DiversityNursing Blog

Via MedicalNewsToday

University of Stirling researchers have secured funding to investigate the effectiveness of training student nurses in mindfulness to reduce stress levels.

The study, which begins next month, will involve student nurses undergoing a stress test and then carrying out four weeks of mindfulness training. The participants will then undergo another stress test to find out if the mindfulness has helped reduce stress levels and increase their ability to cope with stress.

The student nurses will have guided meditation sessions and keep a journal about their own practice sessions at home as part of the research.

Mindfulness, or meditation, is a technique which can be learned and helps individuals to relax and cope better with stressful situations.

PhD research student Jenny Jones and Research Fellow Mariyana Schoultz, based at the Highland Campus in Inverness, are carrying out the study with Professor Stephen Leslie, a cardiologist consultant at Raigmore Hospital and Professor Angus Watson.

Researcher Jenny Jones said: "Hospitals can be a very stressful environment to work in. In my nursing training there was no mention of how to cope with stress but this is something that nurses face on a daily basis. Student nurses are not prepared for the very emotional and sometimes traumatic events they may witness at work, or equipped with the tools to cope and carry on with their job effectively. This study hopes to change that.

"We want to find out if mindfulness will impact on how nursing students cope with stress. If the results are positive, we want it to be introduced as part of nursing training. The ultimate hope is that this will make the nurses of the future more resilient to work related stress."

Nurses experience high levels of work related stress and are at risk of stress related illness. At any one time up to four per cent of trained nurses and up to six per cent of health care assistants are off work with stress or stress-related illness.

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.

From Forbes.com

You might think working well into your eighth decade is preposterous. But it is becoming relatively commonplace. The number of working people age 65 and older reached an all-time low in 2001, when just 13% held jobs. Now that rate is rebounding, and the number of workers older than 65 is 18% of the workforce.

The Future Workplace “Multiple Generations @ Work” survey asked 1,189 workers across the generations how likely they thought they were to work past age 70.

Seventy-seven percent of baby boomers (between ages of 48 and 66) said they believed they would work into their 70s. What is surprising is that 82% of Gen Xers (between ages of 36 and 47) agreed.

There are a number of reasons for employees to believe they will be working longer. First, they are already living longer. Boomers are expected to live longer than any previous generation of Americans. Of the 3.4 million born in 1946 — including Bill Clinton, George and Laura Bush, Donald Trump, Susan Sarandon, Steven Speilberg and Sylvester Stallone — 2.8 million are still alive. The men can expect to live another 22 years, the women another 25.

By 2030, when the first baby boomers reach the age of 84, the number of Americans older than 65 will have grown by 75%, to 69 million. This means more than 20% of the population will be older then 65.

And since we are living longer, we may want and need to work longer – especially to meet the financial needs caused by sagging retirement accounts, and plunging property values. As careers get longer, workplace culture will have to accommodate age diversity. Some traditionalists (those 66 and older) and baby boomers are already working further into their 70s and 80s, so as a new batch of employees from “Generation 2020″ (born after 1997) graduates from college and joins the workforce, it will become common to find five generations working side by side at the office.

A multigenerational workplace has plenty of advantages, including the potential for knowledge sharing, mentoring and coaching. But it can also create tension, the likes of which can erode office morale and sabotage productivity.

The “Generations @ Work” survey asked workers about their expectations and requirements for an employer.  The study found the struggles among the generations often eclipsed the advantages.

As originally discussed, in my book, The 2020 Workplace, each generation brings its own lens to the workplace, and individual and group talents can become obscured by assumptions, myths and real or perceived tensions and criticisms. This can lead to  havoc in the workplace.

Here are five ways to address and prevent generational tension at your company:

Teach your managers to anticipate generational differences, starting in the recruiting process.

Many young workers today approach job interviews differently than their predecessors. For our survey, we asked a sample of 150 managers to give us examples of surprising questions they’ve been asked by interviewees, most of whom were of millennial age. To the surprise of managers, millennials asked questions such as:

“Do I have to show up each day?”

“Can I use my own tablet, phone and laptop at work?

