April 17, 2012 Class

Today in class were were able to talk about discipline in healthcare. I found this discussion/class very interesting as I am just now starting my career in the healthcare field. It was enlightening to go through the discipline process that the manager goes through when disciplining an employee. Discipline is an essential part of running an effective organization or business. The first step that we talked about was the verbal warning. This warning is only in effect for a year. The next step is the written warning. The third step is the "final" written warning, followed by termination. We also discussed at will employment. I found out during this course that this "at will" employment is something that is much more beneficial to the employer then the employee. Another pearl of wisdom learned from today's class discussion is to never discipline an employee on Friday. Why? Well the employee will sit and stew about this discipline all weekend long and come back unfocused to work on Monday. If a manager disciplines during the week, the employee will be able to process the situation and return their focus to work much quicker then if they have a lot of time to dwell on the situation. Overall this class was a great overview of why discipline is necessary and how it is done in work place.

Lesson 12: Conflict Resolution

In your blog (Reflective Journal), Record an example of conflict you experienced in your reflective journal and describe how you would handle the situation as a nurse manager?
I have not had a ton of experience working in the healthcare field. Only recently, was I offered a position at a hospital. Last summer I did work for several months at a long term care/rehabilitation facility. I was able to witness firsthand some of the conflict between coworkers. Luckily, for me I was never really involved in any of them. This could be because I only I worked there for a short time. Anyways, what I witnessed was a lot of gossiping and judgment going on behind nurses backs. Especially, as I was training and orienting for my job I witnessed this. One nurse would give me and my preceptor report and then once they left, the preceptor would then give me the reasons they did not particularly care for that previous nurse. I experienced this with several of the nurses telling me things like this. As a nurse manager, I would be horrified at this behavior. It is essential in healthcare to work as a team. If you cannot trust your coworkers, how can you possibly work as a team to treat the patients. If I were the nurse manager and heard about these types of things going on, I would make it clear to the staff that if there was any conflict going on to try to resolve it first with the person. I would stress to not go around discussing the problem to everyone else. If the conflict could not be resolved on a personal level, then to discuss it with me the nurse manager. I would then try to mediate a conflict resolution. If someone consistently was involved with conflict and instigating things at work, I would terminate them. The team does not need someone who is constantly backbiting and gossiping to bring the team down. There are plenty of other people willing to come in and do the job correctly.

Lesson 11: The Nurse Manager's Role in Quality Control Assignment

1. What do you consider elements of quality care when receiving healthcare services?
I have not had a ton of experience being on the receiving end of healthcare services. My experiences are limited to routine physicals and the occasional instacare visit for a cold or flu. With these experiences, I have developed the opinion that quality care is reflected in the competency and delivery of care by the healthcare professionals. I expect the doctors and nurses to have the knowledge to give me the best care and treatment. I also would consider their professionalism to be an element of quality care. If I am unimpressed with their "customer service" I will take my business to another facility.
2. What do you consider elements of quality care as a professional nurse?
As a professional nurse, I feel the elements of quality care to be similar to my previous answer. I feel in order to deliver quality care I need to be competent and knowledgeable. I feel training is an important aspect in preparing me to give quality care. I also consider my patients to be customers. I need to give the best customer service I can to give quality care.
3. Are the two similar or different?
The two answers are similar for me, but I think that is because I am a nurse. The fact that I am a nurse has an influence on how I perceive care as a patient.

March 27, 2012 Class

The theme of today's class was motivating employees. Many different ideas and theories were discussed on how to motivate employees. As I do more reading and learning about the leadership role in nursing, I am amazed at all of the pieces to their job they must juggle. Motivating employees to perform their job correctly and exceeding patient expectations is a big part of being a manager. Different ideas were brought up in class about how to motivate employees and how we have been motivated. Food, money, parties, etc... were all brought up. Money is one area that is hard to keep up. If a raise is given for a job well done, then six months later the employees will want another raise. In this economy, raises are not always feasible. One simple way to motivate an employee is to just thank them for their service and recognize them. This recognition does not need to be done in a staff meeting or in public. It can be as simple as a thank you card from the manager. Sometimes a personal hand written card can carry more weight then a party for the entire floor. Motivation is an interesting topic. I feel most motivated when I am recognized for my job. If my service goes unnoticed, it is hard to want to excel again. If it feels like no one cares, then why do the job well? I will try to remember the concepts I've learned about motivating employees if/when I get into a management position.

March 20, 2012 Class

We continued the discussion in this class about the hiring and firing process. This time though we also spent a significant amount of time talking about the challenges of staffing. This was a real eye opener into what a manager goes through when staffing the floor. Later when taking an exam for this course, I was able to apply what I learned as I did a "fake" schedule for a medical surgical. There is a lot to take into account when staffing. Full time people obviously must be staffed first in order to attempt to help them get the hours needed for benefits. Maternity leave, vacation, etc... through wrenches into the schedule. The nice thing about healthcare is the PRN staff. Those PRN staff can help fill holes when necessary. This class discussion was really interesting to me, as I will soon start my first hospital job. It was interesting to hear how different floors, hospitals, etc... handle scheduling and staffing issues. It seems to me that managers have to deal with staffing and spend a great deal of time on it.

