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Maureen Bonatch MSN

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Content by Maureen Bonatch MSN

  1. Maureen Bonatch MSN

    What’s Love Got to Do With It?

    Nurses are often the healthcare professional patients turn to when they’re vulnerable. As the most trusted profession, our patients may confide information during routine care that they wouldn’t normally share. Sometimes vague or questionable information about relationships may be concerning, and raise questions as to whether emotional or physical abuse is occurring. The way we respond to the patient may determine whether they feel validated, or persist in seeking help. Emotional abuse may be challenging to define, since the signs may be subtle, or absent. Nurses are in a unique position to provide education on early interventions, prevention, and health promotion. Adequate communication, and developing an awareness of signs of emotional abuse, may provide an opportunity to offer guidance and education. Emotional Abuse Most of us have been in arguments, or yelled at someone we care about. Often we regret it and apologize later, and sometimes we don’t. These occasional outbursts are normal expressions of emotions. But if yelling or hysterical screaming is the first, and only response, that may be a sign of an unhealthy relationship. Emotional abuse is an attempt to control the other in a relationship. Often the perpetrator doesn't even realize they’re being emotionally abusive. They may feel insecure and blame the other for their unhappiness, or think they know what’s best. A few potential signs of emotional abuse include when one person in a relationship tends to: Respond with criticism Attempt to isolate the victim from family and friends Make unfounded accusations Constantly check on their partner’s whereabouts Review their phone, email, and computer history Accuse and place blame for their problems Humiliate with name calling, and other methods to belittle or embarrass Gaslighting Another form of emotional abuse is known as gaslighting. This manipulation tactic to gain power in a relationship makes the victim question their reality. It can occur in a relationship, the workplace, and has been used by abusers and cult leaders. Gaslighting is done slowly so it wears the victim down until they begin to doubt themselves, lose confidence and their own sense of identity. Even if the perpetrator tells lies to distract from their behavior, and deny what the victim knows is the truth, they may be begin to doubt their perception of reality. Codependency Codependency can affect the ability to have a healthy relationship. These relationships are often one-sided and emotionally destructive or abusive. Initially this term was used to describe relationships that involved alcohol or drug dependence, but it has since expanded to include relationships with someone who is mentally ill, or from a dysfunctional family. The victim may neglect their own needs, and their family and friends to support their abuser. This unhealthy behavior has become their normal. They may not know how to respond in any other way. Despite their unhappiness, often they feel guilty, and as if they’re to blame. Look for Subtle Signs We may need to confront their own fears, values, attitude and beliefs about abuse to educate themselves about signs of emotional abuse. Personal experiences and cultural upbringings may cause us to overlook the signs, or question why the patient hasn’t taken the steps to end or leave an emotionally abusive relationship. Relationships are stressful and often the victim invests significant energy into preventing the next emotionally abusive episode. They may not want the relationship to end, but want the emotionally abusive behavior to stop. Nurses can look for subtle physical signs that don’t have an identifiable underlying cause such as stress-related health issues such as digestive issues, headaches, or being evasive to the cause of an injury. Try to communicate with the patient alone in a safe, quiet setting and avoid undermining or judging the victim. Safety First Nurses play a role in identifying, and reporting, signs of domestic violence, now often referred to as intimate partner violence (IPV). Even though the majority of victims are women, men can suffer emotional or physical violence as well. Appearances shouldn’t be judged as to who seems more physically intimidating in the relationship and who might be at risk. Encourage patients who you fear might be in an unhealthy relationship to devise a safety plan if they don’t intend to leave, or a code word for family and friends to indicate they’re in trouble. Provide available hotlines and other resources so they realize that there’s help available. Increase Awareness Often patients who may suffer from emotional or physical abuse don’t ask for help, but that doesn’t mean we can’t offer it. Acquiring ongoing education can help increase the awareness of emotional abuse, and the ability to identify the signs of an unhealthy relationship and how to help these patients.
  2. Maureen Bonatch MSN

    How Do You Referee as a Nursing Supervisor?

