Marie Manthey’s Nursing Salon

The Nursing Salon has enjoyed some good publicity in the current issue (May/June) of NurseWeek. We continue to experience, with the Salon, a healing of the hurts sometimes created by deep-seated problems within nursing practice. A sense of hope continues to be the most prevalent content on our check-out at the end of each discussion. No matter the number of people, no matter the age, no matter the level of education (we have LPNs and PhDs) no matter the specialty, no matter the setting — when we come together to talk about what is currently on our mind about nursing, the talk is authentic, value-driven, and powerful.

I would love to see this idea spread. I believe some other groups have started up and I would love to hear from you, how it is going. I would be happy to help anyone get another group started, and I have information on how to go about doing so. It is practically stress-free for all of us…..me as the host and all those who come. If anyone wants info or help, email me at mmanthey@chcm.com. I will share our experiences, answer your questions and to what I can to support to your group.

It is my New Year’s resolution to post to this blog more regularly.

Join me. Make it your resolution to comment on my writings.

Although I usually don’t share my New Year’s resolutions because they are mostly about my ‘inside stuff’….one that I will share is a promise to write 3-4 times a week on the blog. And…..to encourage you to respond because we all have opinions and experiences to share…and there is value in doing so. What got me started doing this blog in the first place is a comment from my colleague Jane Felgen about putting the Salon idea onto the web. The way it works at my home is that after we sit down to eat, I ask the question of the group….What is on your mind about nursing tonight’? So….let’s try that here…..What is on your mind right now about nursing as you are reading this blog? In a couple of sentences say what you are thinking about as you browse through the blog…or now at the beginning. Others reading your current issue/question/problem/hope/ambition/fear/worry/frustration may wish to comment. I know I will. From this we will be able to have an electronic version of our monthly experience here at my home.

I’ll tell you about some recent responses to that question. At a recent salon, one nurse discussed a recent medical board meeting where MDs expressed a great concern about the new DNP (Doctorate in Nursing Practice degree), saying it might confuse patients to have another ‘doctor’ around! (A great discussion on that point!) A new grad asked what the future will be like for her…when the baby-boomers retire and the future terrific shortage arrives. An experienced nurse talked about her challenges precepting new grads in a NICU and also expressed concern about her unit’s remodeling that will result in all private NICU rooms. A home care nurse exec talked about the isolation nurses experience i.e., the absence of colleagues in the workplace when all their work is in patients homes.

As for this blog, I am asking anyone who reads this comment to answer the question: What is on Your Mind About Nursing Right Now? Post your comment here. Respond to other people’s thoughts, experiences, ideas, solutions, hopes, dreams, wishes and fears. If the blog turns out anything like the ’salons’…..we will all benefit in ways .

And so to get us started, here is what is on my mind about nursing: On this first day of the New Year, I am amazed that after 50 years of nursing, there is still so much to learn and so much for me to do. I marvel at the awe a new nurse has in being able to connect deeply with a patient and KNOW she/he has made an important difference in that patient’s experience. I love to see a manager ‘get’ the meaning of leadership and realize that as a leader they are able to influence the quality of care for a whole group of patients. As a consultant I especially love it when a CNO expresses profound delight at the changes she sees in the delivery of care after a transformational experience for the staff.

I also know in the deepest level of my being that the problems we face working in dysfunctional systems on toxic units and with chronic staffing shortages – all these problems – cannot be allowed to usurp the passion nurses have for patient care. And they will not. We will find ways to overcome them. Of this I am certain.

When I first posted about the overwhelming response to my blog, I left off the comments emailed me by Gary Saltus, a physician colleague. Gary specializes in helping  groups through transformational change and is working with CHCM create a program to build Physician/Nurse relationships.

It’s a shame I left Gary’s comments out because they are so vital to this discussion.

Here are the highlights of Gary’s email, followed by my original response (again):

I enjoy and appreciate your constant journey of discovering more and more in nursing and health care. I keep coming back to your primary statement of talking to the different people in health care because it’s something you want to do. I imagine this is your purpose in life at this time –your constant search for discovery, wherever it takes you. I imagine this is the lens you use to see the world: How do we do health care better?

I agree with you about the importance of conversation, but I look at it through my lens of transitioning with individuals, teams, groups, and organizations.

