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Last Week’s Salon April 22, 2009

Posted by mariemanthey in Professional Practice, Values.
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We met at my house on  April 13th and had great conversation about nursing from many different perspectives. I can’t tell you how important these kinds of meetings are, and how deeply committed I am to helping this concept grow across the US. I do have guidelines available for anyone and you can receive them by just asking me for them. Also I am available for phone conversations to help other groups get started.

With permission from the writer, I am copying an email I received from one of the attendees of that Salon

Hi Marie,

I neglected saying goodnight and thank you to you last night, my  apologies.  I was in a discussion with Paula about evidence-based practice and we just kept talking and walked out!  Oh dear I thought,  but then I imagined, it was okay with you as the salon again fostered  great conversation.

Maybe its because I’ve been away for awhile, but last night struck me  silent.  I was deeply moved by R’s closing comments … I  actually had tears in my eyes. For the first time in her nursing  career she was proud of her profession.  Do we need any more proof how  powerful these salons can be?  I’ve missed them.

Thank you so much Marie! You enable us to ponder the wonder of nursing and how much we can touch other’s lives.  And I am grateful.

See you next time,  D.

So, you see readers, why I am so passionate about this idea … and see it as a way to bring true healing right into our personal/ professional lives.

I need to apologize for not getting to this blog more often and to let you know I intend to change that starting now. I will be responding to all comments after I complete this post.

The Growth of Salons January 27, 2009

Posted by mariemanthey in Nursing Salons.
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Here in the Twin Cities of Minneapolis and St. Paul, we now have 3 salons monthly, with a fourth one being planned.  There is a calendar of local Salons on the website of the Zeta chapter of Sigma Theta Tau at the University of Minnesota School of Nursing. A new development is that often now when I am invited to speak to a group,  they ask me to conduct a Salon while I am there. Plans exist right now for me to do this in California, Indianapolis, Washington DC, England and Germany.  A Salon will probably be starting soon near Chicago, and some colleagues of mine are planning to start one in Sao Paulo Brazil.

If anyone knows of other Salon start-ups, please send a note to this blog. There are a number of ways I can provide support.  Keep the information flowing. Post a note on this blog.

P. S. I am willing to ‘kick-off’ a Salon in your city/town. I won’t charge a fee.. just cover my expenses.

HAPPY NEW YEAR January 1, 2009

Posted by mariemanthey in Inspiration, Nursing Salons, Values.
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January One, Two thousand and nine.

What will this year bring?  Despite the economic down turn, which is undoubtedly affecting every single one of us negatively  in some way, there is the paradoxical feeling of HOPE  — for the future, the world, this country, health care and … the nursing profession.

The downturn is scaring new grads who entered school expecting life-long job security; only to find that in some regions low census numbers require staff reductions, lay-offs and empty positions not being filled. Those of us who have lived through these ups and downs  know this is temporary, but that doesn’t help a new grad with 30-50 K in school loan debt.   They need HOPE in the future job market.

HOPE. We all know the health care system is broken. We know we spend too much money on many things and not enough on other things, all because of reimbursement decisions made by someone somewhere. As the changes in the system come down the pike, I pray we as a community of health care workers find a strong voice to help the decision makers use our knowledge and skills to the maximum in order to improve the health of Americans and the humanity with which are sick are cared for.

As readers of this blog know, I am very excited about the potential for Salons to help heal nurses and to strengthen the contribution every nurse makes every day. I think our conversations help us think creatively about how we can better cope with stress and be a positive force for the health of society and to create healthy workplaces.

My personal HOPE for 2009 is that we have an astronomical increase in Salons — that they start up in every corner of the country. That besides purely nursing salons, another type starts up: interdisciplinary salons. First for doctors and nurses. For us to learn about each other as people so that our role relationships on the job can be healthier.

I am asking every who is currently running a Salon, or planning to start one, to please let us know through the blog or email me personally, so I can begin tracking the spread of this idea. My email can be accessed by clicking on my picture on the CHCM website (chcm.com).

We are moving up to four a month here in the Twin Cities.   We have a calendar posted on the University of Minnesota,  STTI chapter website and people can RSVP just by clicking a button. This is still just beginning, but I think we are creating a model that will help others.

