DiversityNursing Blog

By Anna Gorman, Los Angeles Times
August 22, 2012

Black and Latino children were more likely than white children to be obese, witness gun violence and ride in a car without a seat belt, according to a study released Wednesday.

The study, published in the New England Journal of Medicine, found wide ethnic and racial disparities in health behaviors among fifth-graders in Los Angeles, Houston and Birmingham, Ala.

“The disparities were pretty substantial across so many different health indicators,” said lead researcher Mark Schuster, a Harvard Medical School professor and chief of general pediatrics at Boston Children’s Hospital.  “The breadth of the findings was striking to us.”

The researchers examined 16 health behaviors, including cigarette smoking, alcohol use, exercise habits, terrorism fears, bike helmet use and psychological quality of life.

Many of the behaviors carry potential for lifelong health problems, Schuster said. For example, researchers found that obesity rates were twice as high among black and Latino children, placing those children at increased risk for diabetes and heart problems. Black children were also more likely to be bullied, smoke cigarettes and drink alcohol than white and Latino youths.

Parents’ education and income played a critical role in the disparities, according to the study. Researchers also found that schools had a huge influence on children’s behavior, and that there were differences among schools even in the same neighborhoods.

Researchers interviewed more than 5,000 fifth-graders and their parents between 2004 and 2006. Schuster said the team focused on 10- and 11-year-olds because there was already significant research and public awareness about risky behaviors among adolescents.

“Finding disparities this young suggests that we have to start young to try to address them,” he said. “There is a strong likelihood that these disparities will persist unless we intervene to change them.”

From Human Resource Executive Online By Katie Kuehner-Hebert

It's one thing to be bullied by a co-worker or a boss, but simply witnessing the behavior in the workplace can be enough to make a worker call it quits, according to a study of "ambient" bullying.

Researchers at the University of British Columbia in Vancouver, Canada surveyed 357 nurses in 41 hospital units and found a statistically significant link between working in an environment where bullying was occurring and a desire to leave the organization. The study was published last month in the journal Human Relationsby SAGE.

"We underestimate the power of the impact of just being around bullying in the workplace," says Sandra Robinson, a professor at UBC's Sauder School of Business and one of the authors of the study.

"For those seeking to influence problematic behavior, they need to be sensitive [to the fact] that the impact of such behavior transcends the person or the group . . . actually being bullied, and that there may be other victims who are impacted by the harmful behavior, whether it comes from their supervisor or co-workers," Robinson says.

Marianne Jacobbi, senior editor at Ceridian/Lifeworks EAP programs in Boston, says research has shown that ambient bullying, or "indirect bullying" is pervasive -- 70 percent of employees say they have witnessed other people being bullied or mistreated at work.

"Bullying has a negative effect on team relationships, which creates a toxic work environment," Jacobbi says. "When [people] witnesses bulling, they think, 'This could be me next,' particularly if it's their boss."

Indeed, research has also shown that 72 percent of all bullies are bosses, she says.

HR managers should encourage an environment in which people feel safe to discuss bullying they've witnessed, and assessed that their comments will remain confidential whether they come to their boss, the HR department or the organization's employee-assistance program, Jacobbi says.

"The most important thing is creating a climate where people feel they have someplace to go when they feel uncomfortable," she says.

Ken Zuckerberg, director of training at ComPsych Corp. in Chicago, says HR managers not only have to watch out for employees with low morale after witnessing bullying, but also employees who try to appease the bully and make bad business decisions to avoid getting on their bad side.

When dealing with bullying behavior, organizations should treat it as a performance problem first and foremost, Zuckerberg says. A common mistake that HR managers often make in these situations is to take on the role of a counselor and try to figure out what is going on in the bully's life to cause them to act that way.

"One word of caution ? you want to continue to manage performance, but you don't want to be diagnosing mental-health issues," he says. "Most HR managers are not clinicians and they instead, should refer the bully to their EAP for help in uncovering what might be core issues behind bullying."

Seymour Adler, a partner with Aon Hewitt in New York and an organizational psychologist, says some people who witness bullying in the workplace feel they've been put in "a totally untenable situation of whether or not they need to try to be a hero."

"Who knows what the consequences will be if they do something about it, so they end up being passive about it," Alder says. "That can really be very corroding to their self-esteem, to how they view themselves as human beings."

If top-level managers are bullies, HR managers need to risk confronting them for the sake of the rest of the organization, he says.

"[HR managers have] the responsibility for the motivation, effective use and treatment of all of the human capital within their organizations," Adler says. "They need to be true to their value system, even if it ends up costing them their job."

From thestarpress.com By Michelle Kinsey

MUNCIE — Indiana University Health Ball Memorial Hospital wants to make sure that every person who walks through their doors gets equal treatment.

That commitment has landed the hospital at the top of a list, as the first in the state to be designated as lesbian, gay, bisexual, transgender (LGBT) friendly by the Human Rights Campaign, the nation’s largest LGBT civil rights organization.

The news came in the form of the HRC’s annual Healthcare Equality Index for 2012, which looks at how equitably healthcare facilities in the United States treat their lesbian, gay, bisexual and transgender patients and employees.

IU Health BMH was one of 234 nationwide — but the only one in the state — recognized as a “Leader in LGBT Healthcare Equality,” meeting all four core policy categories — patient non-discrimination; employment non-discrimination; equal visitation for same-sex partners and parents, and training in LGBT patient-centered care.

“We are proud of the recognition,” said IU Health BMH President and CEO Mike Haley. “It’s the result of a lot of hard work.”

