Week 5: July 19- July 25th
Sometimes at work I get disillusioned with the thought that there is no hope. Working with families as they welcome new babies into the world is supposed to be happy work. People always gush when they hear what I do for a living, "Oh how fun that must be". The problem is, whenever people are involved, there are broken people. Broken families, broken lives, broken futures. Lost hope.
My preceptor works with the disadvantaged populations in the Fort Worth area. Like many others in both commercial and charitable organizations. As with any other area of nursing burn out is a factor. This week my preceptor was wondering, "What is the point? Is what we do really making a difference?"
On our first day we had a meeting with a man associated with the United Way. He has just assumed a new position and was clearly inundated with the tasks at hand. He was coming on board to repair a community service program that had been running in a non-optimal fashion. We sat and they discussed the enormity of the tasks and how to find the will to continue.
This meeting about the two organizations became a meeting of encouragement to both of them. They realized they are not alone and they are not the only ones working toward this common goal of a healthy community.
On our second day, we visited the mobile units on location at a neighbor market. The manager of the market shared with RG how grateful he and the corporation were that they were out serving their customers. Apparently there is a homeless shelter behind the market that RG didn't know about and the women in the shelter were accessing our services. The market was providing food and supplies to the shelter.
We met a woman (patient) on the unit who told RG that it was her third year of using the mobile for her well woman exam. RG kept saying, "Three years." She began her week feeling worn out. But by Thursday afternoon she was encouraged and charging full steam ahead. Generating ideas and refreshed.
It was encouraging to me to see this process play out. While my work, the families, the future of those babies seems hopeless...I know better. My hope comes from the Lord Almighty. The One who I watched meet RGs needs. Who met her where she was at and revealed to her some of the effects her work is having. He is the same one who gives me a love for the unlovable mothers. The ones who I want to judge, but He insists I love. I don't know how anyone can survive nursing without Him.
July 20th: 10 hours
July 23rd: 10 hours
Total: 60/60
Monday, August 3, 2009
Wednesday, July 22, 2009
Cultural Diversity & Outcomes Data
Week 4: July 12- July 18th
This week I accompanied my preceptor to a diversity action committee meeting (DAC). The agenda included discussion of the role of this committee of less than 20 people affecting the system culture of a 14 hospital corporation. Each hospital has their own (DAC) in various stages of functioning. The system wide diversity action team made up of two representatives from each facility met and discussed goals and progress for diversity in action.
Our facility is apparently leading the charge in creating a diverse culture. Now this team of people are taking responsibility of leading the other facilities in adapting their cultures. While acknowledging that their is still work to do at "home", these people are willing to act as change agents. This demonstration of professionalism was very inspiring. They took ownership of something that others could have seen as far removed. Made me grateful to work at this facility and to be part of such a great group of professionals.
I also assisted in compiling a spreadsheet of outcomes data for a sister facility. The mobile units had participated in a community outreach and the nurses involved were investigating the effectiveness of the program. We compiled data related to zip code, ethnicity, age, and follow up. The nurses were then planning on directing future health screenings based on the data. I appreciated the fact that they were using data to determine the communities needs.
All and all a great week of exemplary examples of professionalism in nursing.
July 13th: 8 hours
July 15th: 8 hours
Total: 40/60 hours
This week I accompanied my preceptor to a diversity action committee meeting (DAC). The agenda included discussion of the role of this committee of less than 20 people affecting the system culture of a 14 hospital corporation. Each hospital has their own (DAC) in various stages of functioning. The system wide diversity action team made up of two representatives from each facility met and discussed goals and progress for diversity in action.
Our facility is apparently leading the charge in creating a diverse culture. Now this team of people are taking responsibility of leading the other facilities in adapting their cultures. While acknowledging that their is still work to do at "home", these people are willing to act as change agents. This demonstration of professionalism was very inspiring. They took ownership of something that others could have seen as far removed. Made me grateful to work at this facility and to be part of such a great group of professionals.
I also assisted in compiling a spreadsheet of outcomes data for a sister facility. The mobile units had participated in a community outreach and the nurses involved were investigating the effectiveness of the program. We compiled data related to zip code, ethnicity, age, and follow up. The nurses were then planning on directing future health screenings based on the data. I appreciated the fact that they were using data to determine the communities needs.
All and all a great week of exemplary examples of professionalism in nursing.