2009. Just think of it. A New President. New problems. New solutions. HOPE.


Salon Replication! Great News! September 19, 2008

Posted by mariemanthey in Inspiration, Leadership, Nursing Salons, Professional Practice.
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3 comments

After several years of steady growth and solid experience, it became clear several months ago that more Salons are needed. There are several reasons why:

  • Many nurses commented that this is the only place they get to talk about really important issues they face.
  • I was notifying people Salons were “standing room only” or was starting “stand-by lists” because my living room walls wouldn’t expand any more.
  • It was becoming so crowded people weren’t getting enough chance to talk

So, we started encouraging others to consider sponsoring, and I wrote up some easy guidelines to help.  I am delighted to tell you that we now have two new monthly Salons, and a third one may be starting up in the near future.   I am ecstatic!

A calendar of Salons is being developed for the U of M School of Nursing, Zeta Chapter website and I hope to see even more proliferate.  My dream is to have a calendar on the website where any nurse can go any time to find a Salon that fits her schedule and is in her neighborhood.  Maybe 8 or 10 a month! Around the metro area, including the suburbs!  We have a ways to go, but this is a start. It feels similar to the start of Primary Nursing in that it feels so right that it must be replicated.  As you read the posted comments, you can see that people are interested in other parts of the country and I will do everything I can to help them be successful.

***

BTW, I took the summer off  from the blog, but not the Salons. I apologize for not checking it more and sharing our experiences at the Salons we held every month. I will do better at keeping up with the blog.

Last night’s Salon was another powerful experience. There were about 18 people here and the conversation was fairly general: three senior students talked about their “first job jitters” and a couple of middle aged nurses and a soon-to-retired nurse talked about “reinventing” themselves.

Then a relatively new grad told of a recent incident with a patient of hers who fell and sustained an injury. The unit was very busy and the new nurse was not able to get someone in to help her return the patient to bed, despite asking several people — everyone was too busy.   She felt she failed by not being assertive enough and was suffering extreme guilt because she felt totally responsible. That comment opened a floodgate of experiences we had all had when we were involved in a mistake and also very valuable information about root-cause analysis and other error-prevention measures currently in use. The upshot of all of us sharing our “mistake-experiences” was a sense of deep connection.

The new nurse felt the kind of support I had received from my head nurse fifty years ago, when as a new grad, my patient fell out of bed and I felt so guilty I believed I was unworthy to be a nurse. I truly believed I needed to give up nursing!

My head nurse put her arms around me and made me promise to come back to work the next day. She did that for several days.   Last night, all of us, from student to retiree, did just that for the new nurse.

During check-out several people commented how extraordinary the discussion had been and how good they feel being a nurse.

The students had the rare opportunity to again hear the truth about the real world of nursing, something for which they frequently express heartfelt appreciation.

Update (9/29/2011): You can find the Zeta Chapter’s calendar of Salons in Minneapolis metro area here.

“Make Them Stop Fighting” May 16, 2008

Posted by mariemanthey in Academia, Nursing Salons, Professional Practice, Values.
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5 comments

At last night’s (May 15) Salon, a Clinical Nurse Specialist told of an incident he was involved in yesterday, when another staff member asked him to “make them stop fighting”. The “them” was a Nurse Practitioner and a Medical Resident. The “fight” was a role conflict that surfaced during a patient discharge. You can guess. The resident said the practitioner was practicing medicine and the practitioner said the resident … well, you can fill in the blanks. This “fight” delayed the patient’s discharge by 5 hours!

This was one of the many experiences the 20+ guests brought to last night’s discussion. And this particular incident led us into an interesting and informative discussion of role conflicts: what they mean, how to deal with them, and how to avoid them.

Two of the guests had graduated just the day before our gathering and are interested in how to enter the work world in a healthy way. One guest was a nurse leader from Kenya, Africa, whose issues mirror ours in so many ways, even when the systems and the cultures are so different. She spoke of the problem of nurses not being confident and many people talked about ways to acquire inner strength as a nurse.

A topic brought up almost every month is the issue of “entry level” into practice. A related topic was the new roles being created in new education programs. ADs,BSNs, MN, CNS, CNL, DNP, Phd. Last night we eliminated some people’s confusion. Others learned about new developments. The discussion ultimately focused on the many complexities we face, and how we, as a profession, stay united in purpose and integrated in message as we continue to evolve.

