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Incredibly Easy blog
The Incredibly Easy blog will expand on selected topics presented in the print journal.
Monday, August 25, 2014

I recently read an interesting article on cognitive stacking—a wonderful term for multitasking—the coveted nursing trait that truly isn’t to be coveted at all. It’s an evidence-based fact that when multitasking occurs (and it must for any healthcare professional to survive), it comes at the high price of patient safety and quality. Fortunately, multitasking is short-lived and hopefully not associated with the need to make serious decisions.

Cognitive stacking is a form of overload—the main stay of any healthcare environment. The provider is inundated with a constant bombardment of data from every angle. This occurs while we’re simultaneously multitasking; what a combination to function in and be responsible for life and death decisions. People think air traffic controllers have it tough, well, they aren’t alone. 

We arrive, get our assignment, and begin data/chart review while receiving report. During this time, we walk our rounds, answer patient questions, stop to assist a patient need, and leave to get a phone call from a family member or caregiver. We may then get paged that our new admission is coming up from the ED and transport is here to pick up our patient in room 211. The physician needs us to assist with rounds, the nutrition department is delivering breakfast, and The Joint Commission is due. And this is all before 0800!

This isn’t overblown; actually, it’s probably a tame shift start for some as staffing becomes tighter and tighter and the request to multitask has gotten increasingly important. However, this is far more than multitasking; this is cognitive stacking—overload that can create errors, poor patient and staff satisfaction, and burnout.

What’s your work environment like? What do you think can be done to minimize the demand?

Lisa Lockhart, MHA, MSN, RN, NE-BC

Nurse Manager, Specialty Clinics

Alvin C. York VA Medical Center

Murfreesboro, Tenn.


Monday, August 18, 2014

The impact of compassion fatigue is significant and reaches our emotional, physical, professional, and personal well-being. In our professional environment, compassion fatigue may show as assignment avoidance, lack of empathy toward patients or caregivers, and increased use of sick leave. In our psychosocial world, it can appear as depression, anxiety, substance abuse, anger management issues, memory loss, insomnia, irritability, oversensitivity, and perceived lack of objectivity. Physically, it can manifest as cardiac issues, hypertension, fatigue, panic attacks, muscle pain, and digestive issues.

Compassion fatigue poses a significant health risk to healthcare professionals and the family members and patients for whom they care. The question then becomes how do we recognize compassion fatigue and how do we combat it? The first line of defense is recognition; education about the signs and symptoms of compassion fatigue is imperative so you can recognize it in yourself and your peers. Education should include the importance of nurse mentors and support systems to facilitate open communication, involvement of group support, and available organizational employee assistance programs. Openly recognizing the significance of compassion fatigue and giving credence to its impact are significant barriers in many organizations.

Strengthen your knowledge level regarding care for the caregiver, self-care, and combating compassion fatigue (see suggested reading). What does your organization offer for compassion fatigue recognition and treatment? What are the thoughts and perceptions of your peers? Topics worth discussion, indeed!

Suggested reading

Anewalt P. Fired up or burned out? Understanding the importance of professional boundaries in home health care hospice. Home Healthc Nurse. 2009;27(10):591-597.

Figley CR Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized. New York, NY: Brunner-Mazel; 1995.

Sabo BM. Compassion fatigue and nursing work: can we accurately capture the consequences of caring work? Int J Nurs Pract. 2006;12:136-142.

Watson J. Theory of human caring. http://watsoncaringscience.org/images/features/library/THEORY%20OF%20HUMAN%20CARING_Website.pdf.

 

Lisa Lockhart, MHA, MSN, RN, NE-BC

Nurse Manager, Specialty Clinics

Alvin C. York VA Medical Center

Murfreesboro, Tenn.


