Marie Manthey's Nursing Salon

Gallup poll…nursing vs. congress!

mariemanthey — Sun, 01 Jan 2012 15:31:53 +0000

Once again nurses have highest ranking in ethics and honesty among all 21 professions tested. And guess what?….congress members were scraping the bottom of the list right along side of used car sales people. What do you think we should do about this? Elect more nurses to Congress? Have the nursing profession conduct classes in ethics, honesty and trustworthiness for members of congress? What do you think? …..

Key messages about Advanced Practice Nursing

mariemanthey — Wed, 23 Nov 2011 14:37:43 +0000

During this time of system reform, nursing needs to be positioned to maximize -our strengths. Legislative restrictions on advanced practice nursing need to be eliminated. Here are some key messages. Talk it up!

APN’s are trusted professionals who are well tested in the community with a long track record of quality & safety.

When APN’s are allowed to practice fully, they can provide care that is more economical and better than our current health care system allows and this savings can be passed on to the state and to consumers.

Government is in the way, and the legislature needs to act to remove regulatory barriers which prevent APN’s from fully practicing to meet the needs of the public.

mariemanthey — Sun, 13 Nov 2011 16:20:11 +0000

Follow the money. As health care reform initiates evolve, the control exerted by reimbursement decisions becomes abundantly clear. Equally clear is the reality that if an idea is not reimbursed, no matter how beneficial it is for health, it will not be sustained. While it has taken nursing a long time to accept this reality, we ‘get it’ now.

I think the long delay in our ‘getting it’ is the direct result of the concentration of nurses working in hospitals where, within the umbrella of our revenue being inextricably tied to room rates and days of care, we have had freedom to maneuver many reforms/improvements in care delivery without following the money.

No longer. Recent legislation has stimulated many initiatives to change the system . Nurse leaders are now clear about the importance of influencing legislation and clarifying the metrics supporting nurse led health and health care improvements. We all need to commit to being informed and taking action to support legislation that will improve health and the health care system.

For example, reimbursement influenced by patient satisfaction scores is but one of the upcoming changes that will profoundly impact the way nursing departments are managed and led. Withholding reimbursement for conditions caused by errors, is another. What is and is not being paid for will drive both the system and the nation’s health as never before.

At the very least, every nurse needs to know the following:

content, implications and local response to the IOM report on nursing
local developments of ACO’s and Health (or medicine) Care Homes

We need to stop being the victim profession and start being the leaders society needs us to be. Nightingale would be out in front with both metrics and the ability to powerfully influence the decision makers. How can we be less?

I’d love to have a lively discussion about these issues.

From where I stand…..

mariemanthey — Thu, 20 Oct 2011 14:02:34 +0000

this is the ‘best of time and the worst of time’ for nursing. As I travel around the country, I see and hear about nursing departments that are delivering the highest quality nursing care humans have even received. There is a peak of highly personalized, humane care focoussed on the individual and providing opportunities for true healing to occur. A level of care we could only dream about years ago. Highly competant, highly holisitic, highly personalized. And in these places, nurses truly experience a levelof joy that enriches and energizes their whole lives.

And then down the street ….or at the other end of town, there is another place, where the workplace culture is toxic, staff are angry and fearful (the same thing?) and patients are viewed as sources of trouble, annoyances to be dealt with, etc.

In other words, the contrasts between good and great hospitals and the worst ones is sharper than ever. And the finding that my colleagues and I see over and over again is that the difference is in the culture and in leadership. In other words “the protoplasm is the same”.

And of course, a whole hugh chunk in between these two extremes. The good news is the bad ones can change. The bad news is they have to see that the problem is leadership and culture…….and BE WILLING to change!

I’m curious what those of you working today think about these observations. Are you working in one of the best or one of the worse? Have you had a family member in one or the other? The best or the worse of times.

News: A New Salon in Michigan

mariemanthey — Wed, 29 Jun 2011 13:25:07 +0000

Good evening Marie,

I want to let you know that we have formalized our Nursing Salon in Rochester. I was really hoping that someone who attended the salon you facilitated last October would want to do this. After careful consideration, I invited the nurses from our first Tide of Primary Nursing, 15 nurses arrived on time, and I had to suggest it was time to end and leave at 9pm. It was a beautiful evening of insightful conversation, my heart was singing, my brain was whirling. The nurses found the conversation inspirational, energizing, and a sacred place to talk about nursing. Our youngest nurse was 6 months into her profession, our most mature nurse was 40+ years into hers. We had nurses from Medical Oncology, Maternal Child, Critical Care, and Rehab, surprisingly we were all more similar then different in our perspectives of nursing, the complexity and significance of the roles that we all engage in.

Karen (she was the host of the salon you attended with us) has agreed to alternate the evening with me. She has odd months, I have even months. All who attended committed to bringing a colleague with them to the July salon. We agreed to the third Thursday of the month.

Fabulous, phenomenal, and I cannot wait for the next salon in July.

Thank you for your vision, encouragement, and listening.