As always, the contribution of individuals reflected the uncertainty and pain of change — but also the hope and belief that, whatever our preparation, our relationships with patients, with ourselves and each other is the key to honoring our covenant with society.

***

I encourage everyone reading this to, first of all, add your 2 cents worth to the discussion. I love to read your comments and will respond. Secondly, join me in a campaign to replicate these Salons. I am convinced that nurses desperately need a safe place to talk about the issues we face in daily practice, as well as the complexities of providing appropriate care in the broken health care system.

I will help anyone interested in getting one started. I have a new written description that summarizes my experience hosting one for seven years. The healing that occurs when these deep connections are made about important experiences is truly profound. And it is very easy to have a salon. Just ask and I will tell you how easily it can be done.

The wonderful thing about these gatherings is that there is no agenda, no minutes and no action steps! No carry-over from one to another. Each one is a total event in itself. We just come together in a safe environment, agree to professional confidentiality and use the Socrates Cafe format to handle the discussion. The result is hope and healing.

My goal now is to have websites throughout the US where a nurse can go to see the Salons scheduled in his/her city/town for the month! Nurses can then pick the one to go to based on their own schedule and the events location.

Several of us have started talking about how to do this. Frankly, we don’t have a road-map, but then,we didn’t have a road-map for Primary Nursing back in the late sixties. Look how that idea spread from one unit at the U of M to a world-wide movement!

I know this one can too.

Nursing Salon on Jan 17, 2008 January 21, 2008

Posted by mariemanthey in Nursing Salons, Values.
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3 comments

The group at this Salon was another interesting mixture of different ages: from a couple of student nurses, to several new as well as senior Staff Nurses, Nurse Managers, an Educator, a retired Physician and a couple of Clinical Nurse Specialists.

The discussion eventually focused on pressures created by the health care system and the relationship issues present in current practice settings. Systems and Relationships.

As usual, the electronic medical/health record was front and center, but not only the usual age-related differences in use and perception. This discussion also focused on how electronic records are changing the thought processes nurses use.  A very experienced NICU staff nurse mentioned the reality that critical thinking also refers to decisions about what not to do, which is equally as important as the decisions about what to do. However, the structure of the EMR  requires those decisions to be revisited in order to complete documentation.

That comment just opened the door to more discussion about the control over practice thinking that is mandated by the EMR.  An experienced Delivery Room nurse commented about the problem of trying to put in q2min. vitals during a critical episode (not having learned typing), while another commented on the ease of her system that automatically inputs physiological data from another computer system. Both realities impact the nurses’ thinking.

And of course, this whole discussion was framed around the issue of relationships: nurse/patient, physician/nurse and nurse/nurse.  We talked about how important is is for students to learn, while in school, to manage  themselves in these highly stressful situations. It also became clear  that if that skill is not learned in school, it must be learned in the workplace.  The key to healthy relationships is the ability to manage oneself.

At the end of the evening,  comments reflected the belief that the human contact between patient and nurse is the eternal and important truth about nursing and that there is hope it will always remain at the core of our practice.

Here are a couple of follow-up emails I received.

Marie,Thank you for allowing me to attend your last Salon with my preceptor, Michael P! I had a wonderful time. You are an excellent cook and an engaging conversationalist!

I am in the process of writing a paper about the CNS impacting organizational culture. While researching, I came across a paper written by Lorraine Hardingham, a nurse clinical ethicist, who defends her position that “as human beings, we are essentially interrelated, and therefore, both personal and professional integrity, rightly understood, is relational in nature.” It seemed to fit with that night’s themes of Systems and Relationships. I attached the article if you are interested.

You mentioned that you’d be willing to send files on how to start a Salon. I hope to finish the CNS program in May and pass the certification exams. Then, I would love to start a group here in the Fargo-Moorhead area. Please send your information when it is convenient for you.

Again, thank you for a memorable time of connecting at your home.

With deep regard, Patrick S.

