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As it happens: RBC Symposium Day 3_ Wednesday, June 21 June 21, 2017

Posted by mariemanthey in Creative Health Care Management, Inspiration, Leadership, Professional Practice, Values.
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This is the busiest day of the CHCM International Relationship-Based Care Symposium, so to keep the posts from getting too long, will be sharing snippets & segments!

Launched by the wonderful Keynote by Lois Swope on compassionate care; with an all-attendee mid-day session on relationship-building in Indian Health from Phoenix Indian Medical Center; and concluding with a Poster Session; the day also included two breakout sessions with 5 choices each of those sessions! (Please join me in thanking the CHCM staff, they’ve been working extremely hard to bring this all together!)

As it happens: RBC Symposium Day 2_ Tuesday, June 20 June 20, 2017

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Today is the first official day of the 2017 International Relationship-Based Care Symposium, here in Minneapolis at the Hilton Minneapolis! Read on for notes, hand-out links and inside peeks into Day 2.

The MusicParadigm experience made a huge impression on me when I first took it in, several years ago. I told everyone I talked to about it for weeks! It is such a unique,  substantively clear demonstration of the clear power of positive leadership. If you are experiencing it with us today, I would love to hear what you think of it! Otherwise I hope you catch it as soon as you’re able.

I’ve written about The James previously on this blog – along with UC-Davis they hold a pre-eminent position in US critical care health care systems for their extensive and inspired implementation of Relationship-Based Care.

1.Hosp, 6.Doors, 60.Wards   – Such an amazing presentation, from a multi-site hospital in Italian-speaking Switzerland; implementing Relationship-Based Care – escaping silo’s and nurturing compassionate care.

Theory without Practice is empty and Practice without Theory is Blind – Emmanuel Kant

Next was a presentation from the CNO and the CMO about how they’re partnering at Pennsylvania Hospital,  and creating an extraordinarily healthy culture there.  The day ended with a  delightful vocal experience of Full Voice lead byBarbara McAfee!

As it happens: RBC Symposium Day 1 June 19, 2017

Posted by mariemanthey in Creative Health Care Management, Inspiration, Leadership, Manthey Life Mosaic, Professional Practice, Values.
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Today is the pre-conference afternoon of the 2017 International Relationship-Based Care Symposium, here in Minneapolis at the Hilton Minneapolis!

Here are links to the handout materials available at this time:

Gratitude_Human_Connection

DeepenFacilitationCapacity

It’s been great already to have a brunch at my home – to which I invited international guests, several local nursing leaders and CHCM consultants. Conversations ranged over various topics including comparisons between people’s situations in different countries.

The conference itself is a very enthusiastic experience! I have been constantly in motion and it’s wonderful. Everyone is very happy to be here and many are saying ‘this is exactly what we need at our hospital!’

This afternoon I was able to be a surprise guest at the Daisy Foundation session. I spoke about the the impact of Florence Marie Fisher coloring in my coloring book, and also what a wonderful thing it was for me to be able to nominate her for the DAISY award. In closing I brought in Florence Nightingale as well.

I enjoy talking about the power of nursing: as I experienced in my lifetime the impact of my nurse when I was five years old.  I like to make it clear that the work that I’ve been involved in leading is directly the result of Florence Marie Fisher coloring in my coloring book.

I don’t think that that concept can possibly be emphasized too strongly: the power of good nursing care!

Much more to come, looking forward to sharing it with all of you!

 

 

Authentic Nursing: Past, Present and Future June 18, 2017

Posted by mariemanthey in Creative Health Care Management, Inspiration, Leadership, Manthey Life Mosaic, Professional Practice.
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Nursing is a dynamic profession, constantly moving forward for the well-being of patients and their families.

Let’s look back at one of the early mainstream articles about the onset of Primary Nursing; let’s celebrate recent exciting book releases; and let’s prepare for an incredible week of growth and discovery at the CHCM International Relationship-Based Care Symposium!!

Looking back at the Past:

Primary Nursing: Hospitals bring back Florence Nightingale

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This article provides clear details about the way things were before Primary Nursing. This excerpt (from the 2nd page) is talking about Carol Davis, Primary Nurse, who had been ‘foreman’ in a task-based nursing delivery system at Rush-Presbyterian-St. Luke’s in Chicago before the implementation of Primary Nursing there.

