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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!

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.

Announcement: CHCM Book Release! May 22, 2017

Posted by mariemanthey in Announcements, Creative Health Care Management, Inspiration, Leadership, Professional Practice.
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I am  excited to let you all know about Creative Health Care Management‘s newest book publication!

It is called Advancing Relationship-Based Cultures, and I love both the content and the book’s authenticity regarding health care today.

Edited by Mary Koloroutis, and David Abelson, the book explores the  culture of health care organizations, what is  necessary for optimal outcomes, and 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.

A relationship-based culture is one in which a critical mass of people provides care and service with relational competence. In these cultures, the skills that foster relational competence are actively developed, nurtured, practiced, reinforced, and evaluated. While countless thought leaders have championed the importance of improving relationships, this book provides vision and strategies for system-wide culture transformation….and it does so with a depth and authenticity that is breathtaking.

Readers of this book will understand that a strategy that includes improving all relationships will improve all other measures as well. When you empower people, giving them the tools to take excellent care of themselves, one another, and the patients and families in their care; organizations thrive and patient-care is optimal.

Chapter Overview

  • Foreword: The Giver and the Receiver Are One
  • Overview: Advancing Relationship-Based Cultures
  • Chapter 1: A Relationship-Based Way of Being
  • Chapter 2: Attuning, Wondering, Following, and Holding as Self-Care
  • Chapter 3: Attunement as the Doorway to Human Connection
  • Chapter 4: The Voice of the Family
  • Chapter 5: Loving Leaders Advance Healing Cultures
  • Chapter 6: One Physician’s Perspective on the Value of Relationships
  • Chapter 7: Embedding Relational Competence
  • Chapter 8: The Role Human Resources in Advancing Culture
  • Chapter 9: Relationship-Based Teaming
  • Chapter 10: Care Delivery Design that Holds Patients and Families
  • Chapter 11: Evidence that Relationship-Based Cultures Improve Outcomes
  • Chapter 12: Relationship-Based Care and Magnet® Recognition
  • Epilogue: Continuing the Conversation
  • Appendix

Softcover, 344 pages. (2017)

ISBN: 978-1-886624-97-9

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

 

Symposium Update! May 15, 2017

Posted by mariemanthey in Academia, Creative Health Care Management, Inspiration, Leadership, Professional Practice.
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5 Reasons to Attend the 2017 International Relationship-Based Care Symposium – June 20-22 – Minneapolis, Minnesota

The 2017 International Relationship-Based Care Symposium is only five weeks away! It will be an event filled with inspiration, practical action, healing and hope for the future. Need more reasons to attend? Check out the brochure here, and book your flight!

  • Like-minded People with Shared Commitment:Surround yourself with an international community of health care leaders who are transforming the way health care is provided. You will leave inspired and have a renewed commitment to achieve excellence in health care.
  • Dynamic Speakers: David Cooperrider will engage you in the synergistic process of Appreciative Inquiry to boldly envision and commit to a collective future for health care. You will discover more about compassionate partnerships and the art and science of healing relationships with Robin Youngson. Maestro Roger Nierenberg will place you in the middle of a professional orchestra for a multi-sensory experience in organizational dynamics.
  • Celebrate Outstanding Work in the Field:Honor colleagues and learn from stories of extraordinary innovation with the healthcare teams who discovered them. At the Symposium Poster Extravaganza, health care leaders from all over the world will share innovative strategies designed and implemented at their organizations to advance Relationship Based Care and Cultures of Excellence.
  • Interprofessional Continuing Education: We’re proud to be partnering with the University of Minnesota Interprofessional Continuing Education to offer contact hours for this event. The symposium will highlight the critical role of interprofessional relationships in the domains of safety, quality, and experience of health care.
  • YOU WON’T HAVE ANOTHER CHANCE UNTIL 2021! The symposium is only offered every 4 years. Don’t miss this opportunity. Participants from 2013 said, “The most powerful conference I have ever attended!” and “I came here this week with hopes of finding a way to break the barriers between MDs and RNs, and I’ve taken away with me so much more. This has not only been a career changing milestone but a personal stepping stone that I will never forget!”

Read more about the Symposium and register today at chcm.com/symposium. See you in Minneapolis!

RAA Series May 2017 Part II of III May 10, 2017

Posted by mariemanthey in Creative Health Care Management, Professional Practice.
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By Marie Manthey

When the design of nursing service delivery and function allocation is organized with integrity and balance between Responsibility, Authority and Accountability (RAA), the hospital workplace culture is efficient, quality of care is high and organizational trust is in place. That dynamic is similarly true in all other workplace environments.

Working theories and ideas and practices from general industry have been put to use in our work over the years creating Primary Nursing, Relationship-Based Care and leadership practices, now we will also be expressing these ideas in terms of nursing as well as other workplaces.

In using these concepts to design the organization of work, four questions need to be answered. They are:

Who has decision-making authority, and for what time frame?

Is work allocation basically by task/skill levels or whole function assignment?

How is communication handled?

How is the whole function managed?