Clinical Blog

Just a reminder that my clinical blog can be accessed at this link: http://whitneyward4405.blogspot.com/
My clinical hours, including my budget interview can be found at my other blog.

March 6, 2012 Class

This class was very interesting to me. We discussed the hiring and interview process. I have had more experience with the applying and interview process this past year then I could have ever wanted. I have applied to over 300 jobs and had about 10 interviews. It has been a real eye-opener and learning experience for me. In this economic climate, every application and interview counts. In class, we discussed the use of behavioral-based questions. Behavioral based questions are important, because it allows the interviewer to get to know the person being interviewed. These questions are open ended and often asking the interviewer to give specific examples. In my interviewing experience, I feel that some of my interviewers have not been very prepared to interview me, while other times the interviewers were very prepared. This helped me know what kind of company I was interviewing with. Just this week, I was offered a job at LDS Hospital. My interview for this position was my best experience interviewing yet. The manager was friendly, asked appropriate questions, and made me feel at ease. This was so important to me, because it allowed me to show the interviewer who I am. I hope someday when I am on the other side of the table, I will remember the qualities that make a good interview experience.

Personal Career Development Plan

This assignment is very exciting for me. I was just offered a job on the Oncology unit at LDS Hospital. This job offer has given me more of a focus for my career. This has helped me immensely in creating a personal career development plan.

Goal: To become a Nurse Practitioner.

Current Education: Associate of Science in Nursing received April, 2011.

Required Education: Bachelor of Science in Nursing

Current Skills/Experience: Currently licensed as a RN and was just offered a position on the Oncology floor at LDS Hospital.

Required Skills/Experience: I would like to get 3-5 years of experience on an oncology floor in order to become a proficient RN.

Step 1: Complete Bachelor Nursing Program and graduate with my Bachelor of Science in Nursing.

Target Completion Date: April 26, 2012.

Step 2: Complete Intermountain New Grad Residency Program

Target Completion Date: June 30, 2012.

Step 3: Join Oncology Nursing Society

Target Completion Date: December 31, 2012.

Step 4: Work a total of 1872 hours at LDS Hospital on Oncology floor

Target Completion Date: March 26, 2013.

Step 5: Apply to University of Utah's Acute Care Nurse Practitioner Program and take the GRE.

Target Completion Date: Fall, 2013

Step 6: Enroll in University of Utah's Acute Care Nurse Practitioner Program

Target Completion Date: Fall, 2014

Step 7: Successfully complete first three semesters of Nurse Practitioner Program

Target Completion Date: Fall, 2015

Step 8: Successfully complete second three semesters of Nurse Practitioner Program

Target Completion Date: Fall, 2016

Step 9: Successfully finish Doctorate Scholarly Project and last two semesters of Nurse Practitioner Program.

Target Completion Date: Spring, 2017

Step 10: Begin work as a Nurse Practitioner

Target Completion Date: Summer, 2017

February 28, 2012 Class

This class was interesting. We talked a lot about budgeting and managing a budget. We were actually able to look at an example of a hospital's actual budget. We were then split up in groups to discuss the budget and look for ways to cut spending to meet the monthly budget. This was very interesting, because it was a look into how management has to problem solve to meet budgets. This activity readied me for my budget interview that I will be conducting shortly. Who knew budgets could be so complex and take so much management?

February 14, 2012 Class

Our class on February 14 was interesting. It started with an announcement that our syllabus and course structure was completely changing. A little bit after that announcement our teacher left without any explanation. This little "set up" was supposed to give us an example of how not to manage change. Change needs to be explained and dealt with in a professional manner. Despite the unconventional teaching method, I did think it did bring home a point. Many of the students were upset about the change. While preparing for the class, I had read "Who moved my cheese?" A lot of the time our cheese is moved, or change happens that we cannot control. We can control how we react to it. Change will happen. As managers and leaders, I hope to manage change in a professional manner and control how I react to change.

February 7, 2012 Class

For this class, we discussed the different qualities in men and women that make them leaders. We started the class with the questions "Who makes a better leader, men or women?" I don't think men or women make a "better" leader. Both bring different qualities and perspectives to their leadership.
Another point we discussed were the different powers we have. I recently read an article that discussed the different powers, that nurses have. We have expert power. Expert power comes from the experience and knowledge that nurses have. We also have power because nurses are known to be trusted. Another power we have is to persuade. With our knowledge base and trusted status we have the power to persuade some to believe what we believe. All powers are beneficial in different ways. It is important as a leader to understand the different powers we have and use them in the appropriate manner.

January 31, 2012 Class

We discussed strategic planning in class today. Strategic planning is long range planning (3, 5, 20 years). Strategic or long range planning has changed over time. In the past, strategic planning meant that administration leaves the hospital and goes to a remote location. The plan would talk about where they would be in five years, 20 years, etc… The plan would then never be looked at again. Now long range strategic planning is for 12 – 18 months. The planning includes collaboration, deciding in advance “what to do, who is to do it, how it is to be done and when it is to be done.” After reading the articles assigned to us and attending class, I’ve realized that one of the most important parts to strategic planning is collaboration. The game we played in class reinforced this. Nobody wins, if we don’t collaborate. Each department is essential in strategic planning.

