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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.

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

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.

Speak to Groups of People?? Never! May 21, 2017

Posted by mariemanthey in Creative Health Care Management, Inspiration, Manthey Life Mosaic, Nursing Salons, Professional Practice.
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Honestly, that’s how I felt in the early years of my career! The thought of speaking publicly was a nightmare.

As a student, I made a choice between the two options for my Master’s Degree based partly on which one involved less public speaking!

I was sure that speaking to large groups of people was not and would never be necessary for me – it is not a part of Nursing – and it terrified me.

I was physically affected – I’m not exaggerating – every time I had to do it for some reason.

I had nausea, I had knock-knees, I had so much static in my head that I could hardly hear my own thoughts. Every time I did it I felt like I had failed miserably, and no matter what, I would never do it again.

However, life went a different way for me.

I was part of the team that created Primary Nursing, and other people wanted to know about that process. There were two ways to communicate about it – speaking and writing. Writing took forever! The two articles we wrote in 1970 just took a really long time to put together, edit, format, get references, all of that. Then we did another article in 1973 – again, it just took a really long time. I was Chief Nurse at first one hospital and then another, and my available time was just very limited – it was really hard to fit in time for writing.

Much as I hated speaking, it was a way to deliver the information that I wanted others to know, in real time, most efficiently.

So for those initial five years of talking about Primary Nursing, it was excruciating every time. Every time I had knock knees, nausea, static in my head, the physical costs were huge. I would actually feel sick to my stomach just looking at my calendar and seeing a speaking date written on it. But I just had to go out there and do it anyway, because the importance of the message demanded it.

For me, getting up and speaking was a much more effective way to get the word out, than writing. People were curious and I wanted to let them know about Primary Nursing and its benefits for the nurse-patient relationship.  The effect Primary Nursing had on the patient’s experience – that’s what was so important. My passion about that essence of Nursing just saw no boundaries.

So, I made myself learn how to do public speaking, even though for most of the first five years, nothing got better. It was just as horrible, just as debilitating, just as uncomfortable every time as it always had been, for years on end.

Years later, little by little, it started to get better. I began to get some sense of self-confidence about it, to the point where I was actually able to look at  a speaking date on the calendar and not get terrible anxiety about it.

After that, I began slowly to not only be comfortable speaking, but to enjoy it. I began to be able to take in the visual and auditory feedback of the crowd and use that information to fine-tune my delivery. I learned how to be present with my message, and also present with the people I was delivering the message to.

And for these decades since then, speaking has been a huge positive for me. It’s still all about getting the message out – about Relationship-Based Care and other ways to enhance the nurse-patient relationship – in the best way possible.

The power of conversation is really what it all comes back to. I am engaging in a one-way conversation when I speak to audiences. I very much want for the audience to engage as well though, always. That’s why I like to speak within a schedule that allows for break-out sessions. I want folks listening to me to be able to speak with and listen to each other and me as well, and to have their experiences also be part of what is shared.

Nursing salons are another extension of that important need to connect – to hear each other and share each others’ experience.

Conversations Change People, People Change the World! – Margaret Wheatley

 

Blast from the Past: Feisty Former Chicagoan (1978) May 13, 2017

Posted by mariemanthey in History, Inspiration, Leadership, Manthey Life Mosaic, Professional Practice, Values.
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Primary Nursing: Hospitals bring back Florence Nightingale

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This article was one of the first in mainstream media about Primary Nursing, Marie Manthey .. and Florence Nightingale!

The picture on page 1 is so wonderful, isn’t it?

Here are some excerpts from the article, which you can see directly via the links at the top of this post.

“We’re not just dealing with inert lumps of flesh that hurt” Davis says. “We’re dealing with people’s emotional well-being, too. And that’s what makes nursing exciting again.”

Chicago Tribune: Sunday, February 2, 1978

by Joan Zyda

Sometime after World War II, the American registered nurse was forced into being less like Florence Nightingale and more like a factory foreman.

