Career

The rewards of nursing in an ambulatory surgery center

The rewards of nursing in an ambulatory surgery center

The secret is finding balance and working collaboratively.

By Timothy P. Luckett, CRNFA

Takeaways

  • Working as a nurse in an ambulatory surgery center (ASC) requires the ability to take on multiple responsibilities.
  • Success as an RN in an ASC requires knowing when and how to delegate, understanding finances, staying organized, and building relationships with the administration.

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Interprofessional education

Combining skills and knowledge from different disciplines enhances patient care.

By Joanne Disch, PhD, RN, FAAN

 

In 2003, the Committee on Health Professions Education of the Institute of Medicine released a report recommending that “All health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics.” Thus, a common recommendation was directed to all health professions’ schools to ensure their graduates are competent in these five areas. Through its work in the Quality and Safety Education for Nurses (QSEN) initiative, the nursing community divided quality improvement into two competencies, resulting in a sixth area—safety. Continue reading »

edu bsn cap degree

Can nursing meet the 80/2020 goal?

Progress is slow but steady as RNs head back to school to get their BSN.

By Janet Boivin, BSN, RN

Will 80% of RNs hold a bachelor of science in nursing (BSN) degree by the year 2020? Not likely, say nursing experts. But not to worry, they add. For the first time in the decades-old debate over whether a BSN should be required for practice, RNs are heading back to school in record numbers.   Continue reading »

edu nursing school success back school colored pencil

Returning to nursing school? Keys to success

Preparation will help ease the transition.

By Teresa Shellenbarger, PhD, RN, CNE, ANEF, and Meigan Robb, PhD, RN

 

Congratulations! You have decided to pursue additional nursing education and been accepted at the program of your choice. You’re happy—right? But you also may be feeling a bit anxious, especially if you haven’t been in school for a while. Continue reading »

edu accelerated nurse program

Is an accelerated nursing program right for you?

This challenging approach to nursing education offers plenty of rewards.

By Janet Boivin, BSN, RN

Even with a 3.8 GPA from the University of Florida, Katrina Sherman, a junior majoring in English, harbored doubts that she could find a well-paying job when she graduated. So she began considering nursing as an option.

After graduating with a bachelor’s degree in English in 2010, Sherman searched for accelerated nursing programs across the country. She created a spreadsheet and systematically recorded program names, the types of credits each required for admission, and the deadlines for applying.

Continue reading »

educating nurse staff patients

Moving ahead with your nursing education

Take advantage of the resources available to you.

By Deborah E. Trautman, PhD, RN, FAAN

Whether you’re a newly licensed nurse or a seasoned professional, the time is always right to take the next step in your education. Returning to school opens new doors of opportunity for your career, as higher levels of education allow you to work in the settings of your choice and assume more responsibility for shaping care delivery. Continue reading »

Promoting staff engagement

Jaime is a nurse manager in a busy emergency department. He’s been in the role for 1 year and was beginning to gain confidence in his leadership abilities. Last week, he received the results of the Gallup Q12® Employee Engagement Survey, which his staff had recently been asked to complete online. He was surprised to learn that the results showed his employees to be less engaged in their work than staff on other units. Of particular concern was the employees’ assessment that he didn’t recognize their work, care about them as people, or encourage their development. Initially, he was discouraged by these findings, but his director helped him see this as a leadership opportunity with the potential for substantial growth for both himself and the staff.

Jaime’s need to improve staff engagement isn’t uncommon, especially given the focus in many organizations on the triple aim of cost reduction, quality improvement, and patient centricity. But with employee engagement directly linked to quality of care, patient satisfaction, and safety, adding a fourth aim is important: Improving the work experience of clinical staff to build practice environments that promote joy and meaning in work.

Research indicates that most organizations have an employee engagement problem. The Gallup organization reports that only about 33% of the U.S. workforce are engaged in their work, and the Nursing Advisory Board noted in a recent study that only 32.8% of nurses reported being engaged, with 7.4% actively disengaged. The good news for Jaime is that there’s strong evidence that changing his leadership strategy and focusing on improvements in the work environment can make a difference.