    Where there are people, there’s conflict. Unfortunately, as much as we try, we can’t always leave our differences at the door before starting work. Varying opinions, miscommunication, misunderstandings, values, and priorities can lead to tension and stress. Employee conflicts can create an uncomfortable work environment. As a nursing supervisor, you can’t ignore a volatile situation between employees once you’re aware of it. Often it’s not the conflict that’s the problem, but how we deal with it. That’s Not In The Job Description When you started as a nursing supervisor, you may not have considered the challenges of dealing with the conflicting personalities of the employees you supervise. Most employees are hired based upon their knowledge and skill, which doesn’t mean they’ll get along with everyone they work with. It can become an even more unpleasant part of your job if you try to ignore the issue. You might end up spending a lot of your time, thought, and emotional energy dealing with the consequences of the conflict. It’s best to intervene early to help ease the tension. If you ignore the problem, it may nurture feelings of ineffectiveness and frustration with your position. This may evolve into unresolved resentment for the employees that have made the work environment uncomfortable. Step Into the Ring You may be the supervisor, but that doesn’t mean you haven’t formed friendships with some employees and developed your own assumptions of others. This can make it more difficult when dealing with a situation. You’ll have to leave your biases and preconceived opinions behind to approach the situation objectively. It may be your instinct to try to fix the conflict, but you should try to determine the source of the discord before acting. Just as if it were a patient presenting with a conflicting diagnosis, it’s best to seek the true cause of the symptoms before starting to treat them. Put Away the Gloves You might only know part, or one side, of the story. Take the time to listen and try to understand the situation before acting. Sometimes when employees feel as if they’re heard it might be enough to start mending fences. Ask questions to prompt them to think about the situation from a different perspective. If possible, encourage the employees to work it out themselves. Discord could stem from a variety of reasons such as conflicting personalities, gossip, unequal pay, jealousy, feeling as if a coworker isn’t pulling their weight, perceptions, internal or external stressors, believing there’s favoritism—or they just don’t get along. A few ways to work to resolve the discord include to: Allow each employee to privately verbalize their concerns Seek to identify and how to best address the problem Rule out bullying and incivility Give clear, behavioral feedback regarding what could be done differently, with specific information on how to improve Be consistent with standards and set consequences, so employees know what to expect Follow-through to ensure that the problem is resolving Document the situation, steps taken, and resolution for reference Apologize if you’ve played a role in creating the discord Seek another perspective, such as someone from human resources, or another manager, if necessary Ring the Bell It can be challenging to be around the same people every day, and even more so when you work in a stressful environment. The healthcare environment requires teamwork to provide safe, quality care. It’s in your best interest, and the interest of your patients, to work to resolve the situation. Draw on your communication skills to help employees develop a professional, or tolerable, relationship. A nurse leader’s work often involves leading by example and providing guidance and coaching to help employees work through discord. It may be an unsavory part, but it’s a necessary one. Try to be alert for signs of animosity before a situation becomes volatile or uncomfortable. Although sometimes, despite your best efforts, there are situations that disciplinary action may become necessary. Be sure to be consistent with following the steps and guidelines from your facility. There’s No Winner or Loser A nurse leader has to be involved with their employees to know a problem exists. Dealing with employee conflicts may not be the most enjoyable part of the job as a nursing supervisor, but it can help you gain the respect of your employees, and grow as a leader. Although there’s no formula that will work for any, and all, employees, sometimes just taking the time to listen and seek a satisfactory solution can be beneficial for your employees. How Have You Dealt With Employee Conflicts? Article Sources 7 Strategies to Manage Conflict 9 Ways to Deal With Difficult Employees Can’t Nurses Just Get Along? How to Deal With Lateral Violence in Nursing Dealing With Difficult People
  3. Maureen Bonatch MSN

    Stop Putting Your Life on Hold

    Maybe I’ll do that tomorrow, or next month, or next year, or … Maybe never. Nurses are busy. As caregivers, we tend to put other’s needs in front of our own. We strive to do as much as we can, for as many people as possible, in the least amount of time. This can lead to missing breaks, staying for a second shift, or not taking that class we were thinking about. We might feel like we don’t have time to add one more thing, or we’re too tired to spend our personal time the way we’d planned. After a while, the tendency to put things important to us off until another day may become reflexive, and this behavior can leak into our personal life. When we keep putting our life on hold it could eventually affect our physical and mental health if we deprive ourselves of meeting our needs. Why Not Me, Why Not Now? I’ll Be Happy When… Why do we wait for happiness? Sometimes we associate a new job, finishing a class, losing weight, or a specific day of the week, as what’s standing in the way of happiness. But often once we reach that desired destination, we realize that it wasn’t the barrier. Or we discover that there’s something else we believe we should accomplish first before we can be happy. If we continue with this pattern of putting our happiness on hold, dissatisfaction may become our default emotion. I’ll Do That When I Have Time to… So far no one has had any more luck coercing Father Time to slow down than they have had in fooling Mother Nature. As much as we try, we all have the same 24 hours each day. The key is dividing up and prioritizing how we want to spend this time. If we feel as if we have no time to do what we want, or what we enjoy, it can take an emotional toll. Make living life now a priority, instead of waiting to enjoy life. They’ll Be Upset If I Don’t… Sometimes it’s difficult to say no when helping others can feel satisfying. It can provide us with a sense of pride and purpose. But if we spend too much time giving to others and neglecting ourselves it can build resentment. We can still be helpful to others, although if we always say, yes, and never say, no, we might never have any space on our calendar for ourselves. Time to Let It Go We’re allowed to change. What worked at one stage of our life might not bring us joy in another. There are many things that occur in our lives that can cause us to shift our schedule, or our priorities, or to put goals on hold. They could be related to different stages of our career, our life, or those of our family, that require our attention. Although the years may pass, and things may change, sometimes we’re left with the mindset from a different time of our life. It might be time to let go of obligations that don’t fit what we want out of our life now. If we do a self-assessment, we might determine that we might be compromising aspects of our self-care. This could result in us pushing our bodies harder than we should to meet what we feel are our obligations day after day. We should be able to shift our perspective to feel joy, instead of guilt, when we reach for what we want instead of putting our needs on hold. Self-Care Isn’t Selfish It might feel as if we’re being selfish in making ourselves, and our lives, a priority. As nurses, we educate our clients about taking care of themselves with proper sleep and nutrition for better overall health and well-being, but we don’t always listen to our own advice. We know that listening to our body can help more than just us. When we work to meet our needs first, and our goals, we shouldn’t think of it as being selfish. It can help us be more productive, to be able to give more to others, and care for our patients easier. Self-care should extend to examining the goals we’ve put on hold for our personal and professional life. Even starting with small steps toward bigger goals and dreams can help refresh our mindset and help us remember what’s important. Gain a Positive Return on Investing in Yourself Don’t put your personal wellbeing on the back burner by always saying yes to things you don’t want to do, or that don’t serve you purposefully, or that take time away from meeting your goals. You might find a much more positive return on investing in yourself. What Have You Put on Hold in Your Life?
  4. Maureen Bonatch MSN