The shortage of nurses resulted in assembly-line nursing, which brought with it an assortment of nameless, often uncaring persons who trained for brief periods before being turned loose on patients. They were practical nurses, vocational nurses, technicians, orderlies, nurse’s aides, and nursing assistants.

If you’ve been in a hospital in the lst three decades, you have seen this production line in action. Somebody took your temperature, somebody else gave you a bath, somebody else took your blod pressure, somebody else brought in your food tray, somebody else …

Conducting this “orchestra” was, and still is, the chief duty of the registered nurse in most hospitals. Despite years of learning to care for sick people, she ends up in a supervisory job that takes her out of the mainstream of patient care. If she sees patients at all, it’s only briefly when she gives them a shot or a pill, or if there’s a “problem.”

“The patients are completely perplexed and often get irritable or depressed by this fragmented and impersonal care; it frights and frustrates the doctors; the morale of nurses sinks to an incredible low, resulting in a high turnover rate and absenteeism; and it has caused a decline in patient care at many hospitals,” says Dr. William Shaffrrath, diretor of the National Joint Practice Commission in Chicago.

The commission was set up in 1972 by the American Medical Association and the American Nurses Association to solve the growing dissatisfaction with hospital nursing care.

Teh solution, with which the commission has been shaking the pillars of medicine, is to put the registered nurse back at the patient’s bedside, where she can use her training. Some hospitals have already done this, including Rush-Presbyterian-St. Luke’s Medical Center, University of Chicago Hospitals, Good Samaritan Hospital in Downers Grove, and Evanston Hospital.

“Most nurses we talked to are frustrated. They don’t want to be supervisors,” Schaffrath says. “They prefer hands-on nursing in the Florence Nightingale tradition. They want to walk cot to cot, tending to and cheering on the patients.”

Schaffrath credits Marie Manthey, 42, a fiesty former Chicagoan and now vice president of patient services at Yale-New Haven Hospital in Connecticut, for blowing the whistle on nursing. She has advocated for the “return to the bedside” alternative in articles in several prominent medical journals.

As a registered nurse for 22 years, Manthey has had an inside look at the failings of her profession.

“Registered nurses have become faceless people, and it’s the system’s fault,” she says. “Nursing has become extremely production-oriented with very little concern for human needs. Most nurses are embarrassed about that. They say, almost apologetically, ‘Well, I’m just a staff nurse,’ which equates to, ‘I’m just a housewife.’

“But if nurses got their identity back,” Manthey says, “they’d be a proud people again. Then they’d be saying, ‘Hey, wait a minute. I am a staff nurse. I am an important person.”

“Nurses are supposed to be in the thick of things,” Manthey says firmly.

Manthey has coined her remedy, “Primary Nursing” a system whose main goal is just that — to get the nurse to provide total nursing care to a patient during their hospitalization. That means the same nurse does all the work for a patient from admission to discharge.

“The Nurse and the Patient get to know each other,” Manthey says.

With Primary Nursing, the nurse takes over many tasks she used to assign her aides.. because they’re all relevant to patient care.”

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For further content from this article, see clipping number 2, and/or let us know if you’d like us to post further excerpts here.

Isn’t it amazing to look back and remember the days when Nursing was at that factory-process level??

RAA Content Series – Part I May 2, 2017

Posted by mariemanthey in History, Leadership, Manthey Life Mosaic, Professional Practice.
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Part I

 

A useful framework for improving the workplace and other areas of life is RAA. RAA stands for Responsibility, Authority and Accountability. Those words convey multitudes of meanings.   Their use in this paper is based on definitions found in dictionaries, and applied in this article to:

Organizing complex functions,

Clarifying interpersonal relationship issues and

Achieving the full experience of will power.

To introduce this concept, I’ll share the story of its origins, and how this concept came to become the framework I hold up to every aspect of life.

