Change... Can you handle it?

Change is inevitable in healthcare. I discussed change a little bit in my previous post about how healthcare will be focusing more on preventative care. However change happens daily in the healthcare field. Changes happen with patient status, educational requirements, technology, work schedules, nurse-patient assignments,  and many more. Some say change is easy where others say change is difficult. Implementing change in healthcare a lot of the time is implemented by the manager and/or leaders in the field. Staff and other recipients of change are all viewed as an intefral part of the change process. Some of the decisions to make a change go through a theory process. A theory that is frequently used is Lewins Change Process. His change process has three elements.

Lewins Change Process
 1. unfreezing
2. moving (change)
3. refreezing.
 
The unfreezing element is considered "thawing out" the system and is the stage that gets ready for the change. This stage introduces the change to staff and gets them prepared and motivated (hopefully) for the change. Trust, respect, and strong communication to help unfreeze individuals effectively. Effective team building, leadership, and motivation are key strategies that are helpful during this process. Education can also be part of this process if new equiptment or anything effecting the patient is changing.
The second change is the moving/change element of Lewins theory.This is not an easy time as people are learning about the changes and need to be given time to understand and work with them. Support is really important here and can be in the form of training, coaching, and expecting mistakes as part of the process.  This is when the change is implimented. This stage could never work without a strong and effective "REAL TEAM" behind it.
 
Lastly, the refreezing is when all the changes have stabilized, has become a part of the norm, and feels comfortable.
I've found the Kurt Lewin model useful to frame a process of change for people that is quite easy to understand. Of course each stage can be expanded to aid better understanding of the process, but that is how many theories are.

WHAT I THINK ABOUT CHANGE....
I deal with change everyday in the float pool. I am hardly ever on the same unit that I was on the previous day, and sometimes have to float to a different unit half way through my shift. I have really grown to like that change. It keeps me on my toes and I am constantly learning something new everyday I go to work. Now, some people like that for that reason they are in the float pool, and others have no interest and despise when their over staffed and it is their turn to float. At my work we are also implementing change in implementing new glucometers. We are in the process of unfreezing. Each employee has to do some educational learning and attend a class to get them used to the idea of this change. We will be in the "moving/change" stage next week. I like change because I know it is apart of my career and I need to be flexible.

Huber, D. (2006). Leadership and nursing care management (3rd ed.). Philadelphia, PA: Saunders Elsevier

HOW do YOU handle CHANGE? Are YOU in the middle of any kind of CHANGE?

TEAM= Together Everyone Achieves More

In healthcare, every discipline plays an integral role in patient care, making teamwork a HUGE part of nursing. Any lack of teamwork affects the care delivery and relects a negative environment. A real team is defined as a group that is big or small, temporary or permanent, who can come together and bring complimentary skills, shared purpose of collective work, common approaches to work, and hold eachother accountable for outcomes. A pseudo team (fake) is a group of individuals who think they are a team but have dysfunctional and unhealthy relationships anc communication patterns. Most everyone has been a part of a team who works well together and a team that has struggled and been dysfunctional.
 
What Makes A Great Team?
1. Commitment and capability
2. Leadership
3. Trust
4. Collaboration/Communication
6. Motivation
7. High standards
8. Diversity
9. Clear goals
10. Common purposes
11. Address concerns
 
These ten things make a great team because they bring different aspects into a team to make the team successful. Everybody is part of a team, whether it be at work or at home as a family.

I am currently apart of a team at work as a nursing assistant. Everyday that I go to work I am part of a team. The team changes everyday so it gives me plenty of experience working with a real team and a pseudo team. Working with a dysfunctional team makes the day drag on and makes me feel that I am dysfunctional as well. It is unfair for the patient and their family members to have to be involved in a unhealthy environment. Thus, it is important to reflect and discuss how you make the team you are involved in strong and functional. I strive to make the team I am part of functional and strong by staying in communication and collaborate with the nurses I am assigned to by telling them  any abnormal values and concerns. I also gain trust and hold myself to high standards so other people do as well.

So I challenge you to reflect and discuss on what you bring to your team?

Where Have all the nurses gone?!?