Conversations

mariemanthey — Thu, 16 Jun 2011 13:25:08 +0000

Conversations vs. discussions is an intriguing differentiation. A discussion is often as exposition of pros and cons around an idea, or an opinion, whereas conversations are an exchange of points of view between people. I think one of the reasons I like conversations so much is that I am sick and tired of people trying to persuade me to believe one thing or another. Politicians head the list and I have recently joined the No Labels initiative to support the simple idea that we need to stop labeling each other and start honest conversations about issues.

Another thing I’m sick and tired of is TV news programs. The same fact can be totally distorted by the different biases of the station. I am just as tired of CNN as I am of Fox and MSNBC.

And finally! I shop at Costco because they don’t try to persuade me by signs/displays/sale notices, etc. to but something. They just put it out there for me to decide. I shut off commercials. I’m sick and tired of people telling me how I should think or what I should buy.

I love conversations on important topics by people who care about them. It is healing!!

The Power of Conversations

mariemanthey — Mon, 30 May 2011 20:49:36 +0000

Conference: Ways of Knowing Conversations

Over one hundred health care professionals gathered for a day of conversation about Sustainability and Spirituality in Healthcare on May 25 in St. Paul, MN. The unusual format for the day gave national experts 20 minutes for their speeches followed by 30 minutes of “table talk” among attendees with 10 minutes for audience-wide sharing.

This approach was designed to recognize the reality that the experience of attendees provides unique and expansive backgrounds within which to share understandings of the speakers content. The buzz in the room confirmed the validity of the format.

One of the common threads of the people who attended is a deep interest in holistic approaches to healthcare. The insights shared and decisions made and shared point to the reality that, once again, conversation changes people and the lives they lead. Attendees were physicians, nurses, acupuncturists, massage therapists, counselors, etc. Role distinctions blurred around the common interest in holistic health and the environment.

Salons were frequently mentioned as one mechanism for these kinds of life-changing conversations. Many people said they are interested in starting a Salon and I hope they will use this blog to share their experiences.

Nurse Manager vs. Head Nurse

mariemanthey — Tue, 04 Jan 2011 21:08:12 +0000

I’ve been thinking about the title change and its significance. I was active in promoting the change to NM and now wonder about it. In particular, are Nurse Managers still in charge of nursing. Or are they in charge of management? What do you think? When the title was Head Nurse was the role clearer? Your comments, please.

Happy New Year

mariemanthey — Sun, 02 Jan 2011 20:43:20 +0000

One of my New Year’s Resolutions is to post on the blog more often and use it for the kind of conversations that promote healthy interactions and pride in our profession.

One way I want to do that is to encourage nurses to reflect deeply on the meaning of our work, as the connection to our deepest values helps energize our work. It is rewarding to an individual nurse to appreciate deeply the privilege we have in alleviating pain and increasing comfort at any and all levels of our patient’s vulnerabilities. Experiencing this intrinsic reward is important for each nurse’s self care.

Another goal I have is to keep bringing up certain realities about staffing I call these “hidden truths” that need to be acknowledged and understood by nurses and by the system.

nursing work is never done
nursing work is unpredictable
nursing work is uncontrollable (it is based on pt. acuity and MD orders, neither of which nurses will ever legitimately control
there is always more work to do than time available.
prioritizing involves deciding what NOT TO DO when there is more work to do than time available. The truth is there has always been and will always be more work to do than time available.

More of my thinking on this topic is in Creative Nursing Journal, Vol 15, Number 2, 2009. The article is entitled, A Brief Compendium of Curious and Peculiar Aspects of Nursing Resource Management. It is time for staff nurse to quit driving to work fearing they will be short staffed and driving home at the end of their shift angry because there wasn’t enough help.

Finally, I encourage you to view this short video. It is meaningful for nurses and people at many different levels of being.

Happy New Year!

http://www.ted.com/talks/brene_brown_on_vulnerability.html

Salons: Common Sense Therapy for Stress

mariemanthey — Fri, 26 Nov 2010 14:34:14 +0000

Hi Marie,

Thought of you and the salons this morning as I was reading an article
about the risk of “compassion fatigue” in nurses. I copied a snippet
of the article below….makes me even more grateful for the nursing
salons on this eve of Thanksgiving. Thank you again for providing
this necessary venue for nursing. You are the best!

Happy Thanksgiving!

Although it is easy to say that nurses should be given the opportunity to recognize and talk about the stress that they experience, and to make plans for coping, these are challenging tasks. Trauma research indicates that people involved in traumatic events need to be able to “tell their story” 8 or 9 times to defuse the physiologic and psychological impact of what they have been through. Providing opportunities for nurses to get together to talk and support each other is common sense. As laypeople, we support and care for each other during stressful times. Somehow, we have to provide that same sort of commonsense therapy for healthcare professionals. Once people share what they are feeling, then strategies can be developed to cope with those feelings. However, in busy hospitals and clinics, it will be a challenge to find the time to provide these experiences.