It started when a group of nurses on a single hospital unit began to change the way they were taking care of their patients.   It was the late sixties and unrest was a societal norm.   I connect the underlying causes motivating the protesters and the changes initiated by these nurses.     These days, with different kinds of disruptions underway, the relevance of these concepts is higher than ever.

Paul Goodman wrote about decentralization, the Equal Rights Amendment was nearly passed, ‘power to the people’ was a popular slogan.   As I was trying to understand the principles behind the changes the nurses were making, I was led to literature about Responsibility, Authority and Accountability.   Interestingly enough, some of that literature was about the use of these concepts in military organization, and in the law.   Ultimately, I opted for a simple definition based on dictionary terminology.   My definition is as follows:

Responsibility – The clear allocation and acceptance of response-ability so everyone knows who is doing what (who is managing the process of each specific functionality being accomplished).

Authority – The right to act – to make decisions and direct behavior of others – in the area for which one has been allocated and accepted responsibility.   There are two levels of authority: Authority to recommend and authority to act.   Clarification of which level applies in each specific situations is functionally useful.

Accountability – The retrospective review of the decisions made or actions taken to determine if they were appropriate.   In the case of the decision-making having been non-optimal, corrective action can be taken for the purpose of improving functionality. That corrective action must never be punitive.

 

ORGANIZING COMPLEX FUNCTIONS

I spent the next 10 years pragmatically applying these concepts to both a delivery system for nursing care and to the complex bureaucratic institution known as a hospital.   These were not theoretical applications of concepts or armchair speculations, but rather actual reorganizations involving changing roles, relationships and responsibilities of real people working in real hospitals.   During that period of pragmatic and intense organizational application, I learned many things.   Among them:

  1. How changing work organization impacts on personal development, as well roles, relationships, work quality and energy levels of workers.
  2. How disparity in the balance between responsibility, authority and accountability at the personal, departmental and administrative levels of operations creates dysfunctional organizations and troubled human relationships.
  3. How personal maturity and responsibility acceptance are totally intertwined
  4. The defined difference between a profession, an occupation and a vocation.

IMPLICATIONS FOR ORGANIZATIONS

Lack of clarity and disparity of balance regarding among these concepts results in dysfunctional organizations and negative interpersonal relations.   These conditions in turn, produce low morale, inefficiency and low quality work.

First of all, the issue of clarity.   The scope of responsibility involved in each and every role, needs to be clear to both the person in the role and to those who interact with that role.   Role confusion regarding scope of responsibility creates incredible job stress and interpersonal tensions.   Whenever responsibility has not been clearly allocated, there is a power vacuum resulting in power struggles.   These power struggles can fall anywhere on the spectrum from having individuals assume authority way beyond their legitimate scope and …conversely,  things not being done because everyone assumes the other person will do it.   Role clarity with specific attention to scope of responsibility is essential to effective functioning.

Clarity of authority levels is also crucial.     The delegation of authority should ideally be exactly commensurate to the scope of responsibility.   An effective decentralized organizational structure will reflect careful attention to matching responsibility to authority.   In some situations, individuals may be unwilling to accept responsibility and will therefore be reluctant to use the authority they have been delegated.   These individuals will manifest continued dependencies and often fall into victim thinking. On the other hand, some individuals refuse (or are unable) to see the limits of their responsibility scope, and insist on exercising authority over functions that fall outside their scope of responsibility.   These situations result in an abuse of power.

