RSSAll Entries Tagged With: "nurse leadership"

Nurses: What inspires you to reach for excellence?

Nurses Week is a good time to reflect on what sets the nursing profession apart from so many others. Nurses have a reverence for the work (however flawed circumstances may be on a day-to-day basis), and a commitment to bettering the “caring profession.”

This Nurses Week, please give some thought to what inspires Elizabeth Kenney2you to reach for excellence. Submit your favorite inspirational quotes and sayings in the comments box below and we will share them so all can be uplifted. We’ll also compile the best into a resource to sustain you on the days when you face challenges.

Here’s a quote from an amazing Australian nurse, Elizabeth Kenney. In the 1930’s, she pioneered the use of physical therapy, rather than immobilization, for polio victims.

 

It is better to be a lion for a day
than a sheep all your life.

             —Elizabeth Kenney, 1880-1952

 

NOTE⇒ You can use the 20% Nurses Week discount offered in this post through 5/12/2015.

Change agent: Download your action plan for new staff

preceptor package

Yesterday I promised you a free tool adapted from
The Preceptor Program Builder, by Diana Swihart
and Solimar Figueroa.


If you’d like to download their Action Plan for New Nurses, you’ll find it here

Nurses: Say This, Not That

Power can be taken, but not given. The process of the taking is empowerment in itself.
—Gloria Steinem

In a recent post, I promised a free tool adapted from The Image of Nursing.
If you’d like to download SAY THIS, NOT THAT: An Empowerment Glossary for
Nurses,
you’ll find it here. And while you’re waiting for the download, try this: 

If you hear yourself saying:

No one notices my contributions  

Say this instead:

I’d like to share with you how I’ve handled this situation

 

The Image of Nursing: Speak Up!

In a comment on one of my posts last week, Stefani suggested (strongly) that to improve the image of nursing, we need to speak up. I’m reposting her comment below to draw your attention to it.

I’d like to hear your thoughts about why nurses might not speak up when, by staying silent (out of fear?), their personal self-esteem takes a hit and—more importantly—care standards aren’t maintained. Have you developed techniques that help you overcome fear of confrontation so that you can truly speak up?

Speak Up image

Here are a few resources related to speaking up:

  1.  A terrific article from Susan Gaddis, PhD: Positive, Assertive “Pushback” for Nurses
  2.  A table you will be able to download from our reading room in a few days: Say This, Not That: An Empowerment Glossary for Nurses. Look for it on or before 3/19/15.
  3.  Books written by Kathleen Bartholomew, RN, MN, including Speak Your Truth and Team-Building Handbook: Improving Nurse-Physician Communications.

Evidence-Based Practice: A Soundtrack for Nurses

At HCPro, we offer extensive resources designed to help the nursing community build evidence-based practice (EBP) skills and refine strategies for incorporating EBP in daily practice.

EBP Video Clip

From Viva La Evidence, James McCormack

You can find free resources here and purchase books
and videos, including Evidence-Based Practice in Nursing: A Guide to Successful Implementation, here.

What we lack, however, is a musical EBP score to accompany those resources… For that, you’ll have to visit YouTube and view James McCormack’s Viva La Evidence, a parody of Coldplay’s Viva La Vida that sings the praises of evidence-based practice. Enjoy!

Injured Nurses: Who has your back?

In 2013 your nursing staff faced a
15% greater chance of spine injury
than firefighters.

Check out the Bureau of Labor Statistics Table 18 for the spine injury picfinal tabulated 2013 rates of musculoskeletal injuries for FT workers, compared by occupation. Firefighters—who lug heavy ladders, people, and equipment daily—had a rate of 232 per 10,000. For nursing staff, the total was 264 per 10,000 full-time RNs and nursing assistants. A spine injury can end a career in the blink of an eye. But how can these injuries be prevented?

Your mother’s admonition to “bend your knees” while lifting something heavy may not be enough to protect the backs of your nursing staff. In an ongoing article series entitled Injured Nurses, NPR takes a look at what can happen when nurses depend solely on proper body mechanics (essentially, keeping your back straight while following mom’s advice) for moving patients. As of this writing, you’ll find three installments on NPR.org that explore the problem, possible solutions, and how some hospitals may or may not “have your back.”

On a positive note, the Baptist Health System reports that the Transfer and Lift with Care program it introduced in 2007 has reduced patient-handling injuries in their organization by 81%. One important factor in their success? Investing in assistive equipment and devices in each of its five hospitals.

If I can get specific statistics and practices from Baptist, I’ll post them here for you to share with your peers and hospital administrators. I’ll also post a link to a PDF of Table 18, which should be a little easier on the eyes than the official version.

In the meanwhile, if you’d like to share ways your organization has your back, feel free to comment below.


 

UPDATE> 4/4/2015. Here’s a highlighted section of Table 18, with the RN/nursing assistant and firefighter statistics highlighted.table excerpt

Ben Franklin’s advice to nurse preceptors

Tell me and I forget.
Teach me and I remember.
Involve me and I learn.

How do you provide preceptees with constructive advice Ben Franklin2
or feedback? Do you tell them what they did wrong and spell out how to correct it? Or do you encourage them to use critical-thinking skills to truly ingrain a personal understanding of ways to improve their practice?

