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The Growth of Salons January 27, 2009

Posted by mariemanthey in Nursing Salons.
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Here in the Twin Cities of Minneapolis and St. Paul, we now have 3 salons monthly, with a fourth one being planned.  There is a calendar of local Salons on the website of the Zeta chapter of Sigma Theta Tau at the University of Minnesota School of Nursing. A new development is that often now when I am invited to speak to a group,  they ask me to conduct a Salon while I am there. Plans exist right now for me to do this in California, Indianapolis, Washington DC, England and Germany.  A Salon will probably be starting soon near Chicago, and some colleagues of mine are planning to start one in Sao Paulo Brazil.

If anyone knows of other Salon start-ups, please send a note to this blog. There are a number of ways I can provide support.  Keep the information flowing. Post a note on this blog.

P. S. I am willing to ‘kick-off’ a Salon in your city/town. I won’t charge a fee.. just cover my expenses.

Is Polite “Doing For” Really Enough? January 17, 2009

Posted by mariemanthey in Professional Practice.
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One of the consultants at Creative Healthcare Management recently sent me this description, written while her daughter was receiving care at a major medical center in the Midwest. My question to readers is this: if you see yourself in this description, what can you do to “be with” rather than just “do for” your patients?  Or does anyone want to explain why “doing for” is really enough? Responses are welcome.

“Care has been fine, but not extraordinary.  They  received Magnet designation in 2007 and have a great deal of pride.  Everyone asks each time they leave the room if there is anything else we need — and they have clearly received customer service training (AIDET).  The manager just visited our room and was gracious and emphasizing that we let them know if there is anything they can do.  The trouble is, they are doing … But there is no “curiosity”, no whole picture perspective — when asked the nurses rarely know the plan — I rarely see a therapeutic process; the nurse comes in to give meds, check if there is anything needed.  So very nice, polite — but detached.  I found myself charting my perspective using the boundary diagram from my article in the field guide on boundaries for the therapeutic relationship. Underinvolvement is the main descriptor I would use.

We have had some lovely exceptions. The pharmacist, who we know from the transplant team, spent 20 minutes with us yesterday making sure that we had all questions answered and providing some background information. A physician sat at eye level and began by asking Alicia about her and what this means in her life right now.  She was able to talk about school, and it went on from there.  He was extremely encouraging — reminding us that it has always been the case that my daughter would outlive the life of her kidney, and that we will take each challenge as it comes.  We do not have the biopsy results yet, but if it is early rejection we are dealing with, that can be treated and the kidney can continue to serve her.

I try to stay clear and unemotional about the lack of professional consciousness I see in so many nurses.  I feel so sad, because when they only focus on the things they are doing, they lose sight of the human being and the power of their care and they lose the amazing satisfaction that would come from a connection.  I am clear that it would take no more time to connect and involve the patient than to come in and out doing for the patient.  I believe the nurses on this unit like their work, and that transplant nursing would be extraordinarily satisfying.  So, the nursing care is fine.  The question is, is that enough?  I have nothing I would complain about, and I believe most patients would say the care was very good because the staff is responsive.  My daughter asked why so many people (nurse,  physician, nurse practitioner) give her the same information as though she is hearing it for the first time.  Not one nurse has asked Alicia about herself or what this hospitalization means to her — what she might be worrying about — what is most important to her.  This morning as I walked for my coffee I noticed no one looked up anywhere through the hallways to the cafe, so I began initiating and spoke to people even when they were looking at the ground.  I got responses in return and I am teaching my daughter how to be the initiator of relationships so that she can be seen and receive what she needs.  I have also had to work with her to monitor her responses (she got rather hysterical when experiencing pain and not feeling heard by the nurse — who I understand called her a whiner– I was out of the room at the time) — I followed up with the nurse and worked to help her feel safe and less defensive, we came up with an approach to Alicia’s pain and by the end of the day it was managed.  I had to intervene though, because I could see that the nurse was irritated with her and I want Alicia to learn how to care for relationships so she does not get written off.  She will need to be an expert as she will be needing care all of her life. “

HAPPY NEW YEAR January 1, 2009

Posted by mariemanthey in Inspiration, Nursing Salons, Values.
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January One, Two thousand and nine.

What will this year bring?  Despite the economic down turn, which is undoubtedly affecting every single one of us negatively  in some way, there is the paradoxical feeling of HOPE  — for the future, the world, this country, health care and … the nursing profession.

The downturn is scaring new grads who entered school expecting life-long job security; only to find that in some regions low census numbers require staff reductions, lay-offs and empty positions not being filled. Those of us who have lived through these ups and downs  know this is temporary, but that doesn’t help a new grad with 30-50 K in school loan debt.   They need HOPE in the future job market.

HOPE. We all know the health care system is broken. We know we spend too much money on many things and not enough on other things, all because of reimbursement decisions made by someone somewhere. As the changes in the system come down the pike, I pray we as a community of health care workers find a strong voice to help the decision makers use our knowledge and skills to the maximum in order to improve the health of Americans and the humanity with which are sick are cared for.

As readers of this blog know, I am very excited about the potential for Salons to help heal nurses and to strengthen the contribution every nurse makes every day. I think our conversations help us think creatively about how we can better cope with stress and be a positive force for the health of society and to create healthy workplaces.

My personal HOPE for 2009 is that we have an astronomical increase in Salons — that they start up in every corner of the country. That besides purely nursing salons, another type starts up: interdisciplinary salons. First for doctors and nurses. For us to learn about each other as people so that our role relationships on the job can be healthier.

I am asking every who is currently running a Salon, or planning to start one, to please let us know through the blog or email me personally, so I can begin tracking the spread of this idea. My email can be accessed by clicking on my picture on the CHCM website (chcm.com).

We are moving up to four a month here in the Twin Cities.   We have a calendar posted on the University of Minnesota,  STTI chapter website and people can RSVP just by clicking a button. This is still just beginning, but I think we are creating a model that will help others.

2009. Just think of it. A New President. New problems. New solutions. HOPE.