A Nurse's View

Will it help the shortage?

2009-05-13T17:46:00Z

An article in May 12, 2009’s Fresno Bee about Fresno State hoping to begin a doctoral program in nursing highlighted several complex issues faced by our state as we struggle to find solutions to the nursing shortage. Assembly Bill 867 which would allow the CSU system to start the program will next be going before the Appropriations Committee. It will be interesting to see what action this committee takes considering the current fiscal situation in the state. We have all heard about the budget crisis and the cuts to CSU campuses for the coming year.

While the state has increased the number of nursing graduates over the past few years through a variety of programs, there is a critical shortage of faculty. What is not clear in the article is whether offering doctoral programs at CSU campuses would improve that situation since many studies about the shortage identify other factors that could improve the faculty numbers.

It is important for our state to continue to work for solutions to the nursing shortage—the impact for patients is critical. But solutions won’t be easy, we cannot continue to put Band-Aids on our current systems, we have to have change that will provide lasting solutions in the years to come. And as experience shows, that change will come slowly if at all in our current political and educational systems.

Here's a link if you are interested in following what happens to this legislation. Just plug in AB 867 to get the current status: http://www.leginfo.ca.gov/bilinfo.html

Another fun week for Nurses!

2009-05-13T05:49:00Z

As Nurse Recognition Week 2009 comes to an end with Florence Nightingale’s birthday on May 12, I was honored to be featured in one of the many Medwatch Today segments developed by Community’s Communications Staff. It was fun to remember what led me to a nursing career; it doesn’t seem possible that it was over 35 years ago that I received my nursing degree. (I can’t be that old!!) I enjoyed hearing the segments featuring Lydia Miller of the California Cancer Center, Jolie Browar from CBHC and Lou Cook of Home Health Services. Kudos to the Medwatch staff for their great work in recognizing our great nursing staff!

Thanks, too, to all the nurses and nurse leaders who worked so hard to plan the great activities to recognize and provide some fun for all. I hope you enjoyed all the activities planned for you by your facility committees—I know I enjoyed the ones I was able to join you in.

What's this Role-Based Practice I'm hearing about?

2008-10-03T18:45:00Z

You may have heard some different language from one of CMCs nurse leaders recently—Role Based Practice—and may be wondering what this is all about.

We have embarked on a journey to transform our nursing practice at Community Medical Centers through implementation of role based practice. Presently, one hundred & fifty of our nurse leaders, directors, managers, supervisors and educators have participated in learning sessions and another fifty will complete their learning experience on October 31. Many have already started to adopt role based concepts in their work areas, which may the reason why you are now hearing the use of different terms. At present, this collective group of nurse leaders is working diligently on various implementation planning activities to prepare the organization for the transformation of practice.

Why have we begun this journey?

Over a number of years, the approach to care delivery has become task-focused—this impedes our ability to realize the quality outcomes we strive to achieve. Community’s CNO group has committed to changing this trend by transforming our practice culture to one that produces professional role-based nursing practice. To achieve this, we have brought Maria O'Rourke RN, DNSc FAAN to CMC to work with us. Under Dr. O'Rourke's guidance we are adopting her Professional Role Development and Socialization Program™. This program includes her Model of the Professional Role that views the RN role a pivotal decision maker on the interdisciplinary team. Through this reestablishment and reconfirmation of the professional standard of practice, we will enable our nursing staff to take an active leadership role in the development of our organization into the World Class Organization as envisioned in our five year strategic plan.

Organizations who have worked with Dr. O'Rourke have experienced a revitalization of their nursing staff, recapturing their passion for nursing. Along with our facility CNO's, I look forward to leading CMC's nursing staff to these same outcomes!

Did you get out to Play?

2008-06-23T17:56:00Z

Did you get out to play at Community's first "Recess" Friday, June 20? I haven't heard the total count that attended, but I had a great time. Yes, my volleyball team flamed out in our first game, and I couldn't get past "twosies" in jacks--my eye-hand coordination is not what it used to be! BUT-I saw many employees of all our facilities having a great time from serious basketball, dodgeball and volleyball competitions to some fun games of musical chairs, foursquare and hopscotch. The Fresno Heart and Surgical "Double Puck Hockey Team" was awesome-that is a lively game! Congratulations to Clovis for winning first prize overall!

We don't always take time to have fun, and Recess Friday night was a good reminder that along with working hard it is important to take time out to have fun to keep ourselves healthy. So, if you didn't get out to play last Friday night, make some plans to do it soon!

As Nurse's Week 2008 Comes to a Close

2008-05-11T22:47:00Z

Every year America celebrates National Nurses Week from May 6, National Nurses Day, to May 12, the anniversary of Florence Nightingale's Birthday. I think this year's theme "Nurses: Making a Difference Every Day" enables us to communicate how important nurses are to patient safety and quality care. Many times our patients express their gratitude for the comfort we provide, but nurses are not always recognized for the important work they do with their patients. I had the opportunity recently to hear Suzanne Gordon speak at a VHA CNO Conference. She shared the story of how surprised she was (years ago) when she had her first child. Her expectation was that her OB was going to be taking care of her while she was in labor, but through her experience at this time she learned what nurses did, and it was an eye opening experience for her.