When these elements are not in alignment, individuals affected by that have an opportunity to provide correction.   For example:

Imagine a situation where your boss asks you to take over a new function.   Maybe run a new clinic in a nearby town, in addition to your current clinic responsibilities. He/she says “You are responsible for getting this up and running and ‘in the black’ within a year.   Do a good job!”     You may say, will I be choosing the site we will rent?   And the answer is “NO …the site is already decided.”   You may then ask, will I be hiring the staff for this clinic?   And the answer is NO…. the type of staff (and consequent costs) will be controlled by Budget Control Office.   You may ask, will I have a marketing budget to announce this new service. And the answer is NO…that is under the control of the marketing department. And you say, will I have anything to say about location, equipment to be purchased, staff to be hired, services to be given and amount clients will be charged, to which every answer is “NO – someone else has that responsibility.” You are only responsible for bringing it into profitability within one calendar year. In this scenario, a wise employee would say, ‘Boss…. I am willing to coordinate the opening of this clinic and to do everything in my power to assure financial success, but I cannot take responsibility for that since I have no decision-making authority.’

.. to be continued

The Mosaic of Marie Manthey’s Life April 30, 2017

Posted by mariemanthey in Creative Health Care Management, History, Inspiration, Manthey Life Mosaic, Nursing Peer Support Network, Nursing Salons, Professional Practice, Values.
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ColoringBookCover

by Marie Manthey

I became ill at the age of 5 and was hospitalized for a month at St. Joseph’s Hospital in Chicago. It was a traumatic experience in a couple of ways. First of all, my parent’s didn’t know how to prepare me, since they had never been hospitalized themselves.. so they just said I was going to a large building. They left me there for a month, visiting twice a week, and sometimes when one or the other of them came, a very painful procedure was done involving an IM injection of their blood. As a result, I felt not only abandoned but also frightened and confused about the pain associated with their visits.

Florence Marie Fisher is the name of a nurse who cared for me. One day she sat at my bedside and colored in my coloring book. For me, that translated to ‘cared for me’ … and I decided then that I wanted my life to be about that kind of caring.

From that time on I knew I would be a nurse. I entered a hospital diploma program right after high school, and worked for the next four years as staff nurse, assistant Head Nurse, and Head Nurse. During the last of those years I started going to night classes in the community colleges .. not necessarily at first to get my degree.

I was invited to enroll in the degree program at the University of Minnesota, which was one-of-a-kind at that point. After 15 months of full-time study, I received my Bachelors degree in Nursing Administration. Soon after I was recruited into the U of M’s Masters program in Nursing Administration, in what was the last of the 3-quarter Master’s degrees.

Before finishing that degree, I was recruited by Miss Julian to be an Assistant Administrator of Special Projects. This was a new position that gave me an unbelievably valuable opportunity to learn first-hand about leadership and administration. I was able to experience directly not only organizational dynamics, but was also privileged to work with a group of administrators who used Senge’s principles of a learning organization even before he’d written ‘The Fifth Discipline.’

It was during this time that I became one of two Project Directors for Project 32 (at the University of Minnesota), a pilot program to improve hospital services from an interdisciplinary/interdepartmental perspective. This project eventually morphed in to Primary Nursing, and my career became about understanding and implementing organizational changes that result in the empowerment of employees and the accompanying development of healthy workplace cultures.

Throughout the next ten years of my life in nursing administration – first at another community hospital within the Twin Cities, and then at Yale New-Haven Hospital in Connecticut – I freely helped others with Primary Nursing.. Always accepting visitors and often speaking both locally and nationally as well as publishing as time allowed.

During this period of my career, what had been a manageable, socially acceptable level of alcohol consumption escalated in to full-blown alcoholism. There was an intervention and I entered a 6-week residential treatment program on the East Coast, and have been sober ever since.

In my first year of sobriety as I was feeling my way forward, there were no positions in Nursing Administration available to me. Instead I wrote my initial book on Primary Nursing .. and returned calls to all who had ever asked me to speak, putting out the word that I was available for speaking and consulting. The result was that Creative Nursing Management, Inc. was born, now the longest-running nurse-managed health care consulting firm in the U.S.

When I finished writing Primary Nursing, the publisher asked me who I wanted to dedicate it to.. and that had to be Florence Marie Fisher, the nurse who had colored in my coloring book when I was five. We weren’t able to contact her then, and so I gave up on that idea of actually connecting with her.

