Monday, November 30, 2009
Last Clinical Day
I completed my last 4 hours of clinicals today. I had the opportunity to attend two meetings. The first meeting was held in the CNO's office. The people who attended the meeting was the CNO, the ER director, and the ER assistant administrator. The meeting was about the throughput initiative in the ED to increase patient flow. Being familiar with a lot of the initiatives, I was able to give a lot of input in this meeting and everyone actually took my advise. They are even going to hire a disposition/discharge nurse after I informed them of how effective it was because I have personal experience with the effectiveness of having a dispo nurse. It felt really good knowing that they valued my opinion as a professional nurse as opposed to being a nursing student. I also attended a meeting that discussed the use of omnipaque versus gastrografin contrast for patients needing a cat scan of the abdomen. Apparently omnipaque is suppose to digest and work through the bowel alot quicker than gastrografin and more palatable to the patients. It was suggested by the manufacturer that it should shave off approximately 45 mins of the patient's ED visit time. Some of the members, particularly the ED doctor is reluctant about using the omnipaque for fear of rescanning the patient and putting them at risk for more radiation. They decided to give it a 30 day trial period and document well on patients who would have to be rescanned. I thanked my preceptor for taking the time out to educate and mentor me during this semester. I had a great experience and learned alot about effective leadership. This was a great semester and I am glad I was afforded the opportunity.
Saturday, November 21, 2009
Clinicals 8
Hello everyone,
I completed 8 hours of clinicals on Wednesday and I have 4 more hours to go. My preceptor started his day off with checking his voicemail and emails. We attended a Nurse Leadership Council Meeting that discussed the manager's role in Shared Governance. Shared Governance is a concept that can be used in any discipline. Shared Governance teams are decisional for the discipline. The meeting also discussed the characteristics of an effective team which include; competent team members, unified committment, a collaborative climate, results-driven structure, and clear and defining goals. The members of the Shared Governance partnerships with the manager. There is equity, ownership, accountability, and shared decision making. Effective teams require double-loop communication. Double-loop communication is a process whereby the manager is involved in listening to the staff and encouraging feedback. There is back and forth dialogue between the manager and the staff. The manager must possess the characteristics of a transformational leader which include; coaching, role modeling, and goal setting. Manager's must have a thorough understanding of principles of Shared Governance and must be able to routinely engage in personal reflection in order to attend to own issues of power and control. The meeting was actually on Webinar, which is an online interactive website that allows different hospitals to be involved in one meeting. The room consisted of all of the nurse managers in the hospital. The meeting also defined the difference between the manager's role: traditional vs. current, manager's role in discussing Return On Investment (ROI), education of self and staff, and key elements of a leader. Leadership means knowing where your power comes from. I was thoroughly impressed and enlightened by this meeting. I never really understand all of the intricate details of Shared Governance and never had an interest in becoming involved until now.
I completed 8 hours of clinicals on Wednesday and I have 4 more hours to go. My preceptor started his day off with checking his voicemail and emails. We attended a Nurse Leadership Council Meeting that discussed the manager's role in Shared Governance. Shared Governance is a concept that can be used in any discipline. Shared Governance teams are decisional for the discipline. The meeting also discussed the characteristics of an effective team which include; competent team members, unified committment, a collaborative climate, results-driven structure, and clear and defining goals. The members of the Shared Governance partnerships with the manager. There is equity, ownership, accountability, and shared decision making. Effective teams require double-loop communication. Double-loop communication is a process whereby the manager is involved in listening to the staff and encouraging feedback. There is back and forth dialogue between the manager and the staff. The manager must possess the characteristics of a transformational leader which include; coaching, role modeling, and goal setting. Manager's must have a thorough understanding of principles of Shared Governance and must be able to routinely engage in personal reflection in order to attend to own issues of power and control. The meeting was actually on Webinar, which is an online interactive website that allows different hospitals to be involved in one meeting. The room consisted of all of the nurse managers in the hospital. The meeting also defined the difference between the manager's role: traditional vs. current, manager's role in discussing Return On Investment (ROI), education of self and staff, and key elements of a leader. Leadership means knowing where your power comes from. I was thoroughly impressed and enlightened by this meeting. I never really understand all of the intricate details of Shared Governance and never had an interest in becoming involved until now.
