Stepping Away from the Bedside and Moving To Center Stage

This quarter, in my leadership course, one of my assignments was to give a presentation on a topic of my liking to the nursing program’s student body.  Firstly, I am not a good speaker, especially in front of that many people.  I even have difficulty speaking in front of my small, close-knit cohort.  This was going to be a nightmare

Apparently, I am not the only nurse who suffers from this fear.  Many nurses suffer from the fear of public speaking, just like the fear of spiders, snakes, and the boogieman.  Since this problem is so relevant, I am going to provide you with tips, that I had to learn first-hand, on how to lessen your anxiety and prepare a great presentation.     

1.       Make Note Cards: Take the time to make note cards, but keep them brief.  Print clearly and leave pace between key points.  If you know your material well, putting the note cards in outline form will allow you to speak more spontaneously.

2.      Stay Calm: Becoming nervous is a totally normal thing, but there are many techniques that you can use to remain calm such as giving yourself a positive self talk, use relaxation techniques, stimulate audience participation, and keep moving. 

3.      Practice: Before the big day, practice by recording yourself on a tape recorder or a video camera.  You may be surprised at what the audience really sees and hears.

4.      Make it Simple: A simple delivery will hold your audience’s attention better than a speech filled with long, complex terminology.  For us nurses, avoid medical jargon and slang if you are speaking to others who are not familiar with that language. 

5.      Inject Humor: Humor can make your speech unique and interesting.  It can also make you feel more comfortable. 

Hope you found these tips helpful and felt reassured that you are not the only nurse who would rather give a suppository than stand up in front of a crowd J

Please share with me your tips for public speaking.

Restoring Quality of Life

What is Restorative Nursing?

Before this quarter’s clinical rotation, I had never heard the term “restorative nursing.”  Restorative nursing refers to nursing interventions that promote the residents ability to adapt and adjust to living as independently and safely as possible.  This conept actively focuses on achieving and maintaining optimal physical, mental, and psychosocial functioning.  A person can start a restorative nursing program upon admission to a facility with restorative needs, when restorative needs arise during the course of a long-term stay, or in conjunction with formalized rehabilitation therapy.  However, restorative nursing programs are typically initiated when a resident is discharged from formalized physical therapy? 

I question, why are patients discharged from formal therapy programs when they still have obvious restorative needs? 

 

 

**Functional decline can lead to depression, withdrawal, social isolation, and complications of immobility such as incontinence and pressure ulcers. **

What is Included in Restorative Nursing? 

Activities that must be provided by restorative nursing staff:

·         Passive Range of Motion

·         Active Range of Motion

·         Splint or Brace Assistance

Activities provided by any staff member under the supervision of a licensed nurse:

·         Bed Mobility

·         Transfers

·         Walking

·         Dressing and/or Grooming

·         Eating and/or Swallowing

·         Amputation or Prosthesis Care

·         Communication

In a restorative nursing program, these skills must be done at least 15 minutes in a 24-hour period. 

Nurse's Job

Nurses MUST supervise the above skills.  Nurses formulate individualized care plans with goals that are measurable and objective.  It is their responsibility to reassess progress on a weekly basis and revise the care plan as necessary.  Nursing assistants/aides can be trained in the techniques, but again, must be supervised by a nurse when performing these activities.

The Doctor Nurse

Why do Nurses have to put up a fight for the title that they earned? 

Merriam-Webster defines a Doctor as a person who has earned one of the highest academic degrees conferred by a university.  Not in any way, shape, or form does this definition discriminate the profession of which it is earned in.  Physicians are worried that losing control over the title “doctor,” a word that has defined their profession for centuries, will be followed by the loss of control over the profession itself. Patients could become confused about the roles of various health professionals who all call themselves doctors.