“Do I have to wear shoes to work?”

These questions can seem irreverent, but managers must understand what’s really behind them. The applicant who asks if he has to show up each day is really inquiring about the company’s telework policies and flexibility. The applicant who inquires about her ability to bring her own devices to work each day is really asking if the company has a Bring Your Own Device (BYOD) to work policy in place to allow employees to use their own devices instead of company-owned, standard devices.

And, if you are ever faced with a question about shoes, remember Steve Jobs – he frequently went barefoot to work!

Be aware of each generation’s preferred learning and communication styles.

In our survey, 35% of Generation 2020 said they consider mentoring and coaching the most valuable form of career development with only 20% preferring the classroom. This generation also prefers to use the latest tools – such as mobile devices, gaming, video sharing and social networks – for learning new skills.

A study by Deloitte Consulting and the IABC confirms this finding as it relates to communication styles. The study concluded that younger workers want information delivered immediately, and in shorter and more-frequent chunks. Speed and frequency of communication are important to them.

Google provides a good example of how to use games to boost productivity. Google‘s management realized that the company’s large spread of office space was cutting down on human interaction. To help foster connections, the company built an online, multiplayer social game called GoCrossOffice, modeled after the game Risk. Players collaborate, organize and socialize with each other, and in the process, strengthen their team-building and strategic-thinking skills. Since then, other companies have joined in this trend, too.

Enlist Millennials as subject-matter experts on what appeals to their generation.

Some companies think of millennials as a problem to be solved in the workplace. But the forward-looking ones enlist millennials when they are trying to adopt a new product or service inside the company.

Neiman Marcus Director of Learning and Development Keith Meyerson relied on millennials who work for Neiman Marcus to promote the collaboration module of the company’s learning management system (LMS). Instead of using a top-down communication program, Neiman Marcus focused on communicating from the bottom up by using millennials to drive participation and share this practice with older workers who are typically not early adopters of new tools in the workplace.

Don’t believe the myths about each generation in the workplace.

It would be easy to put each generation in a box and characterize them based on stereotypes. But there are also plenty of similarities to be found among workers of all ages.

For instance, flexibility has become an increasingly valued workplace characteristic by workers of every generation. When Future Workplace asked how important a flexible work environment was, 35% of our survey respondents, across all ages, answered either “important” or “very important.” For all generations, flexibility –flexible hours and flexibility of location (i.e., telework) – was more important than both compensation and opportunities for advancement.

As more organizations see the importance of offering flexibility in the workplace, we will see this touted in recruiting materials as a way to attract talented new hires.  Organizations will need to probe for more cross-generational priorities such as flexibility, and communicate with both current and prospective employees about how they are delivering on those demands.

Be prepared for generational tension.

Intergenerational conflict is impossible to prevent entirely, so be prepared to address it when it does arise.

In our survey, 66% of millennials agreed with the statement, “my personal drive can be intimidating to other generations in the workplace,” and the generations’ divergent views on what to expect in the workplace of the future further outlined that tension. A study by PricewaterhouseCoopers found the same.

Take a cue from Bank of America and Pratt & Whitney. Both  organizations have created Employee Resource Groups focusing on Multi Generational issues.

Why focus on the needs and expectations of a multi-generational workforce? Just think of your future employee, the one entering your workplace in 2030. According to the Office of National Statistics, one third of the babies born today in 2012 will live to see their hundredth birthday! Now consider the age of the oldest member on your team in 2030.

The employers who adapt most quickly to the realities of a multigenerational workforce will become the ones who attract and retain the highest-quality employees now and in the future.

From Advance for Nurses By Beth Puliti

The Institute of Medicine recently appealed for a change in nurses' roles, responsibilities and education, proposing to implement nurse residency programs to assist in the clinical practice transition (Advancing Health, October 2010).

The Hospital of the University of Pennsylvania, Philadelphia, identified the need for support much earlier.

Its Gateway to Critical Care Program started 10 years ago and offers new nurses and registered nurses with less than 1 year of critical care experience the opportunity to work alongside experienced ICU nurse preceptors to become safe and competent critical care nurses.

