DiversityNursing Blog

In an era in when hospitals compete for patients by boasting the latest clinical technology, the most prestigious physicians and impressive amenities, patient satisfaction is most influenced by human factors, especially superior service-related communication skills between hospital staff and patients, according to the J.D. Power and Associates 2012 National Patient Experience Study released today.

The study measures patient satisfaction across all areas of the inpatient and outpatient hospital experience, including: interactions with healthcare professionals; tests and procedures; admission and discharge; and facility environment. It serves as a benchmark for the J.D. Power and Associates Distinguished Hospital Program. This distinction program acknowledges high levels of performance by a hospital in achieving an “outstanding” inpatient, emergency department, cardiac, maternity or outpatient experience. 

The study finds that recently-hospitalized patients have high levels of overall satisfaction. Overall patient satisfaction with their inpatient hospitalization averages 825 index points on a 1,000-point scale, similar to that of guests at luxury hotels, among whom satisfaction averages 822. In outpatient settings, overall patient satisfaction is higher, averaging 863. However, patient satisfaction dips to 788 for emergency department visits.

“Hospitals may attempt to attract patients and staff by adding equipment or sprucing up their facilities,” says Rick Millard, senior director of the healthcare practice at J.D. Power and Associates. “From the perspective of patients, it might be more worthwhile to invest in finding and keeping staff with superior interpersonal skills.”

Investments in staff can be overlooked, as Millard notes many hospitals have spent a lot of money in recent years to make their facilities look and feel more like hotels. Yet, facility characteristics are more important for hotels than for hospitals.  For upscale hotels, the facility accounts for nearly one-half (48 percent) of guests’ overall satisfaction, while in an inpatient setting the hospital facility represents just 19 percent of patients’ overall satisfaction. 

“Having an appealing hospital facility matters, but an experienced and socially skilled staff has a greater impact on patient satisfaction,” says Millard. “Personal interactions with the staff have a profound impact in both inpatient and outpatient settings.”

Doctors and nurses account for 34 percent of the overall experience ratings for inpatients, and their influence is even higher (43 percent) among patients in emergency settings. Among outpatients, doctors and other healthcare professionals represent 50 percent of their overall experience.

Solid interpersonal skills are especially necessary for handling the types of problems that may arise during hospitalization. When problems do occur, they may jeopardize patient satisfaction. According to the study, staff service and staff attitude are the most common types of problems that patients experience. Patients who say they had any problem with their room or hospital staff rate their overall experience a 5.3 a 10-point scale, compared with 8.7 among patients that did experience any problems.  

“When problems occur, they produce opportunities to demonstrate a genuine interest in the patient’s needs,” says Millard. “Resolving problems is clearly associated with higher ratings by patients. This has become more important as hospital reimbursement is now linked to patient satisfaction as measured by the government through the HCAHPS [Hospital Consumer Assessment of Healthcare Providers and Systems] survey.”

Millard notes that one area where hospitals can learn from hotels is how transitions occur. The admission and discharge process in hospitals is analogous to check-in and check-out in the hotel industry. Among inpatients, 35 percent of the overall patient experience is predicted by the admission and discharge process; yet the impact is much less in emergency and outpatient settings, where it is 19 percent and 12 percent, respectively.

“The first and last impressions are very important for a patient, much like they are for hotel guests,” says Millard. “Getting a patient into a room quickly at the start of their hospital stay, and ensuring a smooth process during discharge, along with a follow-up call once the patient gets home to make sure they’re doing okay, goes a long way toward achieving high satisfaction.”

Nongovernmental, acute-care hospitals throughout the nation are eligible for the J.D. Power and Associates Distinguished Hospital recognition program. Recognition is valid for one year, after which time the hospital may reapply. The service excellence distinction is determined by surveying recently discharged patients regarding their perceptions of their hospital experience and comparing the results to the national benchmarks established in the National Patient Experience Study.

The 2012 National Patient Experience Study is based on responses gathered between December 2011 and March 2012 from more than 10,275 patients who received care in inpatient, emergency or outpatient facilities in the United States.

Source: Infection Control Today

As a resource for Nurses across the country, DiversityNursing.com wants to be sure our community is aware of the following site: The Future of Nursing: Campaign for Action.

The Future of Nursing: Campaign for Action, an initiative to ensure that all Americans have access to high-quality, patient-centered health care, with nurses contributing to the full extent of their capabilities. Action Coalitions work with the campaign to implement the recommendations of the landmark Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health. The coalitions are comprised of nursing, other health care, business, consumer and other leaders across the country. 48 states have Action Coalitions involved in this initiative.
 
The Campaign for Action is a collaborative effort to implement solutions to the challenges facing the nursing profession, and to build upon nurse-based approaches to improving quality and transforming the way Americans receive health care.
 
Action Coalitions are the driving force of the campaign at the local and state levels. These groups capture best practices, determine research needs, track lessons learned and identify replicable models. Examples of accomplishments to date include:

Texas is collaborating with nursing education leaders to adopt a common menu of core required classes across 106 schools in the state.

New Jersey is advancing practice by disseminating best practice models that demonstrate the benefits of staff nurses working to the full extent of their education and training.

Indiana is working within Indiana University to include inter-professional education into the newly designed curriculum to be used by a number of its health profession programs, including the schools of medicine and nursing.

Virginia is advancing nursing leadership by recognizing and mentoring 40 Virginia registered nurses younger than 40 who positively represent and lead their profession.

