#CARErevolution

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I became a nurse because I wanted to help people.  I wanted to relieve someone’s pain and suffering.  Bring joy in the midst of a difficult situation.  Be a source of comfort for someone who felt alone. I guess you could say I had dreams of being a superhero with “RN” embossed across my chest.

In my career, I’ve been able to help a lot of people.  Now, however, that’s not the only thing that keeps me in nursing.  I don’t stay a nurse just because I want to help people.  The sad truth is, I stay in nursing because I HAVE to help people.  

I’ve worked in hospitals, school systems and the public health sector.  They are vastly different approaches to nursing practice. But the one thing that stays the same is the need for nurses to guide the people in their care along to safe a landing.     

Nationally, our healthcare system is under a tremendous amount of stress and in need of significant change if it ever hopes to meet our nation’s future healthcare needs.  Much like the political revolution our country seems to be undergoing this 2016 election season, our healthcare system is in need of a nursing revolution.  

The epic problems that face our country’s healthcare needs cannot be solved without nurses leading the process.  For far too long others like physicians, insurance companies, healthcare institutions, and other profit generating enterprises have robbed people of the healthcare they require.  They have set up road blocks that delay treatment and, ultimately, cost people their lives.  For too long, nurses have allowed this to happen.  Don’t misunderstand me.  As a nurse, I don’t think this was an intentional oversight on our behalf.  In fact, the very core of the problem is that the system has been designed so nurses, and the people they care for, fail.

As a nurse you spend so much time advocating and fighting for the people in your care.  You can get tired. The system can be brutal.  When I was in nursing school and they said nurses were advocates, they didn’t tell me it was going to look like this.  I believe this is one reason nurses are leaving the profession in droves.

But today, I want you to have a fight moment.

No one said it was going to be easy.  Don’t throw your hands up and resign yourself to “the system”. Nursing is advocacy.  Nothing about advocacy is easy.  It’s going to be an uphill battle for the rest of your career.  If you resign yourself to anything, let it be to the fact that you are a fighter.

Maybe you fight because you want to?  Or maybe you fight because you have to.  Either way, you fight.

Things are changing and the wind is blowing in a new direction.  People are sick and tired of being sick and tired.  Nurses are sick and tired of being sick and tired.  This is the fuel that is necessary to set off an epic blaze that will forever change the way we provide healthcare in this nation.  

All we need now is the spark.  One little spark that can set the entire system ablaze. 

I believe that once you realize your position and your power as a nurse.  The spark will be lit.

Every time another nurse realizes it, and I mean truly ‘gets it’,  the flame gets larger.

That’s why I wanted to start a #CARErevolution.

The #CARErevolution is an opportunity to express how nurses impact healthcare.  It’s the ultimate nursing revolution.  It’s a way to share ideas and the amazing things you do.  What dreams do you have for nursing?  What challenges do you face?  What opportunities do you have?

This is not the place to limit yourself or our profession. This is the place to think big.

That’s what the #CARErevolution is about.  Big ideas for a big tomorrow.    

So, what are you waiting for?  Go start a revolution.

Peace and Love,

Nurse Jessa

 

 

You’re Fired

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No, I haven’t been watching reruns of Donald Trump’s famous reality TV show. Truth be told, I am a fan of reality TV but not a fan of the Donald.  Either way, those are two words that no one wants to hear. Unfortunately, more and more people are hearing those words because of their use of social media.

Social media is a super powerful tool that has the ability to catapult someone’s professional career. Think Justin Beiber. But just as quickly as the windfall of popularity comes, so can the downfall. Again, think Justin Beiber.

With millions of people engaging on multiple social media platforms each day, there are ample opportunities for people to slip up and share something they may regret later.

