All Entries Tagged With: "nurse burnout"
Kathleen Bartholomew, RN, MN, answers questions about ending nurse-to-nurse hostility
Kathleen Bartholomew, RN, MN, dared to ask the question, how can a profession that is based on caring include such uncaring behaviors? Her powerful research exposes the toxic relationships and bullying behavior that causes nurse burnout and threatens patient safety. Here’s a question and answer session where she offers practical advice to real-life problems.
Q: It’s often easy to point out the shortcomings in others. What do you do for people to help recognize and overcome their own bad behaviors?
A: Peer evaluations are effective, but a critical conversation is the most powerful tool both peers and managers have. I ask, “What do you do well?” “What would you like to do better and how can I help?”
Q: What is the most important thing we as nurses can do to turn around toxic work environments that are deeply rooted in bullying and disrespectful behaviors?
A: SAY WHAT YOU SEE. Your voice is your power. These behaviors will be NORMAL until someone stands up and says, “Hey, this is impacting the patients and morale. This needs to stop.”
Q: Any suggestions on how to handle shift-to-shift complaining and bullying?
A: I know this one is hard. When I was a manager, no amount of teaching or counseling could change the shift-to-shift so I asked the nurses to switch shifts for a week. Then I never heard another word. The “walk in their shoes” experiment also worked for nurses complaining some floors were easier. Next, I worked closely with the charge nurses and gave them the knowledge, skills, and confidence to stop these behaviors when they saw them (that took almost two years).
Q: Have you actually seen the “turnaround” of a bully in the workplace work other than dismissal of that employee? Isn’t the bully in a person part of their personality trait?
A: Great question. Personally, it’s been 50/50 in my experience. And if you are a leader/manager and start drawing the line, there is a high chance of the bully going on FMLA/being injured etc. It takes a lot of people skills to turn them around because if they are not going to be the bully, then who are they? How do you create an alternative role for this nurse in the unit? Also, don’t think of a bully as an individual problem. It’s the unit’s problem because many nurses have tolerated the behavior for years (even decades).
Free webcast about ending bullying and toxic behavior in nursing
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.
Click here to learn more about this program.
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.
Are you and your team on automatic pilot?
By Wendy Leebov, PhD
A couple of weeks ago, I was running a workshop on The Language of Caring and how to communicate in a way that builds trust and partnership with patients and families. As we worked our way through the seven skills, we reached the part where we examined what I consider to be one of the most important skills for patient-centered communication: “explaining positive intent.” This involves telling the patient (or other customer) how what you’re doing is for their sake. Often, we just engage in our activities with the patient without much explanation. We’re on automatic pilot and not thinking about how the patient or family member perceives what we’re doing. When we do explain, the explanation typically focuses on the activity: “Here’s what I’m doing.” Rarely, do we go beyond saying what we’re doing and articulate the benefit to the person with or on whom we’re doing it.
Thi [more]
Joint Commission and FDA target alarm fatigue
by Matt Phillion, for the AHAP blog, April 22, 2011
The Joint Commission recently told The Boston Globe that it would work with the Food and Drug Administration (FDA) to make alarm fatigue a priority.
Alarm fatigue is a concern for many, and it’s no wonder as to why. Our colleagues at the Patient Safety Monitor Journal wrote about the dangers in their March 2011 issue in which Kathryn Pelczarski, director of the applied solutions group at the ECRI Institute, said that a nurse for an ICU might be dealing with 150-400 physiologic alarms per patient per day. A nurse in those units typically has one or two patients, but that doesn’t mean they don’t hear the alarms for all the other patients.
Nurses are hearing hundreds of alarms during their shift, some critical, some less important, with many false alarms, and patient safety is suffering as a result.
The Boston Globe article can be found here; to learn more about Patient Safety Monitor Journal, click here.
Nurses refuse raises in the name of patient care
Newspapers and websites have been inundated this year with protests, strikes, and complaints of nursing staff shortages affecting patient care. It’s the same old story that’s being told everywhere, and after a recent poll that asked nurses whether they’d turn down a pay increase to hire more nurses on the floor received an 83% response of “Yes, we need more help,” it’s a story that seems to be evolving into one for the ages. Type “nurses strike” into your browser and enjoy the show of headlines from 2010 that pop up before your very eyes:
- Early in 2010, 18 nurses at Washington Hospital Center, the largest non-profit hospital in the DC area, were fired for not reporting to work during a snow storm, in what was dubbed the Blizzardgate firings. The move was protested by National Nurses United who said such a move was unprecedented in the hospital’s history and brought decreased morale to the hospital’s staff members. Ramifications of the issue were still being felt as of early November, when National Nurses United sent a 19-page report to the DC Health Department informing it that Washington Hospital Center is understaffed and compromising patient safety. The report contained more than 50 different allegations of incidents related to patient care in hopes that the Health Department will investigate.
Take a vacation: Why nurse leaders need time off
By Marsha Egan, CPCU, PCC, ICF
You’re more likely to get burned if you don’t spend some time outside the hospital walls this summer. Burnout is a leading downfall for many busy nurse managers, but here’s one way to prevent it.
Take a vacation! Even if you only have a couple days, it’s vital to maximize your R&R.
Being a nurse leader is not easy and comes with a lot of responsibility, but even you can beat the heat of job stress with the following vacation strategies.
Take the time: Even if you haven’t racked up enough hours for a week-long vacation, make time for a mini vacation. Use the weekend or two days in a row that you have off to take trip to a friend’s or family member’s house to relax.
Plan it out: Plan your vacation months ahead of time. It can be almost as gratifying just thinking about an upcoming trip as it will be to actually take it. Also, it will help get you through stressful times when you know you have something fun coming up. Put up reminders that you’ll see every day. Mark the trip on the calendar, put a picture of the beach you’re going to in your purse or wallet, and make the background of your computer something you’re excited to see on your trip.
New nursing programs geared towards preparing and retaining nurses
Studies show that up to 60% of new nurse graduates leave their first job within their first year, and many hospitals are focusing on ways to help new nurses through the difficult transition from nursing school to novice nurse to competent, confident practitioner.
Rapid City (SD) Regional Hospital is one such facility looking to help its new grads succeed and remain with the organization. The hospital hires an average of 100 nurse graduates every year, but within two years, 25% of those nurses are no longer with the facility. With the help of a recent grant from the Robert Wood Johnson Foundation, Regional Hospital has launched a two-part program to provide guidance to the new nurses. [more]
Driving under the influence of drowsiness
It’s no secret that nursing can do a number on your health. Sore backs from lifting patients and poor eating habits because of strange schedules and lack of time, to name a couple examples, can have a detrimental effect on your health. Add driving under the influence of drowsiness to the list.
According to a new study published in the December 1 issue of SLEEP, staff nurses who work extended hours, work at night, struggle to remain awake at work, or obtain less sleep are more likely to experience a drowsy driving episode. The data was compiled during a four-week span and focused on 895 nurses, who reported, on average, one drowsy driving episode out of every four shifts worked. Additionally, 281 accidents or near car accidents were reported during the study.
Sleep restriction and sleep fragmentation are listed as the two main causes of drowsy driving. To combat the problem, the American Academy of Sleep Medicine recommends getting enough sleep, taking breaks while driving, consuming caffeine, avoiding alcohol, and avoid late-night driving.
Here is a link to the full press release with further information: Sleep Study
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!