Demystifying employee engagement

For leaders like Jaime, knowing where to start can be confusing, especially with no consensus about a definition for work engagement and how to best measure it. Conceptually, engagement is linked to empowerment, job satisfaction, job involvement, and organizational commitment. Staff engaged in their work exhibit passion, commitment, and a willingness to invest in them selves to help their organizations succeed.

Effectively engaging employees is an important business differentiator, but workplace cultures can be difficult to change. Leadership approach, workload, level of organizational change, decision latitude, and career development opportunities all affect engagement and job stress. For example, organizations that embrace the Magnet® culture of excellence or the American Association of Critical-Care Nurses’ healthy work environment standards have higher levels of staff engagement.

Leadership strategies

Gallup research indicates that managers account for 70% of the variance in employee engagement and that U.S. managers are only slightly more engaged in their work than their staff. Work engagement is higher among nurses who work for managers who practice authentic leadership and are themselves engaged in their work. As a relatively new leader, Jaime should reflect on his own level of engagement, build trust, and seek staff support. (See Taking action.)

However, you can’t simply declare that you practice authentic leadership. Your authenticity can be validated only by those you lead, so you must ask for and receive feedback. Jaime could start by sharing the results of the Gallup survey, noting that he’s disappointed and will be working hard to improve his leadership.

Many leaders think they need to have all the answers to be effective, but the interactions with leaders  is what makes or breaks employees’ connection with the organization. Every time you’re in front of an employee, whether one-on-one or in a group, take the opportunity to increase engagement through dialogue and inclusion in decision making. Start the conversation with an open-ended question, encouraging employees to express their opinions and ideas. Showing interest and respect for your employees’ input lets them know you care, helping them grow professionally and own their learning experiences.

A two-way street

While Jaime has a responsibility to build a culture that promotes staff engagement, the responsibility isn’t his alone. Work engagement is a two-way street. Vicki Hess, MS, RN, a nurse expert on employee engagement, contends that a key part of the puzzle frequently missed when evaluating work engagement is the employee, who may not know that he or she has a responsibility in the process.

To foster engagement, Jaime must promote the idea that it’s a shared responsibility. Marshall Goldsmith, in his book Triggers, observed that survey questions asked in a passive voice, such as those in Gallup Q12, promote the idea that employee engagement is an organizational responsibility. The variance sometimes seen in employee engagement may be because some individuals naturally accept their responsibility in the process. Goldsmith promotes the idea that leaders like Jaime should encourage staff to question not only the organization, but also themselves. (See Ask yourself.)

An ongoing journey

Change is a constant in the healthcare environment, and employees’ needs change as new generations with different attitudes, values, and beliefs join the workforce. Leaders must view employee engagement as an ongoing journey that demands intentional interventions. During the past decade, healthcare agencies have experienced unusually low turnover, but this is changing, and turnover rates are beginning to increase. Engaging and retaining staff will soon become a high priority.

Rose O. Sherman is a professor of nursing and director of the Nursing Leadership Institute at the Christine E. Lynn College of Nursing in Florida Atlantic University in Boca Raton. You can read her blog at www.emergingrnleader.com.

Selected references

Advisory Board. The national prescription for nurse engagement: Best practices for enfranchising frontline staff in organizational transformation. April 10, 2014.

GallupQ12 Index.

Goldsmith M. Triggers: Creating Behavior That Lasts—Becoming the Person You Want to Be. New York: Crown Business; 2015.

Hess V. 6 Shortcuts to Employee Engagement: Lead & Succeed in a Do-More-with-Less World (Healthcare Edition). Owings, MD: Catalyst Consulting LLC; 2013.

Hilton N, Sherman RO. Promoting work engagement: One medical center’s journey. Nurs Leader. 2015;13(6):52-7.

Rigoni B, Nelson B. Do employees really know what’s expected of them? Gallup Business Journal. September 27, 2016.

