I switched to a Nurse Practioner and I couldn’t be happier October 23, 2017
Posted by mariemanthey in Inspiration, Professional Practice, Values.Tags: Empathy, Nurse-Patient Relationship, Relationships, Trust
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I am now in the care of an independent Nurse Practioner,working in a Nurse Practioner Clinic within the U of Minnesota School of Nursing and I couldn’t be happier.
The difference in my experience between a humanistic Internal Medicine MD and my nurse practioner is noteworthy. I was in the care of my primary care physician for many years and I had selected him because I knew of his humane approach to his work. He examined me fhrough the lens of either my symptoms if I had a health problem, or through the tasks of the annual physical Sometime during the visit, he always asked if there was anthing going on in my life I needed to talk about. I know he cared, and that he was an expert in internal medicine and for this reason I stayed with him for over 20 years.
Now I am seen in a independently run Nurse Practioner Clinic. The difference in my experience lies in my NP’s approach to me as a person, not a task (the physical) or a symptom. The change it made was powerful….and I believe speaks strongly to the sucessful development of this role and how it is differentiated from the role of specialty medical practices.
Nurses look at people through a different lens than physicians and good nurse practioners blend the strengths of whole person orientation with a focus on health and management of health related problems.
I am so grateful.
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Symposium Reflections July 30, 2017
Posted by mariemanthey in Creative Health Care Management, Professional Practice.Tags: Hospitals, Staff Nurses
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This is a reflections from just on of the many mind-opening events of our recent Symposium. of the Symposium.
A Pre-conference was a program about the Daisy Foundation’s values and accomplishments through their recognition of exemplary nurses as nominated by their patients. Studies of these scores have come under laser focus as reimbursement amounts are now based on those scores. One of the findings had to do with how strongly a single negative experience colors the WHOLE experience for a patient…..even when 99% of the experience was positive.
It reminds me of a powerful paradox the sits within the nursing profession…..the fact that when nursing care is perfect, it simply shows that nothing (No THING) went wrong. It is an absence that is difficult to describe, to count …and even to value.
So….it is fair to say about nursing….
Everyone knows when something is done wrong
No one knows when everything is done right…..because (NO THING ) has occurred.
P.S. Your reflections welcome and much appreciated.
Symposium Review – from Renata Tewes July 28, 2017
Posted by mariemanthey in Creative Health Care Management, Inspiration, Leadership, Professional Practice.Tags: Events, International, People, Primary Nursing, Relationship-Based Care, Symposium
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Professor Dr. Renata Tewes of Dresden, Germany was one of our international attendees at the Relationship-Based Care Symposium last month.
Here are some thoughts she shared with us about the event.
What did I expect? Of course, an interesting conference, good discussions in the workshops and nice meetings with old and new colleagues during the breaks.
Nobody prepared me for what else happened on the RBC Symposium in Minneapolis. The name of the company organizing this event is Creative Health Care Management. The word creative could have been a sign, that it will not be a usual conference. It was not just interesting presentations and workshops.
It was experiencing, how it feels, when a conductor tests different leadership styles, while sitting in the middle of the orchestra. It was feeling the deep respect between a CNE and a CME while they have been explaining the importance and success of their honest relationship to each other. It was sensing the inspiring group dynamic of 400 people working with the method Appreciative Inquiry.
At the end of the conference I felt deep gratitude for being a part of this innovative process – when the participants build new relations, shared their true desires and helped in understanding – showing that building positive relationships in healthcare makes a difference. Needless to say, the empirical results of hospitals that establish Relationship-Based Care (RBC) speak for themselves.
Do I really have to wait another 4 years for the next RBC-Symposium?
Initial conversations about the next Symposium are already underway, and feedback like this is very helpful. We’d love to hear from you as well!
EVERYBODY, SOMEBODY, ANYBODY, AND NOBODY July 24, 2017
Posted by mariemanthey in Leadership.Tags: Escape Victim Mindset, Health Care System, Hospitals, Primary Nursing, RAA, Relationship-Based Care, Trust
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As you know if you follow this blog, we take RAA – Responsibility, Authority and Accountability – very seriously. We feel that that paradigm has the power to create healthy workplaces, excellent health care and healthy nurses, doctors, and staff. Anywhere. These discussions are serious, practical, conceptual, and (we hope) useful.
Variety being the spice of life, today’s entry into the conversation is provocatively different. Today we provide to you a highly-scientific, term-by-term description (or not) of what it’s like when RAA is not in place. Anywhere. Well ok, not that scientific or academic – but highly accurate nonetheless! Think of how often in your personal and private lives you have experienced this exact dynamic!
In this world, there are four kinds of people: EVERYBODY, SOMEBODY, ANYBODY AND NOBODY.