    Stop Putting Your Life on Hold

    Thank you for sharing! This is wonderful how you've invested in yourself.
  5. Maybe you’ve been preparing for years for a leadership position through education and promotions, or perhaps the opportunity was thrust upon you. Regardless of the path you took to get here, you’re now in a nursing leadership position. Even if this position is within the organization you’ve worked within for years, your priorities have changed. In addition to being responsible to your patients, you’re now responsible for your employees, as well. Even if you know all the employees, and have worked beside them, they’ll have different expectations of you in your new role. Most leadership positions have tasks that require the skills of either a manager, a leader, or both. Only you can determine how to balance the key aspects of both roles and carve a successful path as a nurse leader. Manager versus Leader It’s not necessary to be assigned a leadership position to be a leader, and all nurse leaders aren’t successful in leading their employees. You can lead from wherever you are in the organization if you know how to project qualities and characteristics that inspire and influence others. Organizations need both managers and leaders. Both roles have different priorities, and sometimes you might need to combine the skills of each. You might be required to manage budgets, inventory, staffing, and quality improvement efforts, while a leader’s duties extend beyond required tasks. Leaders must consider their employees emotions, and recognize and respect them as individuals. To gain their trust and respect, leaders must ensure their employees feel appreciated, and that they believe their efforts make a difference in the organization. Qualities of a Good Leader Often nurses are promoted into leadership positions because they’re good clinicians, critical thinkers, or since they have the most experience. But perseverance doesn’t procure leadership skills, although that doesn’t mean you can’t work to acquire or enhance these skills. Consider what qualities you’ve sought, or admire, in a leader, and how you might work to develop, or model, those behaviors. A few desired qualities in a leader might include: Presenting as a role model in a professional, and ethical manner Being fair and consistent Taking responsibility, and being accountable for their own performance Keeping the bigger picture within view Displaying passion, vision, and focus A commitment to the organization, and their employees An empathetic and caring nature Excellent communication skills Seek a nurse mentor who will provide you with honest feedback to help you determine where you fall within this spectrum, and what skills you should strive to improve. Listen to their feedback with the understanding that acquiring a nurse leadership position is only the beginning, to succeed it’s important to continue with professional development and keep abreast on potential organizational challenges. Initial Efforts Reap Rewards Without the heart and soul of a leader, you can be in a leadership role but not be successful in leading. Inspired and motivated followers who support their leader are essential to accomplishing organizational goals. Whether you’re new to the organization or adjusting to a role in which you’re now supervising your coworkers and friends, taking the time to listen, rather than making assumptions on what you believe needs done, can assist in achieving success. Initially, most new leaders can benefit from spending more time listening, than delegating tasks and acting. Take advantage of the knowledge and expertise at your fingertips, and share your expectations, as well as clarify what your employees expect from you in this new role. A leader is one person, it requires communicating and collaborating with your team, and addressing individual concerns, to earn the respect and support essential to achieving success. Find Your Peers It can be lonely at the top when you realize that although you can still be friendly, and even friends with your employees, you have a new level of responsibility and often have access to confidential information that you can’t share. It’s helpful to develop a social network, and professional relationships, with other nurse leaders to reduce feelings of isolation. Broadening your network can allow you to establish mutually beneficial relationships in which you can share best practices, knowledge, and validate that you may face the same challenges. If you’re concerned about asking for advice, or sharing experiences, with local competitors, there may be opportunities to establish trustworthy relationships online where you’re not in direct competition. These can be acquired through professional networks, or on social networks such as LinkedIn. New Challenges and Rewards A new nurse leader can be presented with many challenges. But there are also opportunities to reap rewards and gain professional satisfaction from having the chance to make a difference in your organization, and for your employees.
  6. Maureen Bonatch MSN