These four elements ultimately govern how most work is assigned and performed.   The way they are defined has a profound impact on the experience of the workers and the quality of the work.   I was astonished during the formative years of Primary Nursing to see major changes in both performance level and personal growth of individuals when the organization of work changed! That’s all that changed: not the patients, not the doctors, not the staffing, not the hospital systems.   With the same staffing levels, the same level of knowledge and skill of the workers, the same amount of tenure and experience, the quality of work dramatically improved, the culture of the unit did a 180 change and all involved, patients, nursing staff, physicians and others commented on the extraordinary difference they experienced.

For me personally over many years, I have observed whole nursing staffs move from a state of dependency-framed entitlement-voiced victim thinkers, to a group of professionals able to assume their legitimate role as full participants in the collaborative management of patient care.   In order for that collaboration to be real, registered nurses need to be in the role of Primary Nurse where they fully experience the professional autonomy that their license affords them.

Implications for Teamwork

Throughout my years of experience with these concepts, one issue has become crystal clear:   The morale of the work group has a profound impact on the quality of the work.   Furthermore, I fully realize that morale is the result of the interpersonal relationships of the work group, the way the staff treats each other in the face of these every day realities of hospital work. Strong team work and healthy staff relationships create positive morale. These and other attributes of Relationship-Based Care are essential to optimal patient care delivery.

Healthy interpersonal relations require three behaviors.   These are:

Open communication

Functional trust and

Mutual respect

Interestingly, it seems that liking/loving your team mates is not at all essential to healthy team work.   In fact, it matters little, if at all.   What is absolutely vital however is for each member of a healthy work group to accept responsibility for managing relationships using these behaviors.

Open Communication

Of the three, the most challenging is open communication.   It has been my experience, that difficult conversations are often avoided.   In highly stressful situations, this is even truer.   I have found that more often than not, the culprit is inadequate communication skills.   Most of us simply don’t know how to say hard things tactfully.   And the effort to learn that skill is often at the lowest point of a busy person’s priority list.

It is incumbent on everyone to find ways to deal directly with one another about difficult issues tactfully, and for others to learn how to not accept one workers complaint about another, unless it is to help the complainer figure out how to deal directly with the issue.

Functional Trust

In the sense used here, trust means trusting one another to do the work assigned in the right way.   This impacts interpersonal relations in many ways, as well as the effective utilization of the resource of support workers.

It is the person who mistrusts that has the biggest impact on team functioning and therefore it is incumbent on that person to identify and openly communicate to the mistrusted person what they need to do to regain trust.

Mutual Respect

This element is also absolutely key to healthy team work, and requires moving beyond role valuation when that valuation creates dysfunction.

It is vital that each member of the team be recognized as having equal potential for improving or destroying morale, and for contributing to their teams effectiveness.

Are these elements in place where you work now? What has your experience been, currently or at prior work places?

Questions or Comments? Join the conversation!

Part III of this particular mini-series on RAA is coming soon!

Timeless Treasures: ‘Utopia’ April 28, 2017

Posted by mariemanthey in Creative Health Care Management, Inspiration, Leadership, Professional Practice.
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By Marie Manthey

Utopia is a nursing unit where the staff members are treated with respect by both the hospital that hires them and they physicians with whom they work. It is a place where the respect people have for themselves and each other means that relationships are healthy and supportive. It is a place where people understand the value of maintaining their own peace of mind.

In this Utopia, nurses are self-confident and have a sense of self-worth. They know they aren’t perfect, and accept the reality that they will make mistakes. They understand that no one wants to make mistakes, but that mistakes are inevitable because they are human, and only God is infallible.

Nurses in Utopia have a sense of purpose in life and believe they have both the right and responsibility to shape their own futures.

Nurses in Utopia feel good about themselves and can therefore love their patients. They recognize and respect the interests of other nurses, patients and physicians and respond to them appropriately. These nurses have an ability to get the job done, even within their own limitations. They are free to use the very best level of skill, knowledge, intuition, and personality strengths they possess in administering care to their patients. They understand the fundamental value and worth of their profession and are ennobled by the dignity of the human interactions they engage in during the normal course of their professional activities.

Nurses began working in this Utopia early in the Nineties, when they finally learned that the essence of human growth lies in the self and that in order to grow, one must change and that each of us can only change ourselves — not anyone else.

References:

Relationship-Based Care Field Guide

Visions, Strategies, Tools and Exemplars for Transforming Practice

Editors: Mary Koloroutis, Jayne A. Felgen, Colleen Person, Susan Wessel

Part 1: Vision ||Chapter One: Begin at the BeginningPage 41

Originally published in Primarily Nursing Journal, 7[5].

Substance-Use Disorders in Nursing: U of MN curriculum incl Manthey’s story (video link) April 26, 2017

Posted by mariemanthey in Academia, Nursing Peer Support Network.
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School leads collaborative efforts to address substance use disorders in nurses
by: Brett Stursa

The numbers are well documented. About one in 10 people in the United States has a substance use disorder, which mirrors the number of nurses and other health professionals with the illness.

That means about 300,000 nurses nationwide are living with a substance use disorder, and in Minnesota that translates to about 12,700 nurses.

