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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.

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The Roots of Peer Review

The following is an excerpt from Nursing Peer Review, Second Edition

Medical staffs have been peer reviewing their cases for decades, and as fellow professionals, we must hold ourselves to the same high standards. Nurses are professionals who must hold each other accountable and evaluate patient care so we can eliminate system and human errors. Nurses are no different than physicians in this way.

 

An early crusader for quality improvement, E. A. Codman helped develop the concept of outcomes management in patient care. He was a proponent of peer review and quality programs for healthcare delivered at the hospital level.

 

Practicing in the early 20th century, Codman was a founder of the American College of Surgeons and its Hospital Standardization Program. Eventually, that program would morph into what we know today as The Joint Commission. His statement from 1916 calling for review and transparency are as relevant today as they were a hundred years ago:
I am called eccentric for saying in public that hospitals, if they wish to be sure of improvement, must find out what their results are, must analyze their results to find their strong and weak points, must compare their results with those of other hospitals, must care for cases that they can care for well and avoid attempting to care for cases which they are not qualified to care for well, must welcome publicity, not only for their successes, but for their errors. Such opinions will not be eccentric a few years hence.

—E. A. Codman, A Study in Hospital Efficiency, 1916

 

Codman would likely be happy to see today that the practice of physicians reviewing the work of other physicians—peer review—is a common practice and is considered to be a crucial element of ensuring that quality medical care is provided to patients.

 

That element is just as crucial in the nursing profession. The major reason for implementing a peer review process is to improve patient care. If nothing else, peer review is the right thing to do to protect the patient from potential harm. It is just a matter of time before external accreditation agencies, the government, and your hospital will require a formal peer review process of nurses.

 

More and more, healthcare organizations are required to be transparent about quality performance metrics. While the information that is publically reported is aggregate data, it is important for the healthcare organization to know person-specific performance data so that they can drive improved patient outcomes.

 

Typically, the outliers or underperformers are a small number of nurses who may not know they are not performing to the standard of care. It is important to give them specific and periodic performance feedback so that they can adjust their care model. Additionally, providing performance data to nurses helps them understand where they rank among their peers. When doing so, it is important to report the data in an anonymous way so that each nurse is uniquely identified using a coding system. This can be useful when metrics are performance based and specific in nature. Transparency is the way of the future, and moving in that direction will help the nursing infrastructure catch up with performance models used by physicians.

 

The goals and benefits of peer review include:

  • Improving the quality of care provided by individual nurses
  • Monitoring the performance of nurses
  • Identifying opportunities for performance improvement
  • Identifying system-wide issues
  • Identifying educational needs of nurses

If the process of peer review is to be effective, then a formal structure must be created to allow for the tracking and trending of information and the identification of potential system or human failures. Case review is useful for this, as it presents opportunities to identify failures through investigation so nurses and other team members can correct them before injury occurs in another patient or patients.

Tips for recommitting to nursing in the new year

The new year is often a time for retrospection and reflection, especially when it comes to your career. If you’re starting to feel burnt out on nursing but not quite ready for a career change, here is some advice to freshen things up in the new year.

  • Reflect on your past: Sometimes the best way to go forward is to look back. What drew you to nursing in the first place? Why was a career in nursing right for you? Think about the positive experiences you’ve had as a nurse that reaffirmed your career goals. Treat your next shift like it’s your first day; what excites you? What makes you nervous? Sometimes asking these questions can reinvigorate how you approach your work.
  • Connect (and disconnect): If you’re feeling down about your job, sometimes the best solution is to ask for help. Reach out to your peers and develop a support system to help yourself and others. If you think there’s something that could make you happier at work, talk to your managers about it; sometimes a small change can have a profound effect.

    It’s also important to let go sometimes. Being a caregiver, interacting with patients at some of the worst times in their lives can negatively impact your outlook and make your job even more difficult. Try to focus on the good you’ve done for patients and don’t take it personally when a patient struggles or suffers.

  • Commit to the new: Even though it doesn’t always feel like it, taking on new challenges can be a great way to energize your career. Seek out new experiences and opportunities; take the frustrations of the day and channel it toward learning a new skill or pursuing additional training options. Reflecting on your weaknesses can be difficult at first, but identifying them and working towards improvement can be satisfying and build you confidence.