    Make These Resolutions Anytime of the Year

    The New Year’s Eve ball drop starting the year may already feel like a distant memory, and many of us have already dropped the ball on our New Year’s resolutions. This occurs so frequently that January 17th has been dubbed as, Ditch Your New Year’s Resolution Day. There’s no reason to be hard on yourself if your resolution didn’t stick. Just because January 1st feels like a clean slate, you don’t have to wait another year to begin to make positive changes. We tend to wait for a new month, a new week, or a new year, to make a change, when we can resolve to make changes anytime of the year. Focus on Making Small Changes Change is hard. It can take 21 days to, break, or form a habit, and many claim that it takes even longer. The changes we wish to make are usually big ones. Things we think that will bring happiness once accomplished. Perhaps we should focus on creating new habits, instead of breaking old ones. If we start making little changes with ourselves, and the people closest to us, positive changes may follow if we resolve to: Reconnect You’re busy. Before you know it, you’ve lost touch with friends you vowed to get together with once a month. Or you discover you haven’t talked to some of your family since the last holiday. Don’t wait for the next high school reunion, holiday, or tragic event, to get together with friends and family. Sometimes just picking up the phone to talk to a friend or family member, can shine a joyful light on a routine day. Social media makes it easier to reconnect. Although the ease of social media can work against nurturing relationships. People may feel like they can be less personal, and not bother to text or call when they can post on social media. Then when you are together, it can invade that time. Try to focus on being together instead of virtually living life on social media. Apologize Perhaps there’s someone in your life you’ve become estranged from, and by now the reason for the disagreement may seem ridiculous, or you’ve forgotten what lead to the hard feelings. It may feel like too much time has passed to apologize. Usually it hasn’t. Consider whether that difference of opinion is worth not having that person in your life. Decide how much you value that relationship. If there were more positive memories than negative, perhaps it’s time to extend that olive branch of forgiveness. It may be worth agreeing to disagree, or tolerating a conflicting opinion, to have the relief of releasing those ill feelings. Approaching that person may be easier than you thought, and they may be grateful you took the first step. If they remain bitter, it may enable you to move on and not be burdened with regret of not trying to mend that rift. Go Back to School You may have hobbies or dreams you’ve put on hold, but even if years have passed, there’s no reason why you can’t pursue those now. Learning something new may help you improve your career, or your outlook, as you find a healthy way to relieve stress or explore untapped talents. Your school days may be behind you, but if you’re feeling stagnant in your job, or your life, taking a class might reinvigorate a zest for life. These classes may be relevant to improving your career, or it may be taking dance lessons, or pursuing interests you’ve always wished you explored. Change Jobs If you spend your time counting the hours until you’re off work, or the days until your next vacation, or holiday, perhaps it’s time to consider changing jobs. January is the most popular month to change jobs, but if you’re bored, or frustrated, with your work environment, or looking for a new challenge, no particular month will help you make this decision. There are plenty of nursing jobs available, but don’t grab the first one that comes along, or you might end up in a different job but stuck in the same unhappy situation. Take the time to examine the cause of your unhappiness. If you’re unsure if a job change is what you’re looking for, seek out a mentor, or shadow a nurse on another unit, to uncover what sparked joy for the nursing profession in the first place and determine what job might reignite that flame. Don’t Wait for a New Year January 1st might seem like the best time to make resolutions for positive changes, but it’s only one day, and one month, out of the entire year. Don’t give up on finding happiness in the everyday by waiting for another Monday, or another year, to roll around. You can resolve to make positive changes anytime of the year.
  7. Download allnurses Magazine Nurses work at the frontline of patient care. We collaborate and work with other healthcare professionals, but usually provide the most direct patient care. This extra time spent serving as an advocate, resource, and educator, while helping patients facilitate their healthcare journey has prompted the nursing profession to sometimes be thought of as the heart of healthcare. It’s also contributed to nurses earning the honor of being voted the most trusted profession for the 16th consecutive year in the Gallup honesty and ethics polls. Although, the nursing profession isn’t without its challenges. The shift toward quality, value-based patient care with a heightened emphasis on population care that focuses on increased health promotion and holistic patient-centered care, requires a larger, more diverse, and highly educated nursing workforce. To continue to support patients, and manage their care, nurses must resolve to seek solutions for current issues within the nursing profession. Nurses are rising to the challenge, and efforts have already begun to tackle current issues and implement positive changes for the future of the nursing profession. Issue - Nurse Staffing and Recruitment Nurse staffing shortages are not a new issue. The challenge of maintaining adequate staffing to meet the increased demand for nurses remains ongoing. Insufficient staffing can contribute to additional issues that affect job satisfaction and the provision of quality care. As one of the fastest growing healthcare fields, nursing is anticipated to grow by 15 percent from 2016 through 2026. This is faster than average according to the Bureau of Labor and Statistics. This age-old staffing problem, and present nursing shortage, challenges us to meet this need due to a combination of factors that are increasing the demand for nursing staff. These include: The Affordable Care Act (ACA) has enabled more patients to acquire access to healthcare. Some patients may have never had healthcare before, and many patients may be more diverse or have complex healthcare needs. The nursing shortage is aggravated by several. With an aging nursing workforce, and the pending retirement of baby boomers combined with an inadequate nursing faculty to educate future nurses, recruiting and retaining an adequate supply of nurses is even more challenging. A shortage of nursing faculty. The wide gap between clinical and academic salaries, and the need for additional experience and education may have contributed to the lack of adequate nursing faculty. The nursing faculty shortage has forced some universities to limit the student capacity for their nursing programs. Make a Resolution to Seek a Staffing Solution Nurses are unique in that they can choose multiple education pathways. Although it’s felt that additional education can help nurses successfully navigate increasingly complex patient needs. Advanced education can also allow nurses to take on additional roles and responsibilities within the nursing profession. The Affordable Care Act (ACA) was one of the prompts to inspire The Robert Wood Johnson Foundation and the Institute of Medicine (IOM) to begin working toward making nursing education a seamless academic progression with a goal of having 80% of nurses obtain a Bachelor of Science (BSN) by 2020. They recognized the need to rethink some of the roles of the nursing profession and increase their education, to meet the needs of an aging, more diverse, patient population. This progress to transform the nursing profession continues, with the intent to improve effective care for the changing patient population. Having more BSN prepared nurses can also result in shorter hospital