Six to eight years of collegiate education generally earn pharmacists, physical therapists and nurses the right to call themselves “doctors,” compared with nearly twice that many years of training for most physicians. For decades, a bachelor’s degree was all that was required to become a pharmacist. That changed in 2004 when a doctorate replaced the bachelor’s degree as the minimum needed to practice. Physical therapists once needed only bachelor’s degrees, too, but the profession will require doctorates of all students by 2015 — the same year that nursing leaders intend to require doctorates of all those becoming nurse practitioners.

 

 

Banning the Title ?

A bill proposed in the New York State Senate bars nurses from advertising themselves as doctors, no matter their degree. A law proposed stated that it would bar people from misrepresenting their education or license to practice.  Laws in the states of Arizona, Delaware and other states forbid nurses, pharmacists and others to use the title “doctor” unless they immediately identify their profession. 

What do you think?

I would really like to hear your thoughts on this topic.  It is difficult for me to fathom that, even to this day, nurses are still struggling to prove themselves as a profession.  I think doctorate prepared nurses have earned the title, Doctor.  However, I think that it is very important for them to identify themselves as nurses to avoid confusion amongst their patients.  I think a lot of the problem is about power.  I hope that someday nurses will be treated as an equal member of the team, and be valued for their professionalism and knowledge.

 

References

 

Harris, G. (2011). When the nurse wants to be called 'Doctor'. Retrieved from http://www.nytimes.com/2011/10/02/health/policy/02docs.html?pagewanted=all&_r=0

 



Merriam-Webster. (2013). Doctor. Retrieved from http://www.merriam-webster.com/dictionary/doctor

The Magnet Influence

I am doing a presentation on Tuesday, 2/19/13, to nearly 150 students at my school’s annual nursing forum.  My topic is the Magnet Recognition Program.  I would also like to share with you the information that I have learned while preparing for my presentation.  Let me share with you how the Magnet Recognition Program got started, the 14 forces of magnetism, and why I will work in a Magnet designated hospital when I am a nurse. 

Have you heard of the Magnet Recognition Program or Magnet status hospitals? 

Back in 1983, a time when there was an extreme nursing shortage, the American Academy of Nursing (AAN) conducted a study to identify characteristics of a work environment that attracts and retains well-qualified nursing staff.  They narrowed their findings to 14 qualities, and that is where the 14 Forces of Magnetism were first funded.

1.       Quality of nursing leadership

2.      Organizational structure

3.      Management style

4.      Personnel policies and programs

5.      Quality of care

6.      Professional models of care

7.      Level of autonomy

8.     Quality assurance

9.      Consultation and resources

10.  Community and the hospital

11.   Nurses as teachers

12.  Image of nursing

13.  Nurse-physician relationships

14.  Professional career development

In 1990, the AAN joined forces with The American Nurses Credentialing Center (ANCC), the credentialing unit of the American Nurses Association (ANA).  They proposed a plan for the Magnet Hospital Recognition Program for Excellence in Nursing Services.  It was approved in December of that year. 

“Magnet status is not a prize or an award. Rather, it is a credential of organizational recognition of nursing excellence. “    (ANCC, 2013)

 

 

 

Benefits of Magnet Designation

·         Attract and retain top talent

·         Improve patient care, safety, and satisfaction

·         Foster a collaborative culture

·         Advance nursing standards and practice

·         Grow your business and financial success

Top 3 Reasons why I will work at a Magnet Designated Hospital

1.      Quality of Care

-         Quality is the systematic driving force for nursing and the organization. Nurses serving in leadership positions are responsible for providing an environment that positively influences patient outcomes. There is a pervasive perception among nurses that they provide high quality care to patients.

2.     Level of Autonomy

-         Autonomous nursing care is the ability of a nurse to assess and provide nursing actions as appropriate for patient care based on competence, professional expertise and knowledge. The nurse is expected to practice autonomously, consistent with professional standards. Independent judgment is expected within the context of interdisciplinary and multidisciplinary approaches to patient/resident/client care.

3.     Professional Career Development

-         The health care organization values and supports the personal and professional growth and development of staff. In addition to quality orientation and in-service education addressed earlier in Force 11, Nurses as Teachers, emphasis is placed on career development services. Programs that promote formal education, professional certification, and career development are evident. Competency-based clinical and leadership/management development is promoted and adequate human and fiscal resources for all professional development programs are provided.