My career as a successful entrepreneur has continued ever since. Running a business was not ever something I thought I would do. I didn’t see myself as a businesswoman, but rather as a professional woman. Nevertheless, through many trials and many errors, the company grew. I often say we were successful not because of my business acumen, but rather because my work was authentic and based on real-world realities and values.

In time we grew into a multi-faceted, multi-national firm called Creative Health Care Management. I sold the firm when I turned 65 (in 2000) to the employees themselves. Now in semi-retirement (still, in 2017!) I remain involved in the important work of developing nursing practice and improving patient care.. just without the stresses and challenges inherent in leading an entrepreneurial entity.

An additional aspect of my work today involves tackling the challenge of Substance-Use Disorder. A group of us concerned with the problem of shame and stigma associated with SUD formed a Peer Support Network here in Minnesota, and we are partnering with entities involved in all aspects of the situation.

Another vitally important component of my professional life today has to do with my involvement with my alma mater. After transitioning away from day-to-day involvement in the running of CHCM, I became active in the Alumni organization at the U of M School of Nursing, and also became an adjunct faculty member there. In 1999 the University of Minnesota awarded me with an honorary doctorate, which was thrilling beyond compare. Today I am also active with the Heritage Committee at the School of Nursing, and am engaged in other ways as well with the University.

I also continue to be a part of my own and others’ Nursing Salons – a safe space for nurses in all walks of the profession to share conversations and support one another.

My ongoing interest in changing the way we think about workload and resources is part of the same picture. As healthcare incorporates more and more technology, the temptation strengthens to discard the human caring aspects.

As nursing matures as a profession, I am more convinced than ever, that the choice to care – and to express care and compassion by one’s behavior – is the absolutely correct choice nurses must make in order to continue to serve society justly.

Clinical competence must be on one side of the nursing coin, and care on the other. This is the ‘Coin of the Realm’ nurses must choose if, in fact, the covenant between nursing and society is to continue to exist.

Primary Nursing is 40 years old!! June 9, 2009

Posted by mariemanthey in Announcements, Creative Health Care Management, History, Leadership, Manthey Life Mosaic, Professional Practice.
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This year marks the 40th anniversary of the first development of  Primary Nursing – on a medical unit (station 32) at the University of Minnesota Hospital.

The really exciting part of this anniversary is an effort underway to gather the pioneers of that first unit, from the CEO, John Westerman to the other administrators including Dave Preston ( co-director of the project), Peter Sammond, Stan Williams, and nurse leaders  Pat Robertson (Clinical Nursing Director), Diane Bartels, (Head Nurse, now a PhD ethicist), Karen Ciske, (Nurse Clinician) Colleen Person (unit educator),  and as many of the unit staff as we can locate.

There is a reason it started at that place and at that time. Societal changes combined with an energetic surge of  internal hospital reform from the executive suite coupled with deep frustration and dissatisfaction within nursing set the stage for this change. The presence of several thought-leaders who were also involved gave us a system-focused, principle-based understanding of the meaning of the nursing practice changes that evolved. This understanding resulted in language to describe the innovation in a way that facilitated adaption to every setting where there are clinicians and patients.

That paragraph represents my understanding today about why it has had such an impact on practice and patient care. I am thrilled we are celebrating it’s 40th year.

The gathering we are planning is pretty unstructured at this time. So far, we are talking about getting together for lunch at Coffman Union at the U of Minnesota sometime in August. I’m thinking this is a golden opportunity for us to capture the insights and learnings of some key figures in what became a massive change process.  I’m interested in any suggestions readers have about what we should capture and how to do it. What would you like to know about the experience of the execs, nurse leaders and staff involved in the risk that led to Primary Nursing?

The RBC Symposium sponsored by Creative Healthcare Managemenet is the latest manifestation of the current resurgence of Primary Nursing.  This resurgence  has also led me to offer a 5 day practicum in August. Info about both of these is available on chcm.com