No nurse practitioner wants to face a medical malpractice action. According to the National Practitioner Databank, damages were paid by or on behalf of 290 nurse practitioners in medical malpractice cases in the year 2012 alone.…[entire article ]
A nurse, Maria, was working in the ICU. There were 8 patients with 4 nurses. The acuity was very high and for everything that needed to be done for each patient, they needed more staff. One patient coded and 2 nurses were assisting with the code while the other 2 nurses were caring for the remaining 7 patients. One of the remaining patient’s condition was deteriorating and it went unnoticed. That patient coded and died. The nurse was so upset, she took the code sheet and slammed it on her manager’s desk and said “This is what happens when we don’t have enough staff.”
Communication is a two-way street. The communicator is not only responsible for sending the information but for making sure that the receiver properly heard the information. The listener is responsible for actively listening and accurately hearing the information.
But with many of us our brains at times go on auto-pilot and we communicate without really saying anything. Or we communicate out of a reaction, like Maria. In these cases, we’re not really so concerned about whether the listener heard and understood the information we said.
Other times when we communicate, we’re not really listening as much as we’re thinking about how to respond or what to say next.
To get the results you want when you communicate, I suggest that you not do it from a reactive standpoint. You should think through your communication and be proactive. Decide what you want to create when you share the communication. Unfortunately, many of us who communicate from a reactive standpoint find it will create animosity between the two people.
By thinking in advance about what you want to create will help you find the words and the proper tone to communicate effectively.
Had Maria just taken a couple of minutes to cool down, she would have had the opportunity to think what she wanted to create with her supervisor. It probably would have been “I want to talk to you about my last shift. I was wondering if it was possible that we could work together to figure out a way to get more staff when the acuity is higher? And I’m sure that you’d want that too because, as you know, this patient lost his life because we couldn’t be everywhere. So, can we work together on this? Because I know you want the best for the patients too.”
Those responses rather than slamming down the code sheet on her boss’s desk and ranting would have received a whole different reception.
So, keep in mind when you next want to communicate something important, think about how you will be more responsible for the communication delivered and making sure that the listener received it can best communicate. Think about what you want to create from the communication and ask yourself if you are approaching your communication with that end in mind.
The definition of “insanity” is doing the same thing over and over again while expecting to get a different result. Sometimes I feel like a hamster on a wheel – I try to escape the wheel but it keeps going round and round. I also am thinking that if I keep going on this wheel, I’m going to get somewhere, get a different result and then be able to jump off this wheel.
But the obvious reality is that if I keep going around on the wheel the only thing I will accomplish is to keep going around on the wheel. This is what a lot of us in nursing do. We have a certain job, that we would like things to be different and yet everything stays the same.
There are two reasons why things don’t change. The first is called “the cybernetic mechanism,” which is a setting we all have, like a thermostat. If the thermostat is set at 72º and it gets warmer, the thermostat will kick on the air conditioning to bring the temperature down. If it cools down past 72º, then the thermostat will turn on the heat to get it back to that set temperature.
The same is true within our body. We are programmed through the cybernetic mechanism to have a certain comfort zone. We are programmed to make a certain amount of money, to respond to events in a certain ways, etc. This keeps us in our comfort zone.
So, even though we would like things to change, we’re programmed for things to stay the same.
The second reason is what I call “the vicious cycle.” An event will occur and we will have a thought which will create an action in which to respond to that thought which, in turn, will create a belief. Then, when a similar event occurs, we have the thought which triggers the same action which leads again to the same belief.
For example: let’s say that you’re not a person who enjoys gossip. But somebody on the unit starts telling stories, so you’ll think, “oh, good grief, they’re gossiping again,” which will trigger a response in the form of either a thought or comment and then it would trigger a belief about that situation. What’s more, the cycle will continue to perpetuate itself.
To use my kids’ fighting as an example; one does something to annoy another which will trigger an action which then would trigger a belief and the whole cycle starts over and over again.
The only way to break the vicious cycle is to create a vision of something being different. If you manage that, then all of your actions have to be in line with that vision.