 

References

American Nurses Credentialing Center. (2013). Magnet recognition program. Retrieved from http://www.nursecredentialing.org/magnet.aspx

A Nurse-Led Community Health Model

History

Jos de Blok, a home health nurse from the Netherlands, saw that the profession of home health nursing was “dying” right in front of his own eyes.  He entered home care out of passion and compassion, but saw it changing to an organization all about production, protocols, and administration.  He made an agreement with himself that he would not be content until the role of a home health nurse regained its’ social value. 

In 2006, Jos de Blok started a small organization called Buurtzorg Netherland, or Netherland Neighborhood Care.   The organisational model of Buurtzorg is to have care delivered by small self-managing teams consisting of a maximum of twelve professional carers, and to keep organisational costs as low as possible.  Buurtzorg responds to the client’s care needs, tries to find solutions together with the client and their informal carers and other formal carers involved, arranges things around care and social life, and supports self-decision of the client about what is necessary. 

 

 

The Buurtzorg Method

The Buurtzorg method has six sequential components, which are delivered as a coherent package and cannot be delivered separately.

 •Component 1 is to assess the client’s needs; the assessment is holistic and includes medical needs, LTC needs and personal/social needs. On the basis of the resulting information, the individual care plan will be drafted.

•Component 2 is to map networks of informal care and involve them in care.

•Component 3 is to identify and include formal carers.

 •Component 4 is care delivery.

 •Component 5 is supporting the client in his/her social roles.

•Component 6 is to promote self-care and independence.

 

Results

 

As of 2010, Buurtzorg teams were active in 250 locations nationwide. The patient satisfaction was extremely high. The satisfaction of staff and co-working GP’s were also very high. The cost of care was nearly half as expensive as traditional home care.

 

 

Below are links to learn more about Jos de Blok and the Buurtzorg Netherland project:

http://interlinks.euro.centre.org/model/example/NeighbourhoodCareBetterHomeCareAtReducedCost

http://omahasystemmn.org/documents/2010-10-04ArtikelBuurtzorgInHetEngels.pdf

Find the Leader in You

AIC-Appreciation, Influence, and Control

The three power fields (appreciation, influence, and control), are created by purpose.  Every purpose no matter how small or large, creates the same three power fields.  Leaders, who utilize the three power fields and remain well balanced in each field, are exponentially more effective.  Leaders should strive to maintain equal power in each of the fields.  Below, I will explain each field in more depth, and examples of how you can utilize the three power fields in nursing to become a respectable leader. 

The Appreciative Phase

 

 Encourages us to transcend our current perception/beliefs of a situation to be open to a larger perception of our possibilities and have a deeper awareness of our realities.  The appreciative phase allows you to relate to others in an open-minded and accepting way. 

Examples of how to utilize this in nursing include continuing education, listening to our patients and co-workers and respecting their cultural/spiritual beliefs, and discovering new and improved ways to do things through evidenced based practice. 

The Influence Phase

 

In situation where we do not have control, influence gives us power with others and allows us to use our values to engage supporting and opposing forces in a dialogue that facilitates the choice of the most effective strategies.  You find the give-and-take of both collaboration and competition attractive. 

Examples of how you can use the influence phase in nursing include displaying strong values, sharing your thoughts and beliefs with co-workers and managers, asking for advice from others, and working with a dynamic team. 

The Control Phase

 

Creates individual goals (purpose at the control level) that give form to our purpose.  The goals specify the resources and the time races necessary to achieve the purpose.  This phase calls on our capacities to act and reflect. 

Examples of how to utilize this in nursing include completing tasks, setting career goals, implementing change, creating projects, and working independently.

To create your own individualized AIC map, visit www.aic-3.com

My AIC Results

My AIC results were somewhat of a surprise to me.  I scored high in the Appreciative category, being 40% of my power.  Some of my Appreciative strengths include enlightenments, wisdom, and love. 