Wednesday, August 13, 2014

How many of you have ever been a patient or had a sick loved one? Experiencing the hospital from the other side is a great care lesson. The things you notice that are and aren’t done. It’s amazing how intuitive you become to conversations in the hallway, body gestures, and language. Wait times triple in your mind, or is that because you know how long it truly takes to get the results back? You understand short staffing and want to be sympathetic, but somehow you can’t.

I think being a patient or caregiver to a hospitalized loved one is the best lesson in customer service any healthcare professional can have. The idea that service matters; transparency is essential; and simple, direct answers are a patient’s life line.

I was recently hospitalized for a hip dislocation, and I had to spend the night after a closed reduction was performed. I waited 8 hours to have my surgical procedure that really could have been done with conscious sedation, the surgeon of record never actually spoke to me, and his physician assistant who discharged me the following morning had no idea about my care plan or restrictions. The saving grace? The nursing staff!

The nurses were wonderful, they saw to my needs, educated me on all of the essentials, made sure I had my call light and TV controls, and inquired about my pain level in a timely fashion. If not for the nurses, I would have left there a bewildered, “educated” patient. There was no education from the physician at any time.

What you do as a nurse makes all the difference in the world in the lives of your patients and their family members. Never underestimate the importance of everything you do and say to your patients and their caregivers. You’re the link between them and the care they receive. Nurses are the face of healthcare.

Lisa Lockhart, MHA, MSN, RN, NE-BC

Nurse Manager, Specialty Clinics

Alvin C. York VA Medical Center

Murfreesboro, Tenn.


Monday, August 04, 2014

Cultural diversity—what exactly does it mean? There’s so much in healthcare today that involves changing and evolving systems, clinical approaches, and clinical outcomes that are affected by cultural diversity. It involves family composition, race, ethnicity, religion, sexual orientation, and language to name a few. Cultural diversity encompasses many different areas and will vary by region.

Education on cultural diversity is required for healthcare providers, enforced by The Joint Commission when seeking accreditation, and supported by all of our national professional associations. This is wonderful, but ask yourself: What does it mean to me as a nursing professional? What does it really mean? Do you embrace the necessity of understanding our culturally diverse society or do you merely survive it?

It’s vital for healthcare workers to look within themselves when exploring their care and approaches to care. Educate yourself with facts and by self-examination. In the upcoming November/December issue of NMIE, we’ll explore the many facets of diversity and how they impact our care expectations.

Look within your own belief system and at your organization’s values. Compare these with the ideas and knowledge shared in upcoming articles. Let us know what you think.

Lisa Lockhart, MHA, MSN, RN

Nurse Manager, Specialty Clinics

Alvin C. York VA Medical Center

Murfreesboro, Tenn.


Monday, July 28, 2014

From the beginning, nursing has had a rich history of utilizing research to develop its practice as a profession. Today, we call this evidence-based practice (EBP). There are many published models that you can use when implementing EBP, and the best implementation comes at the point of care where practice meets the patient.

There are naysayers who declare this to be cookie cutter medicine, but following protocols and guidelines, along with monitoring outcomes, is the key to quality patient care. To the naysayers, we say that EBP is the conscientious joining of research, clinical trials, clinical expertise, and patient values. How can that be considered anything but quality?

I encourage you to become engaged in your practice. Why do you do what you do? Read articles, follow research, obtain continuing education credits (even if they aren’t required by the state in which you practice), or join a professional organization that’s relevant to your practice environment. Understand why we do what we do. Learn how to know when what we’re doing isn’t working, isn’t correct, or isn’t prudent. Follow and understand new guidelines, and bring your thoughts, concerns, and perceived failures to the attention of your peers, your administration team, and your quality management team. Your patients’ quality of life depends on it.

Lisa Lockhart, MHA, MSN, RN

Nurse Manager, Specialty Clinics

Alvin C. York VA Medical Center

Murfreesboro, Tenn.

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NursingMadeIncrediblyEasy
The mission of the peer-reviewed journal Nursing made Incredibly Easy! is to meet the ongoing educational needs of nurses in a refreshingly original, easily understood format.

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