Nurse Revitalization

Today closes the end of Nurses' Week, a time of appreciation for all the contributions of nurses to the healthcare industry. As I enjoy the thoughtful gestures of fellow nurses and those whom I work for or with, it just brings me closer to the thoughts of how important the profession is from the days of Florence Nightingale up until today. Things have changed but the foundation remains the same, this week for me has revitalized my initial feelings that I need to find my voice within the profession and why I became a nurse. It is time to make changes (small first of course) so that I am rewarded for myself that I contributed to maintaining the respect and notoriety of nurses everywhere. What would nursing look like if we made baby steps towards the necessary business changes so that we can get back to the reason we all become nurses in the first place; definitely something to think about. Have a great day...and you too can make a difference in nursing not just this week but for life times to come.

Happy National Nurse's Day!

Happy National Nurse's Day to nurses, who day in and day out have given a piece of themselves to ensure that the needs of others are met. It is great to be honored for all the contributions that nurses have made to the health care industry, as we are a vital part of its existence. The profession of nursing continues to grow during technological advances and changes in health care, but its foundation remains strong and the basis for why nurses are valuable to everyone in all walks of life. Today and during this week, let's honor the most trusted profession and provide them with the same support that they give so selflessly to others.Please share any stories of nurses who made a impact in your life!

~Thanks to my fellow nurses!

"Nursing Solutions" in Need of Changes.

Nursing solutions to overloaded patient censuses, staff shortage, uncompetitive pay, longer hours, and increased work processes by nurses is to make it work and get the job done. This is actually a great solution for employers as the work needs to be done, but when the gap is closed the deficient isn't easily recognizable. And for those nurses putting in the work, this can equal more stress, decrease in morale, less time to do the much needed bedside care, and poor job satisfaction. A reality, for me as a nurse, is that the very core of what nurses do is to “put the needs of others before our own", but this is without consequences and it can actually eliminate the support and changes we need. My ultimate thought is, in situations where patient safety is compromised gaps in work processes and nursing care have to be seamless to avoid poor outcomes. However, those processes that are non-life threatening and of lower priority, employers have to be given the opportunity to see where the problems lie so they can take a role in fixing what needs to be done or allow the experts to do so (i.e. electronic charting systems, billing, HR issues, etc.). These gaps may create changes that are beneficial to nurses and our profession. A prime example, my first job as a nurse, I worked with an older nurse who had been on the floor for 16 years, being a jack of all trades. She did anything from patient care, staff education, precepted new nurses or new supervisors, helped in the planning of new changes on the unit, and so much more. She became so frustrated because I believe she was burnt out and there was no support from upper management that eventually she resigned. The irony was once she left, no other person was expected to do all that she had done, upper management realized it was too much for one person and the duties were split amongst a group versus one individual; so once the gap was recognized it was quickly fixed. We as nurses can't always create nursing solutions that don't allow much bigger changes that only employers can initiate, we have to allow them to take their part as well so that nurses can get back to the essentials of patient care and improving healthcare outcomes. What do you think employers can do to close the gap in the working conditions of nurses?

 

Empty Hospital Beds...

I have been thinking about the new changes under the Affordable Care Act and how it would work effectively not only for health care professionals, clinics, and hospitals but also for the patients. I came across this article at the NY Times Health Provider Strives to Keep Hospital Beds Empty , about a system in Chicago that is attempting efforts to improve health care outcomes without increased health care costs. I am particularly interested in the ways that they are looking to coordinate care for the patients who have statistically shown to have higher health-related costs associated with care. I truly do not believe that there is going to be a perfect system in moving forward, but I am hopeful that organizations are looking into creative ways in keeping patient care as priority, while managing health care costs . What do you think about the efforts of this organization?

Spirituality in Healthcare: Does it Belong?

I recently read a blog about spirituality in health care, what interested me about it was that I have never thought about the topic and how I felt about it as a nurse. Generally as a nurse, the bulk of the time that I am inquiring about spirituality is as it is related to practices that interfere with health care and when the question is asked patients are very puzzled (in a new light I understand as it is almost as if we are asking if there is any competition). I have never thought about it, although not surprised, as a means for being a protective factor that may even enhance the experiences of modern medicine. As I reflect on the scenarios where doctors gave timelines on patient life and patients surpassed them; I have also seen patients with the best odds of overcoming a condition die because of it. Now, what I have taken into consideration are those patients who used their spirituality to balance their mental and physical being regardless of the diagnosis. I found in these moments, ideal times to acknowledge and to support them (which does not have to interfere with my own spiritual beliefs) in how they saw their walk of life and how they felt about it or how they got through it or how life ended with it. I realized that I can allow my patients to have their first, last, or all those days in between spiritually so that they are themselves fulfilled. As a nurse, if I have to smile as my patients or their families pray, stop as I enter a room so that they can finish a prayer, or remove myself from the room while they pray; I want to create a atmosphere that spirituality is important and is not and should not be in competition with health care. How do you feel as a nurse/doctor respecting and/or acknowledging a patient's spirituality?

