adapt to new standards that are reflected in updated job descriptions, you’ll simply ask each staff member to sign the letter acknowledging and committing to adhere to the revised job description, and place a copy in each employee’s file.

Many thanks to Dinah Brothers for this tool…


Dinah Brothers, RN, JD, is the author of The Essential Legal Handbook for Nurses (just released), sold as a set of 10 handbooks for staff nurses,  and The Nurse Manager’s Legal Companion (release: July 2015), a book offering nurse managers guidance on everything from employment law to dealing with whistleblowers and everything in between.

Accountability looks good on you (and your staff)

I learn from every book I work on, but this latest one on accountability strategies really hit home. I now realize that when I say “I’ll try” to do something by a particular date, I haven’t truly committed to being accountable for the deadline. And when I hear the same words from someone else, I no longer take “I’ll try” to mean the commitment all managers want to hear from an engaged staff: the definitive YES.

I’ll try is what I say when I don’t really see how I’ll be able to I'll Trymake the commitment, but don’t stop to think about what’s in the way. Do I lack the resources, the bandwidth, or (worse) the interest? Am I just allergic to saying a simple “no” when I can’t squeeze the proverbial 10 pounds of sugar into a five pound bag?

As a manager whose goal is positive outcomes from an engaged staff, you need to train your ear to “hear” the difference between words that indicate accountability and those that fall short. Your staff can do the same, and when you’re all hearing and speaking the language of accountability, good things will happen.

 

accountability book and handbook togetherTo find out more about building accountability in your staff, go to the web page for the team-training handbook, Team-Building Handbook: Accountability Strategies for Nurses. For ideas on how to develop a culture of accountability starting with yourself, visit the web page for Accountability in Nursing: Six Strategies to Build and Maintain a Culture of Commitment.

Both are from Eileen Lavin Dohmann, MBA, BSN, RN, NEA-BC,  the Senior Vice President and Chief Nursing Officer of Mary Washington Healthcare in Fredericksburg, Virginia.

What am I doing here? Tips for being accountable in meetings

We’ve all been in meetings where everyone nodded and appeared to agree to something, but a few months later, nothing had changed. Why does that happen?

Because all they’ve agreed to is that they’ve come up with a good idea.

No one committed to a specific plan to make that good idea happen. The meeting organizer most likely didn’t set proper expectations and didn’t ask for specific, measurable commitments. The people attended the meeting, but didn’t have enough context to actively participate. They didn’t have the tools to make a commitment to action, and to hold themselves accountable for real results in a few weeks or a few months.

Great meetings that result in action, improvement, or resolutions are a joy to attend.

The next time you’re invited to a meeting, follow these suggestions so you’re prepared to be engaged and contribute rather than sitting for an hour as a passive participant. If the invitation didn’t explain the purpose of the meeting, if it included only a sketchy agenda, or if it didn’t include one at all, ask the organizer the questions in the following table prior to or early in the meeting.

Meeting questionsAgreeing to a good idea
just isn’t good enough.

Try using these questions to create a structure for great meetings that result in a better understanding, clarity of purpose, and positive outcomes.

 

 

 

 

Note: I’ll have the table as a download for you in a few days. Look for a link in a future blog post to share the tips with your colleagues!


Excerpted from Team-Building Handbook: Accountability Strategies for Nurses and Accountability in Nursing, both by Eileen Lavin Dohmann, RN, MBA, NEA-BC, and published by HCPro.

Nurses Week: Your 20% sneak peek savings

HCPro is celebrating and recognizing nurses all week long with special giveaways, prizes, and promotions, but we don’t want to wait until Wednesday to start the celebration!

Starting today, you can use our special Nurses Week 2015 catalog coverdiscount code to save on any and all nursing books, videos, and webinars… Just use discount code NRSWK2015 at checkout to receive 20% off your selections.

Download and browse our 2015 catalogue of resources for nurse leaders and staff development professionals here, and visit hcmarketplace.com to place your order!

 

 

 

 

——OTHER RECENT POSTS——

⇒ 5/4: Who inspires you? There’s still time to submit your favorite quotes in posted comments, here.

⇒ 5/6: A thank you to our favorite nurses, from Boston. Here’s the post.

Don’t Disclose: Peer review confidentiality guidelines download

confidential Recently, I posted an overview of the key confidentiality requirements for
members of the peer review committee. At long last, you can download a copy
of Don’t Disclose here, for the case review committee members in your organization.

Last week’s peer review webcast (presented by Laura Harrington and Marla Smith) was followed by a lively question and answer period. Topics ranged from the meaning of “timely” in terms of completing a review* to the virtues of including a section in your scoring that considers “contributing factors”** … and much more.

You can learn more about the on demand version of the webinar here and the presenters’ nursing peer review book here.

 

 

  * Answer: <90 days

** Answer: Be flexible. If you want to include special factors in scoring, it may help identify process issues to address proactively separate from the review

Reminder: Nursing Peer Review Webcast

Just a few more days left until our Nursing Peer Review webcast, NPR2cloud3afeaturing nursing peer review experts Laura Harrington, RN, BSN, MHA, CPHQ, CPCQM, and Marla Smith, MHSA. These authors of the HCPro book Nursing Peer Review, Second Edition: A Practical, Nonpunitive Approach to Case Review, will pack a 90-minute webcast with answers to these questions, and more:

How do you actually do nursing case review? How do you deal
with the outcomes? And how can you use case review to monitor performance and track and trend data? And what are the core requirements for confidentiality? (See below for Don’t Disclose,
a cheat sheet of guidelines, and look for a notice soon for download instructions.)

Developing a structure to support nursing case review is just the first step. Join us on Thursday, April 16, 2015 at 1–2:30 p.m. Eastern to explore the practical requirements of implementing this important process. To register, click here.

Don't Disclose-Peer Review