Monday, November 9, 2009
Clinicals 7
I spent 4 hours with my preceptor today because he had to leave early. We attended a patient flow committee meeting. The meeting consisted of nurse managers, registration manager, and environmental services manager. The meeting was led by the VP of quality improvement. She directed the flow of the meeting and allowed the department managers to express their concerns regarding patient admits and discharges. The patient to discharge/admit goal is 130 minutes from door to admit/discharge. This was a very interesting meeting and I was happy to be able to attend because my change project is based on patient flow in the ED. My change project is called the ER Faxed Reporting Change Project. Initially, the ED nurses were waiting until the bed was cleaned before they faxed the report to the floor and the floor nurses either didn't have time to review the report or they were too busy and this would cause a delay in ED patient stay. This also occupies a well needed bed by triage or ambulances. I suggested that instead of waiting for the bed to be clean, why not fax the report once the orders are written and that way once the bed is clean,the patient could go to the floor. The ED director really liked this idea and allowed me to implement this in the ED. I am looking forward to comparing the data and evaluating my project.
Sunday, November 1, 2009
Clinicals 6
My preceptor started this weeks clinicals off with checking his emails, going to paperwork, and returning phonecalls. We attended a trauma meeting on Tuesday morning. They just discussed the current performance on trauma documentation and as of August, they are 100%! My preceptor has worked really hard in finding ways to encourage the staff to comply with the trauma documentation. He stated that one of the main reasons some of the areas were being missed was because of lack of communication amongst the previous manager and the staff. The staff informed my preceptor that they were never educated about the new documentation. I also went over budgeting with my preceptor and as of right now the emergency room is not in the red for staffing and budgeting.
We also interviewed a potential employee for the director position for NICU. DRMC is trying to expand their NICU department and provide a level 3 NICU for the Denton community. The interviewee was very impressive. She had over 20+ years of Women's Services and NICU managerial experience. She also help expand a NICU department from a 6 bed unit to a 42 bed unit. So she is definitely experienced in the change process. She is currently pursing her master's degree at TWU (which I was excited about). My preceptor did not have to ask her any questions because she was really prepared and knew exactly what to say. At the end of the interview, my preceptor stated that this was a rare situation and most interviews don't go that way. He and several other managers were very interested in having her become apart of the DRMC team because they needed someone who had experienced in this change process. Prior to having the interview, my preceptor reviewed her application and educated me on key things to look for on a resume. First, it should not be more than one page long. Second, look for red flags like gaps in employment or a person who goes from a manager/director position to a staff position. The interviewee explained that the reason for going back to a staff nurse was because of school and family and now that her children are out of high school, she is ready to go back to her passion.
I learnt alot during this interview. Number one, presentation is the key. The interviewee looked very professional, confident, and astute. I also learnt how to review resume's and key things to look for on a resume.
I accomplished 12 hours of clinicals this week. My preceptor had to get a lot of paperwork done and he is working on the trauma information. I assisted him in going over the trauma documention. He explained to me that a manager truly has to be sufficient in time management because there a so many day to day tasks and issues that arise. He stated that management goes beyond paperwork and meetings and in order to be an effective leader, a person must be able to handle the multiple demands that is placed upon them.
We also interviewed a potential employee for the director position for NICU. DRMC is trying to expand their NICU department and provide a level 3 NICU for the Denton community. The interviewee was very impressive. She had over 20+ years of Women's Services and NICU managerial experience. She also help expand a NICU department from a 6 bed unit to a 42 bed unit. So she is definitely experienced in the change process. She is currently pursing her master's degree at TWU (which I was excited about). My preceptor did not have to ask her any questions because she was really prepared and knew exactly what to say. At the end of the interview, my preceptor stated that this was a rare situation and most interviews don't go that way. He and several other managers were very interested in having her become apart of the DRMC team because they needed someone who had experienced in this change process. Prior to having the interview, my preceptor reviewed her application and educated me on key things to look for on a resume. First, it should not be more than one page long. Second, look for red flags like gaps in employment or a person who goes from a manager/director position to a staff position. The interviewee explained that the reason for going back to a staff nurse was because of school and family and now that her children are out of high school, she is ready to go back to her passion.
