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Symposium Reflections July 30, 2017

Posted by mariemanthey in Creative Health Care Management, Professional Practice.
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This is a reflections from just on of the many mind-opening events of our recent Symposium. of the Symposium.

A Pre-conference was a program about the Daisy Foundation’s values and accomplishments through their recognition of exemplary nurses as nominated by their patients.   Studies of these scores have come under laser focus as reimbursement amounts are now based on those scores.    One of the findings had to do with how strongly a single negative experience colors the WHOLE experience for a patient…..even when 99% of the experience was positive.

It reminds me of a powerful paradox the sits within the nursing profession…..the fact that when nursing care is perfect, it simply shows that nothing (No THING) went wrong.   It is an absence that is difficult to describe, to count …and even to value.

So….it is fair to say about nursing….

Everyone knows when something is done wrong

No one knows when everything is done right…..because (NO THING ) has occurred.

P.S.  Your reflections welcome and much appreciated.

Symposium Review – from Renata Tewes July 28, 2017

Posted by mariemanthey in Creative Health Care Management, Inspiration, Leadership, Professional Practice.
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Professor Dr. Renata Tewes of Dresden, Germany was one of our international attendees at the Relationship-Based Care Symposium last month. 

Here are some thoughts she shared with us about the event.

What did I expect? Of course, an interesting conference, good discussions in the workshops and nice meetings with old and new colleagues during the breaks.

Nobody prepared me for what else happened on the RBC Symposium in Minneapolis. The name of the company organizing this event is Creative Health Care Management. The word creative could have been a sign, that it will not be a usual conference. It was not just interesting presentations and workshops.

It was experiencing, how it feels, when a conductor tests different leadership styles, while sitting in the middle of the orchestra. It was feeling the deep respect between a CNE and a CME while they have been explaining the importance and success of their honest relationship to each other. It was sensing the inspiring group dynamic of 400 people working with the method Appreciative Inquiry.

At the end of the conference I felt deep gratitude for being a part of this innovative process – when the participants build new relations, shared their true desires and helped in understanding – showing that building positive relationships in healthcare makes a difference. Needless to say, the empirical results of hospitals that establish Relationship-Based Care (RBC) speak for themselves.

Do I really have to wait another 4 years for the next RBC-Symposium?

Initial conversations about the next Symposium are already underway, and feedback like this is very helpful. We’d love to hear from you as well!

A Core Value: Humanization of Patients July 20, 2017

Posted by mariemanthey in Manthey Life Mosaic, Professional Practice, Values.
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Many many years ago I was being pressesd to articulate my deepest passion about Nursing.   Specifically,  what did I believe is the fundamental core value of the nursing profession?     After thinking about it deeply, I came up with a deep believe that  our most important role is to facilitate the humanization of patient care,…. which required that we first humanize the experience, practice and focus of nurses.   Nurses cannot humanize patient care unless they are empowered in their role and in practice.  Humanization of health care for patients  means  engagement of patients and their families in decisions about treatment choices, as well as end of life choices.    This ultimate exercise of free will is the pathway to fulfillment as a human….and the restriction of free will is dehumanizing.

I see this goal  becoming closer to reality in many situations, thanks to nursing’s incredible advances, as well as to advances in technology and  many other societal advances.   However,  I think much work is still needed to promote nursing’s role as patient advocates for their greater involvement in decisions.  The culture change we seek is to humanize patient care.   Nurses must support patients ability to accept responsibility for themselves, and to exercise their own  free will about their treatment and their lives, knowledgeable about the options that are available to them.

Empowered nurses are needed to empower their patients.

Whether the setting is an ICU unit, a Neo-Natal unit, or even hospice. Empowered nurses can make sure the patients and their families have all the necessary information to make their own life decisions – about end of life, or about courses of treatment – and that they are empowered to do so.

The change is coming.   Let’s make sure the nursing profession is ready to fully engage in the humanization of health care. The public is more ready than the health care system.

