HCPro has celebrated nurses all week long with special giveaways, prizes, and promotions.
We are giving away an exclusive excerpt from the brand-new edition of Ending Nurse-to-Nurse Hostility!
In this excerpt, Kathleen Bartholomew, RN, MN, is shining a light on horizontal hostility in nursing school. Read about the effect of horizontal hostility and bullying in nursing school and the positive ways nursing students can be supported and mentored as they begin their nursing career.
Plus you can also enter to win a free copy of the book!
We are giving away five copies of Ending Nurse-to-Nurse Hostility. Be among the first to read the newly updated book from nursing communication expert Kathleen Bartholomew, RN, MN.
Almost 50% of former nurses cite horizontal hostility as their reason for leaving the profession. Beat the statistics! Read this groundbreaking book and discover all-new strategies and solutions to improve the nursing culture at your organization.
Last month, I posted about the ways that technology could improve patients’ communication with nurses but could also place a greater burden on nurses for round-the-clock care and feedback. To get a feel for how often nurses used technology and social media to interact with patients, we posted a poll on StrategiesForNurseManagers.com asking nurses and other healthcare professionals to weigh in.
Approximately three-quarters (74%) of those who participated in the poll responded that they did not use social networking sites such as Twitter, Facebook, or LinkedIn to interact with patients, while the remaining 26% replied that they do use those technologies for patient interaction.
While these results indicate that social networking sites have not become a place for healthcare communications, I still wonder whether nurses and other practitioners use other forms of technology, such as emails, listervs, or websites, to share information with patients and respond to questions about treatment plans. As mentioned previously, these resources have the potential to improve patient care, but they must be leveraged appropriately.
How do you communicate and follow up with patients outside of their scheduled appointment times? Leave a comment below!
American Medical News released a story last month highlighting four ways that social media can be used to improve a medical practice. By now, many people in the healthcare industry recognize that social media can be a powerful tool for communicating with patients, albeit a tool that can have terrible consequences when used incorrectly. The article from American Medical News focuses its attention on social media as a business intelligence resource and customer service tool, as well as a means for reporting to move toward improved care and outcomes. Although the article is primarily focused on how physicians can use social media, the principles discussed can be applied by any leaders within a healthcare organization.
One of the main topics of discussion in the article is using social media to gain insight into what services patients are seeking and what obstacles patients are facing. By identifying health trends and reacting with targeted programs and informational posts, healthcare leaders can use social media to address patient needs quickly and effectively.
Similarly, social media can be a platform for addressing complaints, negative comments, and feedback from patients. Practitioners should exercise caution in keeping specific details about patients offline and out of the public sphere, but can nonetheless use social media channels to provide an apology and offer to correct a situation. Ideally, the disgruntled patient feels as though his or her complaints are being addressed in a timely manner, while other patients see that customer service is a priority for the organization.
Given the ubiquity of social media in most patients’ lives, as well as the nearly non-existent cost of creating and maintaining social media sites, using these resources makes sense for any organization looking to improve patient engagement and interaction. As for any business, developing and implementing an effective social media initiative for a healthcare organization requires careful planning, proper management, and constant monitoring and maintenance. But the benefits of improving overall quality and patient satisfaction could make social media engagement well worth the effort.
What are your thoughts on social media as a tool for healthcare organizations? Does your organization use social media in the ways described here? Leave a comment and share your thoughts!
Hospital chief Sandra Coletta is making waves throughout the healthcare community after being frank with her audience of hundreds at the 10th annual dinner of Medically Induced Trauma Support Services (MITSS), a widely respected group that aims to support patients, families, and staffs after things go medically wrong.
She spoke about the death of James Woods’ brother in the emergency department at Kent Hospital in Warwick, RI, after orders were not carried out in a timely manner.
“Quite honestly, I did nothing other than what my mother taught me,” Coletta said of apologizing.
James Woods and the hospital settled the suit, in the process created a foundation, the Michael J. Woods Institute, in honor of his brother. The institute aims to recreate healthcare from a human factors perspective.
Similar action was taken after Dennis Quaid’s twins were put in peril because of a medication administration mistake. (According to an April 2010 USA Today story, Quaid said Cedars-Sinai hospital in LA “stepped up to the plate and spent millions of dollars on bedside bar codes.” He and his wife also created the Quaid Foundation, which has merged with the Texas Medical Institute of Technology.) Do you think these cases are addressed more swiftly, and more apologetically, because of their high-profile nature? Or do you think the tides are turning?
Of course, Sorrel King, without being famous (at least then), spurred plenty of action on her own. But are hospitals finally reacting with action and apologies, even without fame and publicity?
First published on Patient Safety Monitor Blog.
Be prepared for errors and develop a culture where near misses are reported—and learned from—with the best practices presented in the 90-minute audio conference Learn From Errors and Near Misses with a Just Culture: Stop Punishing Nurses for Mistakes. Experts Cole Edmonson, DNP, RN, FACHE, NEA-BC, and Lucy Bird, RN, ONC, live the Just Culture experience every day and will demonstrate what to do when the worst happens to support clinicians, learn from mistakes, and build a culture of accountability and high-reliability.