"The competency-based orientation program helps foster the knowledge and skills necessary to care for patients within the different critical care units in our hospital," said Lisa Fidyk, MSN, MS, RN, coordinator of the Gateway to Critical Care Program.

Catering to the Adult Learner

Participants enrolled in the program adhere to an educational plan that defines competency expectation, patient assignment and preceptor/learner responsibilities.

"We base our program on Patricia Benner's From Novice to Expert model. We work to assist the graduate nurse's progress from advanced beginner to competent nurse utilizing her framework," explained Fidyk, who is also a professional development specialist in the Department of Nursing Education, Innovation and Professional Development.

As Fidyk mentioned, Benner's framework of skill acquisition and development of the essence of critical thinking is utilized in the Gateway to Critical Care Program. Goals are reached through segmented learning, faculty guidance, a supportive environment and preceptor/orientee relationships.

The 16- to 20-week program consists of 4-5 weeks of classroom/clinical and 11-16 weeks of full-time clinical. It enrolls new-to-practice surgical, cardiac, neuroscience, cardiothoracic and medical ICU nurses, as well as nurses from the emergency department. Fidyk noted the nurses learn from various teaching strategies, including classroom instruction, clinician-supervised skill labs and clinical experiences.

"The program caters to the adult learner and provides different ways for these nurses to learn about the critical care arena. We incorporate case studies, lectures, discussions and simulation to help them develop the skills they would need to care for critically ill patients," she said.

Throughout the program, nurses learn the following core competencies: airway and ventilator management; cardiac monitoring; critical care pharmacology; hemodynamic monitoring; arterial blood gases analysis; acid-based balance; pain, sedation, neuromuscular blockade; and end-of-life care.

Working Alongside Experienced Nurses

Clinical support comes in the way of clinical preceptors, Gateway to Critical Care faculty and critical care advanced practice nurses/clinical nurse specialists/clinical nurse IV staff nurses.

While enrolled in the program, nurses work beside experienced ICU nurse preceptors.

"A preceptor is a mentor," Fidyk said. "They work with that person when they are on the unit taking care of patients. Preceptors are experienced nurses who know what it's like to go through the Gateway Program, how to collaborate and how to make it a great experience."

When the nurses return to their floor, they practice and hone their skills with a preceptor for the duration of the program.

"My nurse preceptor was a nurse on the unit for 5 years," recalled Lauren Mang, BSN, RN, clinical nurse I in the neuro ICU at the Hospital of the University of Pennsylvania. "She was fabulous. She really gave me the confidence and courage I needed to become a better nurse."

Mang noted preceptors help new nurses become more at ease because, as an experienced nurse who knows the ins and outs, they are able to impart their knowledge at a comfortable level.

"She was there side by side with me until toward the end when she started to hide from me so I would learn how to answer questions on my own. She gave me the confidence to be able to do that," she said.

New Graduate Nurse Retention

After the Gateway to Critical Care program, nurses are enrolled in the Nurse Residency Program, a yearlong series of learning and work experiences designed to support nurses as they transition into professional nursing practice.

The Hospital of the University of Pennsylvania participates in the United HealthSystem Consortium (UHC)/American Association of Colleges of Nursing (AACN) National Nurse Residency Program and was actually the first Philadelphia hospital to participate in the National Nurse Residency Program.

The UHC/AACN Nurse Residency Program consists of an evidence-based curriculum developed by academic and nursing experts across the country. It boasts a reduction in voluntary turnover rate for first-year nurses to well below the median of 27.1 percent. Programs that have implemented this residency program model have attained retention rates of more than 94 percent.

Fidyk commented that both the Gateway to Critical Care Program and the Residency Program at the Hospital of the University of Pennsylvania act as a great support system, and with that support she's seen a "huge" increase in retention. A 98 percent retention rate to be exact.

A higher nurse retention rate delivers better patient outcomes by increasing the nursing staff's experience and competency. Retention also helps preserve new graduate nurses' knowledge, experience and competence gained during the first year of professional practice.

