cleo

I struggle each year with helping staff set goals for the coming year. Most are seasoned nurses, great at what they do. I feel I set the bar too low when helping set thier goals. Any suggestions on goal setting?

Is the receptionist a CMA? In our department we have CMA's that are AD level and have been trained to do both office work and patient care.

Congrats on the new job. I have read books by Dale Carnegie, How too Win Friends and Influence People. It was written back in the 30's yet still holds true today on how to deal with people. Dr. John Maxwell has some good leadership books. Develpoing the Leader With-in You to name one. Another good one is Difficult Conversations, I had to read that for a graduate class, and Life Scripts give you pointers on what to say whe. If your hopsital is part of VHA they usually gives a leadership workshop yearly. They do it by geographic location. One was just offered her in the north east. Fred Pryor seminars and Rockhurst University offer leadership seminars and both can be accesssed on line. Good Luck! cleo

The New Hampshire SBON used to publish the names of nurses license's being revoked,or nurses being reprimaned in the quarterly news letter. Now just the license number is published along with the disaplinary action. However we can still log into the website and put in the license number and know the name of the nurse. Again I agree it is public information and see nothing wrong with knowing; we the public have a right to know. cleo

The RN's in our office are telephone triage and patient education. Through out the organization, we are multi specialty clinic, RN's are utilized in the specialty areas, oncology, urology, etc. to do specialized procedures, minor surgery, and some testing. RN's are alos the preceptors for new staff. When interviewing for the position I would ask how exactly what is the role of the RN in that particular department.

I work in a very busy pediatric office. We are looking at new ways to schedule same day appointments. The goal is to have our telephone nurses freed up from taking phone calls that have nothing to do with nursing. ie: "When is Mary's next appointment?" or "Can you tell me how to get to your office." One of the ways we are looking at is having our receptionists book these appointments. The receptionists would have a list of provider approved symptoms that they would be able to book, ie: ear ache, temperature. They would be given certain buzz words or complaints that would automatically be put through to a nurse to further assessment. ie: abdominal pain. The triage nurses are feel that this is not the way to go. They feel the receptionists will miss or not know when something is serious and needs to be seen immediatly. They feel there is a legal componant to this, such as giving advice. This is such a cultural change for our department. How do others in busy offices schedule thier same day appointments? I'd like to hear some other options.

My director gives no support. She undermines every decision I make, never takes any suggestion for improvement seriously. I could go on and on about what she has done to me. The staff is quickly loosing respect for me and I have very little self confidence left. I have set up meetings with her and then she cancels. I've been to HR for advice and they tell me I need to sit down with her and talk. I am ready to quit but the stubborn side of me says fight to the finish. Any advice on how to handle this. I can't sleep some nights just thinking about what the next day will bring.

I attended the LPN to RN program then the RN to BSN. I had a great experience with both programs. Instructors were graet and always available

When we know that JACHO is coming, our managment teams goes to work. We show up unannounced on different units as surveyors. We pretend, yet are very serious, during our mock survey. We ask questions of the staff that the real surveyors would ask, observe the physical apperance pf the department, check meds, medical records anything we can think of that a true surveyor would do visiting the unit. After the visit we write a report of our findings and share with the nurse manager of the department. When JACHO does come the staff are prepared to answer questions and not nervous, they know what needs to be cleaned up in the department and take care of it and knowing that the mock surveyors will return keep the department in tip top shape.

Have you been to see an allergist and be skin tested for the allergy? I worked in an allergy office and orange was on our food skin test panel. I don't think this is wierd at all. I can't tell you how many things I have tested for that I never thought anyone could ever be allergic to.

I believe I have a staff nurse that is impaired. She frequently leaves (at least once a week)to go "see my doctor" to get a shot for headache or some other ailment. It is almost always a narcotic she receives. I document her absences and have been to HR for advice. She is required to give me and HR a note from her doc that she is capable of functioning at her job after the injection. She also in on FMLA I have to give her the time off when she goes to these appointments. I'm very nervous about this person and not sure what else I should be looking for in her behavior. Her co workers are concerned as well. Anyone ever had to deal with an impaired nurse or other staff person? The good thing is we have very few controlled meds on our unit. Cleo

My department chair and I have been talking about changing the role of our telephone nurses. We are in ambulatory care and I have four RN's that do telephone nursing. She has suggested that reception be responsible for scheduling acute visits along with all the other duties they no do. She stresses that it would take intense training for the front desk staff, such as knowing when a call would go to a nurse for further assesment. The RN's would continue to use thier critical thinking and nursing assement skills as phone nurses when needed and in addition take on a role of care managment for chronic diseases or chronic issues. When I presented this to the nurses they were not buying it. I'm not sure I am either. My department chair tells me this model is used in other ambulatory care settings. I cannot find any data. Has anyone out ther heard of this or is anyon using this model?

I hope I'm not to late for your project A good solid back ground in med surg nursing is esential. You also need good phone skills with a 6th sense. You will be asked to make a nursing assement with out seeing a patient. A good sense of humor and broad shoulders. Patients love to rake you over the coals. Please feel free to e-mail me if you would like to discuss this more. And yes you can use my comment I do love the work I do. Presently I educate the asthmatics and manage thier care in our multispecialty clinic. I have done telephone triage and staff nursing in a very busy pediatric office. Good luck cleo

I recently accepted a position as a clinical leader and have one very difficult staff memeber. This person is a complainer, passive aggresive, back stabber. I can't tell you the hoops I've jumped through to communicate my feeling and concerns. Nothing in my bag of tricks has worked. with this person. Does anyone else out there have a person on their staff like this? Any suggestions on how to deal more effectivly with this type of personality? thanks for the advise, cleo