That work began two years ago, after a transgender patient claimed she was mistreated in the hospital’s emergency room.

Transsexual Erin Vaught claimed she was called “it” and “he-she” and eventually denied treatment when she went to the ER on July 18, 2010, for a lung condition that was causing her to cough up blood.

Complaints were filed days later by Indiana Equality and Indiana Transgender Rights Advocacy Alliance and the incident went viral, with the hospital receiving criticism nationwide, and beyond.

Ball Memorial Hospital released a statement saying the hospital was conducting an internal review.

The result?

“We failed to meet their needs,” Haley said. “We acknowledged that openly.”

Then they went a step further.

“It’s one thing to apologize,” he said. “It’s another to say, ‘And furthermore, I want this hospital to be considered as a place anyone would want to go if they needed a hospital.’”

Haley issued a challenge to all physicians, employees and volunteers to meet every HRC key indicator.

Ann McGuire, vice president of human resources for IU Health BMH, led the hospital’s efforts. Members of the LGBT community were asked to help.

Jessica Wilch, board member and past president of Indiana Equality, an LGBT rights group, said she was a “believer in what (IU Health BMH was) trying to do” from the first meeting.

“When this went viral, my concern was that BMH would take the stand that this was an isolated incident and just pacify the process,” Wilch said. “Instead they saw it as a teachable moment.”

New policies were drafted and training was developed.

In addition to hospital leaders, anyone a patient would come in contact with was involved in the training, McGuire said, adding that it was about more than just a tutorial. It was about “eye-opening” conversations.

Wilch agreed, saying that face-to-face conversations with the LGBT community were essential.

“We could talk freely about the things we have encountered and then come up with ways, together, to handle it differently,” she said.

Overall, the HRC reports the number of American hospitals striving to treat lesbian, gay, bisexual, and transgender (LGBT) patients equally and respectfully is on the rise.

This year’s survey found a 40 percent increase in rated facilities.

Last year, IU Health BMH was short a few policy additions for the leadership HRC designation, but was still recognized for its efforts.

Wilch said she was not surprised the hospital “hit all of the marks” this year.

“They have become, essentially, one of the leading hospitals in the country, because it really started with them,” she said. “They were the ones who reached out to us and said ‘How can we make this better? How can we do the right thing?’”

Haley said he believed the training and policies developed at IU Health BMH will be used “across IU Health.”

IU Health BMH has also set out to look at other ways to expand their “best practices” when it comes to diversity, McGuire said. The hospital has been hosting Palettes of Diversity events, which have celebrated not only the LGBT community, but other cultures.

“We are making sure we are hard-wiring an environment recognizing and supporting diversity for all who come here,” Haley said.

McGuire agreed.

“It’s about relationships and dignity and respect,” she said. “It is uniqueness that each of us brings that makes us stronger as a community.”

And, McGuire would tell you, as a hospital.

From the Center for American Progress by Sophia Kerby & Crosby Burns

Our nation and our workforce are both becoming more diverse. The share of people of color in the United States is increasing; more women are entering the labor force; and gay* and transgender individuals are making vital contributions to our economy, while being increasingly open about who they are. To that end, businesses that embrace diversity have a more solid footing in the marketplace than others.

A diverse workforce combines workers from different backgrounds and experiences that together breed a more creative, innovative, and productive workforce. And businesses have learned that they can draw upon our nation’s diversity to strengthen their bottom line. In this way, diversity is a key ingredient to growing a strong and inclusive economy that’s built to last.

Let’s look at the top 10 economic benefits of workplace diversity.

1. A diverse workforce drives economic growth. Our nation’s human capital substantially grows as more women, racial and ethnic minorities, and gay and transgender individuals enter the workforce. A McKinsey & Company study, for example, found that the increase in women’s overall share of labor in the United States—women went from holding 37 percent of all jobs to 47 percent over the past 40 years—has accounted for about a quarter of current GDP.

2. A diverse workforce can capture a greater share of the consumer market. By bringing together individuals from different backgrounds and experiences, businesses can more effectively market to consumers from different racial and ethnic backgrounds, women, and consumers who are gay or transgender. It is no surprise, then, that studies show diversifying the workplace helps businesses increase their market share.

3. Recruiting from a diverse pool of candidates means a more qualified workforce. When companies recruit from a diverse set of potential employees, they are more likely to hire the best and the brightest in the labor market. In an increasingly competitive economy where talent is crucial to improving the bottom line, pooling from the largest and most diverse set of candidates is increasingly necessary to succeed in the market.

4. A diverse and inclusive workforce helps businesses avoid employee turnover costs. Businesses that fail to foster inclusive workplaces see higher turnover rates than businesses that value a diverse workforce because they foster a hostile work environment that forces employees to leave. The failure to retain qualified employees results in avoidable turnover-related costs at the expense of a company’s profits. Having a diverse and discrimination-free work environment helps businesses avoid these costs.

5. Diversity fosters a more creative and innovative workforce. Bringing together workers with different qualifications, backgrounds, and experiences are all key to effective problem-solving on the job. Similarly, diversity breeds creativity and innovation. Of 321 large global enterprises—companies with at least $500 million in annual revenue—surveyed in a Forbes study in 2011, 85 percent agreed or strongly agreed that diversity is crucial to fostering innovation in the workplace.

6. Businesses need to adapt to our changing nation to be competitive in the economic market. Census data tell us that by 2050 there will be no racial or ethnic majority in our country. Further, between 2000 and 2050 new immigrants and their children will account for 83 percent of the growth in the working-age population. Our economy will grow and benefit from these changing demographics if businesses commit to meeting the needs of diverse communities as workers and consumers.