My second preference was the Influence power, with 36%.  My Influential strengths include technology, economics, and authenticity. 

Lastly, my Control power was scored as 24%.  My strengths in the Control category include negotiation, quality, and policy.  These results show that maybe I am too reliant on others’ opinions, and that I need to improve my Control powers by making decisions more independently.

How to Get LEAN

This week our class focused on topics such as economics, budgeting, and finances in nursing.  This post will explain a budget-friendly system that I have become somewhat familiar with through my employer and is widely used in many companies around the world; the Lean system. 

What is Lean?

The core idea of Lean, which was first established by Toyota in efforts to create a more efficient automobile assembly, is to maximize customer value while minimizing waste.  Eliminating waste along the entire system, instead of at isolated points, creates processes that need less human effort, less space, less capital, and less time to make products and services at far less costs and with much fewer defects, compared with traditional business systems.

 

At the hospital I work for, we use the Lean system specifically in our supply rooms.  We have cut down in cost by creating a system where we have less supplies on the floor (less waste), and a well-organized, accurate ordering process for when things get low.  Companies are able to respond to changing customer needs more efficiently and effectively.

Five Core Principles of Lean

The five-step thought process for guiding the implementation of lean techniques is easy to remember, but not always easy to achieve:

 1. Specify value from the standpoint of the end customer by product family.

 2. Identify all the steps in the value stream for each product family, eliminating whenever possible those steps that do not create value.

 3. Make the value-creating steps occur in tight sequence so the product will flow smoothly toward the customer.

 4. As flow is introduced, let customers pull value from the next upstream activity.

 5. As value is specified, value streams are identified, wasted steps are removed, and flow and pull are introduced, begin the process again and continue it until a state of perfection is reached in which perfect value is created with no waste.

Creating an Organization to Channel Your Value Streams

·         Reorganize your firm by product family and value stream.

·         Create a lean promotion function.

·         Deal with excess people at the outset, and then promise that no one will lose their job in the future due to the introduction of lean techniques.

·         Devise a growth strategy.

·         Remove the anchor-draggers.

·         Once you’ve fixed something, fix it again.

·         “Two steps forward and one step backward is O.K.; no steps forward is not O.K.”

Encourage Lean Thinking

·         Utilize policy deployment.

·         Create a lean accounting system.

·         Pay your people in relation to the performance of your firm.

·         Make performance measures transparent.

·         Teach lean thinking and skills to everyone.

·         Right-size your tools, such as production equipment and information systems.

 

 

Down the Drain and Into the Lakes of Minnesota: A Public Health Concern

What's The Issue?

I heard about this concerning public health issue from a co-worker of mine.  The University of Minnesota conducted a research study to test the water quality of Minnesota lakes, and found overwhelming amounts of the chemical triclosan, an antibacterial agent found in many consumer products such as antibacterial soaps, in all eight lakes that were tested.  This issue is raising concern, being that this chemical is directly contaminating the state’s drinking water supply. 

 “Triclosan is not currently known to be hazardous to humans. But several scientific studies have come out since the last time FDA reviewed this ingredient that merit further review.  Animal studies have shown that triclosan alters hormone regulation. However, data showing effects in animals do not always predict effects in humans. Other studies in bacteria have raised the possibility that triclosan contributes to making bacteria resistant to antibiotics.”  

(FDA, 2012)

What Can WE do as nurses? 

This is a concerning public health issue.  We as nurses can make a difference.  Think about how much antibacterial soaps are used in a healthcare settings…Now think,what if we, as nurse leaders, made sure to only purchase soaps that did not contain harmful chemicals such as triclosan.  We, as nurses, also have the ability to educate our patients and communities about the harmful side effects associated with triclosan, and teach them how to choose products that are safe. 

 

 

To read the full Star Tribune article, click on the link below.

http://www.startribune.com/opinion/editorials/189451681.html?refer=y