Archive for June, 2011

Charging Ahead

June 30th, 2011 | General Nursing | 0 Comments

After 8 months in General Surgery, work was finally becoming more relaxing and fulfilling. Of course this is when the ‘higher ups’ decided to throw in a wrench: I was just getting comfortable with the staff and the patient care, and then the Nurse Manager decided it was time for me to be Charge. I was thrown back to stage 1 of transition. I needed to reorient myself, but I also had the opportunity to work more closely with the senior staff on the ward.

The first time I was Charge, it was almost by default as I was the most senior staff member outside of observation! I’d only been out of school for a year! The more experienced staffs’ help was fantastic; I learned that although being in charge is a huge responsibility, you can’t sweat the small stuff. Although I didn’t want to distract the senior staff in observation, I didn’t want to start charging ahead without knowing how to lead in this role (pun intended).

Increasing my responsibility this quickly was a big shock, which really shook me up! I found taking it back to the basics helpful in navigating this new role: educate myself, find a mentor, stay flexible and keep a sense of humour. I started by reading the Charge Nurse binder, and writing down some questions. The experienced staff helped me set up a timeline with key points as a shift guide. Humour was really important: when I walked in to speak with those helping me, they stood up and saluted saying “our fearless leader”! I instantly felt more confident in my abilities.

I got through the shift keeping the above approach in mind. I gave report to the Nurse Manager in the morning: she said “good start”!!  I found reflection to be invaluable – i.e. I summarized the shift in a long winded manner to my half asleep girlfriend. I fell asleep thinking of this new “start” – only a year after graduation, and less than that on the floor?!

Bryan Say, RN, BScN

NTF Saskatoon Chapter Co-Coordinator


Chillin’ Out

June 28th, 2011 | General Nursing | 1 Comment

Thank goodness for transition theory!! It has been such a help to know that I am not alone in my experiences, and that the things I struggle with are NORMAL!! After five months of working, I am finding myself to be solidly in the second stage: TIRED!!

When I first began working, I was so excited, but I quickly became overwhelmed and had trouble focusing on anything beyond the basic tasks of my job. When discussing my work, I could relay nothing beyond the basics, no analysis or exploration of why: I just did stuff. I am so excited to be in the stage where I am comfortable enough to begin asking questions, and rediscovering what it is I LOVE about Nursing!

Although I find myself to be exhausted, I find encouragement and enjoyment in the things that first attracted me to the profession. Interacting with others and building relationships are my primary sources of professional fulfilment. I find that my interactions are developing as I begin to express different parts of my personality depending on the patient with whom I am working. I am learning to read people more effectively and alter my tone and approach accordingly: a basic in psych, but a difficult skill to begin with!!

Cheesy, but I feel like I am sometimes able to stop and ‘smell the roses’!! The other day I sat and played a game of crib with one of my patients. It was fun, and I was also able to explain the rationale for this to my co-workers in terms of patient outcomes. The best part was that I was able to simply enjoy the time, but assess and decipher the interactions after… the rationale and assessments came naturally into my mind!! This was an AWESOME breakthrough for me! It is so wonderful to be experiencing some times of ease and fun in between all the running, stress, and craziness!!

 