I learnt alot during this interview. Number one, presentation is the key. The interviewee looked very professional, confident, and astute. I also learnt how to review resume's and key things to look for on a resume.
I accomplished 12 hours of clinicals this week. My preceptor had to get a lot of paperwork done and he is working on the trauma information. I assisted him in going over the trauma documention. He explained to me that a manager truly has to be sufficient in time management because there a so many day to day tasks and issues that arise. He stated that management goes beyond paperwork and meetings and in order to be an effective leader, a person must be able to handle the multiple demands that is placed upon them.
Saturday, October 31, 2009
Midsemester Self-Review and Analysis
2 Course Clinical Objectives and 2 Personal Objectives so far in the course; relate your progress on these objectives to your work in your specific clinical site:
2 clinical course objectives:
1. Leadership skills-I feel I have met this goal because of the knowledge and wisdom that has been passed on to me by my preceptor. My preceptor has truly inspired me to be a great leader. I have learned that effective leadership involves loyalty, respect, trust, and effective listening. A leader must be self motivated and committed to whatever change or situation that takes place in their department. An effective leader also motivates, educates, and empowers others to see that vision and give them opportunities to express their feelings about the change.
For example, The ED department at DRMC is currently trying to be a level 3 trauma center and in order for them to achieve this goal, they must first be up to date and compliant with the trauma documentation. My preceptor has educated the staff on the items that are being overlooked or not documented like hourly vital signs. He posts the trauma checklist on all the computers to remind the staff. He also offers suggestions in ways to keep improvement and encourages feedback. He also recognizes champions who are documenting 100% in front of their peers and ask those champions to assist him in helping the other staff members improve in their documentation. As a result of this effective leadership, they are currently 100% on their trauma documentation.
2. Communication-I feel I have met this goal because I effectively communicate with my preceptor during all my clinicals. I ask questions and give my emergency expertise when it is appropriate. My preceptor respects my 9 year experience as an emergency room nurse and he is always asking my opinion about the flow of the ED and ways to improve patient satisfaction. My preceptor has also shown me how to de-escalate situations and effectively communicate in group meetings.
2 personal objectives:
1. One of my personal objectives was to be able to identify the effectiveness of managerial decision making in health care settings. I have successfully observed the effectiveness of decision making by my preceptor on several occassions. We all know that emergency rooms can be chaotic because you never know what is going to happen and my preceptor actually has order to this chaotic department. His willingness to step in and help out in critical situations has actually increased the moral and attitude of the department. Everyone works together as a team and he is always ready to make split second decisions effectively.
For example, A patient presented to the ED with chest pain and there were no available beds. There were patients waiting to go the floor and the triage nurse was backed up as well. My preceptor immediately stepped in and assessed the chest pain patient, performed the ekg, and started taking the admit patients upstairs to create empty rooms for the patients in triage. The staff was very appreciative.
2. Another one of my personal objectives was to be able to familiarize myself with the clinical facility, personnel, policies, procedures, and the goals and philosophy of the agency by the end of the second week of clinicals. I actually met this goal the first week of clinicals. The staff has been very friendly and cooperative. Administration kindly acknowledge me when I go to meetings and my preceptor has shown me the policy and procedures in the ED, especially their Core Measures. DRMC is Commited to Excellence in Service and they use a team centered approach by collaborating with one another in order to increase patient safety and satisfaction.
For example, I attended a meeting with all of the directors of the hospital in regards to the flow of patients in the hospital and the reasons for delay. The directors received constructive criticism from one another and they respected each others opinion. They focused on a common vision to solve this problem and ended the meeting with a positive attitude to improve the flow of ED and improve patient care.
An overall review of your personal objectives and relection on how you have/have not accomplished them, support either with reasons and /or examples:
So far my clinical experience with my preceptor has been rewarding. I feel I have successfully accomplished most of my personal objectives as evidenced by the ones listed above. I have 16 more hours of clinicals because I have not been able to do 8 hour days. I am looking forward to completing my change project and my preceptor has been very supportive with my project.