Take for instance a post I saw recently on a local Facebook yard sale site. Someone had apparently posted a cell phone they wanted to sell. Another person had responded they may be interested in the phone and would private message the seller. It appeared from a later post that the two engaged in a discussion, via private messages, that did not go so well. The seller took it upon herself to post a screenshot of their heated discussion on the yard sale page to warn others about dealing with her. Apparently, the buyer had called the seller a few four letter words and told her to stick it where the sun don’t shine, if you catch my drift. Also, included in the screenshot, was the intended buyers fullname as it appears on Facebook, her occupation as a Registered Nurse and her current place of employment (a local nursing home).

By the time I happened upon this post in the yard sale site, one of the 78 comments to the post was by the buyer. She, very heatedly, stated that she has been “let go” of her job as a result of the seller’s post and that she hoped the seller “was happy.”

Now, we don’t need to debate the obvious issues with this cluster f*ck of a situation. I only share this as an extreme, yet real example, of how social media can impact the lives of nurses in a negative way. I certainly don’t think this nurse thought that buying a phone from an online Facebook yard sale was going to lead to her losing her job.

So, let’s cut to the chase. My message about social media is simple:

It’s called social media because it’s social. The very name social implies public. Nothing exchanged in social and public contexts is assumed to be private. Even private messages that are sent via social platforms, like Twitter and Facebook, should be considered private. Just refer to the example above.

Nothing shared over social media should ever be considered private. There is no reasonable expectation of privacy when entering the realm of social media. Now, I am no lawyer nor am I intending to give legal advice. I am, however, saying common sense is a good thing and we should not let it go to waste.

The pull of social media is strong in our culture and will only continue to get stronger. It’s how we connect with friends, family and the world around us. That said, let’s exercise good judgement with what we share on social platforms so that we don’t get caught in our boss’s office hearing those two dreaded words.

Peace and Love,

Nurse Jessa

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Detour Ahead

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One of the things that I love most about my job is that I get the chance to travel and connect with nurses from across the state.  Something about sitting together, drinking coffee and talking about nursing really gets me inspired and motivated.  

I feed off of that level of connectivity and collaboration.

That said, don’t think that I relish every minute of that time that I spend with people.  Let me be completely honest.  

There are some people who just don’t ‘get it’.

You can be in a meeting, totally in the groove with others and then that one (or two) person starts interjecting with random shit and throws the whole vibe of the conversation off course.

Come on.  Really?!  Are you that unaware of the conversation that we are having and the ridiculous words that just came out of your mouth have absolutely nothing to do with what we are talking about?

I’ve led enough meetings and given enough presentations and lectures over the years to gain enough experience to be pretty freakin’ good at corralling these folks back in.  

The problem is sometimes I don’t wanna do it.  Sometimes, I just wanna scream “shut the fuck up” and smile politely.  

Alas, screaming “F U” is not considered professional and really isn’t a true reflection of who I am as a person.  That is, unless, I stub my toe on an inanimate object like a bed rail.  Then, I am totally an “F U” kinda girl.  I digress. 

One of the most important professional skills that nurses can learn is how to redirect a conversation that has taken a detour.  It sounds easy but in practice it’s a real skill.  Do it wrong and you can come across like a bully who doesn’t listen.  Don’t follow through and people may mentally checkout of the conversation and forever miss valuable information.  

One strategy that has worked well for me when someone totally goes off script, whether in a meeting or  in a conversation, is to interrupt them politely.  Say something like “Excuse me for interrupting but I’d like to refocus the conversation back on the fact that gorillas don’t have purple hair…”  Or something along those lines. After you have re-gained control of the conversation, and re-routed their GPS, make sure that you publicly acknowledge them and offer some form of praise.  

People want to be recognized for the work they are doing and receive validation for the challenges they are facing.  

Doing this in front of the entire group goes a long way in supporting this person to feel heard and appreciated.  Then offer to meet with them in private to chat about their concerns for a few minutes.  Also, others involved in the conversation will appreciate this and may even be able offer a better solution to the problem as well.  