January 24, 2012 Class

Today we discussed ethics in healthcare. I really liked the definition presented for what ethics means. " The systematic study of what a person¶s conduct and actions out to be with regard to him/herself, other human beings, and the environment; it is the
justification of what is right or good and the study of what a person's life and relationships ought to be, not necessarily what they are." Ethics is a very complex topic. In class we were able to discuss many different scenarios that demonstrate unique ethical dilemmas nurses face. In My Sister's Keeper a very ethical dilemma was explored. Is it right to have a child for the purpose of saving another? It is interesting because in most ethical situations I can usually relate to all sides of the debate. I think that's what makes it such a complex idea. Ethics committees are often called upon to sort through and try to come to a conclusion. I hope that in my practice I will be able to stay true to my values in the face of all of the different ethical situations I will face.

12 Characteristics of Leaders

1. Leadership requires personal mastery - Nurses demonstrate leadership when they show competence and mastery at the tasks they perform. Nurses are deemed competent by means of a license to practice nursing (NLN 2010).
2. Leadership is about values - Nurses demonstrate values through when they are caring for patients. A "good" nurse demonstrates the core values of caring, integrity, and excellence in their care (NLN 2010).
3. Leadership is about service - Nurses are always serving. The definition of nurses according to the webster dictionary states that a nurse is one who cares for or advises another human. The very basis of nursing is serving the patient.
4. Leadership is about people and relationships - The nurse cares for the patient on an individual level. Their needs to be a relationship built on trust in order for the nurse to provide the best care possible.
5. Leadership is contextual - Nurses are dependent on research, colleagues, patients, etc... to excel as leaders and care for the patient.
6. Leadership is about the management of meaning - Nurses spend a significant amount of time with the patient. The nurse needs to be able to continually assess the patient and manage symptom and every assessment that is happening.
7. Leadership is about balance - At the beginning of every shift, the nurse has sometimes an overwhelmingly long list of things that need to be done. The nurse needs to be able to prioritize and balance that list and effectively deliver quality care. The nurse also needs to be able to balance work and personal life. Without balance, the nurse will burn out easily.
8. Leadership is about continuous learning and improvement - Healthcare is a constantly changing field. New research and technology are constantly being developed. To be a good leader and nurse, nurses need to be lifelong learners. They need to be well read and constantly learning about the healthcare industry.
9. Leadership is about effective decision making - Nurses are constantly making decisions. Assessments, treatments, and all around care for the patient require decisions to made constantly. The nurse needs to be able to make those decisions effectively.
10. Leadership is a political process - There are enough nurses in America that if joined together could potentially sway an election. Nurses know firsthand the challenges that healthcare faces. Nurses need to speak up and become involved in the political arena to promote change.
11. Leadership is about modeling - One interpretation of modeling is that to model means to teach. Nurses are always teaching patients. Another interpretation of modeling is to imitate or reflect an example. Nurses need to used evidence based nursing practice which essentially is modeling.
12. Leadership is about integrity - Nurses face many ethical dilemmas in day to day nursing. Nurses need to have integrity in order to face those ethical dilemmas and react appropriately.

Lesson 2: Successful Leadership and Management Assignment

Think about how theories of leadership and management impact nursing leadership and management roles. Record your thoughts on your "Blog"

Theories of leadership and management definitely impact nursing leadership and management roles. Even though healthcare can be very specialized, it is still a business. Businesses need leaders. These leaders whether they realize it or not, are impacted directly by theories. One theory of leadership is that leaders are not born, but made. Many nursing leaders were not planning on being in management positions. But through a series of events find themselves in a leadership role. They learn from others, and from their own experience to shape their own leadership style. Different types of leadership theories are out there. Some are autocratic, others democratic, and some laissez faire. Depending on the situation and leader, all types can be used. Theories on leadership will continue to develop and continue to affect leadership and management in nursing.

January 17, 2012 Class

I have learned a lot about leadership this past week between preparing for my leadership class, attending class, and witnessing my parents open a Culver's fast food restaurant. The thing that stood out to me in class yesterday was that leadership is about motivating and inspiring people towards an achievement. There are many different types of achievement. Some are considered "good" and others "bad". It doesn't matter what type of achievement it is, it still takes a leader to get there. Craig Culver started a restaurant with just his wife and parents. Since then, he has been able to build a franchise that now has over 400 stores across the nation. I have been able to see the results of his leadership firsthand this past week. He came to the store opening and talked about how in order to do good business you have to take care of the team members and the business will take care of itself. I find this to be very true. It takes a team to achieve something. A good leader treats his or her team with respect and takes care of them. Then together they can achieve great things. I'm excited about this leadership class. I'm excited to learn more about management and leadership. I'm realizing more and more that leaders are not just found in hospitals or government or the workplace. Leaders are everywhere/