To get involved and find out more http://www.thefutureofnursing.org/

This is a great video by Global Novations on Defining Diversity and Inclusion

by Katrina Gravel

This past month, the George Washington University School of Nursing (GW) received a three-year, $1 million grant from the U.S. Health Resources and Services Administration to fund a program that aims to increase the diversity of nursing professionals, according to a press release from GW. The school’s Success in Nursing Education project focuses not only on drawing in African-American, Asian, Hispanic, and Native American students, but also male students and economically disadvantaged students from Washington, D.C., and rural Virginia. A report released by the U.S. Department of Health and Human Services (HHS) in September 2010 showed that men made up less than 10% of employed RNs licensed between 2000 and 2008, while non-white or Hispanic nurses represented only 16.8% of all registered nurses in 2008. While those percentages may have grown in years since the HHS survey, it is unlikely that the gap has become significantly smaller.

The lack of ethnic minorities, males, and economically disadvantaged nursing students does not reflect the immense diversity of the patients these students will soon be treating. As an article in GW’s student newspaper The GW Hatchet cites the school of nursing’s Dean Jean Johnson as saying, “the nursing workforce should reflect what the population at large looks like.”

GW will use the grant to launch a recruitment campaign to reach disadvantage students, as well as students who are changing careers. The program will offer both undergraduate and graduate degrees in nursing, and will utilize retention tools such as mentoring programs. The grant will also create scholarships and financial aid for some students, according to the GW press release.

Has your organization made efforts to diversify its staff? What are your thoughts on the GW program? Leave a comment and let us know!

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 Elizabeth Landau via CNN

(CNN) -- Hospitals near Aurora, Colorado, were flooded with victims after a movie theater shooting Friday morning.

An Aurora Fire Department call log reveals the urgency of the situation.

"If they're dead just leave them," a voice tells a fire department responder who reported that police said there may be a number of people dead inside the theater. "We're in a mass casualty situation at this time. Please make sure that you guys set up some kind of transport officer over there that can contact the hospitals so we don't overload one."

The emergency department at Denver Health Hospital was chaotic as staff prepared for the arrival of patients from the shooting, said Dr. Christopher Colwell, director of emergency medical services there. The hospital received seven victims, but called in extra personnel and was ready to take in more patients.

"You're not sure how they're going to arrive to you, so you prepare for the worst," he said.

Shooter had 100-round rifle magazine

Gunshot wound patients are fairly regular at Denver Health, although not on this scale, he said. In a mass shooting situation, staff assess the severity of the wounds and what steps must be taken -- some need to go straight to the operating room, others can wait, still others may not require surgery.

Colwell was a physician who treated victims at the scene of the Columbine High School shootings in 1999. Five patients were transferred to Denver Health; all survived.

"We have obviously done a lot of training exercises since then to try to prepare for an event like that," Colwell said.

Dr. Frank Lansville, medical director of emergency services at Aurora South Hospital, told CNN his hospital had seen 18 patients so far, 12 of whom suffered from gunshot wounds. There were several tear gas victims who were stable, he said. They had been seen, decontaminated and discharged. "The others had horrific gunshot wounds to various parts of their body," he said.

At Aurora Medical Center, the first victim of the movie theater shooting came in before the staff had even heard about the attack, said Tracy Lauzon, director of EMS and trauma services at the hospital.

Few hints of movie-theater shooting suspect's past

Soon after, the trauma surgeon learned more victims were headed their way. Four other trauma surgeons, two orthopedic surgeons and various other physicians came to help. Six patients have gone through surgery.

Aurora Medical Center has taken in 15 patients from the shooting, she said. Eight have been treated and discharged from the emergency room; the other seven were admitted.

"We do drills twice a year anticipating this kind of thing, so people are very well prepared and the hospitals are very well prepared," Lauzon said.

Most of the hospitals in the Denver area follow established federal guidelines for emergency response, said Nicole Williams, spokeswoman for Swedish Medical Center, which treated four victims from the shooting at the movie theater. "We were extremely prepared coming into this," she said because the hospital has already completed a couple of disaster drills this year.

During such a drill, a mass page goes out to the hospital administration alerting officials that EMS has multiple patients who could be transported to area hospitals, and the staff is told be on standby. Emergency workers call the hospitals to see how many beds are available and how many critical patients they can take.

Then, the hospital brings in essential staff, in addition to extra trauma surgeons or other specialists as needed.

"It's a very controlled atmosphere," Williams said. "We all try to stay very calm and just serve the community to the best of our abilities."

Theater shooting unfolds in real time over social media

Staff at Swedish Medical Center's command center fielded hundreds of phone calls "from very panicked people looking for their husbands, their wives, their children," Williams said.

Swedish Medical Center was still treating three patients for gunshot wounds: an 18-year-old male in fair condition, a 20-year-old male in critical condition and a 29-year-old female in critical condition. A fourth patient, a 19-year-old female, came in a few hours after the shootings with minor injuries, possibly caused by shrapnel. She was treated and released.

The family members of the victims at the hospital have been notified, Williams said. "All of the victims have loved ones -- family or friends -- by their side, while they're here," she said.

Kari Goerke, Swedish Medical Center's chief nursing officer, worked in the operating room in the aftermath of the Columbine shootings of 1999. Swedish Medical Center treated four Columbine victims, all of whom survived.

"We had them all in the operating room within an hour of the event," Goerke said. "That gives them much better chances."

The staff responded with expertise and compassion both in 1999 and on Friday morning, she said.

Aspiring sports reporter killed in shooting

"Afterwards you kind of think about what's happened and the shock and awe of the whole situation and how horrific it is," she said. Her voice cracked as she discussed the emotional aftermath. "Taking care of kids is always hard. I'm a mom, I can relate. That makes it difficult."

But, she added, "it's what we're trained to do."

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.”