"I know a lot of hospitals don't have these programs, and when I was in a leadership class in nursing school, we actually talked about Penn's Gateway program. That really opened my eyes to research this program more," Mang said. "I needed just a little bit of extra help one-on-one and it really helps you with that. Right now, I'm only 11 months into this and I feel very confident and have learned a lot from this program."

Fidyk noted that, for most of the nurses who come into the program, it's their first job - and it's an intense arena.

"You're saving people's lives, you're dealing with emotional aspects of your job, you're coming in contact with many different healthcare providers - it's all very overwhelming. The Gateway to Critical Care Program is a great way to help new nurses figure everything out and have someone to talk to who will listen," she concluded.

From pr-inside.com

Vocational Nursing students at Stanbridge College met with over 40 representatives from Southern California healthcare employers to schedule interviews, hand out résumés and gain insight to their future careers.

Stanbridge College, a technical college that offers training in Healthcare and Information Technology, hosted over 40 representatives from Southern California healthcare employers at the Vocational Nursing Career Fair on June 6th. Over 150 students networked with representatives from skilled nursing facilities, home health organizations, hospice organizations, hospitals, medical offices and other healthcare facilities. Many of the students and alumni made lasting impressions on the employers that lead to potential job interviews.

According to Alice Brinkmann, VN student who is scheduled to graduate this July, “I was blown away by yesterday! I handed out my résumé to 10 employers and by 3pm I had email [responses] from 8 out of 10 employers.”

Subsequently, Ms. Brinkmann stated that she received four more interviews as a result of the connections made at the career fair.

Arman Goshtasbe, Assistant Director of Career Services at Stanbridge College also emphasized the positive results of the career fair. He stated, “One student came to me and within 30 minutes had two interviews.”

Stanbridge College offers career fairs as part of its career preparation for its students and alumni. The Career Services Department at Stanbridge College offers assistance with job placement, résumé preparation, mock interviews and career advising. Alumni members are able to receive life-long job placement and access to educational workshops for continuing education.

Mr. Goshtasbe continued, “I think the career fair was a great success. Our VN students came prepared with questions and were very engaged in conversation. I think they walked away with a clear picture of where they need to grow professionally. Many of the employers were also very impressed by the event and our students.”

From Advance for Nurses

Findings from the NLN's Annual Survey of Schools of Nursing Academic Year 2010-2011 attest to the continued need for more nurse faculty to meet the needs of the U.S. healthcare system.

Conducted October-November of last year, the NLN survey reveals demand for pre-licensure program entry continues high despite a shifting student demographic, while competition for entry into post-licensure is increasing.

Unfortunately, notes NLN CEO Beverly Malone, PhD, RN, FAAN, the percentage of post-licensure programs that turned away qualified applicants also rose between 2009 and 2011.

Most strikingly, the percentage of MSN programs turning away qualified applicants jumped by 15 percent over the past 2 years, from just one in three programs to almost half in 2011.

The survey also shows the percentage of racial-ethnic minority students enrolled in pre-licensure RN programs fell from a high of 29 percent in 2009 to 24 percent in 2011.

The majority of that decline stems from a steep reduction in African American students enrolled in associate degree nursing programs, which dropped by almost 5 percent to 8.6 percent in just 2 years.

Hispanics remain dramatically underrepresented among nursing students as well, according to NLN, representing only 6 percent of baccalaureate and associate degree nursing students.

But while educational capacity is still insufficient to keep up with demand, some promising trends were uncovered by the survey, says NLN president Judith Halstead, PhD, RN, FAAN,

"For example, the percentage of male pre-licensure graduates in 2011 was up to 15 percent after inching up only a percentage point a year since 2009," she notes. "In addition, the percentage of pre-licensure RN students over age 30 has declined in recent years."

From Advance for Nurses

When a patient enters a hospital, she enters an alien environment. 

Her personal things, even her clothes, are set aside. She is given to wear a billowy gown that is not merely unflattering but starkly revealing if one's free hand isn't vigilant about keeping it cinched.