Find answers to all your questions about improving patient safety and increasing nurse satisfaction by building a Just Culture in your facility.
For more information or to order, call 800/650-6787 and mention Source Code EZINEADp1 or visit the HCPro Healthcare Marketplace.
Enter HCPro’s nurse leader contest and share best practices with your peers!
How do you deal with horizontal hostility among your employees? Do you have one staff nurse who makes the unit toxic every time he or she is on the floor? Or a clique who spreads gossip and makes others feel uncomfortable? Share your advice, best practices, and stories on this topic for the chance to win a free book.
The rules: To enter, simply share a recent success story, advice, or policy that has helped your unit become a healthy work environment. The sky is the limit—as long as your entry somehow helped implement positive change, it qualifies! If you are sending a sample policy or tool, please include a short paragraph explaining the goal of the sample.
The prize: The winner, chosen at random from all entries, will receive their choice of one of HCPro’s training resources for nurse managers:
- Lead! Becoming an Effective Coach and Mentor to Your Nursing Staff
- Accountability in Nursing: Six Strategies to Build and Maintain a Culture of Commitment
- Nurse Retention Toolkit: Everyday Ways to Recognize and Reward Nurses
The deadline: We will draw our winner at the end of the business day on Friday, September 16, 2011, and announce the winner in the Monday, September 26 edition of Nurse Leader Weekly.
The best entries will be posted individually on The Leaders’ Lounge Blog.
Please send contest entries to email@example.com. If you have any questions about the contest itself, please feel free to contact me any time.
A live, free, 60-minute webcast, A Conversation with Kathleen Bartholomew: End Bullying and Toxic Behavior Once and For All, is being offered by HCPro Tuesday, October 4, 2011, 1:00-2:00 p.m. (Eastern).
Bartholomew is a visionary nurse leader who dared to ask the question: How can a profession that is based on caring include such uncaring behaviors? Her research exposes the toxic relationships and bullying behavior that cause nurse burnout and threaten patient safety.
During the presentation Bartholomew will share her experiences through true stories about the struggles she has faced and overcome and give listeners the tools and strategies to end disruptive behavior once and for all.
Due to the inspirational nature of this program, HCPro is placing no limits on who can attend. Invite your staff, friends, or colleagues. Forward information to a friend now.
A new proposed rule by the Centers for Medicare & Medicaid Services (CMS) would allow the use of Medicare and private sector claims data to produce public reports that evaluate the performance of physicians, other healthcare providers, and suppliers. Organizations seeking such Medicare information would have to undergo an application process and be continually monitored by CMS.
The proposed rule requires that any reports generated from the Medicare data be shared confidentially with providers and suppliers before being released to the public in order to prevent mistakes. Publicly released reports would contain aggregated information only, meaning that no individual patient/beneficiary data.
“Performance reports that include Medicare data will result in higher quality and more cost effective care,” CMS administrator Donald M. Berwick, MD, said in a statement.
The proposed rule will be published in the Federal Register on June 8, and the CMS will accept public comments for 60 days. Until June 8 the proposed rule is available here.
For further analysis, visit HealthLeaders Media.
by Wendy Leebov, Ed.D.
“I work days and try to have everything ready when the doctors come in (labs in charts, vitals done, etc.). But they are immediately demanding everything at once, not giving me a minute to collect my thoughts and focus on the patient in question. Then, they treat me like I’m stupid when I don’t give the answers almost before they ask the question!”
Alan Rosenstein did a revealing study about nurse-physician relationships.
A few findings that struck me:
- More than 92% of nurses had witnessed disrespectful and/or disruptive behavior by physicians. The most common behaviors cited include yelling, raising the voice, condescension, berating colleagues, berating patients, and use of abusive language.
- Common generalizations about abusive behavior on the part of physicians make it seem as if most physicians are “abusive.” However, in Rosenstein’s study, nurses clarify that very few physicians are abusive. The vast majority are not. I think that’s VERY important to remember.
Still, the instances of abuse stick in the craw of not only the people on the receiving end, but also on people who witness it. So, it’s important to address this behavior, so that it doesn’t erode morale, teamwork and patient outcomes. Of course, that’s not so easy, because many caregivers feel intimidated about speaking up to stop respectful or abusive behavior because of fear of retaliation, lack of assertiveness, and/or a sense of hopelessness that the person’s behavior will ever change.
What to Do?
There’s a lot an organization can do, and should do, such as:
- Commit to and make explicit a code of conduct and link it to your vision, values and standards. Highlight the impact of teamwork, collaboration and communication on quality, patient satisfaction, risk reduction, safety, and outcomes.
- Zero tolerance. Institute and enforce a zero tolerance policy about coworker disrespect.
- Adopt a “respect” signal. Decide on something anyone can say when they witness inappropriate behavior—a signal that means “You have crossed the line.” Stopped in their tracks, many people become more aware of their behavior and more accountable for it. My favorite signals:
o “Time out.”
o “How about a cup of coffee?”