7. Diversity is a key aspect of entrepreneurialism. Our nation’s entrepreneurs are a diverse set of people of color, women, gay, and transgender individuals. According to the Census Bureau, people of color own 22.1 percent of U.S. businesses. Moreover, women own28.8 percent of U.S. businesses, and Latina-owned businesses in particular are the fastest-growing segment of the women-owned business market. According to the National Gay and Lesbian Chamber of Commerce, gay or transgender individuals own approximately 1.4 million (or approximately 5 percent) of U.S. businesses.

8. Diversity in business ownership, particularly among women of color, is key to moving our economy forward. The diversity of our nation’s business owners helps boost employment and grow our economy. For example, women of color own 1.9 million firms. These businesses generate $165 billion in revenue annually and employ 1.2 million people. Latina-owned businesses in particular have total receipts of $55.7 billion since 2002.

9. Diversity in the workplace is necessary to create a competitive economy in a globalized world. As communities continue to grow, it’s important to harness the talent of all Americans. Businesses should continue to capitalize on the growth of women, people of color, and gay and transgender people in the labor force. Our increasing diversity is a great opportunity for the United States to become more competitive in the global economy by capitalizing on the unique talents and contributions that diverse communities bring to the table.

10. Diversity in the boardroom is needed to leverage a company’s full potential.By 2050 there will be no racial or ethnic majority in the United States, and our nation’s boardrooms need to represent these changing demographics. Currently people of color and women only represent about 14.5 percent and 18 percent, respectively, of corporate boards among the senior management of Fortune 500 companies. Recruiting board directors with a breadth of expertise and varied experiences will make companies more proficient.

By Diane Sparacino via rn.com

Imagine a world where hospitals have become so noisy that the annoyance has topped hospital complaints, -- even more than for the tasteless, Jell-O-laden hospital food (Deardorff, 2011). If you’re a nurse, you know that we’re already there -- with noise levels reaching nearly that of a chainsaw (Garcia, 2012). In fact, for more than five decades, hospital noise has seen a steady rise (ScienceDaily, 2005).

But it wasn’t always that way. At one time, hospitals were virtually noise-free like libraries -- respected spaces, preserved as quiet zones. The culture was such that a loud visitor might be silenced by a nurse’s purposeful glare or sharply delivered “Shhh!” As early as 1859, the importance of maintaining a quiet environment for patients was a topic for discussion. In Florence Nightingale’s book, “Notes on Nursing,” she described needless noise as "the most cruel absence of care" (Deardorff, 2011).
 
Fast forward to 1995, when the World Health Organization (WHO) outlined its hospital noise guidelines, suggesting that  patient room sound levels not exceed 35 decibels (dB). Yet since 1960, the average daytime hospital noise levels around the world have steadily risen to more than double the acceptable level (from 57 to 72 dB), with nighttime levels increasing from 42 to 60 dB. WHO found that the issue was not only pervasive, but high noise levels remained fairly consistent across the board, despite the type of hospital (ScienceDaily, 2005).

Researchers at Johns Hopkins University began to look into the noise problem in 2003. They maintained that excessive noise not only hindered the ability for patients to rest, but raised the risk for medical errors. Other studies blamed hospital noise for a possible increase in healing time and a contributing factor in stress-related burnout among healthcare workers (ScienceDaily, 2005).

Technology is, of course, partly to blame. State-of-the-art machines, banks of useful alarms, respirators, generators, powerful ventilation systems and intercoms all add up to a lot of unwanted racket. When human voices are added to the mix, (i.e.  staff members being forced to speak loudly over the steady din of medical equipment), it’s anything but a restful environment. For the recovering patient in need of sleep, that can be a real issue (Deardorff, 2011).

Contributing to the problem, experts say, are the materials used in hospitals. Because they must be easily sanitized, surfaces cannot be porous where they could harbor disease-causing organisms. Rather than using noise-muffling materials like carpet, acoustic tiles and other soft surfaces, hospitals have traditionally been outfitted using smooth, hard surfaces – especially in patient rooms. Good for cleanliness – not so great for dampening sounds, which tend to bounce around the typical hospital (Deardorff, 2011).

Which brings us to the most recent research, published January 2012 in the Archives of Internal Medicine. In the report, Jordan Yoder, BSE, from the Pritzker School of Medicine, University of Chicago, and his colleagues associated elevated noise levels with “clinically significant sleep loss among hospitalized patients,” perhaps causing a delay in their recovery time (Garcia, 2012). During the 155-day study period, researchers examined hospital sound levels. The numbers far exceeded (WHO) recommendations  for average hospital-room noise levels, with the peak noise at an average 80.3 dB – nearly as loud as a chainsaw or electric sander (85 dB), and well over the recommended maximum of 40 dB. And while nights tended to be quieter, they were still noisier than recommended allowances, with “a mean maximum sound level of 69.7 dB” (Garcia, 2012).

Perhaps most interestingly, the researchers broke down the sources of noise into categories: “Staff conversation (65%), roommates (54%), alarms (42%), intercoms (39%), and pagers (38%) were the most common sources of noise disruption reported by patients” (Garcia, 2012). "Despite the importance of sleep for recovery, hospital noise may put patients at risk for sleep loss and its associated negative effects," they wrote. In addition, researchers found that the intensive care and surgical wards had some work to do in dampening noise levels, with ICU peaking at 67 dB and 42 dB for surgical areas. Both far exceeded WHO’s 30 dB patient room recommendation (Garcia, 2012).