July 13th: 8 hours
July 15th: 8 hours
Total: 40/60 hours
Thursday, July 16, 2009
Mid Term Self Evaluation
Mid Term Self Evaluation
2 Course Clinical Objectives and 2 Personal Objectives so far in the course
Course Clinical Objective
1. Leadership Skills: Demonstrates leadership in the development of online unit communication tool. Improving communication and satisfying system requirement for documentation of continuous improvement and shared governance. Developed a blog for distribution and intake of information from staff. For example the change of process in documenting charges is communicated in person and on the blog. The blog allows staff to provide feedback regarding changes.
2. Critical Thinking: Gathers data regarding undetected deviations from policy in patient identification. Makes direct observation of patient intake procedure on mobile unit. Identify point of deviation and develops a plan to re-education staff. Numerous patient identification errors have taken place. I identified the source of error as being a failure to follow patient identification procedure at many points. A staff meeting was held and re-education begun. This included placement of reminder flyers in patient intake areas to prompt staff and educate patients.
3. Professional Accountability: Follows university’s policies, seeks own learning. Seeks opportunity to be of assistance to preceptor in projects and completes projects in timely manner. Working with preceptor’s schedule changes to accomplish clinical goals.
4. Client Advocate: Worked to correct billing issues for patients. Worked to advocate for patient privacy protection and safety in observance of patient identification policy.
5. Cultural Competence: Worked to promote culturally competent care while serving the Vietnamese community. Encouraged signage in mobile units include translations for common languages of people served.
Course Objectives and relate them to your work in your specific clinical site, by providing examples
Discuss current trends and issues in the nursing profession – Discussed the role of the Wellness Clinic and Mobile Units in emergency preparedness. Questioned about role of center in possible pandemic H1N1 response. Also discussed need for more participation and spearheading in preparation effort.
Communicate effectively, both verbally and in writing, with individuals, groups and health care providers. – Communicating with community partners via email, phone, and fax. Communicating with unit staff, delegating tasks related to patient identification policy re-education. Communicating with Nurse Practitioner regarding care of patients and flow of work.
Demonstrate critical thinking in the delivery, collaboration, and coordination of nursing care. – Assist in coordinating mobile unit scheduling at various mulitple sites while allowing for one unit to go in for service.
Incorporate professionalism and personal accountability in the implementation of nursing care. – Encouraging staff to be personally accountable to following procedures for patient safety. Encouraged to strive for excellence even when not being directly supervised. Shared personal story to staff demonstrating transparency of practice and personal accountability regarding a personal error in practice and method used in reporting and correcting error.
Function as a client advocate through collaboration with health care providers. – Worked to clear up numerous billing errors as client advocate. Clarified services provided, charges to account, insurance coverage. Developed spreadsheet and delivered to preceptor showing data related to incorrect billing.
Demonstrate leadership skills in health promotion and health maintenance of individuals and groups. – Demonstrate leadership in increasing preparations for H1N1 demand for services with fall flu season. Working to protect community through promoting preparation for individuals and families according to CDC recommendations.
Incorporate research into the practice of professional nursing. – Educate men regarding research in prostate health recommendations. Encouraging them to know their own PSA number and take ownership of their health.
Enact the nurse’s role in health promotion and health maintenance for individuals and groups from various cultures. – Coordinate culturally competent care to Vietnamese community in Arlington through utilization of translators and observing common Asian cultural norms.
Statement of your personal objectives and discuss how you have or have not accomplished them, supporting them with reasons and/or examples
· Enhance communication with peers with a focus on delegation, through the application of communication theory.
Spoke to unit at staff meeting regarding new UBC communication tool and appropriate professional communication.
· Use time management principles in the scheduling of clinical days.
Established schedule with preceptor at beginning of semester. As a professional courtesy, be flexible with preceptor as her schedule changes. Still assure that my clinical goals are being met in time allotted by adding days when needed.
· Objectively evaluate the Wellness Programs ability to meet the Fort Worth community’s needs.
Identified a need for preparation for possible increased demand of services with the H1N1 and seasonal flu this fall.
· Identify at least one opportunity for enhanced community service in the Wellness Program
Identified a need for preparation for possible increased demand of services with the H1N1 and seasonal flu this fall.
· Identify one process improvement issue in the mobile units.