Stephanie Tonkin, RN, BScN

Saskatoon Chapter Co-Coordinator


About those other Health Professionals…

June 22nd, 2011 | General Nursing | 0 Comments

It well known that nurses comprise the largest single group of employed health professionals in Canada. It used to be mainly RNs and LPNs providing direct patient care, but recent trends have shown that a wide array of various health professionals are thrown into the mix.
Nurses have the opportunity of working alongside a multitude of other health professions. Since I have started work at my place of employment (Emergency) I not only work with so many different professions, but also those with varying levels of training/education/experience. This has been a mixed blessing. I think it is a valuable asset being a part of the growing pains of others. It definitely keeps me on my toes. Being able to provideconstructive feedback to a wide-eyed student intern who is on the 26th hour of their sleep-deprived shift, to gently coaxing out the full patient transfer report from a nervous paramedic student on their practicum with their preceptor looming over their shoulder – I think we all are more of part of others’ learning than we realize.
We were always told that “Nurses eat their young”….well sometimes they eat the young of others. It is easy to make it hard on those who don’t seem to know what they are doing….sometimes they really don’t. That is when you can decide to make a situation a learning experience rather than a shift from hell. I mean, we have all been there, when you might be toodling along feeling like you have your act together, and all it takes is someone who is more experienced (and KNOWS it) to cruelly shatter your day into a badjillion pieces. Any self esteem for the day – gone.
I’ve seen it too many times.
Recently I took on a student from a different profession (EMS). It was eye-opening. There were tasks and skills I was able to pass along to the individual, but I quickly realised that it was a two-way street. Where I have the know-how of correcting a maintaining a patients emergent adverse health predicament, I know nothing about on-the scene assessment and dealing with the pressure of knowing you and your partner ARE the help – there areno physicians/RT’s/X-ray/Social Workers/Ortho techs/Security, etc. to offer a hand in that little vehicle with flashing lights. We helped each other out with knowledge gaps on a regular basis.
That preceptorship changed from a teacher-student role to a partnership of mutual learning (still moreso with him though….he had that skills checklist to fill in). I then was lucky enough to go on a ride-along with his platoon on a later date. Got to ride in an ambulance (with the sirens ON) and go over EMS-specific polices, procedures and expectations of the practicing professional. This I feel helped me to be a better team player, and helped me gain better respect for my colleagues.
I sincerely think that we should all make the effort and take the time to help out our fellow nurses and allied health care professionals. I think we will all have a better shift and will improve the quality of patient care if we can work on diminishing all the toxicities that exist in the present health care culture. The medical intern/nursing student/_____-in-training does not have to be the hospital grunt – one day you may have to count on them.
http://www.youtube.com/watch?v=OEdVfyt-mLw&feature=related
Nic Nanowski
NTF Edmonton


Exploring Opportunities Within Nursing

June 19th, 2011 | General Nursing | 0 Comments

It’s convocation season, and I’ve spent the last few days reflecting on my own convocation four years ago and the progression I have made not only as a clinician, but also as a nurse exploring opportunities beyond clinical nursing. A previous blog post alluded to discrimination towards nursing specialties – an important topic. It’s unfortunate that this type of attitude sometimes exists towards nurses who have chosen a “non-traditional” path, but it’s also amazing that the nursing profession offers a wealth of opportunities to influence practice and become leaders in healthcare. This is something to be celebrated, and something very inspiring for new graduates finding their niches in a diverse and ever-changing world.

I have definitely chosen the non-traditional route in my own career. I spent a year as a staff nurse and then moved into a part-clinical, part-administrative role at an urban community hospital, where I have been for three years. My nursing career took a new turn when, a few months ago, I realized that my plans to immediately return to graduate school (a vision shared by many new grads) never came to fruition and that I was finally in a place where I was ready to diversify my nursing experience and seek out opportunities for further learning and growth. My journey towards selecting the right program was an interesting one, and helped me to realize that everyone’s journey in nursing is unique and special.

A Masters of Nursing (MN) is probably the most intuitive choice for a nurse seeking to develop professionally and I have been inspired personally and professionally by many of my colleagues who have this credential. I explored this option initially, and then at a healthcare professionals networking event, I met several nurses who had found a good fit in public health or administration programs. And so began my journey of program selection, which could have been a full-time job on its own. Two questions shaped my decision: What are my goals? Will this program help me realize my goals in a way that another program can’t? Out of this internal dialogue, as well as conversations with nursing and non-nursing colleagues, I applied and was accepted to a Masters of Business Administration (MBA), after also considering an MN and Masters of Public Health. “Business” is sometimes a bad word in our profession, and I have certainly been questioned already on my view on some tough issues, but for me, this is an opportunity to put myself out of my comfort zone and learn how to apply qualitative (e.g. managing people) and quantitative (e.g. accounting) principles to healthcare to positively influence outcomes for patients and the professionals caring for them. Some of my nursing colleagues have expressed their concern that an MBA will pull me away from the profession and that I will lose my nursing skills, but many of the learning goals in my program of choice – such as critical thinking and problem solving, communication skills, team building, and ethical awareness – are a natural fit for a nursing background. The beauty of nursing is that many of our skills are transferable and the multidisciplinary nature of our work allows us to draw on different perspectives to provide the best care for our varied patient populations.