Happy Birthday Marie! July 17, 2017

Posted by mariemanthey in Creative Health Care Management, History, Inspiration, Leadership, Manthey Life Mosaic, Nursing Peer Support Network, Nursing Salons, Professional Practice, Thought for today, Values.
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This is Claire talking (Marie’s daughter, and co-editor of this site), checking in with you on this celebratory day!

I know Marie values each and every one of you, and loves hearing from you and having conversations with you – whether in person, in various professional / civic roles, on social media, here on the blog.

And so today on her birthday, I wanted to formally welcome you all back to this blog.

In the last few months, we’ve started to get active again — exploring various kinds of posts with a multitude of topics including Nursing: it’s history, challenges, future, best practices, values & inspiration etc.. as well as CHCM activities, Marie’s life (Mosaic), Nursing Salons, the Nursing Peer Support Network, activities at the University of MN School of Nursing, and so on.

If you have a moment today, would love to hear any preferences from you about types of content, questions you have for Marie, how often you’d like us to post, how you’d like to hear about posts, and anything else to make this blog a win-win.

We never know how long any of us have here. Marie is the epitome of taking care of herself, taking responsibility for her health and well-being, and we hope to have years and years yet. In any case, the more conversations she can fit engage in, the better!

Oh, one more thing- Happy Birthday Marie!

Thanks much for your participation.

Sobriety and Nursing – a Page from my Journal July 15, 2017

Posted by mariemanthey in Inspiration, Manthey Life Mosaic, Nursing Peer Support Network, Professional Practice.
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I just celebrated (June 26) my 39th year of recovery from the disease of alcoholism.   What an awesome experience this life is.

As I reflect on this period of celebrating both my natal birthday ( July 17) and my recovery anniversary, my gratitude just grows and grows.   In so many ways my experience as a nurse and my experience in recovery blend into one wonder-ful life experience.

Just one example of this deep connectivity and unity is that both nursing and recovery open doors to an unlimited opportunity to grow spiritually…to be open to the universe and all the wonders of nature, physics, culture and relationships.  There is no limit to what can be learned in every aspect of living in either recovery or in nursing.  No limit!

Additionally, both stimulate me to practice non-judgmental acceptance of what is….rather than be embroiled in day-to-day disagreements and conflicts.  Both are helping me put into daily life the wonderful question….DO YOU WANT TO BE RIGHT OR DO YOU WANT TO HAVE PEACE? Think about it!

Thank you for all you have and are giving me.

Leadership, by the book: the Army Manual book July 10, 2017

Posted by mariemanthey in Leadership, Professional Practice, Values.
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Re: 
U.S. Army's Army Field Manual 6_22 on Leader Development
i.t.o. psychological & psychiatric criteria for leadership.

This content is written by Prudence L. Gourguechon, widely known national expert on psychoanalysis for the fields of business, law, politics and marketing.

“Despite the thousands of articles and books written on leadership, primarily in the business arena, I have found only one source where the capacities necessary for strategic leadership are clearly and comprehensively laid out: the U.S. Army’s “Field Manual 6-22 Leader Development.”

“The Army’s field manual on leadership is an extraordinarily sophisticated document, founded in sound psychological research and psychiatric theory, as well as military practice. It articulates the core faculties that officers, including commanders, need in order to fulfill their jobs. From the manual’s 135 dense pages, I have distilled five crucial qualities:

Trust

“According to the Army, trust is fundamental to the functioning of a team or alliance in any setting: “Leaders shape the ethical climate of their organization while developing the trust and relationships that enable proper leadership.” A leader who is deficient in the capacity for trust makes little effort to support others, may be isolated and aloof, may be apathetic about discrimination, allows distrustful behaviors to persist among team members, makes unrealistic promises and focuses on self-promotion.