Encouraged preparation of administration paper work packet in office prior to taking on the mobile unit. Utilize patient stickers to label paperwork whenever possible to streamline paperwork.
· Identify one patient safety issue in the mobile units.
Identified failure to comply with patient identification policy by numerous staff at multiple encounters within mobile unit. Worked to address the problem through re-education.
Statement and discussion of 1 way in which these items discussed above have enabled or fostered your growth as a professional nurse.
My experience in this clinical with community health has reinforced to me the need to continue my education. The community needs nursing to seek higher education and help fill the gaps in the current healthcare system. My preceptor has inspired me that an individual can make a significant difference in the community they serve.
2 Course Clinical Objectives and 2 Personal Objectives so far in the course
Course Clinical Objective
1. Leadership Skills: Demonstrates leadership in the development of online unit communication tool. Improving communication and satisfying system requirement for documentation of continuous improvement and shared governance. Developed a blog for distribution and intake of information from staff. For example the change of process in documenting charges is communicated in person and on the blog. The blog allows staff to provide feedback regarding changes.
2. Critical Thinking: Gathers data regarding undetected deviations from policy in patient identification. Makes direct observation of patient intake procedure on mobile unit. Identify point of deviation and develops a plan to re-education staff. Numerous patient identification errors have taken place. I identified the source of error as being a failure to follow patient identification procedure at many points. A staff meeting was held and re-education begun. This included placement of reminder flyers in patient intake areas to prompt staff and educate patients.
3. Professional Accountability: Follows university’s policies, seeks own learning. Seeks opportunity to be of assistance to preceptor in projects and completes projects in timely manner. Working with preceptor’s schedule changes to accomplish clinical goals.
4. Client Advocate: Worked to correct billing issues for patients. Worked to advocate for patient privacy protection and safety in observance of patient identification policy.
5. Cultural Competence: Worked to promote culturally competent care while serving the Vietnamese community. Encouraged signage in mobile units include translations for common languages of people served.
Course Objectives and relate them to your work in your specific clinical site, by providing examples
Discuss current trends and issues in the nursing profession – Discussed the role of the Wellness Clinic and Mobile Units in emergency preparedness. Questioned about role of center in possible pandemic H1N1 response. Also discussed need for more participation and spearheading in preparation effort.
Communicate effectively, both verbally and in writing, with individuals, groups and health care providers. – Communicating with community partners via email, phone, and fax. Communicating with unit staff, delegating tasks related to patient identification policy re-education. Communicating with Nurse Practitioner regarding care of patients and flow of work.
Demonstrate critical thinking in the delivery, collaboration, and coordination of nursing care. – Assist in coordinating mobile unit scheduling at various mulitple sites while allowing for one unit to go in for service.
Incorporate professionalism and personal accountability in the implementation of nursing care. – Encouraging staff to be personally accountable to following procedures for patient safety. Encouraged to strive for excellence even when not being directly supervised. Shared personal story to staff demonstrating transparency of practice and personal accountability regarding a personal error in practice and method used in reporting and correcting error.
Function as a client advocate through collaboration with health care providers. – Worked to clear up numerous billing errors as client advocate. Clarified services provided, charges to account, insurance coverage. Developed spreadsheet and delivered to preceptor showing data related to incorrect billing.
Demonstrate leadership skills in health promotion and health maintenance of individuals and groups. – Demonstrate leadership in increasing preparations for H1N1 demand for services with fall flu season. Working to protect community through promoting preparation for individuals and families according to CDC recommendations.
Incorporate research into the practice of professional nursing. – Educate men regarding research in prostate health recommendations. Encouraging them to know their own PSA number and take ownership of their health.
Enact the nurse’s role in health promotion and health maintenance for individuals and groups from various cultures. – Coordinate culturally competent care to Vietnamese community in Arlington through utilization of translators and observing common Asian cultural norms.
Statement of your personal objectives and discuss how you have or have not accomplished them, supporting them with reasons and/or examples
· Enhance communication with peers with a focus on delegation, through the application of communication theory.
Spoke to unit at staff meeting regarding new UBC communication tool and appropriate professional communication.
· Use time management principles in the scheduling of clinical days.
Established schedule with preceptor at beginning of semester. As a professional courtesy, be flexible with preceptor as her schedule changes. Still assure that my clinical goals are being met in time allotted by adding days when needed.
· Objectively evaluate the Wellness Programs ability to meet the Fort Worth community’s needs.
Identified a need for preparation for possible increased demand of services with the H1N1 and seasonal flu this fall.
· Identify at least one opportunity for enhanced community service in the Wellness Program
Identified a need for preparation for possible increased demand of services with the H1N1 and seasonal flu this fall.
· Identify one process improvement issue in the mobile units.
Encouraged preparation of administration paper work packet in office prior to taking on the mobile unit. Utilize patient stickers to label paperwork whenever possible to streamline paperwork.
· Identify one patient safety issue in the mobile units.
Identified failure to comply with patient identification policy by numerous staff at multiple encounters within mobile unit. Worked to address the problem through re-education.
Statement and discussion of 1 way in which these items discussed above have enabled or fostered your growth as a professional nurse.
My experience in this clinical with community health has reinforced to me the need to continue my education. The community needs nursing to seek higher education and help fill the gaps in the current healthcare system. My preceptor has inspired me that an individual can make a significant difference in the community they serve.
Monday, July 13, 2009
Communication Style
Week 3: July5-July11
One of my personal objectives in this class is to improve communication with coworkers. This objective came out of an awareness of my tendency to run into situations where others feel I have been offensive. The thing is, I actually make an effort not to be offensive. So when it occurs I am usually surprised that whatever I said has offended someone. Feedback I have received has included "it's not what you said, it's how you said it" and "I can't explain it, but there is something about the way you said that" or "it is just something about your tone". I think there is a kind bluntness to my communication. I am not intentionally rude so I say it kindly but it is blunt nonetheless.
This week with my preceptor, I assisted her with the resolution of an incident report. Actually, there were three incidents committed by 1 person on 1 day. This high level of error led to the Risk Manager of the facility contacting Rosemary to discuss the employees job placement. In the discussions, we uncovered that there was actually a process improvement issue across the board. Staff are not following the patient identification policy and there are HIPAA violations occurring because of it.
My blunt tendencies, were revealed as Rosemary and I discussed the employee and her future. I asked Rosemary what is the turning point in the employees relationship with the company. When does it become a move toward releasing them? She stated that it is all about the attitude. That if an employee does not want to take steps to improve themselves and is resistant to the correction then it is probably time for them to go. I was ready to give up on the employee.
I was witness to numerous conversations about this employees future and livelihood. I learned from the different types of communication techniques demonstrated by Rosemary and the Risk Manager. Especially in the way they spoke about this sensitive issue with respect for the employee. Not just the words used but the content of their conversation. They were working on developing a plan that would help this employee be successful. They weren't ready to give up on her. Even if this particular job assignment "wasn't a good match" for her they weren't ready to give up. There was no apparent bluntness.
7/7: 7 hours
7/10: 4 hours
Total: 24/60
One of my personal objectives in this class is to improve communication with coworkers. This objective came out of an awareness of my tendency to run into situations where others feel I have been offensive. The thing is, I actually make an effort not to be offensive. So when it occurs I am usually surprised that whatever I said has offended someone. Feedback I have received has included "it's not what you said, it's how you said it" and "I can't explain it, but there is something about the way you said that" or "it is just something about your tone". I think there is a kind bluntness to my communication. I am not intentionally rude so I say it kindly but it is blunt nonetheless.
This week with my preceptor, I assisted her with the resolution of an incident report. Actually, there were three incidents committed by 1 person on 1 day. This high level of error led to the Risk Manager of the facility contacting Rosemary to discuss the employees job placement. In the discussions, we uncovered that there was actually a process improvement issue across the board. Staff are not following the patient identification policy and there are HIPAA violations occurring because of it.
My blunt tendencies, were revealed as Rosemary and I discussed the employee and her future. I asked Rosemary what is the turning point in the employees relationship with the company. When does it become a move toward releasing them? She stated that it is all about the attitude. That if an employee does not want to take steps to improve themselves and is resistant to the correction then it is probably time for them to go. I was ready to give up on the employee.
I was witness to numerous conversations about this employees future and livelihood. I learned from the different types of communication techniques demonstrated by Rosemary and the Risk Manager. Especially in the way they spoke about this sensitive issue with respect for the employee. Not just the words used but the content of their conversation. They were working on developing a plan that would help this employee be successful. They weren't ready to give up on her. Even if this particular job assignment "wasn't a good match" for her they weren't ready to give up. There was no apparent bluntness.
7/7: 7 hours
7/10: 4 hours
Total: 24/60
Sunday, June 21, 2009
Two for the Price of One
Week 2: June 14-20th
This week I began my clinical experience. My preceptor is Rosemary an RN with a Masters in Public Health. She oversees the Wellness for Life center of a hospital in downtown Fort Worth. This includes the mobile health clinics that are used to serve the community and provide health fairs for corporations. She also oversees health fairs and a few other outpatient clinical sites at the hospital itself.
Rosemary was my first choice in preceptor because I am interested in community health. In my past experience, I have worked with FNPs who developed and operated mobile health clinics to serve people in outlying areas without access to care. I wanted to know what was involved in the management of this type of service.
I had 2 clinical days this week one in the office and one in the field. The day in the office I observed Rosemary work on time and resource management. We also had a meeting about Magnet re-certification. As part of the Magnet preparation, we realized the unit needed to document it's CI project and form a functioning UBC. The problem is that the "unit" (the people who make the unit) are mobile. I proposed a mobile UBC. I am developing a blog UBC, where the unit can access the information from UBC and submit comments while in the field. Within the blog, I will document the CI project that they have been working on, meeting the two goals for Magnet preparation.
My second day was at a corporate health fair where they were performing men's health screenings for employees. The focus was on early detection, education, and encouraging regular PCP visits while building hospital loyalty. I spent most of my day with Gayle an RN with a Masters in Nursing Education who was helping Rosemary. Gayle runs the prostate cancer education center and is the head of the nursing research board for the facility.
Gayle talked to me in depth about the behind the scenes funding that goes on in our facility. She was a wealth of information about the politics in funding. She also shared her passion for prostate cancer and men's health. I watched as she educated the men, using EBP, with the most current information available on prostate cancer. She also shared how she is working to develop a new service for patients who are diagnosed with lung cancer.
At the end of my day, I felt glad to contribute and grateful for the wealth of knowledge these two ladies shared with me. My preceptorship is going to be a great experience!
6/16: 7 hours
6/19: 6 hours
Total: 13 hours
Preceptor Selection
Week 1: June 7-13th
The task of selecting a preceptor came as an unexpected one. It was another frustration in the lack of preparation I have felt through this BSN process. It is easy to feel disconnected from the University when you are an online student. The school of nursing has failed to provide leadership for online RN-BSN students that is consistent. For the task of finding a preceptor, it would have been helpful to make us aware in the leadership class that we would be completing clinical hours and we could have been locating a preceptor over the break.
It may seem like I am just complaining. In fact, I am looking at the process of being an online RN-BSN student from the management/professional nursing perspective and seeing opportunity for improvement. When your BSN program is unorganized and no on seems to be planning ahead or know what is coming next, what does that say about the quality of the program? What does it say about the professionalism of the program?
In every setting there are ways to improve the process. Who is the professional nursing leader that is evaluating the process and working on improving it? I have recently begun to ask this question in my clinical setting (as well as at TWU). I have recognized the strengths in my manager and some opportunities. Our unit is in a time of transition and watching her 'lead' us through has revealed she may not be up to the task.
When I realized I needed to find a preceptor I sent an email to my manager and the department director on the same day. While they both are very busy with many responsibilities the director got back to me within 24 hours. Within a few days she had sought out information from me about what I desired in my clinical experience and contacted a potential preceptor. By four days later I had an emailed preceptor agreement.
My manager responded to me 8 days after my original email. 8 days. I received her email on the day I completed my first clinical. This slow response and unprofessional behavior makes it difficult to respect her as my 'leader'. It did however reinforce a lesson to go to the right resource person. It also gave me new respect for my director.
Friday, June 5, 2009
Unofficially Underway!
Summer semester is unofficially underway. I am nervous about this class and maintaining my GPA. Since spring semester ended I had surgery and am off work until July. Now trying to figure out how to get in the clinical hours for this course is weighing heavily on me. My biggest concern is that my employer won't let me precept at our facility because I am on disability...so I am just having to wait it out and see what happens.
I have been involved in leadership in some way or another all my life. From leading a group of girls on the school yard to being both formal and informal leader on my current unit. It is funny that even while I am off work, the issues on the unit are being brought to me via email or facebook!
I enjoy helping my coworkers navigate conflict situation. I am thinking about this role in the development of my personal objectives for this class. I think I need to improve my communication style and techniques. Some of the problems I have had relationally at work revolve around communication. My manager recently told me she thought I would fit well into a CI position. So these are some of the things I am considering to discuss with my as yet unknown preceptor.
I have been involved in leadership in some way or another all my life. From leading a group of girls on the school yard to being both formal and informal leader on my current unit. It is funny that even while I am off work, the issues on the unit are being brought to me via email or facebook!
I enjoy helping my coworkers navigate conflict situation. I am thinking about this role in the development of my personal objectives for this class. I think I need to improve my communication style and techniques. Some of the problems I have had relationally at work revolve around communication. My manager recently told me she thought I would fit well into a CI position. So these are some of the things I am considering to discuss with my as yet unknown preceptor.
Friday, April 17, 2009
Nurses as Teachers - a Magnet force
Well almost everyday I work, I have a student assigned to my patients. Sometimes I enjoy the students and sometimes I just wish they would go away! This past week I went 2 for 3. So I have decided to take a new approach with them. First thing in the morning I ask them what they would like to get out of the day, and what they expect from me. Essentially asking them their personal objectives for their clinical experience. Working in mother/baby, often the students have no interest in that department. So given they don't really want to learn about the nursing process related to that patient population, what else can I teach them?
So yesterday I had a fun loving, outgoing male 26 year old, working on his second degree. He doesn't intend to work mother baby so I taught him time management and critical thinking. I made him think through things: Me: "Can you get the patient some jello" Student: "Sure, where is it?" Me: "In the pantry behind the desk" Student:"There wasn't any in there" Me"Where did you look?" Student:"In the fridge" Me:"Try looking in the door of the fridge" Student: "Oh, OK"
He returns victoriously with the jello in hand. Me:"What is she going to do with that jello" Student: "eat it????" Me: "Is she going to do some Jello shots?" Student:"Ohhh, a spoooon!"
Eventually the patient got the jello and a spoon! Actually the critical thinking came with the diabetic patient who prior to pregnancy had been on oral meds with insulin therapy started during pregnancy. She was post op 12 hours on clear liquids 1800 ADA which was presented on a tray as non-diabetic juice, jello & popsicles....Me: "What do you think about this tray?"
So going the extra mile to teach while providing patient care and learning an ever evolving process related to the EHR, is exhausting! But very rewarding...and at the end of the day my student said "I really learned a lot today. Thank you" He was surprised and grateful and I realized I like teaching! Oh oh...double masters??? FNP and Education?
So yesterday I had a fun loving, outgoing male 26 year old, working on his second degree. He doesn't intend to work mother baby so I taught him time management and critical thinking. I made him think through things: Me: "Can you get the patient some jello" Student: "Sure, where is it?" Me: "In the pantry behind the desk" Student:"There wasn't any in there" Me"Where did you look?" Student:"In the fridge" Me:"Try looking in the door of the fridge" Student: "Oh, OK"
He returns victoriously with the jello in hand. Me:"What is she going to do with that jello" Student: "eat it????" Me: "Is she going to do some Jello shots?" Student:"Ohhh, a spoooon!"
Eventually the patient got the jello and a spoon! Actually the critical thinking came with the diabetic patient who prior to pregnancy had been on oral meds with insulin therapy started during pregnancy. She was post op 12 hours on clear liquids 1800 ADA which was presented on a tray as non-diabetic juice, jello & popsicles....Me: "What do you think about this tray?"
So going the extra mile to teach while providing patient care and learning an ever evolving process related to the EHR, is exhausting! But very rewarding...and at the end of the day my student said "I really learned a lot today. Thank you" He was surprised and grateful and I realized I like teaching! Oh oh...double masters??? FNP and Education?
Thursday, April 2, 2009
Crunch Time
Well at this point in the semester it begins to feel like you are home free. This feeling is deceptive. It is actually the busiest time of the semester. All papers start coming due, while the weekly work stays on pace. Meanwhile I am feeling more ahead than before, wrong! I am feeling the presence of these five classes waiting anxiously to register for the final 2 this summer. Mentally there is something to registering for the final step! Of course for me that the end of the beginning and in the fall the Masters program. I have applied and await notice of acceptance.