So, if you have a vision of creating a non-gossip workplace, then, when gossip occurs, you must take a different action than what you have been taking before with the intention (vision) of creating a non-gossip workplace. It may be as easy as saying, “you know, I love working with you but when you gossip, I find it upsetting. How do you feel about gossip? Wouldn’t it nice if we could all help each other to have a gossip-free unit? As a suggestion, maybe we could have a sign or gesture to let each other know that we have to stop the gossip? Let’s get everybody on board with this new way of being.”
Believe me, it works. However, it needs to be introduced in a way where everybody buys into the new philosophy.
So, the next time you’re wondering why things are staying the same, now you know and your not crazy! But you now also know a way to have it be different by doing something different and getting everyone to buy in to create a good result for everybody.
It’s estimated that almost ten percent of all nurses are males. And, for whatever reason, I represent more males in my practice than in the general nursing population. I don’t know whether it is because men more readily hire an attorney than do women. I’m not really sure.
But what is interesting is the male perspective on the practice of nursing. I love having men in nursing because it brings a different energy and a different balance to the profession.
I interviewed several male nurses for this article and some of the responses have been very interesting.
One is that, according to male nurses, they don’t tend to gossip as do the female nurses. This definitely is something that we can learn from male nurses. I am not sure why female nurses gossip but it is not something that is productive in our profession. Therefore, let’s learn a lesson from our male counterparts and stop the gossip.
Second, some of the nurses I interviewed said their female counterparts are more likely to ask them to turn or lift patients than to ask other female nurses. If you need help turning a patient, be sensitive to this issue and seek assistance from any nurse. Both male and female nurses should be able to turn and reposition a patient so it is not necessary to always turn to the male nurses for that task.
A third point is that some of the male nurses interviewed stated that they are approached more often to help with equipment malfunctions. Just because a nurse is male does not mean that they are better at handling equipment problems. Nurses make up a very creative group and the women should be able to fix any equipment malfunction just as well as their male counterparts.
Lastly, of the males interviewed, all were happy to be at the bedside. None of them wanted to go into management. It is a misconception that males go into nursing only because they want to go into management. Both genders of nurses are equally qualified to go into nursing management should they choose.
I hope this article will bring you an awareness of some of the plights of the male nurse and what we can learn from them. Be respectful when asking them to help turn or lift your patient and if there is an equipment malfunction. This can take the male nurse away from his own patient load and make it difficult to get their own work done.
With the economy as it is and the nursing job market being tight, many nurses find themselves taking the first offer to have a job. You would be surprised how many nurses get into trouble in their job or with the JOBBoard working somewhere that is not a right fit for them.
I suggest that if you’re looking for a job, do your homework on where you are applying and before you accept an offer to make an informed decision.
- If it is a nursing home, check out nursing homes under medicare.gov and look for “nursing home report card.” This website has all the Department of Health surveys for those facilities. If there are deficiencies in the surveys and the facility did not obtain a high score, especially under the area of quality of care, you may want to rethink about whether you want to work there. It could indicate short staffing.
- Talk to people who actually have worked or are working there. When you interview and take a tour of the facility, the staff is going to want to impress you. However, I suggest that you ask your colleagues if they know anyone who is working at the facility or have worked at the facility. Former employees usually give you the most information about what it’s really like to work there. But remember it was only their experience. That way you can make an informed decision.
- If the facility is constantly short-staffed, ask yourself if you really want to work there. Do you want to set yourself up for that environment in which you are going to work harder without adequate staffing? This can also lead to trouble with your license.
- If there is a way to look up malpractice actions that have been filed against the facility, check it out! Here in Indiana, that information is public record available at www.indianapcf.com and you can look up any provider, organization or facility to see if any malpractice actions might have been filed and how many. Would you trust a doctor with your healthcare needs that had a lot of malpractice claims against him or her?
If you take a job in fear and scarcity and end up working in an environment that is not a good fit or possibly even unsafe, it may provide you an income temporarily but, in the long run, it could be a problem.
Do your homework first so that you can go in with open eyes as to what you may be getting yourself into rather than just taking the first opportunity as a result of a fear in this type of job market.
It is well worth it to be proactive.