Besides patient sleep deprivation, which itself can lead to a multitude of health problems including high blood sugar, high blood pressure and fatigue, studies have reported that elevated noise levels can increase heart and respiratory rates, blood pressure and cortisol levels. Recovery room noise causes patients to request more pain medication, and preterm infants “are at increased risk for hearing loss, abnormal brain and sensory development, and speech and language problems when exposed to prolonged and excessive noise” (Deardorff, 2011).

There is still more research to be done, of course, but Yoder and his colleagues had good news, as well; much of the hospital noise they identified is modifiable, suggesting that hospitals can take steps to successfully create a quieter environment for both patients and healthcare providers (Garcia, 2012).

Around the country, “quiet campaigns” have been launched by hospitals in an attempt to dampen nighttime noise. Besides dimming lights and asking staff to keep their voices down at night, they are working to eliminate overhead paging systems, replace wall and/or floor coverings – even the clang of metal trashcans. Northwestern's Prentice Women's Hospital in Chicago was built with noise reduction in mind, replacing the idea of centralized nursing stations with the advent of smaller, multiple stations (Deardorff, 2011)

Billed as “one of the nation’s largest hospital construction projects,” Palomar Medical Center in North San Diego County is a state-of-the-art facility that has been designed “to encourage quietness,” according to Tina Pope, Palomar Health  Service Excellence Manager. Slated to open its doors this August, the hospital will feature a new nursing call system to route calls directly to staff and help eliminate the need for overhead paging, de-centralized nursing stations and clear sight lines, allowing staff to check on patients without having to leave unit doors open. With measures already in place including “Quiet Hospital” badges on staff and posters at the entrance of every unit, a “Quiet at Night” campaign (9 p.m. – 6 a.m.), and a “Quiet Champions” program that encourages staff to report noise problems, Palomar is one of a growing number of hospitals working toward a new era of quiet.

By Debra Wood via NurseZone.com

July 12, 2012 - Who says that mentorships are only useful for new, fresh-out-of-school nurses?  Health care facilities, schools of nursing and professional associations are trying new approaches to reach out and support nurses throughout their careers, resulting in benefits for all parties involved.

Mentors can guide a nurse’s career and help the mentee weigh alternatives and avoid pitfalls; at the same time, mentors enhance their own skills and the profession as they pass along knowledge and intangibles necessary for success. And employers can realize a double bonus--by improving retention rates at both levels within their workforce.

“Mentors are critical to our profession,” said Lois L. Salmeron, Ed.D, RN, MS, CNE, ANEF, associate dean for academic affairs and professor at the Kramer School of Nursing at Oklahoma City University in Oklahoma. “This is one way to nurture our own and retain nurses.”

The Kramer School offers a formal mentoring program, assigning a seasoned faculty member to someone new to the program, ideally team teaching. Most remain close after the one-year formal program ends.

“We view [mentoring] as key to a positive transition,” said Salmeron, who adds that mentors also are important when a nurse wants to change specialties.

Cynthia Nowicki Hnatiuk, EdD, RN, CAE, executive director of the Academy of Medical-Surgical Nurses, called mentors the single most effective way to help nurses learn a new role and increase their confidence.

“It provides a one-on-one opportunity for two individuals to teach and learn together,” Hnatiuk said.

“Mentorship is something that never really stops, and something each person has to take responsibility for themselves,” added Ora Strickland, Ph.D., RN, FAAN, dean of the Florida International University (FIU) College of Nursing and Health Sciences in Miami. “You will have many mentors through your career, and more than one mentor at one time, depending on what you are trying to gain skills in.”

Strickland has found most mentors enjoy the experience.

FIU offers a research mentorship program to increase the research productivity of its faculty and help them learn how to network, seek funding, conduct studies and publish their findings. The mentorships cross disciplines to encourage collaboration.

Formal mentoring programs

Many nursing employers provide formal mentoring programs.

UnitedHealth Group Center for Nursing Advancement built its own nurse mentoring initiative, leveraging best practices. It facilitates monthly in-person and virtual mentor/mentee interactions. Mentees submit profiles about development needs and potential mentors’ strengths, and the center electronically matches them. After the one-year mentorship ends, mentees can continue attending special events.

Dawn Bazarko, DNP, MPH, RN, senior vice president of the Center for Nursing Advancement, reports 100 percent of the first cohort of nurse mentees has continued working at UnitedHealth and 21 percent have received a promotion. The center is now building a new mentoring program for more seasoned nurses within the organization to take on broader leadership roles.

“We’re taking our experience to inspire and evolving that to address the needs of our senior nurses,” Bazarko said. “Nurses are critical to the people we serve, modernized health care and our business success. It’s a deliberate investment in their personal and professional enrichment.”

MedStar Good Samaritan Hospital in Baltimore also offers a formal mentoring program and has found it reduces turnover and increases productivity, reported Joy Burke, RN, MSN, CCRN, a clinical specialist at Good Samaritan. The hospital offers mentoring classes to prospective mentors, who must have at least two years of experience. Approximately 130 nurses have taken the course and are currently mentoring 67 novice nurses.

“The nurse has a friend, a buddy, someone they can call on,” Burke said. “They get critical feedback from the mentor.”

Huntington Hospital in Pasadena, Calif., pairs new hires with a mentor, said Lynette Dahlman, MSN, RN-BC, director of clinical education and academic partnerships. Serving as a mentor earns credit toward a nurse’s career ladder.