stays, lower healthcare costs, reduced patient mortality rates, and improved patient outcomes. Issue - Struggling with Nurse Retention Although once nurses obtain a position, the environment and culture of the organization must provide positive benefits to encourage them to stay. Organizations that focus more on recruiting nurses, and then not making efforts to make positive changes to retain them, often endure ongoing struggles to retain nurses and maintain adequate staffing levels. Retention issues that may occur due to the facility environment and culture can include: Excessive overtime Inadequate staffing levels Nurse burnout High staff turnover Scheduling dissatisfaction A wage or benefit package that isn’t competitive Inadequate time to provide patient care Nurse bullying or incivility Fear of workplace violence Inability to achieve a satisfactory work and life balance Lack of opportunities for advancement Resolve to Work to Retain the Nursing Staff Gained Poor retention affects more than the organization. Inadequate staffing can disrupt productivity, impact patient care, and decrease job satisfaction. Patient satisfaction is often linked to the quality and contentment of the nursing staff, so neglecting issues within the nursing environment can spur a vicious cycle of patient dissatisfaction and nurse turnover. Issue - Overwhelming Stressors in the Workplace The healthcare environment may be fast paced and ever changing, but it’s not normal for nurses to be constantly overwhelmed and exhausted. Passion isn’t always enough to sustain nurses through the physical and mental demands of the job, yet many neglect their own mental health and wellness. Some may even feel as if it’s a sign of weakness to admit to these feelings, or as if they should be able to handle everything on their own, get over it, or that it’s part of the job. But long shifts, working extended days in a row along with conflicting demands can lead to fatigue and burnout. Many nurses overlook the signs to slow down, implement personal preventative care measures, or seek treatment. A negative or toxic work environment may be related to some of these issues. This can result in other mental or physical issues overlooked or unnoticed such as: Burnout- The cause and the way the symptoms of burnout manifest can vary. This can lead to an increased risk of medical errors, may affect patient care, impact job satisfaction, and increase turnover. Post-Traumatic Stress Disorder (PTSD)–Intense, ongoing stressors combined with staffing issues may leave little to no time to process a distressing event at work. Bullying, harassment, and incivility- The RNnetwork survey indicates that 45 percent of nurses report being harassed or bullied by peers. Repeated, unwanted harmful actions intended to humiliate or offend the recipient can infect staff with fear and humiliation, decrease productivity, increase absenteeism and increase turnover. Alarm fatigue- The multitude of devices meant to assist and alert staff to patient needs can result in sensory overload and desensitization. Their purpose is defeated when nurses ignore, overlook, or are unable to differentiate critical or routine alarms. Alarm fatigue can become counteractive to enhancing patient safety. Resolve to Commit to a Supportive Environment The way we treat each other is as important as the care provided. Nurses should respectfully support each other as professionals and encourage others to adhere to the advice they give to their patients and realize that mental health can be just as important as physical health to provide safe care. Nurses are less likely to encourage others to enter the nursing field if they aren’t engaged, or don’t feel supported, or appreciated, in the workforce. Promote a professional environment that realizes value and shares goals and success to attract and maintain the best employees by: Recognize and hold people accountable by rejecting negative behavior and reinforcing what behaviors are unacceptable and detrimental Align a positive atmosphere to patient outcomes to attract and retain staff who support each other and the organization Encourage and model clear, calm communication that’s mindful of volume and body language Nurture a culture of mental and physical wellness and invest in individual health needs Seek evidenced-based practice to develop an approach for alarms to perform appropriately and reduce false alarms and risks accompanying alarm fatigue Issue - Increased Risks of Workplace Violence & Job Hazards Performing procedures which can cause discomfort or pain for patients that may be fearful or confused can put nurses at risk for workplace violence. The risk of physical or verbal abuse from patients, or family members, can be exacerbated by inadequate staffing and can contribute to an undesirable, unsafe, work environment. The Occupational Safety and Health Administration (OSHA) states that from 2002-2013 the rate of serious workplace violence was 4 times greater in healthcare than private industry. This may be even higher since many may not report because they don’t want to lose time, think reporting won’t make a difference, or that violence is part of the job. The highest rates of violence usually occur in the emergency room and psychiatric units due to substance abuse, cognitive impairment, waking from anesthesia, fear or frustration. This risk for violence for nurses is in addition to the environmental and physical risks associated with the job due to injuries from patient care, exposure to bloodborne pathogens or needle sticks. The increased age of much of the nursing workforce, inadequate staffing hectic pace, fatigue and long hours, can result in decreased alertness and awareness and increase the risk of injury. Resolve to Reduce the Risk Education and awareness of situations with increased risk and incorporating a zero tolerance for violence can assist with proactively addressing these issues. Other methods to work to decrease the risk of violence and injury include: Emphasize the importance of reporting and documenting Report and gather data regarding incidents and risks Set a zero-tolerance policy standard Develop an expected code of conduct Build awareness of the importance of ergonomics to reduce injuries Educate on awareness and how to identify and address if there is a risk for performing safe care Remove items in the patient care areas that could be used as a weapon Ensure there is adequate lighting and an awareness of available exits in a crisis Encourage clear patient communication on what to expect for their treatment, and wait times Alert staff if patients have a history of violence Issue - Meeting the Needs of Diverse Patient Populations The patient population is becoming increasingly diverse. Striving to increase diversity in nursing staff, and education on cultural awareness can assist with improving cultural competency. Knowledge of cultural differences, expectations and how to identify personal assumptions, can assist nurses to reduce communication and cultural barriers to care. This could potentially lead to better patient compliance and outcomes. Many patients are reassured to have a caregiver from the same ethnic or racial background. They may be able to better understand cultural preferences, communicate more effectively and appreciate the patient’s perspective. This can help in gaining patient trust and confidence in the care and increase patient satisfaction. Resolve to Educate and Incorporate Cultural Awareness Patients depend on nurses to adhere to their professional obligation to make healthcare decisions that balance treatment options and patient wishes. The nurse may not agree with the patient’s beliefs, or may struggle with conflicting personal values, but should still strive to provide care in the client’s best interest. Cultural awareness can help the nurse understand and support the patient’s unique care needs even if they conflict with the nurse’s personal beliefs. Education and understanding on cultural diversity can increase awareness of personal attitudes, and beliefs, and allow nurses to provide fair treatment to patients regardless of their economic status, race, religion, ethnicity or gender identification. Factors such as the