While the numbers are straight forward, the consequences of substance use disorders on lives are complicated and nuanced. Concerned about the scope of the problem and its impact on patients and nurses’ well-being, Dean Connie White Delaney, PhD, RN, FAAN, FACMI, sought to identify strategies to address the issue of substance use disorder in nurses.

“Nobody is untouched by addiction,” said Delaney. “Even though it brings to the surface many difficult issues, it is critical to the health of our patients and nurses that we talk openly and address it.”

In 2014, Delaney invited state leaders in licensing, education and recovery, as well as the school’s largest clinical partners University of Minnesota Health and Fairview Health Services, to develop a deeper understanding of the landscape in Minnesota and identify a blueprint for action. All who were invited were quick to accept the invitation. Shirley Brekken, MS, RN, FAAN, executive director of the Minnesota Board of Nursing, was eager to get to work. “I think that each of us was looking for something, for a way to protect the public, be supportive of recovery and make nurses aware of how easily addiction can occur,” said Brekken. “There was recognition that if we do it together we can have a far greater impact than if each of us is operating on our own.”

“Nobody is untouched by addiction. Even though it brings to the surface many difficult issues, it is critical to the health of our patients and nurses that we talk openly and address it.” – Dean Connie White Delaney

The group, called Prevention Awareness Addiction Recovery Reentry and Support, quickly determined that education and support were priorities. Since the first meeting in 2014, the School of Nursing developed and launched an integrated statewide approach encompassing education, prevention, recovery and support.

Educating students on the risks

A stressful job, stigma and shame about substance abuse, and a lack of education regarding self-identification all contribute to the risks nurses face. “There are a lot of risk factors that are unique to nurses that weren’t being discussed in the education that the students were getting,” said Dina Stewart, RN, a Doctor of Nursing Practice student who worked with Christine Mueller, PhD, RN, FGSA, FAAN, associate dean for academic programs, and others to develop a learning module for all pre-licensure students. “It’s largely something nurses don’t talk about still because of the stigma.”

The module, which will be made available to pre-licensure programs across Minnesota, is designed to help students understand the risk factors nurses face, with the idea that if nurses know their risks they are better equipped to avoid them. Another objective is to give emerging nurses a plan of action if a colleague exhibits symptoms. “One of my biggest hopes is that it can be discussed openly without any shame associated with it,” said Stewart.

Many nurses don’t seek help because they fear they will lose their licenses to practice. The education describes the protections in place to assist nurses and other health professionals. Minnesota offers nurses and other health professionals a confidential monitoring program. “Nurses are worried they are going to lose their livelihood when really there are protections in place to assist them if they come forward on their own,” said Stewart.

Introducing peer support for nurses in recovery

The goal is that the education being taught in the classroom will be bridged to extend to orientation and ongoing professional development in practice settings. Until recently, nurses who sought treatment and hoped to re-enter the profession had little assistance from each other. Nurses in Minnesota now have a peer support network, which works to foster peer support for nurses in recovery.

The meetings do not take the place of treatment or AA, but rather provide an opportunity for nurses to talk about their recovery and the challenges unique to nursing. “The main hurdles are stigma and shame. That’s especially true in nursing because we are dedicated to helping people and when we realize that we may have harmed people, the shame of that is overwhelming,” said Marie Manthey, RN, Nurses Peer Support Network board chair. Manthey’s own story of recovery is shared in the School of Nursing’s module.

Regular meetings of the network are held in eight cities across the state, and on any given week, there are 10 to 15 people at each meeting. Plans are underway to expand to more cities. “We would like to have meetings in every area where there are groups of nurses who would benefit from it,” said Manthey, a School of Nursing alumna.

Reflecting on the progress made and the work still to be done, Dean Delaney credits the group’s collaborative spirit and willingness to be vulnerable during difficult conversations for its successes. “What’s underlying the development of this integrated model, ultimately, is ensuring the highest trust and safety of the public and also supporting our professionals,” said Delaney. “The way to enhance the health of the public is ensuring the health of care providers, including nurses. We have the framework and we are committed to build on it.”

From the Heart – Writings in Process, an inside peek April 23, 2017

Posted by mariemanthey in Creative Health Care Management, Professional Practice.
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For this first ‘From the Heart’ note, I wanted to let you know what I’m working on next from my writing queue. Almost my whole career, there has been a constant backlog of things I wanted to write. Now, after all these years, it’s as intense as ever!

So there are two immediate things I’m working on: One on RAA, and the other on coping with workplace stress.

RAA – many of you know stands for Responsibility, Authority and Accountability. There are so many aspects to these concepts and their implementation – I could write a book about it all! Hey.. first things first though, we’re planning on putting out a series of articles in this space. We’d like to incorporate your comments, stories and questions as well! So anything you’d like to share, please feel free!

And then in the more immediate future, in the next week or two I’m planning to post some thoughts about the endless struggle to respond optimally to workplace stress. This is another struggle this is as present as ever these days. How is it going for you? Do you have any particular strategies that you’ve found special success with over the years? Is it an even higher mountain to climb lately? How is it going?

When you write, if there are aspects of your comments that you don’t want posted and/or if you want your name withheld or anything like that, just let us know.

Looking forward to hearing from you!

 

MM/cs