    Another great way to embrace the new is working with nursing students or new nurses. They bring energy and enthusiasm to the job, and becoming a preceptor or informal mentor can be a great way to grow your own enthusiasm while furthering your career.

For more articles about avoiding burnout and developing your career, check out the Health & Wellness section of the Strategies for Nurse Managers Reading Room!

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

Rock Your Health: Network or Die!

Are you contemplating having your own business? Check this out!

Did you know that “people need people” and in some cases when people don’t have human contact they can die? Newborns denied physical contact with other humans can actually die from this lack of contact, even when provided with proper nutrition and shelter. Older people who lack social contacts may be at increased risk of death if acute symptoms develop, because there is less of a network of confidantes to prompt medical attention.

Working for yourself is certainly different than having a job working for a boss and being around lots of people all day. There are always opportunities to make connections, be seen and known, and create new opportunities. But when you work for yourself, it is up to you to make those connections happen.

I’m just giving you a reality check in case you are about to embark on starting a business of your own and want to find out how to grow your business and avoid the “kiss of death” that happens to 50% of new businesses.

NETWORKING rules as a business builder and here’s why:

N – new connections are made with new people who may need your services
E – enjoyment happens when you learn about people’s hopes and dreams
T – trust develops when you connect with people on a regular basis
W – wonderful conversations often lead to friendships
O – opportunities arise to find even more people whom you can serve
R – rewards come from being able to help someone improve their life
K – kindred spirits show up the more people you meet
I – intimate conversations can lead to deeper relationships
N – notice what happens when you give the gift of listening to another person
G – great things occur when great people get together

So if you are going into business for yourself, networking with people on a regular basis is critical – but pays off with great rewards. What are your thoughts about this issue?

House calls can benefit patients and cut costs

Two of the lasting images of early healthcare professionals is the doctor with their big bag making house calls and a midwife rushing to a family home to facilitate a birth. As healthcare has advanced, we’ve moved away from this home-based model toward the consolidated approach of the modern hospital. However, some practices have returned to house calls, with some positive results.

Independence at Home, a program created by the Centers for Medicare and Medicaid Services (CMS), seeks to identify patients that would benefit from homecare or cannot be helped in a hospital setting. The project sends mobile interdisciplinary healthcare teams, lead by physicians and nurse practitioner, out to the homes of these patients and provide care.

According to a recent Medscape article, the program reports a few different benefits. The patients receive more attention and care from providers, and the setting can foster trust between patient and provider. Hospitals and nursing homes can be difficult places for many patients, and they would prefer to get treatment in their homes. Terminal patients particularly benefit from this; as one provider notes, hospitals are not where people want to die.

The providers benefit from the more personalized patient relationship as well, but there are also financial incentives for homecare. CMS reports that they saved $25 million by using this system and $11.7 million of that went back to the providers. Because the system targets some of the most expensive Medicare patients, hospitals can save a lot by providing in-home care in this system. In addition to the CMS program, Veterans Affairs Medical Centers report that providing home care for some of their patients cost 12% less than standard care.

Women executives face more criticism than men

There are many hurdles for women pursuing executive roles. Normally a male-dominated field, many women struggle to get the opportunities and resources they need to obtain leadership and executive positions. Unfortunately, things don’t get much easier once they get there, according to a new study.

The Harvard Business Review published a study by the Yale School of Management that investigated gender stereotypes in executive evaluations. The study gave participants a scenario where a police chief misused resources and let a protest get out of hand. In one scenario, the police chief was male, in another the chief was female. The female chief received significantly more criticism than the male; some participants suggested that she get demoted, while none of the participants suggested that for the male chief. This pattern continued: “A decision that backfired led to harsher scrutiny for female leaders.”

The study concluded that women in positions that are traditionally occupied by men—which are often leadership roles, unfortunately—were criticized because they were going against gender stereotypes. For nurse leaders looking to transition to executive positions, this is yet another hurdle to overcome.

For more articles about women in health care, check out some of our articles in the Strategies for Nurse Managers Reading Room:

Women in healthcare want to find a healthy work-life balance

Nurses bring layers of diversity to hospital leadership

Newly promoted leaders need support too

Many companies have clear guidelines for onboarding a new hire; they often have formal training, manuals, and extra resources to help them adjust to their new responsibilities. However, many nurse leaders are promoted from within, and their training path is often less clear. As a new study suggests, the training process for internal promotions is often inadequate, and internal hires require just as much support as external ones.