Discipline and self-control

“The manual requires that a leader demonstrate control over his behavior and align his behavior with core Army values: “Loyalty, duty, respect, selfless service, honor, integrity, and personal courage.” The disciplined leader does not have emotional outbursts or act impulsively, and he maintains composure in stressful or adverse situations. Without discipline and self-control, a leader may not be able to resist temptation, to stay focused despite distractions, to avoid impulsive action or to think before jumping to a conclusion. The leader who fails to demonstrate discipline reacts “viscerally or angrily when receiving bad news or conflicting information,” and he “allows personal emotions to drive decisions or guide responses to emotionally charged situations.”

“In psychiatry, we talk about “filters” — neurologic braking systems that enable us to appropriately inhibit our speech and actions even when disturbing thoughts or powerful emotions are present. Discipline and self-control require that an individual has a robust working filter, so that he doesn’t say or do everything that comes to mind.

Judgment and critical thinking

“These are complex, high-level mental functions that include the abilities to discriminate, assess, plan, decide, anticipate, prioritize and compare. A leader with the capacity for critical thinking “seeks to obtain the most thorough and accurate understanding possible,” the manual says, and he anticipates “first, second and third consequences of multiple courses of action.” A leader deficient in judgment and strategic thinking demonstrates rigid and inflexible thinking.

Self-awareness

“Self-awareness requires the capacity to reflect and an interest in doing so. “Self-aware leaders know themselves, including their traits, feelings, and behaviors,” the manual says. “They employ self-understanding and recognize their effect on others.” When a leader lacks self-awareness, the manual notes, he “unfairly blames subordinates when failures are experienced” and “rejects or lacks interest in feedback.”

Empathy

“Perhaps surprisingly, the field manual repeatedly stresses the importance of empathy as an essential attribute for Army leadership. A good leader “demonstrates an understanding of another person’s point of view” and “identifies with others’ feelings and emotions.” The manual’s description of inadequacy in this area: “Shows a lack of concern for others’ emotional distress” and “displays an inability to take another’s perspective.””

===========================

From an intraprofessional leadership perspective, this is a universal summary of essential leadership skills from a valid source.   Going back to Florence Nightingale, great leaders when matched to this set of criteria have great capacity to be powerful leaders who truly make a difference. Hospital origins were deeply linked to the military mindset of regimentation, discipline, following the chain of command, and maintaining discipline. Sometimes in ways that de-humanized patient care.

This value-based list of leadership skills represents an exciting awareness important values that can greatly improve performance and promote better engagement.

My own learning during the early development of Primary Nursing included an invaluable gift from ‘military literature’.    I don’t remember the exact document or book, but I know the conceptual paradigm of Responsibility Authority and Accountability came directly from a description of  a military ‘chain of command’ writing.   We were not using words like that in nursing during PN’s early development.

Every sector has a contribution to make to the collective well-being!

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References:

http://www.latimes.com/opinion/op-ed/la-oe-gourguechon-25th-amendment-leadership-mental-capacities-checklist-20170616-story.html

Meeting Challenges – Ripple Effects July 3, 2017

Posted by mariemanthey in History, Inspiration, Leadership, Professional Practice, Values.
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Nursing through a lens of history.

As we celebrate the victory in battle that lead to the signing of the Declaration of Independence this weekend, my thoughts are on how often nursing is spotlighted and impacted during wartime.  A cataclysmic example of this is the lasting affect  of Florence Nightingale’s work during the battle of Crimea.

That situation was a terrible one, full of despair and unpredictability.  Florence went voluntarily into that mess  because of how desperate it was, and acted on her values, knowledge and skills to change that reality. The depth of the damage to soldiers and the impact of her reforms  set in motion a profound  reaction, which in this instance included seeds of change vastly greater in scope than that particular problem.   The death rate among hospitalized soldiers was amazingly reduced due to her reforms, and the whole country of England honored her for this achievement.

In particular, she provided compassion, and she managed the environment to a degree of sanitation that was new to that setting. The depth and cohesion of her response to that situation was beyond what anyone expected.  No one involved in that war would have  predicted or imagined that the outcome of that war would be the modern practice of nursing.

When people engage in the struggle to do their best in difficult times, positive outcomes are more likely.. not only in that moment, but decades and centuries later.