And from Deb M:

Again, another stimulating evening Marie. I come home all revved up and unable to sleep with thoughts racing through my brain. Thank you so much for these incredible forums! I am able to feed my body and my soul and I thank you

The Salon Last Night:: Dec. 6, 2007 December 7, 2007

Posted by mariemanthey in Nursing Salons.
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There was a large group here last night, several returnees and several first-timers. The mix of newbies and old-timers was energizing, and provided both balance and passion to the discussion. Mid-career nurses brought workplace dysfunctionality experiences to the discussion, while students and new grads expressed concern about being accepted as members of a nursing staff after they graduate and about being able to handle the incredible stresses and workloads required of staff nurses in today’s hospitals. Because we were able to listen to each other intentionally we quickly found common ground to express ways to handle various situations within the workplace and to acknowledge the value of the wide age-distribution that exists in nursing today.

One nurse spoke with deep feeling about a terminally ill seven-year-old whose disfigurement in death was extremely disturbing to this nurse in her second year of practice. Older nurses were able to help this young nurse see this experience from a perspective that was both comforting to her and that allowed her to see the value she brought to this patient by her compassionate presence. It is this kind of support and perspective that is only available from seasoned nurses who have learned these things from their own experience.

It brought to my mind again the importance of using reflective practices to absorb and learn from the often incredible experiences we nurses have in this work of ours. In the old days when student nurses lived in dorms there were usually times and opportunities to talk about the sometimes mind-blowing sights, sounds and smells of nursing, of dealing with life and death and disfigurement. In today’s health care reality, nurses often don’t have time to even talk to colleagues at work, and end up suppressing or stuffing unprocessed feelings. These Salons provide that kind of opportunity and really deserve to be replicated. I would like to help anyone get one started, and I have a written description of the way to do it which I am happy to share with everyone.

Salon Update June 18, 2007

Posted by manthey in Nursing Salons, Professional Practice, Values.
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The Nursing Salon has enjoyed some good publicity in the current issue (May/June 2007) of NurseWeek. We continue to experience, with the Salon, a healing of the hurts sometimes created by deep-seated problems within nursing practice. A sense of hope continues to be the most prevalent content on our check-out at the end of each discussion. No matter the number of people, no matter the age, no matter the level of education (we have LPNs and PhDs) no matter the specialty, no matter the setting — when we come together to talk about what is currently on our mind about nursing, the talk is authentic, value-driven, and powerful.

I would love to see this idea spread. I believe some other groups have started up and I would love to hear from you, how it is going. I would be happy to help anyone get another group started, and I have information on how to go about doing so. It is practically stress-free for all of us … me as the host and all those who come. If anyone wants info or help, email me at mmanthey@chcm.com. I will share our experiences, answer your questions and to what I can to support to your group.

Increased Salon Activity September 5, 2006

Posted by manthey in Inspiration, Nursing Salons.
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I have always wondered what would happen if salons all over the county were touching the heart of nursing.  It looks like I am beginning to find out. Over the weekend, I received this email from Dawn, a nurse in Virginia.

I just wanted to let you know how you have inspired me. I read your article on the Nursing Salon and have since started a nursing salon of my own at our hospital. Our salon is a combination book club/discussion group. We read a book and then meet for “lively conversation” and refreshments!  We have read Code Green: Money-Driven Hospitals and the Dismantling of Nursing (we used several of your articles and interviews to support the reading and supplement the discussion) and we just finished Suzanne Gordon’s Nursing Against the Odds. The Nursing Salon is fully funded (I applied for a Nursing Morale Grant and was awarded $1,000 from our health system) and so there is absolutely no cost to the participants. We have increased in numbers since beginning in May and presently average 20 participants each month. Thank you so much for all you have contributed (and continue to contribute) to the profession; you are an inspiration to us all.

Dawn, thank you so much, both for your kind words and for starting another salon. I hope your inspire others.

When I first read Code Green, I was sort of heartbroken. It was a book about people I knew and respected tremendously and hospitals I considered among the best in the country from a nursing practice point of view. So I was disheartened. Then I found out about changes at the very top and a refocusing of the facility. I was given the opportunity to conduct rather lengthy interviews with the new CEO and CNO, and my feeling of devastation was greatly relieved. Although the culture changes required in order to merge these two great places was enormous, the new leaders were able to go to the staff for answers about how to improve the situation. You can read my conversation with these leaders in this back issue of Creative Nursing.

Please keep my blog updated on your salon activities. The same goes for everyone else.  Let me know what you are doing. If this idea takes hold, there might be a regular section of the blog devoted to Salon Notes.