Nurses do everything they can to help a nurse grow, so they are proud to work alongside [of them],” Dahlman said.

Texas Children’s Hospital in Houston also offers a formal mentoring program. The hospital matches mentors and mentees with like backgrounds and with the skills the mentee needs. Formalized classes provide resources and an objective look at internal resources.

Kara Boakye, RN, BSN, CPN, nurse manager of the progressive care unit at Texas Children’s, said she has gotten to know herself better and become a better leader after being mentored by Emily Weber, RN, NEA-BC, nursing director for newborns at the hospital.

“I feel I gain just as much from the relationship, because it makes me pause and think about why I would make that decision,” Weber said. “Both parties gain a lot from it.”

South Nassau Community Hospital in Oceanside, N.Y., takes a slightly different approach with its mentoring program, designed to help nurses advance to the expert level. It matches nurses with potential to move up with outstanding stars who can mentor and coach them in communication skills, working within the organization and understanding the health care industry.

“Mentoring isn’t about clinical skills,” said Sue Penque, Ph.D, RN, CNP, chief nursing officer at South Nassau. “A mentor is above and beyond what you get in didactic training.”

South Nassau conducts annual assessments of nurses’ strengths and performance to evaluate the effectiveness of the program. It also identifies experiences where people can grow and take on new responsibilities while the mentor is present and able to coach.

Finding a mentor

While a formal program might make it easier to connect with a mentor, nurses often can find one independently. Nurses should observe others who practice as they aspire to and approach that person, advises Hnatiuk.

Penque has asked a nursing leader in academia whom she admired to mentor her.

Strickland has approached subject-matter experts whose abilities and skills she respected and asked them for mentoring and has never been turned down.

Finding the right mentor “can be just as hard as finding a good husband or wife--and well worth the search,” said author and relationship expert April Masini of Naples, Fla. She recommended being persistent and trying until you connect with the right person; when you succeed, be careful not to seek more time than agreed upon and to respect professional boundaries.

The Academy of Medical-Surgical Nurses recently launched a free, self-directed mentoring program with online validated tools, including mentor and mentee guides, for nurses new to the specialty and those who are changing settings.

“We would love for people to use the resources,” Hnatiuk said.

Mentoring across the profession

In addition to mentors in clinical and academic settings, nurses also mentor each other in professional associations.

The Association of Pediatric Hematology/Oncology Nurses recently introduced a members-only, two-year mentoring program, which matches experienced mentors with mentees. The goal is to facilitate member’s career growth and leadership development.

Ramón Lavandero, RN, MA, MSN, FAAN, senior director of communications and strategic alliances for the American Association of Critical-Care Nurses and a clinical associate professor at Yale University School of Nursing in New Haven, Conn., said mentoring is embedded in the fabric of the association’s community of nurses. The organization has a formal process for newly elected board members, and chapter advisors offer mentorship to local leaders.

“Mentorship ranges from coaching on leadership development and succession planning to problem solving challenging situations,” Lavandero said. “A newer chapter known for its innovative activities may mentor an experienced chapter that wants to explore new direction.”

By Rose O. Sherman via American Nurse Today

Editor’s note: At American Nurse Today, we believe every nurse can be a leader. This article is the first in what will be occasional guest blogs by Rose O. Sherman, founder of the Emerging RN Leader blog (www.emergingrnleader.com). In addition to her guest blogs, Rose will contribute articles on a regular basis to help nurses achieve their leadership potential.

 You may know that you want to be a nurse leader but are unsure about your next career step. It is important to recognize that you don't have to be a chief nursing officer or a nurse manager to "lead." You can begin leading from wherever you are in the organization. If you manage your career around this concept, you will focus less on your linear progression up the career ladder and more on your own personal mastery and impact.

An important question to ask yourself as you begin your leadership journey is whether you have the qualities that nurses look for in their leaders. Successful leaders are unable to achieve goals without inspired and motivated followers. We have all probably observed nurses who have been placed into leadership positions and had the formal title of leader but are not successful in capturing the heart and soul of those they lead. John Maxwell, in his book The 21 Irrefutable Laws of Leadership, makes the important point that leadership is above all the ability to influence others. We know from research some key qualities that nurses look for in their leaders include:

• ·       A commitment to excellence
• ·       Passion about their work
• ·       A clear vision and strategic focus
• ·       Trustworthiness
• ·       Respectfulness
• ·       Accessibility
• ·       Empathy and caring
• ·       A commitment to developing others

Honest feedback about whether or not you demonstrate these qualities is important at the beginning of a leadership career. A good mentor can help you grow as an emerging nurse leader and open doors to new learning. Unlike the preceptor relationship, which you may be familiar with in the clinical setting, a mentor provides career guidance and helps you become more aware of your strengths and areas where you need development. An ideal mentor for an emerging nurse leader is someone who is knowledgeable, has leadership experience, and is interested in helping you to grow.

For some nurses, just getting noticed in their organization can be a challenge, especially if it is very large or if you work a night tour. When opportunities become available for advancement, you want to be someone that the nurse leaders in your organization think about as a great candidate, so consider these tips:

 1. Look professional

First impressions do count if you want to get noticed. Professional dress and being well groomed matter in creating a good image. When nurse leaders see nurses with wrinkled scrubs and dirty shoes, the impression is generally not favorable. You want to be remembered as someone who will be a good candidate to represent the organization.