changes in the economic environment, stable employment options, and the variety of settings and opportunities for advancement have played a role in increasing diversity in nursing: This has also influenced males and other minority groups to pursue nursing. This may help ensure the nursing profession can be sensitive to cultural specific needs while providing care for diverse populations. Developing and supporting a more diverse, culturally aware, ethical environment may increase the nurse’s comfort in speaking up to act as a patient advocate and provide culturally appropriate care. Issue - Blending Generations in the Workforce Nurses delaying retirement, and an influx of new nurses, has resulted in blended nursing generations in the workforce. Generational differences and efforts to work coordinately can result in conflict and job dissatisfaction. Although individuals can’t be classified by their generation, since each person may have their own unique characteristics and expectations, most are influenced by the period they grew up in and experiences they’ve encountered. Generational differences can affect thoughts and perspectives and impact the ability to work coordinately. The generation we grew up in can also influence: How we interact Preferred work and life balance Methods of communication Values and beliefs Significance of education and training Desire, and preferred method, to be recognized for work performance Preferred management style Don’t Overlook Technological Challenges Today’s nursing workforce must be both clinically skilled and technologically perceptive by balancing hands-on patient care with technology. This can prove challenging with blended workforce generations. Each generation, and individual may have varied comfort levels, and views, regarding technology. Some may be challenged to learn new processes, while others harbor fear and uncertainty. Resolve to Work to Embrace Generational Differences Incorporating technology into the workplace can provide opportunities for education and reverse mentoring between generations. If effective methods of learning are considered, opportunities can be created to develop leadership skills for new nurses. New generations may be more accustomed to utilizing technology, while other generations may be accustomed to relying heavily on touch, sight and smell to gauge the patient’s medical condition. Both methods of patient care have positive benefits. The challenge is to create a balance that doesn’t completely rely on technology while maintaining the human element in nursing care. Ways to strive to embrace generational differences include: Recognize the unique characteristics and expectations of each generation Identify traits shared between nurses of all generations to foster teamwork and collaboration Work toward a sense of purpose and overall goals Focus on expectations, rather than outcomes, when approaching tasks Technology and scheduling software can be beneficial to reduce paperwork and to work toward a better work-life balance, reduce overtime and the risk of short staffing. But quality, knowledgeable nursing staff must be available for technology to be effective. Issue - Striving for Safe Staffing Levels Staffing is one common element that can affect multiple nursing issues. Inadequate staffing contributes to more than nursing retention. As patients shift out of hospitals for better reimbursement, it can mean shorter stays with patients with more complex needs. Mandatory overtime, long shifts, or extended workday stretches can affect the ability to provide safe patient care. It can also contribute to: Increased fatigue and rate of injury Medication errors Length of patient stay Patient mortality Nurse burnout Patient dissatisfaction Resolve to Seek and Support Staffing Solutions Staffing issues have not gone unrecognized. The American Nurses Association (ANA)recognizes the significance of safe staffing and has implemented surveys, incorporated research and data collection to work toward positive legislative changes. This exploration of optimal staffing levels hopes to emphasize the importance of nurse and patio ratios and the effect on patient outcomes. Hospital patient levels are constantly fluctuating. Staffing levels are dependent on patient acuity, complexity of care, the number of admissions, discharges, transfers, and the skill level and expertise required. Nurses have the best judgement on staffing levels and how to best manage flexible staffing while supporting each other. Working toward mandated staffing levels may help reduce the risk of patient harm and improve nurse job satisfaction. Find Our Voice for Ourselves and Our Patients The role of the nurse continues to grow to meet the complex demands of the healthcare system. Nurses need to become change agents and have a voice for themselves, and their patients, to work toward being full partners in redesigning healthcare. Nurse’s voices are important and can contribute the expertise acquired from education and experience across many healthcare settings and specialties. Nurses Can Get Involved by: Volunteering and participating in committees Continuing with personal and professional growth and education Becoming a mentor to: Appreciate, and explain, the history of why tasks are done the way they are, and to take a critical look for areas for improvement Share expertise, guide and educate Inspire and empower future nurses and nurse leaders Gain a feeling of ownership in the success of the organization Bridge generational gaps by comprehending the strengths of different generations Contribute toward a positive workplace culture Display a willingness to embrace change Acquire a fresh perspective on the newest and latest trends Nurses Voices Carry Nurses can make a difference by taking ownership of the nursing profession and committing to change the culture and status quo by getting involved within their organization, their community and contributing their voice to public policy. Nurses are generally underrepresented when major healthcare decisions occur. The Nurses on Boards Coalition is making strides to correct that with a goal of having 10,000 nurses on boards by 2020. To begin acquiring a broader strategic mindset nurses can: Start prepping mid-career to prepare Work with a mentor, or other members of the board Take courses on presentation skills and public speaking to build confidence Recognize that nurses have valuable contributions Serving on a board can be personally and professionally rewarding. It may also provide opportunities to enhance professional networks, impact public and community health, and be on the forefront of strategic planning. If nurses become a voting member in decision-making roles in healthcare they can: Have a seat in decision making Lead conversations Hold other board members accountable for decisions Be the voice for nurses and patients Bring the patient perspective Resolutions for Future Change The Robert Wood Johnson Foundation(RWJF) initiative, The Future of Nursing: Campaign for Action, emphasized improving access to care, collaboration, diversity, healthier communities, nurse leadership and education. We’ve made great strides toward these goals, but continue to have more work to do. Many of the issues in nursing are interrelated and ongoing. But by making small steps, and increasing involvement within, and outside, organizations, nurses can work to find their voice to make a better future for our patients and ourselves. The public continues to place their trust in the nursing profession to provide compassionate, honest and ethical care, and nurses are honored to provide it. Recognizing the contributions and impact of nurses can help us realize that together we can lead positive changes for the nursing profession and lift each other up for future success. Article Sources 5 of the Biggest Issues Nurses Face Today Current Issues in Nursing and Healthcare Focus on Self-Care Could Help Prevent Nurse Burnout HealthLeaders Top 10 Nursing Stories of 2018 Low Nurse Staffing Increases Risk for Inpatient Death Our Nation Needs More Nurses on Boards Ready to Serve The Case for a Nurse Trustee Update on Future of Nursing Report: Are We There Yet?
  8. Maureen Bonatch MSN

