RoxyDi

Sounds like you might want to brush up on assessment skills, gain more experience and also understand the unintended negative consequences associated with the use of technology. Neither people or machines are perfect. The saying is intended to remind us that the patient should always get first and last attention when a machine gives us data. Nothing more, nothing less. I think you already knew this from your post's comments re: using judgment to decide actions. Healthcare wasn't necessarily "safer" 50 years ago, despite the huge influx of technology since then. Look at the IOM reports.

While I'm sure your personal experiences are important, not everyone will have the same experiences with being managed by someone in or outside their field. I believe that in many cases, nurses MUST supervise nurses, so I am talking about Management, which would be a level above the nurse supervisor. Not everyone with the title RN must be managed by a nurse. There are ineffective RNs and effective business majors who can influence outcomes in practice every day. It isn't black and white in my opinion.

Thanks for the information. What I meant about not seeing information about the topic is that in the publications I've seen (management, patient safety, risk management, health care industry in general) most of the discussion on safety about sleep has been regarding physicians. I will try to catch your webinar if it is available to the public. It is good that more attention is being given to the effects on other workers as well.

How can you manage nurses if you don't have more than a superficial knowledge of what their job entails? The same way people without management skills (nurses without management education) can manage business entities, like hospital departments: by learning on the job. This is the way most nurses entered the higher positions in health care. They possessed qualities that would make for good administrators, as well as those that make good nurses. There are commonalities, but there are also very different skills for each profession, which is why today, a master's degree is all but required in most administrative positions. From what I see, nurses with MSNs qualify as readily as MHAs and MBAs, which makes perfect sense. Each person will take unique qualities to their positions.

Great points. My son in law recently graduated from MBA school and is in a corporate leadership program with a major health care company. I am about to graduate with an MHA and I have 30+ years experience in the industry as an RN. Each of us will bring strengths to an organization--he with a better business focus and me with a better clinical understanding. The great thing is that we could end up working with different professionals who are like-minded about both clinical and business success going hand-in-hand, which I think they do. So does he, by the way!

I am with you, RiskManager. In my experience, more and more administrative positions are being filled with nurses, but that historically has not been so. I think the essential thing here is putting people with the right perspective into positions of leadership, with some having clinical primary educations and others a more business oriented background. There is no perfect administrator mold in my opinion.

Recently, I've read several articles in healthcare industry publications related to sleep deprivation and the unsafe conditions faced by medical students and residents, and how their work is negatively impacted as well as their personal lifestyles. Missing from most of these articles, it seemed, was the corollary discussion of the same problems facing far more individuals right there at the patient's bedside: nurses. Rarely am I captivated by the HR component of my current MHA degree coursework, but in the 7th chapter of my Healthcare Resource Management text, I was intrigued from the first paragraph that discusses how one corporation that owns three hospitals developed and implemented programming related to adjusting to the night shift into their orientation of new graduate nurses. Bravo! This led to reflection on my own experiences. I graduated from nursing school in May in Central Illinois in 1981. Immediately I took a position at my local hospital on the night shift on a medical floor, as was the usual custom. Within 3 months, I got married, adding another layer of stress on top of graduation, a new position and the night shift challenge. Unlike today when HR personnel are looking at work/life balance, at that time, nurses knew they just had to get lucky” to land a day job, or work the dreaded 3-11 shift instead, or pay dues” on the night shift. Eventually, we knew we would be rewarded with a more normal lifestyle if we hung in there. If. No one seriously considered the consequences of night shift duty and sleep disruption to the nurse or his or her patients re: safety, but we nurses felt them. I remember many days when I slept for only a few short hours, only to be awakened in the middle by a telephone that couldn't be turned off, or by the dog barking at the mailman, or by the sight and feel of pure and lovely sunshine pouring through my curtains, begging me to join the rest of the daytime world. It was my introduction to the frustration of sleeplessness in the midst of exhaustion. Inadequate sleep didn't affect only me, but also my husband, and very likely, my patients. Those short few hours of poor sleep caught up with me between 1 and 3 am during my shift, when caffeine wasn't sufficient to make up the difference, and I had to will myself to stay awake and focused on my work. It was difficult, but I was young. Apparently, I was supposed to be able to handle it. But my nursing school friends and I were all too aware of much more serious things than jitters from excessive caffeine consumption that could befall new graduates working the night shift. One of the nurses ahead of our class died shortly after graduation—within the first year or two, having fallen asleep at the wheel on the way home after work one morning. Only in her early twenties, she was at work one day and gone forever the next. That somber event was tragic and memorable for her fellow schoolmates and all nurses who knew her. I'm not sure we stopped to wonder how it could have been prevented by workplace's policies, though. It was a different time. Today, our text tells us that the psychological contract between employers and employees has been altered to incorporate the expectation of work and home life balance. Thank goodness things are changing. Just as warned in the chapter that discusses the corporation's strategies to protect their nurses and thereby, their patients, I left my first position before a year was up, and took a daytime job with one of the internists who practiced on my unit. I loved hospital nursing—but I didn't love working the night shift! I am just one example of the undesired outcome of new graduate nurses who leave nightshift employment due to unresolved associated stresses. New grads need all the help they can get. Since then, I have repeatedly been amazed at the lack of attention paid to retention of hospital employees, especially nursing staff members who are the backbone of hospital care. Things are changing for the better, but more needs to be done. Upon my graduation from my MHA program, I plan to add to others' contributions by remembering where I came from, and where we need to be as a profession that cares for the safety and well being of the workforce and patients alike. I hope to work as a leader in hospital administration, where I can influence those outcomes directly, in remembrance of those who paid a high price for our former ignorance.