There was an important job to be done and EVERYBODY was asked to do it. EVERYBODY was sure that SOMEBODY would do it. ANYBODY could have done it but NOBODY did.
SOMEBODY got angry about it because it was EVERYBODY’S job. EVERYBODY thought that SOMEBODY would do it, but NOBODY realized it wouldn’t get done by ANYBODY.
It ended up that the job didn’t get done, but EVERYBODY accused SOMEBODY and NOBODY accepted responsibility.
Moral: EVERYBODY’S job is ANYBODY’S. NOBODY can be SOMEBODY unless he’s willing to do ANYBODY’S work.
How about you? All EVERYBODYs, NOBODYs, ANYBODYs, and SOMEBODYs welcome – tell us your story.
Salon Update – Wednesday, July 19 – Draft July 21, 2017
Posted by mariemanthey in Leadership, Nursing Salons.Tags: Conversations, Empathy, Hospitals, My Salon Updates, Staff Nurses
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The salon recently at my home was one of the best… which is what we always seem to say as we are checking out.
I’m often asked the ideal size of a salon, and I’ve come to the conclusion that something between 10 and 15 is just about right.
Having said that, I have had wonderful conversations with just 2 or 3, and I’ve facilitatated mass salons simultaneously for about 180 people seated at round tables at the TX nurses assn. delegates meeting. The excitement, enthusiasm and utter joy experienced during the checkout of all the groups was absolutely magnificient.
So, size for a salon is a moving target and should never be a determining factor on whether to hold one or not. If a group is very large – say 30 or more – it is entirely possible to have them divided in to two salons that meet simultaneously.
A further word about Wednesday night’s salon: it was truly inter-disciplinary, as so many are now. There were occupational therapists, a social worker, a physician, and the rest were nurses from such far-ranging occupations as a forensic-health medical examining nurse, a faculty member, a nurse executive, and staff nurses from different places working in different specialties. Truly eclectic yet the conversation was totally congruent in values and in the experiences of being a health care practitioner.
A Core Value: Humanization of Patients July 20, 2017
Posted by mariemanthey in Manthey Life Mosaic, Professional Practice, Values.Tags: CHCM, Empathy, Hospitals, Staff Nurses
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Many many years ago I was being pressesd to articulate my deepest passion about Nursing. Specifically, what did I believe is the fundamental core value of the nursing profession? After thinking about it deeply, I came up with a deep believe that our most important role is to facilitate the humanization of patient care,…. which required that we first humanize the experience, practice and focus of nurses. Nurses cannot humanize patient care unless they are empowered in their role and in practice. Humanization of health care for patients means engagement of patients and their families in decisions about treatment choices, as well as end of life choices. This ultimate exercise of free will is the pathway to fulfillment as a human….and the restriction of free will is dehumanizing.
I see this goal becoming closer to reality in many situations, thanks to nursing’s incredible advances, as well as to advances in technology and many other societal advances. However, I think much work is still needed to promote nursing’s role as patient advocates for their greater involvement in decisions. The culture change we seek is to humanize patient care. Nurses must support patients ability to accept responsibility for themselves, and to exercise their own free will about their treatment and their lives, knowledgeable about the options that are available to them.
Empowered nurses are needed to empower their patients.
Whether the setting is an ICU unit, a Neo-Natal unit, or even hospice. Empowered nurses can make sure the patients and their families have all the necessary information to make their own life decisions – about end of life, or about courses of treatment – and that they are empowered to do so.
The change is coming. Let’s make sure the nursing profession is ready to fully engage in the humanization of health care. The public is more ready than the health care system.
Happy Birthday Marie! July 17, 2017
Posted by mariemanthey in Creative Health Care Management, History, Inspiration, Leadership, Manthey Life Mosaic, Nursing Peer Support Network, Nursing Salons, Professional Practice, Thought for today, Values.Tags: CHCM, Mosaic, My Salon Updates, People, Substance-Use Disorder, University of MN SON
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This is Claire talking (Marie’s daughter, and co-editor of this site), checking in with you on this celebratory day!
I know Marie values each and every one of you, and loves hearing from you and having conversations with you – whether in person, in various professional / civic roles, on social media, here on the blog.
And so today on her birthday, I wanted to formally welcome you all back to this blog.
In the last few months, we’ve started to get active again — exploring various kinds of posts with a multitude of topics including Nursing: it’s history, challenges, future, best practices, values & inspiration etc.. as well as CHCM activities, Marie’s life (Mosaic), Nursing Salons, the Nursing Peer Support Network, activities at the University of MN School of Nursing, and so on.