On Trial at the Doctor’s Office...

How many times have you dreaded going to the doctor's office because you just felt that you would be judged? Have you even been asked questions like, why aren't you performing this medical task or ridiculed because you had not followed through with the plan from the last visit. How does that make anyone feel when they have yet to develop a relationship with their healthcare provider? Let me say I do believe that when you are already comfortable with whom you are seeing and the relationship is established there is more room for direct conversation, but still respectful and honest. But the problem for me is when that relationship is not yet to be established. Don’t get me wrong there still has to be honest, respectful medical conversations sometimes with bad news or things that you need to do immediately to improve your health, but can it be done in a way that patients don't feel like they are being judge or labeled the "bad patient"? As a patient I have had the similar situations where I felt that I was being judged (whether real or perceived) and it just didn't make for a pleasant healthcare experience for me. So I thought about it and here were some things that I did to improve my healthcare experience because I too have to play my part:

 

· Changed healthcare providers (after two visits)---I wanted to give the previous healthcare provider a chance because maybe I was a little more sensitive on the first visit.

· Asking, open and honest questions---No matter how uncomfortable they made me feel to ask because as a nurse I don't know everything about everything; but that was my issue with being judged that I also had to address with myselfJ

· Participate in dialogue and initiate it---I don't have to make it a you ask me a question and I answer session.

· Listen and clarify---Listening is important to learn anything, but I also learned to clarify statements that I perceived as judgmental; sometimes it was a misunderstanding on my part and this cleared it up immediately.

Tell me about times that you felt judged at the MD office. What did you do to improve your future experiences?

Nursing Retention: When It's Broke, You Must Fix It!

Nurse retention. The system of nursing retention, is broken and it must be fixed to remain sustainable as American grows older and healthcare for all becomes a priority. Many facilities are thinking of ways to address the nursing shortage, but what about the nurses who are top-notch and will not be retiring, what are you doing to keep them? So often, we either are so focus on looking into the future or either looking back to see how we can improve things, both not bad business models, that we forget about what is in front of us. There are nurses in front of us who are working everyday and too making a difference in patient lives and patient outcomes, what would it mean to lose them? And don't get me wrong, finding ways to close the nursing shortage is important but it does not focus on retention in the least. Here is a bit of free advice, that I have about nursing retention:

• Have a working nurses at the table, depending on who you want to retain you need to know what makes them stay at a job and figure ways around providing those opportunities, when feasible.  The question, is you have so many people at the round table looking at nursing retention, but make sure you have a key player at the table maybe more to speak up for the "working nurse". Working nurses will provide you valuable information about what it would do to keep them and their colleagues on the job; we have these conversations everyday far from what may be thought.
• Provide incentives, the reality is everyone likes these and it doesn't have to cost alot either. On Nurses Day provide your nurses will a small token to know they are appreciated. At a staff meeting recognize a staff person who has gone the extra mile and is the "A list Employee" for the month or year.
• Listen, sound simple enough; well it is not that easy as many employers forget the basic skill of listening. Nurses are on blogs, we are having conversations on the floor, if you stop long enough to hear what we are saying you may find valuable ways to retention.
• Look at "model" agencies. Some places have nursing retention down to a science, these are the places you almost never see posting a nursing job unless someone does retire. Find out what they are doing and how their strategies may be of assistance to you.
• Look at work processes, I would say this should be a yearly priority and a plan in place to how to address needed changes with the less bit of disruption. As work process are constantly evolving, but that being said some agencies are not looking into ways to streamline the busy work so that nurses can focus on what we like "hands on patient care."
• Have competitive pay,  I know the dollar is what is a driving factor for many healthcare agencies and I can't say that it is always the priority for most nurses, but it is important that your nurses can also meet their basic needs as well and if they are being paid appropriately or you are trying to save a buck you could lose them to a more competitive company.

Nurses..........I need you input as those are a few ideas I have about nursing retention, tell me yours, how can they keep us?