The challenge as I see it is to get the people involved to have these conversations with themselves first, to learn who they are and what their purpose/vision is. They need this self-knowledge so they have the self-permission to present who they are to the interpersonal environment (another individual, team, and group) with confidence.

Before the individual, team, group or organization can tackle the difficult and major issues that you present in you blog, they must go through orientation, differentiation with resultant cohesion conversation with each other first. These are the stages of maturation according to John Cater, PhD at the Gestalt Center for Organization & Systems Development. They also must go through these stages in three phases. Assimilation, differentiation, and manipulation. Each phase brings the system closer with the common denominator being trust. This process is how I facilitate working with groups. So the bottom line is we can’t start tackling the big issues until the system has matured. The dilemma is that organizations don’t think they have the time to let the Nurses/Physicians/Administrators do this group work.

I admire your passion and drive to facilitate change in the Nursing/Health Care arena. Our passions are in attunement. Thanks for including me in your thoughts. I look forward to talking to you in the future about our passions and shared visions.

Gary, thanks so much for your thoughtful and insightful comments. I don’t have the grasp on gestalt that you do…but I definitely get the ‘gist’ of what you are saying. I agree that the transformation has to start with the individual, and then move to groups and teams and that the employing institutions do not yet see the benefit of this kind of staff development.

Throughout my career I’ve been fascinated by how attitudes/behaviors of employees change as institutional and leader values change. I’ve seen so many dramatic changes (both positive and negative) in the lives of patients and nurses that I feel compelled to continue working with these issues. The issue of no time to engage in these discussions is really daunting. Also, the separation between professional cultures has erected many barriers to communication I am beginning to see coming down. Another thing that I find very interesting is that the barriers between nurse educators and practice nurses are also beginning to crack. Real light is beginning to shine through. One of the ways I get to see this is thru the monthly Nursing Salons which I have been doing at my home for the past five years. Attendees vary according to the email lists interests in coming on that evening. It is sort of a blend of the Open Space technology and Socrates Cafe conversation format. I have so enjoyed seeing nurse educators and nurse managers, staff nurses, alternative therapy nurses, public health nurses, etc all sitting around talking about some issue or another in nursing. A retired physician comes whenever he can. And you are right…..it really is about improving Health Care.

So, here we are: after a few months of talking planning and learning by trial and error, we are ready to get my blog up and out there for everyone to see. I go forward in this with very mixed feelings.

First of all I’m excited because I see this as a new way for nurses to come together, discuss important issues, gain strength and focus while recognizing and respecting differences. I believe this kind of discussion will clarify our understanding of complex issues and help us discover new truths.

That is the good news. The hesitation is because I’m not exactly sure what a blog is and exactly how it works. Friends of mine in the office of Creative Health Care Management are helping me with all that and assure me it is a good idea and entirely doable. So….here goes.

I’ve always believed that professional nursing occurs at the point of interaction between the RN and the patient whether that is the bedside in the hospital; the exam room in the office or clinic; or in the patient’s home. So to me, the staff nurse position is the one we need to focus on for development, enrichment and support.

I’ve enjoyed the big challenge of tackling and removing the barriers, both external and internal, which interfere with the nurse delivering the very, very highest level of competent compassionate care during those moments of interaction with the patient. This has involved changing the focus of management to leadership. That means the individual staff nurse’ must mature and develop enough to manage his or her self, relationships, and practice. It also means organizations have to change so they support creative problem solving of the staff nurse at the bedside. Obviously this has been ‘a tall order’. But Primary Nursing was a giant leap forward from which many lessons were learned that are still being operationalized today.

In all my 50 years in this field, I have never been so convinced that we have what it takes to move nursing into true mature professionhood. I have a profound sense of the changes in organizational dynamics that has occurred in my lifetime. Every time I speak with a group of nurses, I am amazed and energized by the incredible passion for patient care alive in nursing today.

A few years ago, I started a Nursing Salon. My intent was to bring nurses together to talk about the big issues of the day and to get in touch with the down-deep values of nursing. These Salon meetings always restored our hope.

Our cumulative wisdom is now so much more accessible due to the electronic revolution. Nurses from all around the world, in all settings and specialties can pool our experience and knowledge, thus increasing the intellectual capital available to all of us in the field. I hope this blog can play a role in energizing and informing the lives of those who visit.