This is a win-win for everybody.  The person gets a solution or additional support for their problem, the others in the conversation hear the information they originally needed from the conversation and you get to keep your sanity.  Ain’t life grand!

The above method has served me well and I am sure it will do the same for you.  

Now I would love to hear from you.  

What has worked for you when conversations have taken a detour?

Leave a comment below and let me know.

Peace and Love,

Jessa

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1,2,3…1,2,3…

A few years ago, I was working evenings on an inpatient psychiatric unit. It had been a busy evening full of admissions and I was behind on completing my rounds. I finally managed to check-in on everyone but one last person. As I approached her room, I could clearly hear she was crying.

That kind of loud, choked up crying.

In between sobs, she was counting “1, 2, 3…” I stood outside her door and listened for a short while, wondering if she was going to say anything else. But she didn’t. All she did was count 1, 2, 3 and sob.

I tapped on her door and asked if I could come in. When I entered her room, she was sitting on the bed with a box of tissues. With my best psych nurse in play, I asked her how she was feeling and if she wanted to talk. She began to tell me a story that was a bit difficult to follow and some of the pieces didn’t line up but as we talked her tears subsided, her face cleared up and the energy in the room shifted. By the end our our conversation, she appeared to be doing better.

As I was leaving the room, I asked her why she was counting and what she said next surprised the hell out of me.

She said “President Obama told me that when I get upset, I should count to three and breathe and it will calm me down.”

O.K., so I know for a fact that President Obama didn’t tell her this. (I mean what was I expecting, I worked on a psych ward. Rarely did people make sense.)

But the counting to three and breathing part totally made sense.

She was using the best coping mechanism she had.

Get upset, count and breathe.

As a nurse it is super important for us to have coping mechanisms. Every day you are surrounded by someone else’s difficult time all while having your own difficult times. Your individual coping mechanisms bring a sense of relief and control to a situation that feels uncomfortable and uncontrollable.

We all have something that we do.  Something that helps us cope.

For me, when I feel overwhelmed, I make lists. Lots and lots of lists. In fact, I LOVE lists!

I always write lists with little boxes next to each item so I can check everything off and have a tangible way to see my progress. There is something about developing a plan of action and carrying it through — getting s*** done just makes me feel better.

When I was a med-surg nurse, I always made lists when the you-know-what was hitting the fan. When the shift was spinning out of control, a list helped me cope and feel better prepared to manage whatever came at me.

123 list

 

See, I feel better already!

An effective coping mechanism is as individualized as you are.

You know yourself best and what things you need to keep your head in the game and your Danskos on the move.

So, engage now.  What coping mechanisms do you have? Do you breathe or write lists? Both? No matter what you choose, make sure it’s an effective and healthy way to tackle all that life (or a 12-hour shift!) can throw at you.

Remember, when in doubt, ask Obama and count to 3.


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Being Understood:  The Ultimate Power Play

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As you know, last week I wrote about the impact of empathetic listening and the importance of seeking first to understand people.  This one simple action can transform your personal life and nursing practice.  (In case you missed it, check it out here.) 

I also mentioned that this week I was going to discuss what to do after you understand (“get”) someone. Everybody caught up?  Good! 

In Stephen Covey’s book The 7 Habits of Highly Effective People, Covey says the key to effective communication is effective relationships.  But in order to have an effective relationship you have to have stellar communication.  Stephen’s advice is to 

Seek first to understand then to be understood.

 

Notice the emphasis on “then.”  This is a significant distinction you’ve got to make when communicating with someone. 

First you need to understand them — then, and only then, is it your turn to be understood.

So many times we come into a conversation with preconceived notions of what someone else needs to do or we arrive at that destination very early on in a conversation.  We’ve made our judgment and determined what needs to happen.  We then spend the rest of the time trying to make someone else understand what we so easily understood. 

That’s a problem.

Being understood does not necessarily mean we give directives or advice.