So, new graduates, whether you are entering an acute or community setting, urban or rural, medical or surgical, embrace the many doors that will open for you. The opportunities are limitless and you could find yourself practicing in a place or specialty you never thought possible – welcome to nursing!

Kate Young


Where’s my Final Eval??

June 17th, 2011 | General Nursing | 0 Comments

Having been out of nursing school for 9 months now, and after surviving my first annual practice evaluation in the facility for which I work, I’m oddly confused, and mildly let down, but feel greatly empowered. In nursing school, my Clinical Education Facilitator (CEF, i.e., nurses who supervised our clinical rotations on the floor) had only six evaluations to complete compared to my manager’s 120, I had weekly assignments which we could both use to expand upon our opinions, and my CEF was consistently on the floor with me monitoring my practice, assisting me with skills on which she could jot notes and give me either immediate or short term feedback. Nowadays my manager is in meetings daily, and if I am on a stretch of nights I won’t see her face until I return to the day shift.

As students, we are graded, told what part of the sterile field we seem to continue to contaminate,and how we might differently approach a certain procedure or discussion with a patient (and usually have an opportunity to correct our mistakes in front of our CEF soon after). Out in the real world we are left to silently observe our senior nurses in the distance, often while we are working with a cohort of similarly new nurses with equally large workloads, leaving little time for immediate discussion the way we had in school. What disappointed me was when I received news I would not be advancing to a course to further my education within the department because I “wasn’t ready.” They’re right, I do need more experience. The more time I spend in the department doing what I’m comfortable with so far can only help increase my confidence when faced with new challenges, but when my advancement within my career depends on “being ready” and nobody can tell me what it is I need to work on, and offer no concrete examples of what it is I’m doing wrong, yet as a group, senior staff and management have decided I’m “not quite there yet” the student in me wants to scream out “I CAN DO IT! I CAN FIX IT!!” That feedback we relied on most in school to guide us in the right direction is suddenly vacant and we, as junior staff are left thinking things are ok until we hear that we’re “not ready” for advancement. We are all too busy to give each other a tip, helping hand, or sound bite for thought.

It was during this annual review, after I expressed my concern over the lack of feedback, that my manager so plainly reminded me, “If you like feedback, ask for it!” Such a simple idea I had not even dared to ponder. You mean APPROACH my senior nurses and ASK for their feedback on my practice?! Being new I often forget that we are now all colleagues, and those walls between teacher and student are now blurred. While people may not be forced to offer you advice or may not always be looking, there’s always at least one person with their eyes on you (we of course, are too busy trying to getthrough the day to notice!).

Compounding the problem is the environment in which we work. It’s often hard to approach a senior staff member during shift because of a multitude of reasons, one of the largest barriers being workload. Both senior and junior staff are running, leading to limited opportunities to even approach said senior staff. As well, the lack of privacy on the unit can make it tough for some people to feel comfortable approaching a senior staff member regarding a personally sensitive subject. As well, if senior staff don’t know you’re looking for their opinion, they might not be prepared for what to say. Finally, there’s always the problem of WHICH senior staff to ask. Some communicate with managers more than others (e.g., Clinical Resource Nurse, the charge nurses at work on the floor) and therefore can offer helpful advice during or after your shift, and hopefully be that supportive voicewhen your manager is looking for people to advance in the department.

Because I never had a formal career before I completed my university degree, this world of giving and receiving feedback and anticipating/fretting performance reviews was a whole new world for me. In a place where I assumed no news was good news, I ended up being slightly mistaken. While I am proud to say I am doing just fine (according to the powers that be), the notion of being responsible for garnering feedback on my nursing practice was such a new concept. One that was discussed in nursing school, but which I had never seen practiced. It was during this period of uncertainty over what to do and how to do it, I found this article on the web, and found it VERY helpful in a nursing specific, step-by-step approach to broaching the tough subject of asking for feedback.

If anyone else has any other helpful tips I would love to hear them. We as nurses, and especially new nurses are usually pretty good at self reflecting, but seeing a problem or a situation from a senior point of view is nearly impossible. So seeking out those people to keep a watchful eye, or offer a tip here or there, especially in places where there is no formal mentorship program established, is a sometimes difficult but I believe VERY useful task to undertake. Good luck and happy feedback searching(I know I’ll need it)!

Brittany Weber