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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:

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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.

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.

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.

Learning Objectives for upcoming RBC Symposium! June 2, 2017

Posted by mariemanthey in Academia, Creative Health Care Management, Inspiration, Leadership, Professional Practice.
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Register Today for the International Relationship-Based Care Symposium, co-sponsored by the University of Minnesota School of Nursing!

From Silos to Synergy: Showcasing Fierce Commitment to Extraordinary Care

June 19-23, 2017

Join experts in compassionate care, leadership, and organized development at the 2017 International Relationship-Based Care Symposium. During this event, you will identify strategies that you and your team can use to improve interprofessional collaboration; and learn practical tools and actions to achieve committed partnerships, cross-departmental teamwork, and cultural transformation.

Accreditation

In support of improving patient care, this activity is planned and implemented by the University of Minnesota, Interprofessional Continuing Education and Creative Health Care Management. The University of Minnesota, Interprofessional Continuing Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Upon completion of this activity, learners should be able to:

  • Identify how health care systems investing in Relationship-Based Care are improving interprofessional collaboration and cross-departmental teamwork.
  • Articulate how a culture grounded in mutual respect, trust, commitment, and accountability promotes well-being of patients, families, colleagues, and self.
  • Describe how all members of the health care team can experience joy and meaning in their work through full engagement and shared purpose.
  • Discuss how to cultivate a health care culture that promotes synergy between health care disciplines to bring the organization’s vision and mission to life in daily practice.
  • Identify best practices in interprofessional partnership resulting in improved health care outcomes.
  • Define ways in which technology can be a powerful vehicle for strengthening partnerships between the health care team and the patients and families they serve.

Don’t miss this exciting opportunity, we are looking forward to seeing you there!

Discipline without Punishment (Poll!) May 30, 2017

Posted by mariemanthey in Creative Health Care Management, Leadership, Professional Practice.
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A crucial component of the Responsibility/Authority/Accountability paradigm is accountability, which means looking at results and determining what lessons can be learned, what needed behavior changes can be identified, what course corrections can be made.

Sometimes there is a need for the manager to address a staff nurse’s behavior directly, and the best way to do that is via positive discipline, which never includes punishment.   The derivation of the word punishment is penalty, while the deviation of the word discipline is learning.   We need a shift to discipline and away from punishment.

Punishment for mistake making and behavior problems is punitive when it incudes the intention of making the person feel shame or guilt.   Guilt as a behavior modification tool seems to be coming back in to popularity again, and that is truly mind-boggling.   And it is punitive.

I’d like to hear about your experience! Please join the conversation by participating in these two polls, and/or commenting.

 

Readers, please share examples of experiences when punishment (suspension, shame or guilt) was the goal; in contrast to times when discipline (learning) was the goal.

Memorial Day Remembrance: Nurses Serving! May 29, 2017

Posted by mariemanthey in Academia, History, Inspiration, Leadership, Professional Practice.
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Wartime nursing is unique, but also those periods in history tend to have an outsize effect on peacetime nursing as well. During World War II for example, huge changes took place. No one wants war, but we can honor those who served. I personally find this period fascinating, and with my work with the Heritage committee at the University of Minnesota School of Nursing’s Alumni Society, have been able to delve into it with great delight. Here are a few notes on some of what took place then, creating our present moment today.

As of 1943 the US Public Health Service had already funneled $ 5.7 m into nursing education, to stem the inevitable shortage of nurses, even as they knew that amount would be insufficient.

So Frances Payne Bolton, US Rep from Ohio, set in motion the Cadet Nurse Corps which was signed in to law that year. Under that program $150m was dispersed for scholarships and direct stipends – uniformly across the country, without regard for race and ethnicity, to all nursing schools.

Not only did this result in a massive surge of paramilitary recruits (targets were met every year), but nursing schools themselves radically transformed. The program was terminated in 1948, but by then 124,000 women had been enrolled, and nursing schools – especially those serving non-white populations – took huge steps forward in the condition of their facilities and equipment.

Here in Minnesota,  Katherine J. Densford, Director of Nursing at the U of Minnesota, was another leader active during that period, serving as president of the American Nurses Association among other positions.  She worked closely with Payne Bolton and Roosevelt to help supply nurses to the front lines – the University of Minnesota School of Nursing educated 10% of all US Cadet nurses educated during that period.

Densford also determined that the lag time between when nurses completed the recruitment application and when they were actually inducted actually took 6-8 months initially. She spear-headed efforts to reduce the bureaucratic tangle and as a result that lag time was reduced down to only 4-6 weeks!

A much needed -addition to the  Powell Hall nurses dormitory was built at the University of Minnesota with  Cadet Funds, and this is where I had my office while Primary Nursing was being created.

Another tidbit I wanted to share: May 1944, the national induction ceremony was held in DC, and it was for all nurses being inducted around the country, and so it was broadcast nationally on the radio.   KSTP carried in the Twin Cities. Thousands of nurses attended the induction  in Minnesota at the Northrop auditorium. The program included a song composed for the occasion, sung by Bing Crosby.

The ‘snappy’ nurse cadet uniform was actually created by Edith Heard – a famous Hollywood costume designer.  Wearing this uniform gave Cadet nurses the same ‘perks’ given to military men and women….like free admission to movies!

This bold initiative was a vital part of the war effort, serving both the military and civilian hospital needs.   This memorial day is a good time to remember the dedicated nurses who saved the lives of soldiers on the battle field.

 

Additional resources:

U of MN School of Nursing History

Leadership at the U of MN School of Nursing

Smithsonian website for the National Museum of American History, Kenneth E. Behring Center: