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?
Thursday, February 26, 2009
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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