- Physician-nurse rounding. Have physicians and nurses round on patients together and provide training to support effective communication during these rounds.
- Provide personal coaches for individuals who behave in an outrageous way.
- Adopt-a-Doc: Have nurses each adopt a physician with whom they will deliberately build a positive relationship and for whom they will act as an advocate.
- Provide assertiveness training for nurses! This is critical!
- Discussion forums: Provide forums in which physicians and nurses talk to each other!
BUT, while the organization can work to reduce abusive or disrespectful behavior between nurses and physicians and among colleagues in general, in my view it is essential that the individual who perceives the behavior takes responsibility to address and handle it effectively, one situation and one person at a time.
What can the individual do?
In one of my roles years ago, I was in a position to field physician frustrations every day. My friends called me the LIVER of the organization, because so many toxins flowed through me. In my early years, in the face of a hostile physician, I would get defensive or cower. Both approaches seemed to increase the behavior I was hoping to eliminate. Then, after spending about $5 million on therapy, I learned other MUCH more effective techniques, and I have had a less stressful life ever since, because these techniques WORK.
Tips from my experience:
- Alter your own inner monologue. These are the statements you say to yourself. Look within: What do you say to yourself when someone is abusive to you? “This jerk! How awful! Poor me! I hate this! I don’t deserve this!” If your inner talk makes you angrier or more defensive, change it. You CAN decide to think something different, such as, “This is not about me,” “I deserve respect,” “I don’t have to react,” “I can stay calm and help this person,” “I can take the high road here.”
- Don’t respond in kind. It’s human nature to want to strike back when attacked. Resist. Handle the inappropriate behavior respectfully. Stay on the high road, since this will make you most effective and also enable you to feel good about yourself at the end of the day. CALMLY SAY, “What is happening is not okay.”
- Give direct feedback without anger. “I saw you do this….” or, “I don’t appreciate your tone,” “I would appreciate your keeping your voice down,” “When you belittle me in front of our patients, I resent it and it makes it hard for me to support you.”
- When someone is verbally attacking, instead of getting defensive, make explicit your positive intent. Instead of saying, “WHOA! Hold it a minute” say, “You know, I really want to help you.” Then if they persist, say that over and over in a sincere tone, “As I said, I really DO want to help you.” And then wait until they have vented enough to allow them to calm down and address the facts of the situation with you.
- Use the caring broken record. In the face of persistent disrespect, repeat your bottom line message each time with caring. “I hear how frustrated you are, and I really want to support you,” “I realize you’re under extreme pressure, and I really do want to provide the support you need,” “I’m sorry this isn’t what you wanted. I really do want to help.”
- If the abuse continues, remove yourself from the situation. “I’m hanging up now. Please call me back when you’re ready to talk with me in a respectful way about this. I really do want to help you.”
- “There you go again.” If you’ve addressed the behavior over and over and it still hasn’t changed, when it happens next, say very calmly, “There you go again. I want to discuss this with you when we can both be respectful.” And do that EVERY time it happens again.
And with your TEAM:
Talk about the elephant in the room. Work together with your team to identify great ways to respond to the disrespectful or inappropriate behavior you handle most often. I’ve provided a worksheet to guide your discussions. You can be sure you’re not alone. So, the activity will help everybody.
Healthcare environments are inherently stressful and it’s upsetting to think about the times when colleagues add to this stress instead of relieving it. To be effective and to do your part in altering an atmosphere of disrespect, it takes courage and caring — backbone and heart.
For helpful resources about handling disrespectful behavior, click here.
A new study by the Beryl Institute, an organization that promotes better patient experiences within the healthcare system, finds that although patient experience is among the top three priorities for hospital executives, patient experience itself is still largely undefined.
The study surveyed more than 790 hospital executives and found that patient experience/patient satisfaction was ranked number two at 21%. Quality/patient safety (31%) was the number one priority, and cost reduction was ranked number three at 9%.
Despite its importance, the majority of hospital executives (73 percent) surveyed said they do not have a formal definition for patient experience. As a result, they are purposefully addressing the issue by examining the state of the patient experience in the nation’s hospitals and identifying the greatest roadblocks to implementing change, with the top three priorities being noise reduction, discharge process and instructions, and patient rounding.
Despite the challenges around the issue of patient experience, nearly 61% felt positive or very positive about their progress in addressing the issue. Forty-two percent of respondents said the most common structure for improving patient experience is a small committee that meets at their facility on a monthly basis.
Hospitals are also turning towards interactive technology to communicate with patients, according to the Beryl Institute’s latest white paper. A study based on six hospitals using technology from San Diego-based Skylight Healthcare Systems, and using scores from industry-standard Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPS), showed that patient interactive systems has increased patient satisfaction scores by about 10%. Hospital educational materials and courses have increased patient satisfaction by as much as 42%.
Click here to visit the Beryl Institute website and read more information on the patient experience.
Source: Healthcare Finance News