If you have a moment today, would love to hear any preferences from you about types of content, questions you have for Marie, how often you’d like us to post, how you’d like to hear about posts, and anything else to make this blog a win-win.
We never know how long any of us have here. Marie is the epitome of taking care of herself, taking responsibility for her health and well-being, and we hope to have years and years yet. In any case, the more conversations she can fit engage in, the better!
Oh, one more thing- Happy Birthday Marie!
Thanks much for your participation.
Sobriety and Nursing – a Page from my Journal July 15, 2017
Posted by mariemanthey in Inspiration, Manthey Life Mosaic, Nursing Peer Support Network, Professional Practice.Tags: Addiction, Escape Victim Mindset, Substance-Use Disorder
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I just celebrated (June 26) my 39th year of recovery from the disease of alcoholism. What an awesome experience this life is.
As I reflect on this period of celebrating both my natal birthday ( July 17) and my recovery anniversary, my gratitude just grows and grows. In so many ways my experience as a nurse and my experience in recovery blend into one wonder-ful life experience.
Just one example of this deep connectivity and unity is that both nursing and recovery open doors to an unlimited opportunity to grow spiritually…to be open to the universe and all the wonders of nature, physics, culture and relationships. There is no limit to what can be learned in every aspect of living in either recovery or in nursing. No limit!
Additionally, both stimulate me to practice non-judgmental acceptance of what is….rather than be embroiled in day-to-day disagreements and conflicts. Both are helping me put into daily life the wonderful question….DO YOU WANT TO BE RIGHT OR DO YOU WANT TO HAVE PEACE? Think about it!
Thank you for all you have and are giving me.
Leadership, by the book: the Army Manual book July 10, 2017
Posted by mariemanthey in Leadership, Professional Practice, Values.Tags: Decision-Making, Empathy, Florence Nightingale, Health Care System, Mindfulness, Nurse Managers, Trust
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Re: U.S. Army's Army Field Manual 6_22 on Leader Development i.t.o. psychological & psychiatric criteria for leadership.
This content is written by Prudence L. Gourguechon, widely known national expert on psychoanalysis for the fields of business, law, politics and marketing.
“Despite the thousands of articles and books written on leadership, primarily in the business arena, I have found only one source where the capacities necessary for strategic leadership are clearly and comprehensively laid out: the U.S. Army’s “Field Manual 6-22 Leader Development.”
“The Army’s field manual on leadership is an extraordinarily sophisticated document, founded in sound psychological research and psychiatric theory, as well as military practice. It articulates the core faculties that officers, including commanders, need in order to fulfill their jobs. From the manual’s 135 dense pages, I have distilled five crucial qualities:
Trust
“According to the Army, trust is fundamental to the functioning of a team or alliance in any setting: “Leaders shape the ethical climate of their organization while developing the trust and relationships that enable proper leadership.” A leader who is deficient in the capacity for trust makes little effort to support others, may be isolated and aloof, may be apathetic about discrimination, allows distrustful behaviors to persist among team members, makes unrealistic promises and focuses on self-promotion.
Discipline and self-control
“The manual requires that a leader demonstrate control over his behavior and align his behavior with core Army values: “Loyalty, duty, respect, selfless service, honor, integrity, and personal courage.” The disciplined leader does not have emotional outbursts or act impulsively, and he maintains composure in stressful or adverse situations. Without discipline and self-control, a leader may not be able to resist temptation, to stay focused despite distractions, to avoid impulsive action or to think before jumping to a conclusion. The leader who fails to demonstrate discipline reacts “viscerally or angrily when receiving bad news or conflicting information,” and he “allows personal emotions to drive decisions or guide responses to emotionally charged situations.”
“In psychiatry, we talk about “filters” — neurologic braking systems that enable us to appropriately inhibit our speech and actions even when disturbing thoughts or powerful emotions are present. Discipline and self-control require that an individual has a robust working filter, so that he doesn’t say or do everything that comes to mind.
Judgment and critical thinking
“These are complex, high-level mental functions that include the abilities to discriminate, assess, plan, decide, anticipate, prioritize and compare. A leader with the capacity for critical thinking “seeks to obtain the most thorough and accurate understanding possible,” the manual says, and he anticipates “first, second and third consequences of multiple courses of action.” A leader deficient in judgment and strategic thinking demonstrates rigid and inflexible thinking.
Self-awareness
“Self-awareness requires the capacity to reflect and an interest in doing so. “Self-aware leaders know themselves, including their traits, feelings, and behaviors,” the manual says. “They employ self-understanding and recognize their effect on others.” When a leader lacks self-awareness, the manual notes, he “unfairly blames subordinates when failures are experienced” and “rejects or lacks interest in feedback.”