Saturday, March 28, 2009
Spring What?
That was anything but a break! I am worn out. We are in a very busy season of back to back out of town guests, school and health issues. We might have a surgery coming up and I am not sure I have time for that. I am hoping our family can put off the surgery until May 19th! Well see? In the mean time, time management is the key.
I continue at work to brainstorm regarding the communication problems that I will be addressing in my paper. I have been discovering some of the communication requirements that our facility requires but that our unit is neglecting. I am excited about making a difference.
I continue at work to brainstorm regarding the communication problems that I will be addressing in my paper. I have been discovering some of the communication requirements that our facility requires but that our unit is neglecting. I am excited about making a difference.
Sunday, March 15, 2009
Spring Break
For the first time since 1989 I lucking forward to spring break! I am taking my children to San Antonio which will be our first visit. Sometimes good leadership means knowing when to put work aside and have some fun!
Wednesday, March 4, 2009
Discipline
All lives have seasons. This for me is a season of discipline. I must be disciplined to manage my responsibilities or I will succumb to faulty time management. Sitting at the computer to write DB postings, blogs, papers etc...puts you in the vulnerable position of searching the Internet. I keep multiple windows open at a time, pandora for music, blackboard of course, TWU email, and Facebook! Although I have to say I am sort of over FB, I still check it a couple times a day. Yesterday, I ended up on Ebay looking for some computer software which led to looking for a computer...which led to me saying, "What are you doing?".
For the most part I am disciplined with my time, out of necessity. One of my coworkers asked how school was going, what was I taking etc...when I told her she said, "what are you trying to do kill yourself?" Absolutely not! Honestly, the only way I am surviving this season is by relying on others. My husband, daughters and most importantly my Savior - Jesus. He is the God of my days, the God of my nights, the Divine of my discipline and the Peace in my peril. In my weakness He is made strong. By his Holy Spirit, I will be led back to my task from Ebay or FB, and given clarity to see it through until the end.
For the most part I am disciplined with my time, out of necessity. One of my coworkers asked how school was going, what was I taking etc...when I told her she said, "what are you trying to do kill yourself?" Absolutely not! Honestly, the only way I am surviving this season is by relying on others. My husband, daughters and most importantly my Savior - Jesus. He is the God of my days, the God of my nights, the Divine of my discipline and the Peace in my peril. In my weakness He is made strong. By his Holy Spirit, I will be led back to my task from Ebay or FB, and given clarity to see it through until the end.
Thursday, February 26, 2009
2 hour Wait for a Rapid Strep Screen?!
My youngest daughter had a sore throat the other day and woke with a mild temperature elevation. So I took her in to make sure it wasn't strep. Everyone knows that when you present to the office for a sore throat, they are going to swab for a rapid strep and culture. The rapid strip takes 5 minutes for results. Why is it that we must continue the culture where the DR is the expert who I will have to wait for patiently. Can't we run an office where you walk in, c/o sore throat get swabbed by assistant, put in room for exam, when the "expert" comes in results are there, exam done out in 30 minutes.
Wednesday I waited 20 minutes to go to the back room, 40 minutes for Dr. to come in, 15 minutes for swab to be done, 10 for lab to give results, 10 minutes for Dr to come back in. That is 1 hour 35 minutes. How much is my time worth? How much is the exam room worth per hour? Why are we okay with the wastefulness?
My plan is to be an FNP, can I set up a protocol that says I want the swab done after the patient signs in? I want result on chart when the patient is brought back. I am in that room once and my patient is on their way home to rest. Next patient, next billing code, next reimbursement. Efficiency, rather than pomp and circumstance. What do you think?
Wednesday I waited 20 minutes to go to the back room, 40 minutes for Dr. to come in, 15 minutes for swab to be done, 10 for lab to give results, 10 minutes for Dr to come back in. That is 1 hour 35 minutes. How much is my time worth? How much is the exam room worth per hour? Why are we okay with the wastefulness?
My plan is to be an FNP, can I set up a protocol that says I want the swab done after the patient signs in? I want result on chart when the patient is brought back. I am in that room once and my patient is on their way home to rest. Next patient, next billing code, next reimbursement. Efficiency, rather than pomp and circumstance. What do you think?