2. Stay updated

It is important to stay updated by reading professional journals and attending educational programs. Be a "go-to person" for new information in your specialty area. In addition to staying updated clinically, pay attention to the news and what is happening with health policy. Think about how proposed changes in health reform could impact your organization and share your knowledge with other staff. Recognize that health care is also a business and become knowledgeable about the business of caring.

3. Take leadership roles

Take leadership roles at the unit level. They can be small but it is a great way to get started. Volunteer to take a leadership role on a unit shared-governance committee. Take charge when you have the opportunity. This is an excellent way to connect with other staff and leaders in your organization.

4. Volunteer for task forces and committees

Volunteer for organizational committees and task forces, even if it does mean coming in on your day off to participate. Leaders do notice when staff members are committed enough to an organization that they are willing to give back some of their personal time to be involved in activities.

5. Participate in organization-sponsored community activities

Join the heart walk team, the breast cancer walk, the March of Dimes, or other teams your organization may put together to support the community. Get others on your unit to join you. You will find that organizational leaders participate in these activities, and it can be a great way to introduce yourself in an informal setting and meet many new people.

6. Be professionally involved

Join a professional nursing association and attend the local meeting. You will probably meet staff and leaders from your organization that you might not interact with in other forums. Local professional associations are always looking for members who are willing to assume some leadership responsibilities. Holding office in a local association can be a good way to gain recognition.

7. Serve as a preceptor and cheerleader to other staff

Be ready to share your skills and knowledge with others. Sharing and volunteering to be a preceptor can be a great way to get noticed. Your manager will appreciate your willingness to be a strong team player. Be the first to congratulate others for their achievements and be the person who helps create a healthy work environment on your unit.

8. Keep your commitments

I once asked a great nursing leader what he attributed his success to. He told me that he did what he said he was going to do when he said he was going to do it. This will get you noticed, he assured me, because so few people actually keep their commitments. This is really great advice. If you volunteer, be sure to follow through.

There has never been a better time to choose nursing leadership as a career goal. The retirement of a large number of baby boomer nurse leaders will result in great career opportunities by the end of the decade. Oprah Winfrey often says that “luck is preparation meeting opportunity.” The time to start preparing for these opportunities is now. 

By Lea Rae Keyes via Nurse Entrepreneur Network

There are a few things any nurse entrepreneurs can do to increase their likelihood of being successful. One of the easiest and most powerful is to blog or write articles. This is also a very low cost way to promote your business. If you are wondering what blogging or writing articles has to do with the success of your business, read on....

1.  Develops your brand - Your brand tells your potential customers what you stand for, what you deliver, and portrays an overall experience. It tells your potential customers why they should buy from you.

2.  Helps people get to know you - Blogging is a way for you to share your personality and brand so your potential customers have a feeling that they know you or are at least getting to know you.

3.  Establishes you as an expert -- Blogging gives you the chance to share your expertise and knowledge with a larger audience.

4.  Helps to create community -- As you blog your audience will begin to add comments. Next they will start commenting on each other's postings and ultimately a community will begin to be form in a space you created.

5.  Aids your 'know, like, and trust' factor -- The more people read with you have written the more they feel as though they know you. As this continues they begin to like and trust you. People are far more likely to buy from someone they know, like, and trust.

6.  Enhances readability -- When you blog or write short articles it is easy for your audience to scan or quickly read what you have written. If your target audience can quickly read what you have written they are more likely to do this than if you are writing a long, complex newsletter or white paper.

7.  Increases you chances of being invited to write for others -- Blogging helps others notice you and then ask you to be a guest blogger for them. When you guest blog for someone else it broadens the number of people exposed to your writing.

If you want a low cost, effective way to become better known you need to add blogging to your marketing plan mix.

By Amy Standen via NPR

If there is a founding ethos in the world of high-tech startups, it's this: The idea is everything. Facebook's initial public offering might have seemed like the perfect illustration. A simple concept, conceived by a college student, became a $100 billion empire in just 8 years.

But if you look around California's Silicon Valley, ideas all seem to be coming from the same kinds of people. By a recent estimate, 1 percent of technology entrepreneurs are black. Only 8 percent of tech companies are founded by women. Facebook's Mark Zuckerberg isn't just a model of success in the Valley; he's a blueprint.

A new three-week boot camp for entrepreneurs is aimed at adding more diversity to Silicon Valley's startup scene.

Making Their Pitch In Silicon Valley

The New Media Entrepreneurship boot camp trains startup hopefuls to focus their business ideas and present them to investors. Some recent participants:

Seizing Opportunities, From An Early Age

It may be safe to say that some people are just born entrepreneurs. Take Chris Lyons of Johns Creek, Ga., outside Atlanta. When he was 12, he started mowing lawns.

"I'd take my mom's trash can and I would take my lawn mower," he says. "And I would push my lawn mower up and down the hill with one hand, and carry the rolling trash can for the other. I had over 30 lawns in my neighborhood. Then I bought a John Deere tractor."

Someone like that isn't going to stay in John's Creek forever. By the time he was 25, Lyons had set his sights on Silicon Valley.

"There's no other choice," he says. "Like, I want to be in an area that nurtures strong-willed, forward-thinking individuals. And there's no better place than Silicon Valley or San Francisco."

The thing is, when you look at Silicon Valley, especially at people who are starting businesses, they don't typically look like Chris Lyons, who is black.

And that is the whole point of the three-week boot camp for startups called NewMe, for New Media Entrepreneurship.

Reporting To Camp

On the first day of the camp, Lyons is sitting in the living room of a San Francisco townhouse, along with six other entrepreneurs — all women or African-Americans, most of them in their early 20s.