“I was the kingpin who cracked a whip over a crew of people who were unskilled, making sure they got their tasks done,” Davis recalls. “That kept me running around like a chicken without a head.”

She managed about a dozen or so aides, assigning them to various tasks for 25 to 40 patients. Davis made sure the chores were completed on schedule and recorded on patients’ charts, and that her workers went to lunch and returned on time.

Having her own ‘team’ was unheard of. Her aides, like chessmen, were constantly shifted around to other registered nurses, new patients, new units and new tasks. She didn’t have time to get to know her helpers and their abilities.

Furthermore, she had no time for interacting with patients except at pill time. “We were caught in a system that put procedures ahead of patients’ needs,” Davis says. “Nursing didn’t have much of a human face, yet none of us knew how to correct that.”

Results included a turnover rate of RN’s of 48.7% each year!

Celebrating the Present:

Advancing Relationship-Based Cultures is Creative Health Care Management’s newest publication, just in time for the Symposium! Edited by Mary Koloroutis, and David Abelson, the book explores the  culture of health care organizations, looks at what is  necessary for optimal outcomes, and suggests strategies to achieve those outcomes. Advancing Relationship-Based Cultures explains and expands a fundamental and often overlooked truth in health care: It is the confluence of relational and clinical competence that advances healing cultures.

Not as recent, but very relevant: Transforming Interprofessional Partnerships – A New Framework for Nursing and Partnership-Based Health Care by Riane Eisler and Teddie Potter. The only interprofessional partnership text written from the nursing perspective, it provids a model for partnership with patients and other health care professionals.

Prepare for the Future: The Symposium is Here!!!

And moving forward, the Symposium is here! Next week will be an incredible journey, which we’ll share here on the blog as much as possible.

In addition, there will be content on Twitter, Facebook, and even other channels possibly. Find me at @colormenurse on Twitter and join the conversations!

This will be an amazing event, coming only once every 4 years, and each Symposium has many dynamic, passionate health care leaders from around the world. Attendees this year are coming in from Germany, Switzerland, Brazil, Italy and with the US a large number of states are represented.

I am looking forward to seeing many of you next week and together with you working  to advance healthy workplace cultures for those receiving care, and for those who work there.

RAA Part III – Achieving Full Experience of Will Power June 15, 2017

Posted by mariemanthey in Creative Health Care Management, Manthey Life Mosaic.
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This is part III of an initial series of articles about RAA. Here are links to the previous parts:

RAA Part I

RAA Part II

 

After 10 years of experience applying these ideas to professional roles and organizational structures, I began thinking about them in relation to my own life.

By this time one thing I knew for sure was that when nurses accepted responsibility for the Primary Nursing (PN) role, they experienced empowerment and manifested less victim behavior than before…..and much less than those who’s did not accept responsibility.

I also knew for sure that accepting responsibility was an experiential activity……not an intellectual activity.   You can’t just think you are responsible….you have to experience it, to literally place yourself in the position of being responsible, in order to have full access to legitimate authority.

In PN, this only seemed to occur when the nurse established a responsibility relationship with the patient.   The explicit establishment of that relationship was necessary in order for the nurse to experience responsibility acceptance. The closed door of power (personal or other) only opens when an individual experientially recognizes their responsibility.

So, my epiphany moment occurred when I asked myself the question of whether or not I had accepted responsibility for my life.

I immediately remembered with resentment areas of my life where I felt victimized.   My ex-husband, a former boss….etc.   With great clarity I knew that if I had truly accepted responsibility for all aspects of my life, I would not feel victimized by past events. As this thought process evolved, I recognized that accepting responsibility for one’s own life involves the three major components of behavior: thinking, feeling and acting.

So, accepting responsibility for my thinking meant I had to develop new thought processes.  Often, my thinking fell into automatic pathways developed over the passage of life.   These pathways needed to be examined and in many cases changed, as they led directly to victim thinking.

The new thinking required the development of new neuron pathways, and then also lots of deliberate practice until consciousness of choice became my automatic thought process in response to situations and events in my life. This involved learning to make space in my reactions to events and people for the experience of choice.

