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Storytelling and Problem Solving January 17, 2007

Posted by manthey in Academia, History, Leadership, Nursing Salons, Values.
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Staff nurses and nurse managers tell me they really like Crucial Conversations as a guide in managing morale problems. Here’s the deal: morale problems are always caused by problems in interpersonal relations among the staff. This book gives very specific and useful advice about how to talk about important issues/behaviors that are a problem among co-workers. Everyone has to handle these issues for themselves. It usually doesn’t work to expect the nurse manager to step in and solve problems at the staff nurse level. The more each individual develops the skill of managing their own relationships successfully, the healthier a unit’s morale will be. The manager’s job is to help the staff develop the skill to talk about difficult situations skillfully, so that a solution can be reached that doesn’t make the situation worse.

So … if there are managers out there who haven’t found the book yet, I suggest you get it. Add it to the unit library and use it to provide guidance and support to the staff to manage their own relations successfully.

Add your stories about handling difficult situations to the blog.You never know when your experience will be a “teachable moment” for someone else struggling with a similar problem.

Latest news indicates the shortage produced by baby boomer retirements will only be in the neighborhood of 350,000, rather than the 700,000 originally projected. Great news! But the shortage is still a huge problem. Besides losing the experience, skill and wisdom gained over years of clinical experience, I worry that we also might lose some of our history. One of my personal delights at this point in my career (50 years this year!) is being involved in “heritage-work” with the University of Minnesota SON. If you have artifacts, pictures, etc. of nursing decades ago, see if your local school of nursing has an interest in preserving items of historical value.

An advantage to having 50 years of experience is the personal knowledge of how it was to compare to how it is and the ability to creatively think about how it can be. One of the realities that sometimes clouds the incredible upward trajectory of nursing is the way changes in the workplace can negatively impact nursing’s contribution to the health of society. This kind of thinking, remembering and projecting is an important contribution senior nurses can make as they prepare to retire. Also, retirement itself is being re-considered as we speak. Clinical support for student nurses is just one of the ways being implemented now to pass on the experience and wisdom acquired in years of practice.

Another need is to pass on the underlying values of the nursing profession. We who know need to teach the value-foundations of the nursing profession to the new crop coming in. Our covenant with society is profound. Our opportunity to make a difference in the lives of human beings is the constant that occurs in busy ICUs, ambulatory surgical suites, in nursing homes, on peds units, in doctor’s offices … in every setting every day we have an opportunity to make a difference in the lives of the people we contact. What a privilege! Those of us who learned that in years of practice need to take responsibility for passing it on to the younger generation of nurses.

I invite veteran nurses to share stories of the “good old days” that might help young nurses connect with our heritage. Do you know someone who made a difference in the life of an iron-lung patient? How did nurses care for people with TB, knowing they might become infected? Did you care for patients recovering from cataract surgery, on bed rest with sandbags holding their head steady for 10 days? Where did YOU make a difference?

Send us your stories about handling difficult situations. You never know when your experience will be a “teachable moment” for someone else struggling with a similar problem.

What is on Your Mind About Nursing Right Now? January 8, 2007

Posted by manthey in Inspiration, Leadership, Nursing Salons, Professional Practice, Values.
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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. 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 her nurses experience; they lack 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.