NewME director Angela Benton presents them with bags of swag — sponsor-donated items like shirts, headphones and mobile tablets.

Everyone here came with business ideas. Lyons' company is called PictureMenu, which he hopes will eliminate paper menus.

He's thinking big.

"We're trying to make this a worldwide mobile application," Lyons says.

The idea behind the boot camp is that when it attracts people like Lyons to the area, it also helps nudge Silicon Valley toward diversity.

And that, says venture capitalist and consultant Freada Kapor Klein, is something the Valley badly needs.

"This isn't about being bigots, this isn't about who's mean-spirited and who's enlightened," she says. "This is about how our brains are wired.

Klein says it's human nature: People tend to help people who look like them and who come from similar backgrounds. It's largely subconscious.

"We're not even aware of that hurdle that we've put in the place of a different kind of entrepreneur," she says.

Klein sees the NewME program as a two-way street because without diversity, the industry — and consumers — are missing out.

"If we've got a very insular world, then the kinds of companies that are created — most scratch the itch of a particular set of people and ignore everyone else," she says. "And I think that's the real loss for everybody."

Trouble With The Pipeline

One reason Silicon Valley is so homogenous is what's called the pipeline issue. There just aren't a lot of women, blacks and Latinos enrolling in science and engineering programs.

But there are subtler forces at work, too.

"No one's gonna say, 'I'm not gonna fund you cause you're black,' " says Chris Bennett, a NewME alum who is now a working entrepreneur. "No one's dumb enough to say that. But everyone will tell you that there is a bias."

Working with attorney Nnena Ukuku, Bennett started a Bay Area group called Black Founders.

"I think for some people it's sort of like a chicken-and-egg issue," Ukuku says.

"They've never seen a successful black entrepreneur, so it's hard for them to envision it. But then, they do exist ... it's just a mess."

Removing Self-Imposed Roadblocks

It's a mess because tangled up in all of this are roadblocks that women and people of color often put in front of themselves.

Take, for example, NewME participants Rachel Brooks and Amanda McClure. One day I asked them why instead of NewME, they hadn't applied to a different, more established program, one that wasn't based on race or gender.

And when I asked them this, they seemed kind of stumped.

"I don't know, maybe it just felt a little out of reach," Brooks says.

"Definitely," McClure agrees.

"Maybe that's what it was," Brooks says.

"It wasn't in my realm of conception, you know?" McClure adds.

"That's a much deeper issue," says Ukuku, with a sigh and a laugh.

She's laughing, she says, because she hears this all the time. It's the mindset, Ukuku says, that people have to be brilliant, at the top of their game, to even take a stab at Silicon Valley success.

"And the people that sort of have that tendency to say that tend to be women and minorities," she says. "Whereas I'll talk to some of my friends who I adore, who don't fit into one of those two buckets, and they'll say: 'I got an idea. I'm going for it.' "

Ukuku says she recognizes this confidence because she's seen it among her own relatives back in Nigeria.

"They're the majority in that culture," she says. "There's just an assumption that you will, like — why would you not succeed?"

Campers Pay A Visit To Google

That confidence of belonging is exactly what the NewME participants are trying to cultivate on the program's second day.

They're at the Google headquarters in Mountain View. And guess what? It's exactly the dot-com fantasy everyone imagined it would be. Lyons sounds giddy.

"I just walked outside, and they're playing pool and drinking coffee," he says. "And I saw a yoga session when we walked in here."

But Lyons is nervous, too. Tonight is a bit of an initiation: An American Idol-style pitch session.

At the event, the emcee is Navarrow Wright, an established entrepreneur in the Valley.

"What we're going to do tonight is give the NewME founders an opportunity to pitch their companies for the first time in public," he says. "They will have two minutes to pitch their startup, and we will each have one minute to give feedback."

Making A Pitch To Investors

When it's his turn, Lyons walks up to the lectern and flashes a winning smile at the audience.

"How's everyone doing today? Good, good. Well my name is Chris Lyons and I am the founder and CEO of PictureMenu."

He starts out pretty strong.

"And what we do is we allow any restaurant the opportunity to transform your boring paper menu into a beautiful mobile application for your smartphone, for free."

But after that, things get a little muddy, as Lyons compares the service to the way you can upgrade a car. After he wraps up, the critique begins. One of the judges is Chris Genteel, Google's development manager for global diversity.

"It was a great first half of the pitch and the second half kind of went off the rails," he says.

As Genteel goes on, Lyons' face falls a bit.

"I think you gave me a lot of ideas in the beginning," Genteel says. "And then confused me with a lot of kind of features."

For Lyons and the others, it's just a starting point. They've got three months of training ahead of them. And their pitches are all going to need some work.

By Suvarna Sheth, Hcareers.com

There's been a lot of contentious chatter lately on the state of job boards as social media moves in. Some say job boards are waning in popularity, while others say they're not going anywhere. The fact is the number of job boards are still proliferating and they are widely used by advertisement agencies and HR departments for many professions from retail to research. We speak to some industry insiders for their views on the importance of job boards in implementing an integrative recruitment strategy.

Bruce Dorskind, president of the Dorskind Group, a strategic consulting firm specializing in marketing communications, global recruitment, and business has seen the advertising recruitment industry evolve over decades, from one that relied 90% on print media to one that is dominated by digital media today. Dorskind claims there are over 10,000 job boards in the United States and probably 100,000 around the world, and growing.
"The big general job boards, Monster, Hotjobs and Career Builder were very important early on," says Dorskind," because they educated the public about the concept of a job board." They were basically a game changer says the industry veteran. "What the big job boards did was it sold the American public the idea that a job board is a viable way to find a job."