Nurses are not known for publicly touting the great things we do for our patients, we don't consider what we do to be anything special. From monitoring the medical condition to identify if the patient is stable or becoming unstable to assessing their response to both the medical plan and nursing plan for care, and for being a patient advocate when the patient needs you to be their voice, I want to thank CMC's nurses for the work you do for our patients 24/7.

Joint Commission Nurse Surveyor Compliments CRMC Nursing Care

2008-04-23T03:55:00Z

The week of April 14 - 18 The Joint Commission surveyed CRMC for their regular triennal survey. At the Leadership Session on the last day of survey, the nurse surveyor complimented the facility's nursing staff for the care they provide for their patients and the quality of nursing assessments and care plans. During her visits to patient care units the previous four days she had seen many of our nurses in action and had the opportunity to interact with several of you every day during her patient tracers.

Kudos to the nurses at CRMC! Thank you for making a difference for our patients - every day. Congratulations to Karen Buckley, RN, CRMC CNO, her leadership team and the nursing staff for a successful survey.

Recent News about CNA

2008-03-13T21:28:00Z

You might have missed the news about the RNs at Cedar campus (the former UMC) filing a decertification petition asking for an election to remove CNA as their representative.

I was surprised when I opened the Fresno Bee this morning (March 13, 2008) to the headline “Community aims to oust nurse union.” Surprised because I had been informed yesterday about the National Labor Relations Board (NLRB) fax—a one-page decertification form filed by the Cedar campus RNs and a notice of a hearing on the matter. But more than surprised, I was dismayed that the headline the paper chose to run did not reflect the facts. The headline incorrectly depicts that CMC is leading the effort to “oust” the union, when in fact; the petition was filed by the nurses at the Cedar Campus.

I, along with other hospital administration, don’t have much information about the nurses’ request to decertify the union, but I have heard that RNs on the Cedar campus are upset about CNA holding up raises we gave to other Community nurses last fall and the opportunity to be rewarded and recognized for their leadership through participation in the RN Career Ladder. I can understand how the Cedar campus nurses might be unhappy with the union, especially if they do not feel that CNA is representing them as they would like to be represented or if they feel that CNA is holding up compensation they deserve. They have every right to request decertification—just as nurses have a right to vote differently in an election.

Unfortunately the issue of CNA representation has to be played out in what can be a slow process. Any election to decide representation is strictly between CNA and the RNs at Cedar campus with the NLRB overseeing the process. Administration can only provide assistance when asked.

I want to assure you as Community’s Chief Nursing Officer, I echo CEO Tim Joslin’s statement in today’s article about supporting nurses’ rights to freely make their own decisions about unions. And I second his sentiment: “We believe that we can achieve more through collaboration (with our nurses) rather than confrontation.” Clarification is mine.

Such events can distract us from the more pressing and important work we do at Community caring for the health of our community, working to advance the nursing profession, and creating a top-notch workforce and workplace.

I would hate to see the pending election on this union issue polarize our wonderful staff. We have so many other great things to focus on here at Community with our career opportunities for nurses, new technology, and expansion plans at all our hospitals. And we all know patient care truly takes a team effort with all of us pulling together.

If you’re curious about the dates or would like more details about this decertification petition, make sure to read the full story at http://www.medwatchtoday.com/1476.htm

Finally, I welcome your questions and comments. Please don’t hesitate to stop me in the hall when I am doing rounds or send me a comment through my blog.

You can keep those New Years Resolutions!

2008-01-01T19:56:00Z

As the new year starts, many of us have made resolutions - it is always easy to make New Year's promises. I was talking with some friends last evening about resolutions. Most of them said they don't make resolutions any more because they never kept them...

This got me to thinking about why we don't keep those resolutions we make. Many times, they are not serious for us. But, sometimes we do want to keep a resolution, we just don't have a plan. If you are serious about a resolution this year, you can be successful with a little work up front. Just as with any goal, a New Year's Resolution isn't realized just because we wish for it! The difficult part comes when we have to make changes to achieve what we have identified as a goal. Keep in mind some basic things to be successful. Make sure your resolution is realistic, develop some plans to incorporate changes in your life that will ensure you succeed. If you plan to make a few small changes to achieve your goal, you will be more likely to follow through because you won't be overwhelmed by what seems to be unsurrmountable change. You may want to share your plan with someone who can be a support to help you get there. And be sure to celebrate your successes as you complete the smaller steps to your goal-this will help you continue to make those small steps and a year from now, when you look back on 2008 you will be able to say "I made it!"