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Think About It
A forum for discussion of the latest news and ideas in nursing management and healthcare.
Wednesday, November 16, 2016

Over the past few years, healthcare reform laced with economic unrest may have brought us the feeling that there's something bad looming. And the election process may have accentuated these fears. It doesn't matter if you voted for or against the President-elect, the change that will occur with a new President will affect all of us. And this gives us anxiety about the unknown. The change may be positive or negative – whichever, it's still looming.

 

I just read an article posted on Fierce Healthcare, which gives us further reason to be anxious. We should prepare for a potential recession that will impact hospitals with even more fiscal uncertainty than is happening now. We're in the middle of healthcare reimbursement changes that result in hospitals and other healthcare organizations sitting on shifting fiscal sand. The future of Obamacare is uncertain and now we have a possible recession to add to the financial unpredictability.

 

Hospitals will be challenged to deliver low-cost, high-quality care with good outcomes. Being fiscally conservative, tightening belts, and making do with less will be the norm. As nurse leaders, we'll be stretched to care for our patients with fewer resources and less staff. It sounds gloomy, but this new reality may push the nursing profession even more toward creativity and innovation. Our usual care models will be challenged and our processes will require greater efficiency. Nurses have always risen to the challenge and we'll be proactive in creating the best care environment for our patients.

 

Caryl Goodyear-Bruch, PhD, RN, NEA-BC

Senior Director, Children's Mercy Hospital, Kansas City, Mo.

Nursing Management Editorial Board Member


Monday, September 26, 2016

​I’ve had some really good dialogue lately with clinical nurses in the critical care setting about nurse-patient ratios, staffing assignments, and acuity. In a world where nursing organizations are fighting for safe nurse-patient ratios and standardized staffing laws, we’re faced with increased in-house acuity levels and financial responsibility. How does an organization manage this safety and equitably? How do you empower frontline nurses to manage this in a financially sound, effectively safe, and staff satisfying manner?

I believe the answer lies in acuity-based staffing processes. Staffing by acuity enables bedside nurses and their immediate supervisory staff the ability to decide what their unit needs based on care needs and changing situations. This allows some semblance of control over poor staffing, as well as the ability to make safety-based assignment adjustments as needed using professional judgment and experience as guides. In the past, we’ve struggled nationally with acuity tools and processes that fail to meet validity needs because they’re often subjective in nature (barring tools such as APACHE). What does staffing by acuity mean to you? What does your organization do regarding staffing vs. numbers vs. assignments? Let’s hear from you!

Lisa Lockhart, MHA, MSN, RN, NE-BC
Nurse Manager
KentuckyOne Health, Saint Joseph Health System
Lexington, Ky.

Tuesday, September 13, 2016

I currently work with a CNO that has a true belief in succession planning! I’m excited by this on a professional level because I also believe in succession training and the way it empowers staff members and ensures the strength and unity of nursing’s future. Although our nursing education and organizations support this type of legacy, I’ve rarely seen it in action. Why do you suppose that is? I remember being told once by a respected mentor that a leader’s job is to educate and empower those you lead to the point where you’re no longer needed! Could it be that some of our leaders fear they may encourage, support, educate, and empower themselves out of a job? I think it may actually be that many don’t truly understand what succession training is. It requires empowering future leaders to think for themselves and stand on their own. Your successors will be in various roles throughout the organization, forging ahead to carry the torch of quality, safety, engagement, and empowerment that was instilled in them by igniting their power to think, grow, and develop as professionals. What are your thoughts on and experiences with this topic?

Lisa Lockhart, MHA, MSN, RN, NE-BC
Nurse Manager
KentuckyOne Health, Saint Joseph Health System
Lexington, Ky.

Monday, July 18, 2016

Again, we’ve sadly watched violence unfold in our country this past week. As healthcare workers, we’re in the middle of these scary times. The very nature of our roles as caregivers, emergency responders, and advocates for social awareness/justice places us at the heart of each crisis. I know this is sparking reflection and dialog at home and work. We must be mindful of our thoughts, feelings, and innermost fears. The ability to maintain the core beliefs that led us to care for others will keep us strong. Please take the time to share your thoughts honestly and respectfully as we move forward. It’s essential to your personal and professional growth, as well as your stability, that you look inward at how your concerns are affecting you: as an individual, a family member, a friend, a coworker, and a professional. If you feel like you need help, see what resources are available where you work, live, or gather.

Lisa Lockhart, MHA, MSN, RN, NE-BC
Nurse Manager, Specialty Clinics
Alvin C. York VA Medical Center
Murfreesboro, Tenn.

Monday, July 11, 2016

I’ve been trying to work on myself this past month by reading up on healthy habits - both physical and mental health. As a nurse, I know that caregivers are often the worst at self-care. In addition, we frequently work in an environment that doesn’t always lend itself to self-care. Long shifts; poor staffing; junk food; infrequent or nonexistent breaks; missed family functions, abuse from coworkers, families, and patients; and the list goes on. This takes its toll on us internally and externally, and we process that stress somewhere...

How do you manage your stress? How do you take care of you? How do you prevent taking stress out on others and how do you keep from turning it inward? Does your organization have an employee assistance program? Does it encourage healthy eating, exercise, regular break times, and allowances regarding limitations on shift length and overtime hours worked weekly? What’s the stance on harassment, respectful communication, and anger management? Take a look at what your environment is really like and how it meshes with your life and your personal and professional goals. If you don’t like what you find, consider making the necessary changes to promote self-care and decrease your stress levels.

Lisa Lockhart, MHA, MSN, RN, NE-BC
Nurse Manager, Specialty Clinics
Alvin C. York VA Medical Center
Murfreesboro, Tenn.
About the Author

Nursing Management
“Think About It” is an extension of Nursing Management. Here, you can read and discuss professional information geared toward helping nurses excel as leaders. This blog tackles important topics without the worry of print publication deadlines!