Reading List – Treasures! June 30, 2017

Posted by mariemanthey in History, Inspiration, Leadership, Professional Practice, Values.
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Here are some books I’ve enjoyed and gained a great deal of insight and resources from. I’d love to hear your thoughts on these and your favorites as well!

The Power of Now by Eckhardt Tolle — I learned the incredible value of learning how to observe my thinking…..thus creating the opportunity to grasp a powerful truth.   That I am more than my thinking.   I am a whole being and by stepping away from my thinking I learn that my thoughts do not define who I am.    My being is more than my thoughts.   That awareness shifts my perspective on life.. Fascinating and exhilarating!

Small Great Things by Jodi Picoult – an ambitious tackling of the racial issues of our time, through the setting of nursing.   A highly experienced black nurse is forbidden by her nurse manager from taking care of the baby of a white supremacist couple….at their insistence.   The story from there presents a dilemma for the black nurse that results in a life-changing lawsuit.

Blessed Unrest by Paul Hawken (2007) – the world is undergoing transformational  changes of people, on a  small scale – in conversational salons and discussion groups, between neighbors and friends. These group conversations are about serious topics like spirituality and the role of governments.   And he makes the point that conversations can change people and people change the world.

The Immortal Life of Henrietta Lacks  by Rebecca Skloot incredible (true) story of medical ethics involving HeLa – two dime-sized tissue samples taken from Henrietta. The cells possessed unusual qualities and yielded amazing benefits for science; the effects for Henrietta and her family were.. less. Bioethics, racial injustice, and history co-exist in this story which starts in Baltimore, involves the Tuskegee Institute, and spreads benefits globally (for specific groups and humanity in general). Talk about health care disparity – really incredible. Recognition, Justice and Healing – hopefully this book brings us a step closer to these goals.  The film, staring Oprah Winfrey, premiered on HBO this past April and will be on DVD soon!

About a Paradox June 25, 2017

Posted by mariemanthey in Creative Health Care Management, Inspiration, Professional Practice.
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On CHCM‘s recent publication – ‘Advancing Relationship-Based Cultures’ by Mary Koloroutis and David Abelson.

This book was just released in the last few weeks, and was given out to all attendees of the International Relationship-Based Care Symposium.

Here is the first line of its ‘Epilogue:

‘It is a paradox that our work includes so many painful elements of the human experience and still ends up being, somehow, profoundly beautiful.’

That is a sentence I read when I first saw a preliminary draft of the book. I said to my colleague who I had borrowed it from: ‘Oh, this is so beautiful – it makes me want to cry.’

As I went on to read the rest of the paragraph, I was filled with awe at the authenticity and practicality used in the writing process.

The rest of the paragraph goes like this:

‘That contradiction is a lot for any one person to hold. It’s even more for a person to effectively make sense of it, to sort it out – to reconcile the paradox of it. Not very many of us can do that kind of reconciling in isolation.

 

Subsequently: RBC Symposium Day 4_ Thursday, June 22 June 23, 2017

Posted by mariemanthey in Creative Health Care Management, Inspiration, Leadership, Professional Practice.
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Collective process and action were the agenda for this amazing day!

Robin Youngson started off the day leading a session around the impact of compassion on the healing process.   He shared compelling scientific data on that impact, driving home the point that compassion GREATLY impacts healing.   It is hard to imagine any justification for not being intentionally compassionate.   It does not involve the use of time….just the use of heart and brain.

Another powerful event was an inter-professional conversation of young clinicians on  their work and their ideas about a better future for health care.   This was a ‘fishbowl’ type of event where they sat in the middle of the room on a raised dias, with the audience sitting around them…..listening to their conversation.   A stunning event….there is so much to learn from each other.

Culminating today’s events, David Cooperrider explained  the well-known Appreciative Inquiry (AI) methodology; and utilized that to lead participants through a synergistic process that focused on what people do right – instead of focusing just on problems.

Conference participants continually comment on the magnificence of this conference, how it is changing the way they feel and think and how grateful they are to be able to attend.