Statement and discussion of one way these items have fostered your grown as a professional nurse.
I have learnt so much about leadership and the effectiveness of managerial decision making from my preceptor. I have been a staff nurse for 9 years and I never understood the decision making of certain managers, especially when it involved staffing. I know have the knowledge about understaffing and overstaffing as related to budgeting. I understand that leaders must be committed to their staff, loyal, respectful and communicate effectively. A leader must be an advocate for their staff. Just as the bedside nurse is the voice for their patients, the manager is the voice for their employees. I feel this class as empowered me to be a better nurse and to continue my education as a nurse professional. I am going to pursue my master's degree and maybe even my doctorate degree. I may even want to go into management one day. This has truly been a wonderful experience.
Statement and discussion of one way these items have fostered your growth as a professional nurse.
2 clinical course objectives:
1. Leadership skills-I feel I have met this goal because of the knowledge and wisdom that has been passed on to me by my preceptor. My preceptor has truly inspired me to be a great leader. I have learned that effective leadership involves loyalty, respect, trust, and effective listening. A leader must be self motivated and committed to whatever change or situation that takes place in their department. An effective leader also motivates, educates, and empowers others to see that vision and give them opportunities to express their feelings about the change.
For example, The ED department at DRMC is currently trying to be a level 3 trauma center and in order for them to achieve this goal, they must first be up to date and compliant with the trauma documentation. My preceptor has educated the staff on the items that are being overlooked or not documented like hourly vital signs. He posts the trauma checklist on all the computers to remind the staff. He also offers suggestions in ways to keep improvement and encourages feedback. He also recognizes champions who are documenting 100% in front of their peers and ask those champions to assist him in helping the other staff members improve in their documentation. As a result of this effective leadership, they are currently 100% on their trauma documentation.
2. Communication-I feel I have met this goal because I effectively communicate with my preceptor during all my clinicals. I ask questions and give my emergency expertise when it is appropriate. My preceptor respects my 9 year experience as an emergency room nurse and he is always asking my opinion about the flow of the ED and ways to improve patient satisfaction. My preceptor has also shown me how to de-escalate situations and effectively communicate in group meetings.
2 personal objectives:
1. One of my personal objectives was to be able to identify the effectiveness of managerial decision making in health care settings. I have successfully observed the effectiveness of decision making by my preceptor on several occassions. We all know that emergency rooms can be chaotic because you never know what is going to happen and my preceptor actually has order to this chaotic department. His willingness to step in and help out in critical situations has actually increased the moral and attitude of the department. Everyone works together as a team and he is always ready to make split second decisions effectively.
For example, A patient presented to the ED with chest pain and there were no available beds. There were patients waiting to go the floor and the triage nurse was backed up as well. My preceptor immediately stepped in and assessed the chest pain patient, performed the ekg, and started taking the admit patients upstairs to create empty rooms for the patients in triage. The staff was very appreciative.
2. Another one of my personal objectives was to be able to familiarize myself with the clinical facility, personnel, policies, procedures, and the goals and philosophy of the agency by the end of the second week of clinicals. I actually met this goal the first week of clinicals. The staff has been very friendly and cooperative. Administration kindly acknowledge me when I go to meetings and my preceptor has shown me the policy and procedures in the ED, especially their Core Measures. DRMC is Commited to Excellence in Service and they use a team centered approach by collaborating with one another in order to increase patient safety and satisfaction.
For example, I attended a meeting with all of the directors of the hospital in regards to the flow of patients in the hospital and the reasons for delay. The directors received constructive criticism from one another and they respected each others opinion. They focused on a common vision to solve this problem and ended the meeting with a positive attitude to improve the flow of ED and improve patient care.
An overall review of your personal objectives and relection on how you have/have not accomplished them, support either with reasons and /or examples:
So far my clinical experience with my preceptor has been rewarding. I feel I have successfully accomplished most of my personal objectives as evidenced by the ones listed above. I have 16 more hours of clinicals because I have not been able to do 8 hour days. I am looking forward to completing my change project and my preceptor has been very supportive with my project.