I echo supportive comments re: getting diagnosed for appropriate accommodations. When I graduated from a diploma program in 1981, I wanted to earn a BSN degree, but was petrified of having to take algebra and/or statistics. I never did well in junior high or high school related courses, but I knew this didn't mean I wouldn't make a great nurse. I completed nearly all of the required coursework for my RN-BSN a few years ago, and had stats and algebra remaining, along with research and my capstone class. After getting a full battery of tests done by a qualified diagnostician, I had extra time on my algebra tests, worked like crazy for the semester with a private tutor, and earned a B in algebra and a C in stats. This was a personal goal, and I achieved it for the degree and to prove to myself that I could master my nemesis (algebra) by hard work, focus and dedication. I can't tell you how that has improved my personal outlook on other things. I say go for it but be prepared to put forth great effort. Now I am in a graduate program, and I actually earned an A in statistics! You can do this!

As a fellow nurse over 50 who has gone back to school twice now, starting at age 49, I agree that it is a great thing to do if you really do plan to use the degree. I was a diploma grad from the 70s who managed to get into several positions usually requiring BSN degrees, because of my professionalism and determination to learn what I needed to know to do the job I desired. I've had several certifications along the way, too, and each accomplishment helped me achieve my next goal. I don't think we should ever stop learning, but the choice to participate in a formal education vs personal learning is determined by the goals. For me, I knew that stopping with the BSN was not going to work longterm, because I know that I have the potential to drive the bus, and I can't do it without the master's! For those who think this should be a ROI question only, would you also suggest that the same amount spent on foreign travel or a luxury cruise is also a bad idea if there isn't a longterm benefit? I believe that all learning is as valuable as a vacation that is here and gone in an instant, and I don't have to know that I will recoup dollar for dollar what the degree cost me, although I have no doubt that I will. Best of luck to those who go for it!

Aw, don't let other people's perceptions worry you. You could have a perfectly lovely experience there! You might get a great position with a leader who has a terrific attitude - one who hasn't been scorned by newcomers in powerful positions:cool:.

I agree completely that whatever decision a woman and her family make about BF should be honored. My real message was that the author seemed angry that her experience wasn't scientifically backed up, as though there had to be hard science that made BF worthy of her time and personal sacrifice. As a mom who BF 3 kids, I understand first hand the difficulties and the time commitment required. It wasn't always easy, but I didn't need a scientific study to reward my investment in my kid's health and well-being. The experience spoke for itself with every encounter, and I wish the author felt this way, too.

Sounds like someone knows "tricks" to being successful as a professional. Be quiet for 3 months? Don't offer suggestions? Having a hard time understanding how this makes a facility "a awesome" place to work. A better idea is to find a place where your contributions are respected, wherever that might be. This post could be titled "Mind your P's and Q's."

Good luck with your first course. Keep me posted on how it is going, and weather you are glad you made that decision. I'm looking forward to getting started soon after you.

Recent new management with resulting high turnover from what I've heard.

I would offer to report anyone who suggested you take meds from home and use them without verification to their respective licensing board. Of course, you would have to have proof, and that would be difficult to get. I agree it sounds fishy.