    Make the Most Out of Meetings

    Committees, conferences and staff meetings-oh my! There are some days when it might feel like all you do is attend meetings. Meetings can be a great way to efficiently communicate, gain feedback or spark creative conversation if they're structured effectively. If not, they might end up feeling like a distraction from your real priorities and can take up a huge amount of time. Your time is valuable. How can you make meetings more productive and time saving, instead of time wasting? Whether you're the facilitator, or an attendee, consider implementing these suggestions when you feel as if you're drowning in meetings. Five Meeting Rights Planning is an important aspect of preparing for a meeting. If you're attending, asking the right questions can help ensure you make the most of your time and let your supervisor know you value productivity. If you just show up and hope for the best you might waste your time, and everyone else's, until you hit your stride. Right purpose Consider the meeting's purpose, and the goal. If it's only to share information and not gain feedback or other input, consider if an email, or a memo, would be more efficient. Prepare an agenda of essential points to structure discussion Allow extra time for discussion and unexpected topics. Include time for initial greetings and networking. Spontaneous conversation can often be as important as the meeting itself for improving teamwork, gaining cooperation and increasing morale. Right people Determine the key people who should attend. If you're uncertain whether someone needs to be in attendance you could: Provide them with the option of attending and determining if this is a valuable use of their time. Don't have them sit through irrelevant information. Invite them for part of the meeting Consider if it's more effective to share the information after the meeting rather than have them attend. Right format Your goals can help you decide what format, and location, would be most effective. Perhaps consider if an unconventional, or casual, setting might be beneficial to inject a shot of creativity into the conversation. Provide handouts, or an outline, to enable people to listen rather than take notes. Consider travel costs and convenience if you want to ensure maximum attendance. A few meeting options include: Conference call In person Webinar Zoom or Skype Right time Consider the time of day and the time length for your meeting. If it's over lunchtime, inform your attendees whether they can bring lunch, or if food is provided. Let attendees know the time length and challenge everyone to stick to it. Think of creative methods for redirection to achieve this such as: Use a timer with each agenda topic Assign the roles of timekeeper and notetaker. If it's an ongoing meeting, consider rotating these roles. If someone is monopolizing the conversation, veering off topic, or refusing to move on to the next item use the, "enough let's move on" method. Choose a cute item to take the sting out of interrupting, such as an Elmo doll, or a white flag, to toss on the table to refocus the conversation. Right frequency It might take a little trial and error to get the meeting frequency just right. Too little and the meetings might end up being longer than you desire, or information might get missed, or forgotten. Too often and people can turn into a bear when there seems to be no end to meetings. Do an Assessment There is value in the act of the meeting itself. They can be a great opportunity for building teamwork, bonding, networking, collaboration, reflection or brainstorming. Just talking doesn't provide the same benefits as listening. Don't focus too much on what's next and miss what's going on now. Use the opportunity to build, and not crush, team morale. Encourage participation by going around the table, assigning topics for individuals on the agenda, or asking them to present information from a conference or project. Meetings can outlive their purpose. Make sure your meeting hasn't CTB by asking for feedback. Use open-ended questions such as what they found valuable, or what needs improvement in the meeting structure. Consider an anonymous survey if you want to ensure honest feedback. Foster Positive Outcomes With a little planning and preparation, meetings can be a great way to return to work motivated with clear steps to meet your goals and to foster collaboration and teamwork. If all else fails, sharing, a little chocolate can go a long way. What Are Your Tips for a More Productive Meeting?
  9. Maureen Bonatch MSN