Being understood means changing the tone or “feel” of a conversation by being a steady influential presence.

You see, the more time and effort you put into making sure you are understood, the less likely someone is to trust you.  Then you’re more likely to frustrate the other person in the conversation, making them more likely to shut down and tune you and your valuable insights out.

It’s a vicious cycle.

Being understood is actually an organic evolution within a conversation.  It’s akin to being the strong silent type. You don’t need to use many words or exert a tremendous amount of energy.  Because you took the time and initiative to understand them first, they feel heard and respected, and therefore more willing to hear what you have to say.

This is where the power play takes comes in.

Once you’ve gained someone’s trust, your ability to influence them increases exponentially.

That is the true power of being understood.

So, the next time you have a conversation with someone, put Stephen’s great advice to work and watch how the dynamics shift in your favor.

Engage now!  During the last week did you put Stephen’s advice to the test?  If so, how’d it go?  Leave a comment below and share how this impacted your life for the better.  Or, if you haven’t, make a public commitment to start today.

Just so you know, you have my deepest respect and admiration.  I think you are truly phenomenal.

Peace and Love,

Nurse Jessa 

 


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The Power of Understanding

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Every day as a nurse you have numerous interactions with people from all walks of life.  From the people you care for to your coworkers, friends, family and acquaintances.  So let me ask you a question.  After all that talking and listening, how well do you understand them?

In his book, The 7 Habits of Highly Effective People, Stephen Covey states that the basis of all positive relationships is communication.  In order to effectively communicate with someone you must:

seek first to understand…

Understanding someone involves knowing what makes them tick.  It involves getting to the root of someone’s thoughts, feelings and behaviors.  In other words, it is “getting” someone.

Understanding a person only comes from listening to them.  Actually, I take that back. Understanding someone comes from listening empathetically.

Empathetic listening means to listen to someone with the sole purpose and intent of understanding them.  It goes far deeper than merely hearing them.

To listen empathetically, we must silence our own internal dialogue because, no matter how hard we try, it is prejudiced with our own feelings and judgements.

Empathetic listening can be deeply emotional and therapeutic.  Remember that first time you got dumped in high school and you called your best friend?  You were on the phone with her for hours!  You and your friend had a connection and you were communicating with each other on a deeper level.  That is empathetic listening.

As a nurse, you need this skill.  The ability to listen to someone’s story and “get” where they are right now.  This can have a tremendous impact in your professional practice AND your personal life.

The more you listen empathetically, the more people begin to trust you.  The more a person trusts you, the more influence you have over a person.

Influence is power.

Influence, when used for good (cue super hero music) is not manipulative.  It’s actually the natural consequence of building trust which is the foundation of positive relationships.

Imagine the impact you could make in a person’s life if you took the time to connect and understand them first? How could that relate to the people you care for?

This is a true game changer.  The momentum alone would change the course of the world.

I believe in my heart of hearts that seeking first to understand is the starting point for world change.

I believe this single shift in our thinking sets into motion an energy and power that can change the course of history.  If you do this, you become a change agent. You usher in new generation.

That is true power.  That changes the world.

But, it doesn’t end there.  Check back next week to see what to do after you have taken the time to understand someone.

Engage now and make a commitment to yourself and others that you will seek first to understand.  Also, leave a comment below on how this has helped you personally or professionally.

Peace and Love,

Nurse Jessa

 

The Best Question You’re Not Asking

You go to work every day with good intentions.  You want to do your best and you want the best for the people you care for.

To make that happen, you’re likely do a lot of talking and asking questions.

How are you today?  Did you sleep well?  Are you in pain? What’s your goal for today?

You’ll use the answers to these questions to develop a care plan and implement interventions that are important for someone’s well-being and healing.

The people you care for are placed into a system designed around what’s important for their health.  For example, it’s important for diabetics to follow a diabetic diet and it’s important for someone on dialysis to follow a fluid restriction.  As a nurse, you implement interventions that you recognize as necessary to someone’s health.