Goals and actions for a healthy lifestyle

Hitting a milestone of 50 years or older can spark renewed attention to personal health goals, along with the recognition that there’s much more to a healthy lifestyle than diet and exercise. What is (or is not) consumed, along with activity (or lack thereof) and how we practice a peaceful existence form the connections to our goal of achieving a healthy lifestyle balance.

Healthy lifestyle goals

The process of achieving and sustaining a healthy lifestyle is not a momentary goal but a continuous state of mind that we must practice. Normal weight and a strong body and mind help us to enjoy all that life has to offer. But where does one start? Think of it this way: Never start a diet to lose weight; start a nutrition, exercise, and mindfulness plan to gain a healthy lifestyle.

Healthy lifestyle actions

Research has shown that although nurses have knowledge regarding healthy lifestyle, knowledge doesn’t always translate into self-care. As a first step, set your healthy lifestyle goal(s) and consider these actions to include in your healthy lifestyle plan:

Join Healthy Nurse, Healthy Nation™ (HNHN) Grand Challenge of 3.6 million RNs leading the nation’s journey to better health (www.healthy nursehealthynation.org, see The Healthy Nurse, Healthy Nation Grand Challenge).

Set five goals adapted from the Nurses Living Fit™ research study:

Goal 1: Get 15,000 steps daily. Invest in a device that monitors your steps. Test yourself and see if this equation works for you: More steps = more activity;  more activity = more energy!

Goal 2: Practice yoga weekly. If new to yoga, find a local yoga studio to learn the basics before joining yoga classes that don’t focus on variances in yoga practices for beginners.

Goal 3:

Practice mindful food and drink consumption. Consume foods that are healthy and natural. Avoid foods that are processed, and high in salt, fat or sugar. Practice mindfulness of portion sizes; portion distortion = body distortion; big portions = big bodies. (See the portion distortion page on the National Heart, Lung, and Blood Institute website.)

Goal 4: Drink water. Be mindful when you’re thirsty—your body is asking for water, not soda or juice. Don’t mistake thirst for hunger.

Goal 5: Be in bed at least 8 hours before you have to get up. Sleep matters. If you can’t sleep, meditate. Don’t make the mistake of thinking you’re hungry when you’re really just tired.

• Study meditation, relaxation, and stress management techniques. When you’re not sure where to begin, simply observe and catalog your life stressors. Instead of reacting to stressors, observe their frequency and effect on your body and mood. Trends may emerge over time and stress-related triggers may become more predictable. For those you can identify, evaluate how to best mitigate the stressors before they occur again.

• Evaluate workplace stress. Talk to a trusted mentor, review the literature, and study how to best manage stressors while practicing patience, civility, and compassion. Talk with your nursing leaders, human resource professionals, and fellow nurses about how to implement best practices for a healthy work environment in your setting. The literature is rich in improvement opportunities for stress management, healthy workplace foods/nutrition programs, exercise options, healthy lifestyle coaching, and health related events for both employees and the community.

Nurses working together for positive change can lead the way, one nurse at a time, for healthy nurses and a healthy nation! Ideally, you, your nursing career, the profession, and your patients will benefit when you meet healthy lifestyle goals.

Karen Gabel Speroni is an independent nursing research scientist consultant and a consultant and educator for ANA Nursing Knowledge Center.

Selected references

Gabel Speroni K. Designing exercise and nutrition programs to promote normal weight maintenance for nurses. Online J Issues Nurs. 2014;19(3):6.

Healthy Nurse, Healthy Nation™ Grand challenge. 2017.

National Heart, Lung, and Blood Institute. Portion distortion. 2015.

Ross A, Bevans M, Brooks AT, Gibbons S, Wallen GR. Nurses and health-promoting behaviors: Knowledge may not translate into self-care. AORN J. 2017;105(3):267-75.

Speroni KG. School nurse facilitated programs for families living fit. NASN Sch Nurse. 2014;29(3):140-4.

Speroni KG, Earley C, Seibert D, et al. (2012). Effect of Nurses Living Fit™ Exercise and nutrition intervention on body mass index in nurses. J Nurs Adm. 2012;42(4):231-8.

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