    Advice for Myself for When I Was a Nursing Student

    I've been a nurse for a long time. Long enough to look back, reflect over my career, and consider the choices I made and the paths I followed. If I could go back in the day and talk to myself when I was a nursing student I might share a little advice. In general I might say Doctors are just people. They don't know everything and they aren't scary-well, usually not. No, midnight shift never gets easier Yes, psychiatric nursing is a real, valuable nursing skill. Ignore anyone who tells you otherwise. Yes-that nursing cap does look stupid, but you'll cherish it later. You still won't want to wear it, but you will proudly show it off. Take Your Time Don't rush through nursing school. Taking as many credits as possible while working part-time, and taking summer classes may allow you to finish school much quicker, but you'll miss out on much more. That heavy schedule prohibits you from allowing yourself to be a college student. Slow down, and enjoy the journey more. Stop only focusing on the destination because you have years to work. Take those extra classes that you might enjoy just for the benefit of learning. Make the most of this time. Speak Up You may not have access to online nursing networks that are available today like allnurses, but don't treat advice like facts, instead realize they are just one person's opinion. Speak up, ask questions. Maybe you really don't know what you're doing yet. You're not supposed to. You're a student, but you already know more than you realize. This is the time to embrace your curiosity and learn as much as you can. Most seasoned nurses love to share their expertise with an eager, interested student. Stop Worrying You know all those hours, days and who knows how much time you spend worrying? It doesn't change the outcome. Worry does nothing but cause extra stress. Use that time you spend worrying about tomorrow to enjoy today. Ignore the, "What if..." and tell yourself, "I don't care", or "It doesn't matter." Even if you do care, and it does matter, because all you can do is do your best and things will turn out fine. You won't even remember most of the things you wasted time worrying about, because they weren't worth the space in your memories. Consider the Big Picture Don't make all your decisions based on how they fit in your current schedule. You're going to be a nurse for a long time. What might not look like a useful class, skill, or a viable option now, might serve as a building block for expanding your future career options. (P.S. Don't back out of starting your doctorate once you do all the preparation. Put your needs in front of everyone else's occasionally.) You won't just have one job. Each will provide skills and experiences to take with you to make you into the nurse you are in 2018. There Are Options You may have starting nursing school when there was a nursing shortage, and it seemed like the next logical career step. When you finish school the nursing shortage will be over, and jobs will be few and far in between. Believe that older nurse who tells you that the nursing shortage repeats in cycles. Don't cling to whatever job you can get like it's your last. Don't Stop Looking and Learning Even after you're at a job for a long time, there are still options and ways to get out of "doing things the way you always have." Once you do you'll realize you can use your nursing degree for much more than you realized. There are endless options. If you delve more into researching nursing articles, and making connections, then more opportunities might present themselves sooner. It doesn't have to be an either, or, choice. You take your nursing knowledge with you in whatever you do. Make Your Own Path Over the years, you'll come to believe that a nursing degree is more versatile than others and provides more opportunities. Those nurses you're going to school with will go on to use their degree in different capacities. Some will come full-circle once they find what they enjoy. Others will keep spreading their wings. Who knows If you'll listen to what I say- they say we often don't heed our own advice. Although perhaps I can start listening a little more to my heart and my head today, that way I can continue to carve my best career path for tomorrow. If You Could Return to Back in the Day, What Advice Would You Give Your Nursing Student Self?
  10. Maureen Bonatch MSN

    Advice for Myself for When I Was a Nursing Student

    Thank you so much for sharing your story and congratulations on your retirement!
  11. Maureen Bonatch MSN

    Advice for Myself for When I Was a Nursing Student

    So glad that mental health is one of your nursing loves! There is definitely a need for psychiatric nurses in a variety of settings. If you are concerned about not practicing other skills, it depends on the setting you are working in mental health for many will require you to continue to utilize med-surg skills, etc. Since there is a significant need for nurses, you could also consider working varied roles part-time, or casual to sharpen a variety of skills. Good luck!
  12. Maureen Bonatch MSN

    Advice for Myself for When I Was a Nursing Student

    You're never too old to start a new career, or follow your dreams. Good luck with nursing school-and don't forget to enjoy the journey. :)
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