Likewise, accepting responsibility for my feelings meant I had to learn some skills for handling feelings in an appropriate way which also often involved changing the way I think.   The connection between thinking and feeling began to be more manageable. Further, accepting responsibility for my actions helped me recognize the connection between thinking and acting and how action can positively influence thinking and feeling.

This overall development required me to develop new ways of being in my life, and the results have been increased positive energy, increased choices, and increased well-being.

Role of Nurse Manager: Needs Support to be Supportive June 13, 2017

Posted by mariemanthey in Creative Health Care Management, Leadership, Professional Practice, Uncategorized.
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I’m reminded frequently about how strongly a leader’s influence drives the quality of work done…on nursing units and in every workplace.  The clarity of role definitions in the workplace – and in particular how the role of the leader is defined – is essential to effective leadership.

Leadership is often confused with limitless power.  Unclear scopes of responsibility for leaders and others creates confusion, unsatisfactory outcomes and personal stress among workers which in most cases results in bad outcomes.   This seemingly simple element is often the culprit of toxic work environments.

Leaders Empower Staff – that is the name of a basic curriculum component of CHCM’s work, and it’s also a phrase which sums up  much of our leadership philosophy and seminar focus.

We believe that the people who do the work should be empowered to make  decisions about the work, and good leaders actively support that by intentionally putting that power in the hands of their staff.

There are many specific skills and practices that need to be in place for the leader to do that and to support that structure. One of our accompanying basic beliefs is this: nobody walks in to a leadership role with everything already in place to be successful. Each new leader will have some parts of the skills set, and they’ll need to gain the rest on the job.

Each time a new leader is hired, there needs to be a systemic process of determining what they need to be successful in that role, and to provide the training, support, skills development, mentoring, etc.. necessary in order for them to grow in to that role.

Otherwise, insecure, ill-prepared leaders may assume that empowered staff are a threat to their authority and therefore to their success.   These leaders …at all levels in a hierarchy…..will hold on to power  to feel secure. Staff then are hindered from contributing at their highest level, restrained from using their actual knowledge and skill, and devalued within the workplace.  Morale is negatively affected.

Staff  need to be developed professionally so that they are confident and comfortable using their legitimate power.  Within their scope of responsibility, they need to learn how to identify operational problems, to generate solutions, to implement the solutions.  This level of employee engagement is a dream scene for most executives.

Both staff and leadership need to accept the fact that as humans, they’ll make mistakes, and that those mistakes are to be treated as opportunities for growth, not punishment. Integral to that is for leadership to actually react that way to mistakes!

Leaders do constantly need to bring their best selves to the job, to actively create for themselves a goal behavior pattern based on best leadership practices, and do their best to live up to those goals.

Accountability is crucial.

In some workplaces – within healthcare and outside of it – the accountability of leaders is sometimes problematic.  It is easy for leaders to obfuscate personnel problems, particularly if they don’t know how to or don’t want to deal with them..   The obfuscation may show up as being able to provide assurance to those they report to that staff are fine, operations are fine, progress towards goals is happening, the ship is tip-top. They may not  share sufficient detail about problem employees, hence  obfuscating their own responsibility to act, resulting in avoiding personal accountability as  leaders.   A great deal of the angst, stress and toxicity in workplaces today is due to inadequately prepared  leaders who are not held accountable for learning the basic skills necessary to create a culture of safety and empowerment.

Our values, principles and practices of Creative Health Care Management focus on changing workplace  cultures so that all members of the team (starting with the leader) have the support they need to produce efficient and effective productivity. The clear allocation of responsibility coupled with the delegation of commensurate authority and accountability are the key components to leadership and management success in every workplace.

The Nurse Managers who gain these leadership skills are the MOST essential element to creating a relationship-based environment that is healing for both the staff who work there and the patients who receive care there.

Personally… Being Mortal by Atul Gawande June 11, 2017

Posted by mariemanthey in Inspiration, Manthey Life Mosaic, Professional Practice.
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I lost a close friend recently, after a long struggle with some chronic medical conditions.

It’s a sad period, but one comfort is that his last days went as well as they possibly could. I’m reminded of this book: Being Mortal, written by practicing surgeon Atul Gawande.

In the book Atul explores what it means to ensure that the positive meanings of one’s life extend through the final phases of that life, clinically and in all other ways. Atul has completely defeated the normative medical profession’s reluctance to address that period after medicine stops being applicable. He explores what continues to be important for the person themself and their family.