Inside this linoleum landscape of wheelchairs and rolling beds, where strangers in scrubs politely jab and weigh and probe her, the only haven that offers her a modicum of quiet in which to gather her thoughts and to reclaim herself, to semi-relax, to take stock, or just to escape into the beams of an innocuous sitcom floating overhead - the only personal space in this impersonal world is that humble but all-important retreat, the patient room.

Respecting the sanctity of the patient room is the first lesson Pam White, RN, gives when teaching the basics of relationship-based care (RBC).

"When I talk to nurses, I tell them 'We all have busy lives taking care of many patients, but before you walk across the threshold of a patient's room, pause, take a deep breath, let other things go and prepare to focus on that patient's needs,'" said White, director of nursing administration at Mayo Clinic Health System in Eau Claire, WI. "I always reinforce the need for them to reintroduce themselves to each patient every time they enter the room."

RBC - a philosophy based on honoring and respecting your relationship with your patients, your co-workers and yourself - is fast emerging as the care delivery model of necessity.

Experts say respecting patients will become more and more important as healthcare adopts its new culture of accountability. Reimbursement will hinge, in part, on patient satisfaction.

A Way of Being

RBC as a concept appeared in 2000 and coalesced in 2004 with the publication of Relationship-Based Care: A Model for Transforming Practice by Creative Health Care Management Inc., Minneapolis.

"It's a model, a philosophy, a framework and a way of being," said Mary Koloroutis, RN, who co-authored and edited that text. "RBC creates a methodology for aligning values and operations within a healthcare system so clinicians can establish relationships with patients," Koloroutis explained. 

Finding time to develop relationships with patients isn't easy for nurses, though. 

"Time is a nurse's greatest challenge," Koloroutis acknowledged. 

"You are dealing with large volumes of patients with highly complex medical needs," she said. "We don't have a long time to spend with a patient. It could be just 5 minutes at the bedside to learn about the person and plan their care."

However short, interpersonal time with patients is crucial for a successful outcome. 

"The role of the primary nurse is to understand who this patient is, and what it will take to prepare her and her loved ones to take ownership for her own care after discharge," Koloroutis said.

Family members "will be the village surrounding the patient, so they need to be every bit as supported as the patient is," she added. 

"The likelihood that a plan of care will be followed increases with their learning and understanding."

HCAHPS Survey

Communicating with patients is becoming as vital as vital signs. Officials from the Center for Medicare & Medicaid Services care so much what patients think they instituted the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.

HCAHPS asks patients to rate their hospital stays on a scale of one to five through a series of questions such as: How well did doctors and nurses communicate with you? How well was your pain managed? How clean was the hospital? How quiet?

"As of 2013, there will be reimbursement attached to HCAPS scores, so this is a strong push right now and part of why the patient experience is so potent and important," Koloroutis said.

ThedaCare, an integrated care delivery system in northeastern Wisconsin, increased its patient satisfaction scores by working with a firm called Simpler Consulting to adopt Toyota-inspired "lean" initiatives to streamline its processes and allow nurses to spend more time with patients.

For example, it implemented a variation of a Toyota production strategy called "kanban," so nurses have all the supplies they need at their fingertips.

"We have designed patient rooms so that 90 percent of all nursing supplies are stocked by a central stocking person, using the kanban system," said ThedaCare CEO Emeritus John Toussaint, MD. "Nurses are at the bedside nearly all the time. Medications are delivered directly to rooms in portable supply cabinets called nurse servers. There are no central nursing stations. They've all been eliminated."

Thanks to such changes, 95 percent of ThedaCare patients in 2011 gave top approval ratings when asked to assess their stay.

Eye-to-Eye Care

More time spent at the bedside "brings you to the heart of nursing," declared White, who instructs her nurses to sit down when interacting with patients.

"We typically stand up and over a patient," she said. "But research shows if you sit down and speak with them eye-to-eye, patients feel you spend more time with them - even if the amount of time you spend is the same."

She continued: "As a nurse, my needs for the patient are important, but they may differ from the patient's needs. For example, patients need to walk so many times a day, take so many pills. But those are not necessarily the goals of patients. We determine those goals simply by asking them. They could say 'I would like my hair washed,' or 'I would like to call my granddaughter.' Those things are important to them."