Empathy
“Perhaps surprisingly, the field manual repeatedly stresses the importance of empathy as an essential attribute for Army leadership. A good leader “demonstrates an understanding of another person’s point of view” and “identifies with others’ feelings and emotions.” The manual’s description of inadequacy in this area: “Shows a lack of concern for others’ emotional distress” and “displays an inability to take another’s perspective.””
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From an intraprofessional leadership perspective, this is a universal summary of essential leadership skills from a valid source. Going back to Florence Nightingale, great leaders when matched to this set of criteria have great capacity to be powerful leaders who truly make a difference. Hospital origins were deeply linked to the military mindset of regimentation, discipline, following the chain of command, and maintaining discipline. Sometimes in ways that de-humanized patient care.
This value-based list of leadership skills represents an exciting awareness important values that can greatly improve performance and promote better engagement.
My own learning during the early development of Primary Nursing included an invaluable gift from ‘military literature’. I don’t remember the exact document or book, but I know the conceptual paradigm of Responsibility Authority and Accountability came directly from a description of a military ‘chain of command’ writing. We were not using words like that in nursing during PN’s early development.
Every sector has a contribution to make to the collective well-being!
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References:
http://www.latimes.com/opinion/op-ed/la-oe-gourguechon-25th-amendment-leadership-mental-capacities-checklist-20170616-story.html
Position Statement on Substance Use Disorder: Great Step Forward! July 8, 2017
Posted by mariemanthey in Academia, Leadership, Nursing Peer Support Network.Tags: Addiction, Self-Care, Staff Nurses, Substance-Use Disorder, University of MN SON
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http://www.healthleadersmedia.com/nurse-leaders/impaired-nurses-benefit-alternative-discipline-approach#
Impaired Nurses Benefit from Alternative-to-Discipline Approach
Nursing organizations advocate for rehabilitating rather than punishing nurses experiencing substance use disorder.
The American Association of Nurse Anesthetists is endorsing a new position statement that advocates for an alternative-to-discipline approach for nurses and nursing students with substance use disorder.
The position statement Substance Use Among Nurses and Nursing Students, co-authored by the International Nurses Society of Addictions and the Emergency Nurses Association calls for an alternative-to-discipline approach with the stated goals of:
- Retention
- Rehabilitation
- Re-entry into safe, professional practice
The position statement also says drug diversion for personal use should be considered a symptom of a serious but treatable disorder rather than strictly as a crime.
“It’s about education for prevention and fair handling when it happens,” says Lynn Reede, DNP, MBA, CRNA, FNAP, AANA senior director of professional practice. “Education raises awareness and understanding, and at the same time decreases the stigma related to the disease. Treatment of substance use disorder helps keep patients and healthcare professionals safe.”
Recovery is the Goal
A disciplinary approach to impaired practice or drug diversion involves due process with a state board of nursing and suspension or revocation of a nurse’s professional license. There is no offer of a recovery program and the nurse may be terminated and legal charges can be filed.
Through an alternative-to-discipline program, a nurse does not practice for a specific time while undergoing treatment and establishing sobriety and recovery program. He or she may undergo psychiatric evaluations, specialized treatment like one-to-one therapy and support groups, and random drug screens. A return-to-work agreement is created and often involves a reduction in hours, limited shifts, and restrictions in assignments with continued treatment and monitoring for periods of up to three to five years. Restrictions are lifted as the nurse demonstrates he or she is making progress.
Alternative-to-discipline programs make it easier for impaired nurses, including nurse anesthetists, to step away from work while they receive treatment, says the AANA in a news release.
“An ATD approach gives Certified Registered Nurse Anesthetists and student registered nurse anesthetists three opportunities: 1) To enter treatment to address their addiction, 2) To work toward lifelong sobriety, and 3) When possible, their eventual return to the workplace,” says Linda Stone, DNP, CRNA, chair of the AANA peer assistance advisors committee.
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Response from Marie: This position statement is also included as a position statement of the American Nurses Association.
In our work creating and building the Nursing Peer Support Network (NPSN) in Minnesota, I believe the position taken here is vitally important. Within the culture of nursing, there are negative attitudes toward addictions which act as a disincentive to get help when the person with the addiction is a nurse. One large piece of the problem is the lack of education for student nurses to understand the heightened risks and extreme consequences experienced when a nurse becomes an addict. The incidence with nursing is now thought to be one in seven!!! Fortunately, the U of M SON has developed a curriculum module that DOES present important information about the RISKS AND CONSEQUENCES OF ADDICTION IN NURSING. See our earlier post here for more information about that exciting curriculum addition!
For more information on NPSN go to the website www. npsn.org/mn
It’s great to be part of this point in time, moving forward together on this important issue!