Statement and discussion of one way these items have fostered your grown as a professional nurse.
I have learnt so much about leadership and the effectiveness of managerial decision making from my preceptor. I have been a staff nurse for 9 years and I never understood the decision making of certain managers, especially when it involved staffing. I know have the knowledge about understaffing and overstaffing as related to budgeting. I understand that leaders must be committed to their staff, loyal, respectful and communicate effectively. A leader must be an advocate for their staff. Just as the bedside nurse is the voice for their patients, the manager is the voice for their employees. I feel this class as empowered me to be a better nurse and to continue my education as a nurse professional. I am going to pursue my master's degree and maybe even my doctorate degree. I may even want to go into management one day. This has truly been a wonderful experience.
Statement and discussion of one way these items have fostered your growth as a professional nurse.
Tuesday, October 20, 2009
Communication is the Key Journal 5
Well everyone,
I have done 8 hours of clinicals this week. The director started off his day as usual with checking his emails and voicemails. He also had to follow up with a couple of patients via telephone in regards to the care they received in the emergency room and questions regarding their bill. The manager has the responsibilty of maintaining staff and patient satisfaction. I also attended a "door to balloon" meeting yesterday. The Emergency Department is really progressing in their door to balloon time with their STEMI patients. This is the time it takes for the patient to go from the ED to the Cath Lab because we know that time is muscle.
Today, I attended a director's meeting. The meeting was lead by the ED medical director in reference to the increase in occurrence reports on patients that were sent to the floor. The ED medical director felt tha this could have been handled better with effective communication as opposed to writing occurrence reports. There were a series of barriers that ED was encountering from the floor in regards to admissions. Effective communication is one of the main qualities that a leader/manager should possess. Having a positive attitude is also another important quality of a leader because this can have a major affect on the attitude of the staff and can also affect patient satisfaction. Therefore, the medical director wanted to discuss the change of attitude amongst the different departments in the hospital. For example, the ED has an Angina Pathway implemented by the hospital that is being rejected by the medical floor because the nurses are saying that it doesn't meet criteria which is causing a major delay in patient flow and patient care. This has caused animosity amongst the hospital staff. The floor is stating that they don't do Chest Pain patients until they have 2 cleared troponins in the ED. The ED medical director stated that they are not admitting Chest Pain patients to the floor. For example if a patient is diagnosed with pneumonia and the patient has a history of CHF then they will order lasix and write the orders on the Angina Pathway. The problem seems to be the title of the orders which read Angina when admitting these patients. Another main issue is that if a patient goes to a floor that doesn't require that level of care then the hospital does not get paid. This is due to managed care by the insurance companies. The ED director stated that this past month ER patients stayed 1600 hours total in the ED waiting on admission beds. This can have a major impact on patient care. She believes that the departments need to have a common goal: the best quality patient care possible. The medical charge nurse stated the medical floor is med/oncology and the nurses on that floor does not have ACLS nor can they read EKG strips. The rest of the department managers seemed to be unaware of this. So they decided that education was one of the ways in solving this problem and decided to make this meeting a regular monthly meeting until this issue is resolved. The directors decided that they needed to move forward in a positive manner to improve flow of ED and improve care of the patients through education and communication. This was a very informative and productive meeting. It was good to see the directors respect each other, handle constructive criticism, and come together and collaborate with one another to come up with a common goal: Patient care.
I have done 8 hours of clinicals this week. The director started off his day as usual with checking his emails and voicemails. He also had to follow up with a couple of patients via telephone in regards to the care they received in the emergency room and questions regarding their bill. The manager has the responsibilty of maintaining staff and patient satisfaction. I also attended a "door to balloon" meeting yesterday. The Emergency Department is really progressing in their door to balloon time with their STEMI patients. This is the time it takes for the patient to go from the ED to the Cath Lab because we know that time is muscle.