For hospitals thinking about instituting RBC, Koloroutis had this advice:

"Recognize that transformation is not a quick fix. It is a cultural evolution. Some aspects of RBC are already alive and well in every organization. Use them and build on that success. Commit to a 3-5 year process."

Healthcare workers, she concluded, "can grow weary of hearing about new programs. They'll ask, 'Is this another flavor of the month?' I say no. This is a way to get back to the basics, back to the care and service of patients."

From Nurse.com

Alisa Glaister, RN, credits her opportunity to ascend from new grad to nurse manager to a few key colleagues, including a director from a different unit who advised her as she led a project to treat angioplasty patients on the telemetry floor. “He helped me get my foot in the door for this project, which I believe has led to my current management position,” said Glaister, a nurse manager at St. Mary’s Medical Center in San Francisco.

Glaister met with her mentor weekly to discuss techniques of effective leadership. “He was a tremendous help and guide,” she said. 

Mentoring has gained considerable respect as an essential element for training new nurses, whether they’re fresh out of school or recently transferred from another unit. “The first year [out of school] you have those vulnerable moments all the time, and you forget what you have accomplished,” said Hazel Curtis, RN, BSN, MPH, an education specialist for staff development at Loma Linda (Calif.) University Medical Center. “A great mentor picks you up, dusts you off, gives you a pat on the back and says, ‘You can do it.’” 

Going one on one

Formal mentoring programs hatched in professional associations and hospitals are popping up around the country as researchers and managers find the practice boosts a nurse’s job satisfaction and confidence. 

Cecelia Gatson Grindel, RN, PhD, CMSRN, FAAN, studied the outcomes of Nurses Nurturing Nurses (N3), a mentoring program designed by the Academy of Medical-Surgical Nurses. The year-long program was rolled out to 40 medical institutions across the country in 2002. Grindel, a professor and interim dean at Georgia State University in Atlanta, said data she could gather indicated more than 90% of mentored nurses stayed on the job, compared to attrition rates as high as 30%. Feedback collected throughout the pilot year of the program suggested mentored nurses had more job satisfaction and confidence. 

Yvonne Brookes, RN, director of clinical learning at Baptist Health South Florida in Miami, found similar results after implementing a residency program that included a mentorship component. Previously, turnover among the system’s 4,000 nurses averaged 22%, often because new graduates left the profession or pursued an advanced degree after their first year. Since implementing the program in 2007, the new graduate turnover rate dropped to 6%, she said.

“We realized it wasn’t about the science, it was all that other stuff that goes to the head of a new grad,” she said. 

“Other stuff” can range from implementing unit procedure to dealing with difficult managers or unhelpful preceptors. It can be conflict with patients or their families dealing with the shock of witnessing a death for the first time. “Sometimes you just need to vent,” Brookes said.

A mentor also can help a nurse recover from making a medical error — a potentially traumatic experience — by offering emotional support and emphasizing that one mistake doesn’t make a bad nurse. 

Choosing teams

Matching the mentor who responds to help with complaints, concerns, self-doubts and errors with the nurse who needs to share them is somewhat hit and miss in formal mentorship programs. Both parties have to accept the relationship takes time — not an easy pill to swallow in today’s intense work environment.

N3 guidelines advised managers to look for someone with three- to five-years of experience in the same field who worked outside the nurse’s unit. In a new mentoring program at St. Mary’s, nurse managers help match personalities and proximity, among other factors, Glaister said. “We really take into consideration who we’re matching with whom,” she said.

At Baptist Health, the process was more intuitive, Brookes said. Mentors and mentees gathered in one room to talk one on one and then rotated until every mentee had met every mentor. “It’s sort of a speed-dating situation to find a mentor that will work for you,” she said. 

Programs across institutions vary, but the time commitment can range from trading a text message or two per month to having biweekly meetings for one year. Since many new nurses are assigned to the night shift, a good deal of these conversations happen in the evening. But meetings also can be irregular or precipitated by emergent situations, said Abigail Mitchell, RN, DHEd, MSN, a professor at D’Youville College, Buffalo, N.Y., and a nursing supervisor at Kaleida Health, Buffalo, N.Y. “If they’re in crisis, you have to handle it,” said Mitchell, who runs a private mentoring firm. “You can’t just say, ‘It’s not our date to meet.’”

