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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.

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.”

ATTENTION: Blog Revision April 19, 2017

Posted by mariemanthey in Announcements, Values.
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I want to announce a new beginning here on my blog!

In coming weeks and months you will notice a much increased level of activity here! I’m bringing my daughter, Claire Stokes,  in to the operations of the blog, in her capacity as Managing Editor (previously of Primarily Nursing Journal), in order to provide you with much greater access to my career-long body of work. We will be creating and making available written content that will be a combination of completely new writing and the best of past writing, as well as the best out there of the work of others. This will culminate into a new era here on my blog. And we want to invite you to participate more as well.

We are doing this NOW for several reasons:

  • Time is passing, and I want to provide all I can that is of use to you while I have the chance
  • Challenging times call for heightened values-based activity on all our parts, and this is my way of giving what I have to the struggle
  • My daughter has availability now that I am able to take advantage of
  • I am bursting with new ideas and content that I want to share with all of you!

I am looking forward to being more in touch with all of you throughout this process. With Claire as the logistics person, I’ll be able to respond more to your comments and your requests for content also. So feel free to let me know what’s on your mind, and your responses to what we publish here and elsewhere!

NURSES IN RECOVERY….. September 1, 2014

Posted by mariemanthey in Announcements, Nursing Peer Support Network, Professional Practice.
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Substance use is a serious problem in society and even more serious in the nursing profession.
Nursing is the largest single licensed group within health care. Nurses spend the most time of any health professional in close contact with highly addictive drugs. Historically, chemical dependency and alcoholism have long been identified as significant issues for the profession. Addiction continues to be a major problem….and yet, no nurse enters the field expecting to succumb to a hidden trap that will jeopardize his or her own life and/or license and which may in fact cause harm to vulnerable people entrusted to their care.

The sacred, trusting covenant the nursing profession has with the public is ripped apart by the disease of addiction. Statistically, at least one in ten nurses will acquire a Substance-Use Disorder (SUD) within his or her lifetime.

SUD identification often results in an intervention that brings the individual into a place of treatment.

Regardless of how that identification is triggered, two actions ensue:

  •     the regulation of practice to protect patients, and
  •     treatment of the disorder.

Both the regulation by the Board of Nursing and the reality of treatment and recovery are major life consequences that are challenging and life changing. The need for peer support groups is well understood and already established for most other health professional groups, including physicians, pharmacists and dentists, but there is no such support group for nurses in Minnesota.

UNTIL NOW. A new organization is being formed called the Nursing Peer Support Network. Contact me for further information until our website is up. Meanwhile….this is a draft of our eventual goal statement.

To create within the nursing profession a commitment to value every single nurse….especially those on the road to recovery from SUD. This commitment is manifested by ‘return to work strategies’ that permeate every level and type of employment opportunity throughout healthcare. Nurses will become literate about SUD and recovery and be able to help others in places of employment better understand how to reduce the risks of employing in recovery…..even those with felony convictions. Various strategies and educational opportunities will be created to achieve this goal.

We need you help and support. Feel free to contact me via blog directly to my email or call me at 612-827-1611

Happy New Year January 2, 2011

Posted by mariemanthey in Professional Practice, Values.
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One of my New Year’s Resolutions is to post on the blog more often and use it for the kind of conversations that promote healthy interactions and pride in our profession.

One way I want to do that is to encourage nurses to reflect deeply on the meaning of our work, as the connection to our deepest values helps energize our work. It is rewarding to an individual nurse to appreciate deeply the privilege we have in alleviating pain and increasing comfort at any and all levels of our patient’s vulnerabilities. Experiencing this intrinsic reward is important for each nurse’s self-care.

Another  goal I have is to keep bringing up certain realities about staffing I call these “hidden truths”  that need to be acknowledged and understood by nurses and by the system.

  • nursing work is never done
  • nursing work is unpredictable
  • nursing work is uncontrollable (it is based on pt. acuity and  MD orders, neither of which nurses will ever legitimately control
  • there is always more work to do than time available.
  • prioritizing involves deciding what NOT TO DO when there is more work to do than time available.  The truth is there has always been and will always be more work to do than time available.

More of my thinking on this topic is in Creative Nursing Journal, Vol 15, Number 2, 2009.  The article is entitled, A Brief Compendium of Curious and Peculiar Aspects of Nursing Resource Management.  It is time for staff nurses to quit driving to work fearing they will be short-staffed and driving home at the end of their shift angry because there wasn’t enough help.

Finally, I encourage you to view this short video. It is meaningful for nurses and people at many different levels of being.

Happy New Year!

http://www.ted.com/talks/brene_brown_on_vulnerability.html

Video clip on Primary Nursing November 10, 2010

Posted by mariemanthey in Announcements, Creative Health Care Management.
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There is a short video of me talking about Primary Nursing on You Tube you might find interesting.   Click here to watch CHCM’s YouTube channel

I think    you’ll get there by this link…..enjoy.

Facebook? Twitter? April 3, 2010

Posted by mariemanthey in Nursing Salons.
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I’m looking for advice about how to use social networking for on-line Salons. Anyone want to help?

A Salon in England May 21, 2009

Posted by mariemanthey in Nursing Salons, Professional Practice, Values.
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Last week, on the eve of Nightingale’s birthday, nurses gathered in a private home to have a discussion about nursing. They invited me to be there for the kick-off of the first Salon in the UK. It was energizing, rewarding and exciting. The issues we discussed had to do with the basic values of nursing … and what it means to use a holistic approach. I felt completely at home, although I had only met one or two of the people there before. But: we were nurses … and there is a feeling of knowing one another that surfaces at times like this.

This event  took place in Doncaster, near Leeds, north of London. Hopefully more will start up around the UK and this first one will continue on a regular basis.

A couple of my English nurse friends were there, including Steve Wright, a well known leader in the UK whose book Sacred Space has guided my thinking about my own spirituality and the connection spirituality has with nursing practice. A couple of other leaders were there as well.

The age/experience/education span was as generous as it is here. We had a student nurse and a wonderful retired enrolled nurse (similar to LPN here). The passion for practice encompassed all present.

I am hoping someone who was there will contribute to the blog and that everyone starts sharing this experience with the nursing community through this blog.

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.