This is not a bad thing because it leads to people getting better.

But what if you started asking another question?  A question that truly symbolized your understanding of the uniqueness of each individual under your care?  Imagine a question that showed people that you are concerned with their whole life, not just their health?

What if you decided to broaden your focus to more than what’s important for someone?

What if you instead asked this one simple question:

“What is important to you today?”

Pretty easy, right?

Answers to this question can vary greatly and may have absolutely nothing to do with someone’s physical health.  You may get answers like, “finish the last chapter in the book I’m reading” or “call my nephew” or “take a 2-hour nap.”

 

As a nurse, you probably already know what’s important for someone’s physical care, but only the person can let you know what’s important to them beyond their basic health needs, and these are equally important aspects of helping someone see that you care about their complete well-being.

What’s important to someone is just as important as what’s important for someone.

 

At the end of the day, we nurses can plan a whole slew of activities based on what’s important for someone but let’s not forget the other half, too.

 

Setting aside the time and resources to help someone with what matters most to them each day can go a loooonnnnggg way in making someone feel empowered and supported.  

So the next time you start working with a someone, make sure to ask them “What’s important to you today?” and do everything in your power to make it happen!  I guarantee you that it will be appreciated.

Engage now!  I’d love to hear from you on this.
Leave a comment below to let me, and the other super fabulous nurses that swing by here each day, know what you’re thinking.  Your insight may be just what someone needs hear, so get it out there for the world to see.

With my deepest admiration and respect,

Nurse Jessa

 


I’ve Got Your Back

Nurses stick together.  We have each other’s backs.  Today, I’m watching your back — literally.  You have heard time and time again how important it is to “watch your back” and use proper lifting techniques.  You’ve also probably heard a lot of “I’m busy right now” or “give me a few minutes” or even a flat out “no” when asking colleagues for help transferring a patient.

When you don’t have the support, equipment and time you need to complete a transfer safely, you may let being busy and harried tempt you to take matters into your own hands and use unsafe lifting practices “just this once.” Don’t deny it. We’ve all done it from time to time.

But what you may not know is that each year, thousands of nurses across the country develop chronic and often debilitating musculoskeletal disorders by using poor lifting techniques. This has become quite a problem recently and has received national attention in the media.

Earlier this month, NPR did a weeklong series on nursing injuries in hospitals that were the result of unsafe lifting techniques. The results of their investigation were shocking and scary.

Click here to view the entire series.

So, what can you do to protect yourself and your patients? Here are a few tips you may find handy:

1) Get help.

Never attempt to move someone without extra hands, even if it is something simple like pulling someone up in bed or helping someone turn and reposition. It may take some time to find the necessary backup, but doing this one thing can save you from years of agony later.

2) Get equipment.

Make sure to use the lifts and slings your facility provides, and make sure you understand how to use them properly. If your facility does not have enough of these supplies to go around, speak up for yourself and your patients and demand that your facility supply the equipment you need to do your job well AND safely.

3) Use your connections.

Ask for additional training and suggestions for you and your team members. Consult with your facility’s physical therapy department for additional resources. Every physical therapist I have ever met has been more than willing to share their expertise and insights. In fact, they’ll probably be flattered that you asked them for help.

You work hard to ensure that the people you care for get only the best. Don’t forget — the same standard applies to you, too! You can’t continue to be the superhuman nurse that you are without taking care of you.

Engage now and use the comment section below to share your best lifting tips and other insights with me and the other rockstars that visit this site.  We’d love to hear from you, and remember — we’ve got your back!

Leadership Fatigue

One word has been buzzing around my head lately. And that word is…fatigued. I don’t know about you but sometimes no matter how much sleep I get or yoga and meditation I do, I still feel utterly worn out! Between all of life’s obligations and responsibilities, a** is dragging at the end of the day.