Generation gaps can present challenges in mentor-mentee relationships. For instance, younger nurses are often more comfortable communicating through texting and email. Nurses from the baby-boomer generation are sometimes reluctant to mentor the next generation. “The work ethic is different,” Mitchell said. Boomers will pick up extra time or stay over their shift to help coworkers, while some younger-generation nurses rather go home and pick up extra hours when it works for them, around holidays, for example, she said.

Sometimes the mentor-mentee relationship just doesn’t work out, but that doesn’t necessarily mean mentoring didn’t work. Anecdotal evidence from the N3 program indicated nurses who’d been assigned a mentor were likely to seek out another if the first relationship wasn’t helpful. Managers also have noticed that mentored nurses go on to mentor their junior colleagues. “The process has fed on itself,” Brookes said. “The more professional their approach, the more they want to contribute to the next group coming in.”

The program’s success has inspired Brookes to extend the model to other levels of the profession. A med/surg nurse with 15 years experience still needs guidance when transferring to a different unit, like critical care, she said. She is mentoring four managers to help them ease into their new roles. “They’re degreed up to the caboozle, but that doesn’t mean they know whom to reach out to,” Brookes said.

At this level, mentoring is more about handling people and situations than about patients and skills. Healthcare management involves evaluating staffing ratios, managing human and fiscal resources and strategic planning. Sometimes advice is just practical: a nurse manager would do well to keep a pressed blazer in the office closet, for example. 

Recently, Curtis convened a small mentor circle for managers. The new managers come together about once a week to ask questions and hear presentations on broad topics of interest, such as the hospital culture. The program has boosted their confidence, she said. 

Educating educators

Academia, too, reaps benefits from mentoring. Shellie Bumgarner, RN, MSN, CEN, EMT, a clinical educator at Lenoir-Rhyne University School of Nursing in Hickory, N.C., sought help to implement an education day for nurses at a small rural hospital. 

She found a mentor at the 2010 national convention of the Emergency Nurses Association, which had started EMINENCE (Establishing Mentors InterNationally for Emergency Nurses Creating Excellence) in 2008. The pair worked together for one year, talking about once a month and trading emails frequently. 

Her mentor helped her with the substance of her topic, which focused on pediatric care in smaller, rural facilities. She also contributed creative ideas to help Bumgarner find a way to cover the shifts of nurses who attended her training. “She advised how to tweak my ideas to better fit the smaller hospital,” she said. 

Retention of nursing faculty is as urgent as the need for unit staff, as professors leave academia for higher paying jobs. The National League for Nursing, which focuses on nursing education, released “The Mentoring of Nursing Faculty Tool Kit” to promote recruitment and retention of nurse faculty (available online at NLN.org/facultydevelopment/mentoringToolkit/index.htm). 

Beyond orientation, mentoring faculty includes the development of teaching and research skills. 

Mitchell has started her own mentoring program targeting faculty. Managing workload and outlining governance procedures are primary topics, she said.

The idea may be slow to grow, but more nurses at all levels are realizing the importance of mentoring, said Brookes. Is it a widespread practice? “No,” she said. “But it should be.”

From SouthtownStar via Chicago Sun-Times

Ray Mendez’s first year of medical school at Loyola University has ended, but there’s no slacking off on his “to-do” list.

Next up is “effect social change.”

Mendez, 26, of Palos Heights, recently was selected for an Albert Schweitzer Fellowship, a program in which fellows design community health initiatives. Mendez was one of just 31 Chicago-area candidates selected.

“This may be one of the most important things I’ve ever done,” Mendez said. “As important as medical school.”

The fellowship, a yearlong program, is designed to develop leaders in community health and give students in health-related fields a unique social and economic perspective on issues they may face as professionals. Recipients can be from a variety of fields, but they have a common goal to improve some aspect of health care in the Chicago area.