Wednesday, February 18, 2009
Week 5 - Paper Planning
I have been considering an identified change needed on my unit. The problem is there are so many to choose from. My unit is in such a state of flux and has been through so much over the past couple of years, the last thing anyone wants is more CHANGE. What we need is consistency and predictability.
One of the consistent problems on the unit, even through the other changes, is poor communication. Every time we go to work there is a new policy or procedure in place that has not been communicated to staff. So we play a version of the game telephone that is very dangerous.
My goal is to address the communication and bring about standardization to our unit. I will use the Unit Based Council of our unit as the means of bringing about the change. All of this will be consistent with the facility goal of re-designation as a Magnet facility. Hey I think I just came up with my proposal. Cut, paste, email, and check off another assignment. :)
One of the consistent problems on the unit, even through the other changes, is poor communication. Every time we go to work there is a new policy or procedure in place that has not been communicated to staff. So we play a version of the game telephone that is very dangerous.
My goal is to address the communication and bring about standardization to our unit. I will use the Unit Based Council of our unit as the means of bringing about the change. All of this will be consistent with the facility goal of re-designation as a Magnet facility. Hey I think I just came up with my proposal. Cut, paste, email, and check off another assignment. :)
Wednesday, February 11, 2009
Week 4 - Financial Management
Well in the wake of the tuition reimbursement mistake I decided to apply for financial aid. I have been awarded a loan and am waiting for disbursement of funds. The question now is how to use the funds. In our home my husband is the manager of our finances. So we will be working together to find the priorities of our home and choosing how to allocate the available funds. Much like a business would do if extra income were to come in.
Prioritizing is key. This is not the time to purchase luxuries. This is the time for peace of mind. It also may be a time of exercising negotiation skills as we work through our thoughts on the priorities as we see them. It will be an exercise in discipline.
Prioritizing is key. This is not the time to purchase luxuries. This is the time for peace of mind. It also may be a time of exercising negotiation skills as we work through our thoughts on the priorities as we see them. It will be an exercise in discipline.
Friday, February 6, 2009
Week 3 - Tuition Reimbursement
Well I just realized I made a $4200 mistake. My employer reimburses tuition up to $5200 per year. In order to be reimbursed you must file a request within 10 days of the first day of class. Well a few days ago I realized in all the excitement of the new semester and trying to get my degree plan taken care of I did not get my request in on time. So I will not be reimbursed for this semester.
This is a great example of what can happen when you are stretched too thin. I will eventually use the reimbursement with this summer and fall semester but it was still a costly mistake. The lesson stay organized and focused. Make lists and stick to them.
This is a great example of what can happen when you are stretched too thin. I will eventually use the reimbursement with this summer and fall semester but it was still a costly mistake. The lesson stay organized and focused. Make lists and stick to them.
Saturday, January 31, 2009
Leadership & Management in Nursing
Well here we go with my first blog post. In relating this blog to management or leadership in nursing...I would say my work place is suffering from a serious mismanagement problem. We have lost a large portion of our patient population to a competing facility. This happened in March of 08. The corporation agreed to guarantee all staffs hours for one year in exchange for not having a mass exodus from our unit. They did give us our hours but only for seven months, now we are losing 1-2 shifts out of 3 (12 hour) shifts per week to cancellation. We cancel 5-6 RN's per shift.
This problem could have been averted had management been proactive 7 months ago. The company was paying us to come to work as "work crew" for 7 months when they could have been orienting us to other units with staffing shortages. Their fear was that we would be busy with orientation and be short on our current unit. Yes it was a possibility but creativity could have solved that problem.
The most frustrating part of this whole process has been the mismanagement of funds. We may not have been able to walk onto another unit and taken an RN load but with patients in hallway beds couldn't we have been of some assistance? Instead we goofed around for months! Idle hands are never happy hands and our patient satisfaction scores reflect this.
This problem could have been averted had management been proactive 7 months ago. The company was paying us to come to work as "work crew" for 7 months when they could have been orienting us to other units with staffing shortages. Their fear was that we would be busy with orientation and be short on our current unit. Yes it was a possibility but creativity could have solved that problem.
The most frustrating part of this whole process has been the mismanagement of funds. We may not have been able to walk onto another unit and taken an RN load but with patients in hallway beds couldn't we have been of some assistance? Instead we goofed around for months! Idle hands are never happy hands and our patient satisfaction scores reflect this.
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