Look at these two approaches to feedback, and see which you think would be more effective. (More examples excerpted from The Preceptor Program Builder can be found in the Reading Room.)

The preceptor observes the preceptee greeting the manager correctly, giving her name, and stating that she is a preceptee. However, she was not wearing her name tag.

Evaluative feedback
Your name tag is missing, and the manager
won’t like it!

Descriptive feedback
You greeted the manager according to the facility protocol.
Can you think of anything that would help your manager remember you?

The descriptive feedback encourages the preceptee to use critical thinking, which illustrates Ben Franklin’s timeless recommendation to “involve me, and I learn.”

If you would like to share “aha” moments and techniques for constructive feedback, please feel free to comment below…

Aetna’s Preceptor Program: The Proof Is in the Program

Do preceptors and preceptees benefit by moving from an
ad-hoc preceptoring program to a formal one?

Lorri Freifeld, editor-in-chief at Training: The Source for Professional Development, recently reported some exciting findings from a formal nurse preceptor program initiated by Aetna, Inc.

Following a 6-month pilot, Aetna launched a formal nurse preceptor program in January 2013. At its outset, the formal program provided 65% of new hires with preceptors, incorporated beefed-up workshop offerings, instituted weekly progress reports between preceptors and their supervisors, increased communication of best practices, created a community calendar of training events, and implemented on-demand training and follow-up with recently preceptored new hires.

The result after three months?

  • 53% of new hires were managing a full caseload
  • 100% of preceptors said soft skills training was sufficient (up from 0%!)
  • 97% of preceptors felt the tools and resources were effective
  • 67% of new hires reported having adequate time with their preceptors

And after six months?

  • Turnover was down 50%
  • 100% of new hires had a preceptor
  • 150 new preceptor volunteers had joined the program

Pretty impressive and immediate results from a new program. Kudos to Aetna for committing to a professional approach in this most important phase of a new hire’s experience.


To read the full article, click here.

To see related HCPro offerings, including The Preceptor Program Builder, click here.

Review finds quality of NP care equal to physician care

Care provided by nurse practitioners (NP) is comparable to care provided by physicians in terms of patient satisfaction, prescribing accuracy, preventative education, and time spent with patients, according to a literature review conducted by the National Governors Association. The group examined 22 articles and studies regarding scope-of-practice for NPs.

The review found that NPs could successfully manage chronic conditions such as hypertension, diabetes, and obesity, and rated favorably in gaining patients’ compliance with recommendations and reductions in blood pressure and blood sugar. The report notes that patients often stated a preference for a care from a physician when it came to medical aspects, but had no preference with regards to nonmedical aspects of care.

NPs are currently allowed to practice and prescribe independently in 16 states and the District of Columbia, while NPs in the remaining 34 states must have some level of physician involvement in order to practice. The authors of the report note that expanding scope-of-practice laws for NPs could help states meet the increasing demands for primary care services. The debate over whether or not NPs should be allowed to practice independently has been ongoing for several years, with many physicians groups opposing NP independence. However, those states and healthcare systems that have expanded the role of NPs have reported positive results, according to the report.

Emergency preparation in the face of a hurricane

Editor’s note: This post originally appeared on the Patient Safety Monitor blog.

The anticipated impact of Hurricane Sandy undoubtedly led many hospitals on the east coast to reevaluate their emergency preparations, and now that the storm has hit, facilities will keep patient safety a priority in the aftermath. It is no small feat to assess the risks associated with a major natural disaster, from loss of power to compromised infrastructures and depletion of essential supplies. In addition to keeping existing patients safe, hospitals must also consider the possibility of an influx of new patients if the storm wreaks havoc elsewhere in the community. It is one thing to have disaster recovery plans sitting in a file somewhere, but another thing entirely to put those plans into action.

Healthcare Finance News highlighted the extensive preparations undertaken by Hackensack University Medical Center (Hackensack, N.J.) in advance of Hurricane Sandy’s arrival, noting that the hospital stockpiled medical supplies and medications, increased food and water supplies, and backed up essential equipment by generator. The hospital also deployed mobile satellite emergency vehicles to service the community. Each vehicle contains seven critical care beds with monitor-defibrillator capability, a portable digital X-ray unit, telemedicine capability, and a full functional mobile emergency department consisting of physicians, nurses, and operations personnel.  As demonstrated in Hackensack’s preparations, even the smallest details must be considered to ensure patient safety in the event of an emergency.

Sometimes even the best preparations can’t match the power of a natural disaster, and a hospital is forced to evacuate, as was the case with NYU Langone Medical Center in New York City. Although emergency generators kicked in, 90% of the hospital’s power went out and the hospital’s basement and lower floors filled with more than 10 feet of water. Approximately 1,000 physicians, nurses, residents, and medical students worked alongside firefighters and police officers to evacuate patients by the light of flashlights. Nurses carried several newborns down nine flights of stairs while performing manual respiration, since the respirators the newborns were on had stopped working in the power outage.

Hopefully the extensive preparations that many hospitals took will prove successful in the face of Hurricane Sandy. Even without the threat of a monster storm, hospitals are wise to review emergency plans and perform risk assessments on a regular basis; patients’ lives depend upon it.

Are you aware of your organization’s emergency procedures? How often do you review those procedures? Share your thoughts in the comments section.