I have noticed this has especially affected my abilities as a leader. As a nurse you are well aware of compassion fatigue, but what about leadership fatigue? Those feelings of frustration and burnout that come from days and days of saying and doing the right things and still not getting the results you want? Whether you’re looking for improvements in patient outcomes, corporate compliance or collaboration among your immediate team members, you will face leadership fatigue from time to time. But there is light at the end of the tunnel (and it’s not a train)!

I’ve got a few simple tips to help you along the way.

1)  Remember the Why

When things get overwhelming and fatigue sets in, remember why you do what you do. You are where you are because you are supposed to be there. The Universe has placed you there because only you can do the job that needs to get done. One of my favorite authors and speakers, Simon Sinek, reminds us that refocusing on why we do what we do will re-energize us and that energy will overflow to others. Awesome, right?!

2)  Focus on One Thing

It is entirely too easy to get distracted and allow yourself to be pulled in a zillion different directions. How can you be effective if your energies are all tied up doing different things? You can’t! Take a moment and choose one thing you will focus on right now. Don’t worry about tomorrow or next week, only think about today. If you could only make one difference today, what would that be? Once you have figured that out, be like Nike and “just do it.”

3) Breathe

Oxygen is an amazing and magical molecule. The problem is we don’t utilize it enough. Research shows us that deep breathing on a regular basis triggers our neurons to fire and we get more creative. Cool, huh? So, practice deep breathing. Slowly inhale for 5 seconds and slowly exhale for 5 seconds. Repeat for 6 & 7 seconds. By the time you get to 8 seconds, you’ll feel like you can’t go on but I promise you there is more space in those alveoli than you give them credit for. So buck up and suck up some of that awesome are.

 

Engage now and comment below.  Are you suffering from leadership fatigue?  If so, how is affecting you?

Tell myself and everyone here what is one thing you do to help combat leadership burnout?  Give as many details as you want.  You may have just what someone else needs.

Thanks for being your amazing and awesome self.

Peace and Love,

 

Nurse Jessa


No S*** Sherlock

Sherlock Holmes is one of the world’s most famous (albeit fictional) detectives. The creative genius behind Detective Holmes was Sir Arthur Conan Doyle. Sir Doyle was a Scottish author and physician. He made Sherlock famous by using wit, logic, and attention to detail.

From time to time, we nurses need to do some creative sleuthing of our own.  We use our wit, logic, attention to detail with a little charm sprinkled on top to get to the truth.

Every day as a nurse, you’re investigating something.

Sometimes things are easy and fairly painless to figure out and sometimes you open Pandora’s Box. No matter where you find yourself in the detective process, keep it up! The people that we care for depend on our inquisitive and curious nature.  In fact, their very lives may depend on it.

Nurses work in a variety of arenas: inpatient, outpatient, home health, advanced practice areas, etc. For this reason, nurses have to be on the ball all the time. We can’t let one little detail escape our attention because, if we do, we might endanger the safety of the person we are caring for. Promise yourself right now that you will take the time to converse with the people you care for about their medications, illnesses, ailments, disabilities, nutritional modifiers and so forth because you never know what you may find.

You may realize that the pharmacy entered a medication incorrectly or that dietary services didn’t bring Thick-it for someone’s dinner.  Maybe that person does not have anyone to come check on them at home to make sure their meds are straight or the physician transcribed the dosage of a medication incorrectly.  Perhaps one of our co-workers didn’t have a witness when they hung a unit of blood or the procedural “time out” didn’t occur as it should. Oh my, oh my! The list could go on and on.

Whatever the case may be, your superb sleuthing skills and attention to detail can save a life.

Sherlock Holmes said it best;

To a great mind, nothing is little.

Engage now!  Leave a comment below describing how your keep attention to detail and inquisitive nature saved the day?

Just in case you haven’t been told today…you are awesome, beautiful, and smart as hell!

Peace and Love,

Nurse Jessa

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