I found it extremely moving and useful – not just for that period but for everyday. Highly recommend!

Additional Resources:

NY Times Book Review

Frontline: PBS Special

Pennsylvania Library Book Discussion Notes

The Guardian Book Review

Silo’s to Synergy: Symposium of Empowerment June 7, 2017

Posted by mariemanthey in Creative Health Care Management, Inspiration, Leadership, Professional Practice.
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In my career as change leader, I have constantly paid attention to what worked – and done more of that.

I’ve paid attention to what didn’t work – and tried to avoid that in the future.

A tactic for change that I’ve long been aware of is reaching outside the bounds of one’s own work area, and making connections with people who do different kinds of work. Finding common values and shared tactics with those people whose work is different from mine. Learning from their perspective on these shared values has been invaluable.

Oftentimes people in other areas have already invented this or that wheel, that I can use to get where I’m going faster (without having to invent it myself).

Much of the literature I’ve absorbed and learned from is written for a non-nursing audience – it was written for general business usually. Or sometimes was from other areas of the health care industry.

By reaching across the distance and making connections with others who share our goals, the work we can achieve together increases exponentially.

The CHCM International Relationship-Based Care Symposium will be that process, an accredited program curated specifically for leaders who want to achieve all they can in their careers.

We hope all of you attend who are able, and for those of you who can’t we will make available the materials and information as possible. It won’t be sufficient to create the experience and the relationships gained by attending, but we’d like to expand the positive outcomes in all ways possible!

Stay tuned, and if you have been able to see your way clear to attend just recently – it’s not too late to sign up!

Nursing: More Work to do than Time Available June 6, 2017

Posted by mariemanthey in Leadership, Professional Practice.
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Nursing staffs often face unpredictable peaks in workload. These peaks can occur at any time and maybe be caused by any of a number of factors: unexpected admissions, sudden changes in patients’ acuity levels, or true life-or-death emergency situations.

These peaks are sudden, stressful, and highly charged emotional events.

As workload escalates, experienced staff members begin prioritizing and scanning: scanning the care environment, selecting the next most important thing to do, and doing it.

This triage process may go on for minutes or hours, is informed by high-level critical thinking, and results in  patients receiving safe and adequate care but not receiving every item of ordered or desired care.

Those non-delivered care items are not consciously omitted, nor are they forgotten. In fact, they lie waiting in the nurse’s professional- thinking brain space until the stress is over, the documentation is done and they have left for the day. On the way home, these ‘undone’ activities float to the surface and cause feelings of guilt, failure and anger – anger because the quality of care delivered didn’t meet the nurse’s own standard for care.

I believe that the treatment for this situation is to acknowledge explicitly throughout the profession and throughout the health care system that, as professionals, nurses have the right and the responsibility to determine what to do and what not to do when there is more work to do than time available.   And when questioned,  nurses need to be able explain their rationale for the decisions that were made.

Common sense requires recognition of this reality.

Recognition and understanding of heretofore  ‘hidden truths’ about nursing work can lead to much more productive research and practices, and can help dispel legacy myths about nursing practice…that we  always give total patient care.   That leads us right into the dysfunctional mind set of fear and guilt about staffing that now is all too often present in the life of a staff nurse.

More about ‘hidden truths’ relation to nurse resources and nurse workload in another posting.

Belief: Health in Healthcare June 4, 2017

Posted by mariemanthey in Creative Health Care Management, Inspiration, Manthey Life Mosaic, Thought for today.
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From the notebook of Marie Manthey, 1982

Belief:

CNM (CHCM now) believes that the relationship between mind and body is absolutely integrated and that the state of mind clearly influences the health of the body.

Management of health professionals, therefore, must consist of teaching this relationship as a management value and teaching managers how to manage their lives.

Basic principles of management should be taught at both the humanistic and scientific levels.

Advanced management training programs we developed promote the use of unique creative living approaches to solving complex organization problems.

Hospitals must be healthy so that the staff can help patients regain their health. The organizational diseases of disinterest, apathy, anger, isolationism,  generally negative interpersonal relationships and the illegitimate punitive use of power are manifestations of disease and can be treated by changing attitudes and perspectives and teaching basic truths of human existence and behavior.