“Every fellow creates his own program, and we have to put in 200 hours of work toward it over the next year,” Mendez said.

The projects are varied, ranging from putting together a music therapy program for refugee and immigrant children to one that will provide preventative health care for the homeless.

Mendez’s goal is to increase the presence of minorities in the health care profession.

“There’s an acute (lack of) representation of minorities in the health care field. Less than 9 percent of all physicians are black or Latino, and less than 7 percent for nurses, while they make up 28 percent of the U.S. population,” Mendez said.

He said this is significant because there’s a direct link between low minority representation and a lack of health care support for those minorities.

“One of the most important aspects of the program is making sure students stay in touch afterward so that when they succeed and get out of their communities, they can come back and uplift those same communities,” Mendez said.

He hopes to achieve his goal by expanding on an existing Loyola program that works closely with some Chicago-area high schools. He plans to use motivational speeches, activities and an immersion program with the Loyola School of Medicine to introduce students to the field and to encourage them to pursue careers in health care.

A visit to Cristo Rey Jesuit High School in Chicago as part of a social justice class he took convinced him that putting the idea into action is necessary.

“When I went to Cristo Rey and saw how enthusiastic the students and teachers are about going to school, I thought, ‘Wow, this is what needs to be done,’ ” Mendez said.

As a Latino student, he has realized the difficulty a minority can face pursuing a career in health care.

“I definitely didn’t have a lack of educational opportunities in Palos, but when I was applying to medical schools, it was still really hard. I didn’t have a mentor to look up to and to guide me through the process,” he said.

He said he didn’t understand why more minorities were not applying to medical school, and he feels like it is his responsibility to help change that. So after some reflection and research, he applied for the Schweitzer Fellowship.

“I feel I have the power and time to do it,” Mendez said.

He said he’s prepared for the challenge of balancing medical school and his fellowship work. He said he’s dropped a few extracurricular activities.

“It’s gonna be tough definitely, but I’ve created a pretty good support network of friends who are really interested in this project,” he said. “So I think I can handle it.”

From PRNewswire

Academic Program is First of Its Kind

ATLANTA, May 30, 2012 /PRNewswire/ -- Morehouse School of Medicine today announced the creation of an endowed academic chair devoted to issues related to sexuality and religion.  The Marta S. Weeks and David E. Richards Endowed Chair in Sexuality and Religion will develop innovative health and pastoral services as well as teaching, research and public leadership related to issues that bridge the topics of sexuality, religion and medicine.

"Through this unique chair, Morehouse School of Medicine will provide national and international leadership addressing the challenges of sexuality and sexual health in the worlds of medicine and religion," said David Satcher, M.D. Ph.D., 16th Surgeon General of the United States and founder of Morehouse School of Medicine's Satcher Health Leadership Instituteand its Center of Excellence for Sexual Health.

The Marta S. Weeks and David E. Richards Endowed Chair in Sexuality and Religion is a major accomplishment of more than a decade of work by Satcher, who in 2001 released the Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behavior. That document outlined a framework of initiatives to strengthen the national dialogue on sexual health. It recognized that sexuality and religion are deeply connected in the United States and that public health would benefit from coordinated efforts of leaders in public health and religion as well as other major constituencies with deeply held beliefs relating to sexuality.

"While the chair will address sexual health issues in all communities, it will place a particular emphasis on underserved populations which is integral to Morehouse School of Medicine's mission," added Satcher. "The continuing disparities in access to quality health care services for minorities, poor people, and other disadvantaged groups results in a weakened public health infrastructure, which ultimately affects everyone."

The endowed chair will focus its efforts on:

• Teaching sexuality and sexual health topics to current theological and medical students;
• Training the next generation of religious and healthcare leaders to meet the sexual health challenges of  both disciplines;
• Bringing together leaders of constituency organizations that have diverse viewpoints for consultations and consensus-building;
• Research directed toward documenting and suggesting ways to overcome disparities in sexual health with a special focus on underserved communities.

For more information on Morehouse School of Medicine and the institution's latest endowed chair in sexuality and religion, please visit www.msm.edu.