In 2002 there was around 4.2 million people employed in hospitals of those 4.2 million, 2.3 million were employed as registered nurses. Yet, even though it may seem like a pretty big number, health care workforce shortages represent a cyclical challenge in the U.S health care system. Nurses are key players in the health care role, and when there is a shortage of the key players, access and quality are compromised, and increase of costs may be a consequence.Within the next couple years the aging population (baby boomers) is anticipated to live longer, making them the greater population that is being cared for. This can be concerning because the workforce is also aging and they will retire, when the demand of nursing continues to grow rapidly. Shortages of nursing isn't a new issue, it first began in 1998. Shortages can be related to economic, workplace, social, and demographic issues. Nursing shifts are often unattractive, pay rates become flat over time, and the lack of nursing faculty creates high stress on units. Nursing management has done many things over time to help alleviate the shortage. They have attempted to increase wages, enhanced recruitment programs, use of agency nurses, bonuses, hiring foreign nurses, and recruiting more men and women through a scholarship program and lean repayment programs. Patient safety is what really matters when it comes to nursing shortages. When nursing has less staff on, they have more patients and more responsibilities. More responsibilities with less time  to fulfill them.

This topic of nursing shortages is of interest to me because although there is not much of a shortage in the twin cities yet, it could very well happen at any time. In my place of occupation I have had many opportunities to see how ineffective the health care world is when we are not staffed correctly. It makes the day very difficult, and it when most mistakes and errors happen. Patients feel like they don't matter, and that their health care is not important. I do not want my patients to feel like they are not important, because they matter, and they are why I chose this for my profession.

How will the shortage of nurses affect you?

Change Is In Our Futures....

Currently in my nursing leadership course we are reading the textbook " Leadership and Nursing Care Management by Diane Huber. In chapter 14 of this book it talks about how currently there is a lot of focus on acute health care (hospitals), which ends up being extremely costly. Predictions for the future are that in the next couple years, there will be less focus on the acute care and more focus on community-based health care. Like myself, you may be wondering what exactly this means for nursing? Well, as the health care delivery system goes through this huge change, there will be more nursing focus on preventative care. This means taking action before a disease actually occurs. This can be done by thorough patient education on preventing illness, immunizations, and risk assessment for specific diseases. There will be more job opportunities for nursing in the community setting as the health care reform continues to progress, making an increase of demand for great nursing skills.
I wanted to talk about this, because I think preventative care is really important and I believe and am really hopeful that the health care reform will help reduce some of the high costs due to how expensive acute care is. I wasn't aware of all the many opportunities there was in community nursing, and although I don't think I will go right into the public health setting of nursing, it is always a possibility. Nursing is always changing and it's important to stay openminded and be aware of the changes around nursing. I look forward to see all the changes that the future holds!

Huber, D. (2006). Leadership and nursing care management (3rd ed.). Philadelphia, PA: Saunders Elsevier

TED TALKS: Steve Jobs "How to live before you die."

This TED talk was done by Steve Jobs. Steve Job’s was a successful co-founder of Apple at the young age of twenty. He shared his speech at his Stanford university commencement. His speech is very inspiring. Within his speech he shared three great stories. Within his first story he shared that we cannot connect the dots going forward but you can connect the dots going backwards, this reinforces my belief that everything happens for a reason, even when things seem really tough. His second story shared some of his toughest times, one of them being when he was fired from apple. He never gave up on his dreams and his love of his work. He said during his second story that “sometimes the only thing that can keep you going is your love of what you do. Work fills a large part of life, and the only way to be truly satisfied is to do what you believe is great work and the only way to do great work is to absolutely love what you do.” I couldn’t agree with him more. I know for me, I could not have gotten this far in nursing school if I did not love it. His third story he shared his experience with a scare of cancer. Luckily, it was just a scare, however he learned that time is limited, so don’t waste it on living someone else’s life. He states “don’t let the noise of others opinions drown out your inner voice, and most importantly have the courage to follow your heart and intuition, they somehow already know what you truly want to become.” His words really are inspiring because he shares a lot of his personal life and also has great motivational quotes. His inspiring words have made me grateful for going into the nursing profession because of the love and enjoyment I feel from it.

Mission Statement

My mission is to promote patient safety and overall health through nursing care that emphasize integrity, compassion, and respect.