Michael Watkins wrote in the Harvard Business Review about this issue, and coined the term “inboarding” to describe the process of training internal hires for their new position. About two thirds of the new hires in his study were internal; 70% of them said that their transition was as difficult as joining a new company, and 35% found the transition more difficult. This results in unnecessary failures and difficulties for the organization.

Watkins identifies the lack of support given to inboarding as one of the main reasons for this disparity. So how can an organization make inboarding easier? To start, leaders should adopt a common methodology when approaching new hires. This includes using the same framework and tools for all leadership transitions. Watkins also suggests performing a risk assessment for transitions: identify the potential difficulties (such as relocation, new business divisions, or shifts in work culture) and provide additional support for those risks. This might sound simple, but changing an organization’s culture can be difficult and the first step is identifying that internal hires need the same support as external hires.

Did you receive formal training when you got your first leadership position? Did you feel prepared for your new responsibilities? Let us know in the comments, or take our Strategies for Nurse Managers Poll.

Perspectives on nurse leadership

The responsibilities of nurse leaders are changing rapidly and the role is more fluid than ever. We collected perspectives from several nurse leaders on how nurse leaders can stay effective in the ever-changing world of healthcare.

Jeanine Frumenti, RN, an expert in leadership consulting, posits that the most important aspect of nurse leadership is the ability to create a healthy work environment. “[Nurse Leaders are] always looking at what’s good for the organization, what’s good for their patients, their staff, their team — it’s not about them. And their focus stays on the goal… They’re transformational, giving those around them a voice, encouraging them to share in the decision-making, and owning their work and their practice.” This focus creates a healthy culture, that can allow their staff to flourish and take pride in their work.

Toby Cosgrove, CEO and President at Cleveland Clinic, writes that healthcare leaders need to embrace the quickly changing healthcare environment to remain effective. “Today’s leaders must have a clear vision of the future based on the most fundamental values of the organization. We need to communicate our strategies, achieve consensus, and move quickly to implement change. Innovation is essential, and so is the courage to fail. Most importantly, we must never give up.” Cosgrove agrees that leaders should rely on their staff and create an environment for them to grow: “A leader creates a learning environment that opens all caregivers to new skills and capabilities. Each of us needs to inspire and uplift our teams with a commitment to their professional growth and development.”

Claire Zangerlie, MSN, MBA, RN
, president and CNO for the Visiting Nurse Association in Cleveland, Ohio, argues that this impetus to teach should be applied to patients as well through population health management. As nurse leaders take on more and more responsibility, they will be able to educate “entire populations of patients through workshops and printed materials.” According to Zangerlie and her team, competencies that nurse leaders will need for population health management include: “Effective communication, including excellent negotiation skills; relationship management, including asserting views in nonjudgmental, nonthreatening ways; [and] diversity, including creating an environment that recognizes and values differences in staff, patients, families and providers.”

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Featured webcast: Drug Diversion in Healthcare: Improve Security and Avoid Fines

Phcpro_live_webcast-iconreventing the theft of controlled substances at hospitals continues to be an tremendous issue even with increased security measures. Failed drug diversion programs in hospitals have led to record fines and in the midst of heightened scrutiny over drug security, hospitals must improve their processes to avoid litigation.

On Thursday, April 26 from 1–2:30 p.m. Eastern Time, join us for a live webinar with expert speaker Kimberly New, JD, a nurse, attorney, and consultant who specializes in helping hospitals prevent, detect, and respond to drug diversion.

During this program, New will discuss drug diversion by healthcare personnel and present specific steps facilities can take to minimize the risk of patient harm. She will discuss fundamental components of a diversion prevention, detection, and response program through an overview of the scope of the problem, including case studies. New will also review regulatory standards and best practices relating to controlled substance security and diversion responses. She will additionally provide tips on how to promote a culture in which all employees play a significant role in the deterrence effort.

At the conclusion of this program, participants will be able to:

  • Identify risk factors and signs of employee drug diversion
  • Fully comply with regulatory requirements of the DEA and other accrediting organizations
  • Train staff on how to report suspected abuse and who to report it to
  • Create a culture of accountability and develop an effective drug diversion prevention plan

Don’t miss this opportunity to hear practical advice and have complex regulations simplified in this program suitable for your whole organization. For more information or to order the webcast on demand, call HCPro customer service at 800-650-6787 or visit the HCPro Marketplace.