But today, 20 years into the concept of a job board, the market has changed, according to Dorskind. "Like every nascent market, it starts out in a very general way, and migrates to the specific," he says.

In the beginning, Dorskind explains everyone from the person working behind the retail counter at Wal-Mart to the person developing next generation pharmaceuticals for Genentech went to the same job board. "Now, the market has moved from general to segmented and you have the opportunity to only deliver your message to the specific group of people you are interested in through a targeted job board.

The niche job board has managed to be a very successful model for many reasons. One is that it has allowed employers to get resumes or responses from people that are relevant. "And it allows you to pay for the candidates you are getting, while with a general job board, you're paying for the entire audience, 95% of who aren't qualified," says Dorskind.

Still, not all niche job boards are successful. The ones that are, according to Dorskind are the ones that get their visitors involved, constantly produce fresh material, have current and real jobs and promote potential advertisers.

Dorskind says ad agencies and individual employers have five benefits to using niche job boards: you have a targeted audience, you can build a brand among the people you're trying to reach, they tend to be far more cost efficient, they tend to be where you're competitors are advertising, and they tend to do a better job reaching the passive job seeker than the general job boards.

Whether a particular recruitment strategy involves using large or niche job boards, Dorskind recommends ad agencies to use the strategy that meets their client's needs most efficiently.

"Certainly if they're looking for hundreds of people working in thousands of different locations for a retail store, then a strategy of being on a large job boards makes sense," he notes.

The problem for ad agencies, according to Dorskind is that there are too many job boards, and there is too much noise in the marketplace and within given industries. "In healthcare, there are over 500 job boards and it's impossible to keep up with all the new job boards unless it's a dominant player in its market," he adds.
Dorskind says niche job boards are a way to go for recruitment advertising. "I think in a world where technology is changing as quickly as ours and the options are as great as ours, there is no one solution," he remarks.

Like Dorskind, Sean Quigley, senior director of digital media at Bernard HODES Group says it's the obligation of the ad agency to do what's best for the client.
Quigley, who works on building strategies for clients and formulating digital media plans based on a given budget and set of targets, says there's definitely a shift going on in the recruitment world because of digital media.

And that's why he says it's not only about job postings at Hodes. "E-mail campaigns, banners, videos, as well as traditional job boards and niche job boards are all usually considered as part of a recruitment strategy," he says, "It's different for every client and there are more options on the table now so we're looking to take advantage of everything we can," he says.

According to Quigley, it's also important to have strategy on some of the more generic boards because that's where a lot of the target is ending up anyway. "On the other hand, we do see awesome results on more targeted job boards, which preform extremely well and rise to the top, delivering great results for certain accounts," he states.

For example, for a large pharmaceutical client who was more engaged in science oriented candidates, Quiqley and his team did extremely well on BioSpace.com, using large posting packages and creating a very strong branding presence throughout the site including e-mail sponsorships and a continual presence on the BioSpace pages. "BioSpace was an extremely beneficial option for us to have; it really helped us reach our client goals," he says.
Adele Mirabelli, a field sales representative within the healthcare division of onTargetjobs works with ad agencies to create media plans and posting packages for their healthcare clients.

She says the benefits to using a niche job board is quality vs. quantity. "Clients may not get as many candidates but the few that they do will be better qualified candidates," she states.

Also, she says clients can get lost within a general job board. "They have so many more jobs and unqualified candidates and at times healthcare employers can get lost in the mix of all the other industries out there."

Since niche job boards are focused and targeted to one industry, it makes it a lot easier for job seekers to find the jobs that they are looking for.
Mirabelli can't say without a doubt that niche boards are more successful than larger boards because it depends on the client and the job advertisement. "A lot of factors come into play when it comes to measuring success for our clients and the job boards they use," she says. However, with the economy picking up and recruitment opportunities on the rise, there is a need for better qualified candidates.

And when it comes to finding quality, Mirabelli is hearing that her clients are not finding it on general job boards like Monster. She finds that specifically healthcare employers are using niche job boards more because they are finding that the quality of the candidates is better.
Mirabelli says a lot of ad agencies use niche job boards for some of their client's hard to fill vacancies because they find they can reach a higher caliber of job seekers through them.

"At the end of the day, it's all about ROI and the quality of the candidates that they bring on board," she says. Like Dorskind and Quiqley, she notes that ad agencies need to recommend the best solutions out there to ensure that their clients are performing as well as possible.

This is true today, especially when everyone is tightening their belts and spending less. "When budgets are being cut, ad agencies really need to focus on what is the best solution for their clients and how they can help their clients achieve the best ROI," Mirabelli comments.

As for whether niche job boards are going to survive the rampant changes going on in digital media, Quiqley has no doubt. "Any site that's able to attract a high value audience that is engaged in looking for jobs-that's always going to be something that's going to be valuable," he notes.

"I don't see any evidence for job boards becoming extinct," Quiqley states, "While social media is powerful and is going to get more and more important, it's a different function in terms of actually being a destination where someone in a given career can look for job openings," he says.

The digital media expert says the business model for job placement on social media sites hasn't really developed yet, and while the potential may be there, nothing compares to achieving goals in a measurable way than job boards, SEO, smart placement of advertising and e-mails to targeted candidates.
"None of them are going to be replaced," he says, "there are different stages and audiences you're simultaneously reaching with these tools, so none of the individual tactics are going to be completely ruled out because of social media," he comments.