Today, I attended a director's meeting. The meeting was lead by the ED medical director in reference to the increase in occurrence reports on patients that were sent to the floor. The ED medical director felt tha this could have been handled better with effective communication as opposed to writing occurrence reports. There were a series of barriers that ED was encountering from the floor in regards to admissions. Effective communication is one of the main qualities that a leader/manager should possess. Having a positive attitude is also another important quality of a leader because this can have a major affect on the attitude of the staff and can also affect patient satisfaction. Therefore, the medical director wanted to discuss the change of attitude amongst the different departments in the hospital. For example, the ED has an Angina Pathway implemented by the hospital that is being rejected by the medical floor because the nurses are saying that it doesn't meet criteria which is causing a major delay in patient flow and patient care. This has caused animosity amongst the hospital staff. The floor is stating that they don't do Chest Pain patients until they have 2 cleared troponins in the ED. The ED medical director stated that they are not admitting Chest Pain patients to the floor. For example if a patient is diagnosed with pneumonia and the patient has a history of CHF then they will order lasix and write the orders on the Angina Pathway. The problem seems to be the title of the orders which read Angina when admitting these patients. Another main issue is that if a patient goes to a floor that doesn't require that level of care then the hospital does not get paid. This is due to managed care by the insurance companies. The ED director stated that this past month ER patients stayed 1600 hours total in the ED waiting on admission beds. This can have a major impact on patient care. She believes that the departments need to have a common goal: the best quality patient care possible. The medical charge nurse stated the medical floor is med/oncology and the nurses on that floor does not have ACLS nor can they read EKG strips. The rest of the department managers seemed to be unaware of this. So they decided that education was one of the ways in solving this problem and decided to make this meeting a regular monthly meeting until this issue is resolved. The directors decided that they needed to move forward in a positive manner to improve flow of ED and improve care of the patients through education and communication. This was a very informative and productive meeting. It was good to see the directors respect each other, handle constructive criticism, and come together and collaborate with one another to come up with a common goal: Patient care.
Sunday, October 18, 2009
Journal 4
Well, unfortunately I was able to be with my preceptor this week. The days that I was available, he had to be the unit clerk on the floor and he had ACLS the other 2 days. He was very apologetic about not being available this week either, but I let him know that it was ok and I was looking forward to learning from him in the weeks to come. This gave me the opportunity to work on my change project. I have learned so much in this class. I understand how important communication is with my coworkers especially when I am in a leadership position. I know that as a leader I must have the right attitude because it can affect and infect my entire staff. A positive work environment means better quality care for the patients which is our ultimate outcome.
Sunday, October 11, 2009
Journal 3
Unfortunately, I did not have clinicals this week because my preceptor went out of town to an ENA conference. I have truly enjoyed my clinical experience thus far. Having the opportunity to actually shadow a nurse director and to be involved in management decision making as made me a stronger nurse. I can recall the characteristics of my last nurse manager and those characteristics did not reflect an effective leader. My preceptor is very positive and encouraging to his nursing staff. He is an effective communicator and listener which are all the qualities I would like to possess as a leader. Actually, when I think of leadership qualities, I think those are qualities that we should have regardless of our hired position. When you have a positive attitude and are able to communicate and listen to your peers, it truly creates a positive enviornment. I am looking forward to meeting with my preceptor this following week and obtaining new knowledge for my professional career.
Friday, October 2, 2009
2nd Week of Clinicals
Hello everyone,
I had a really productive week with my preceptor. I had the opportunity to attend an ER staff meeting on Tuesday. There were several initiatives discussed in the meeting. Some of them were the Door to Balloon time on STEMI patients. These are Cath Lab patients that are needing stents placed. DRMC's goal is 45 minutes and they actually had a door to balloon time of 28 minutes on Monday! That was exciting to hear. They are also implementing online scheduling. The staff can view the schedule on the internet, including in the privacy of the home. One of the biggest issues discussed was patient satisfaction scores. DRMC patient satisfaction score is currently below satisfaction and the new director (which is my preceptor) is actually implementing new ways new improve those scores. He discussed customer satisfaction, where the nurse acknowledges the patient by name when entering the room and then the nurse gives them their name, credentials, and years of experience. When patients are discharged the nurse thanks them for choosing DRMC in addition to giving them their discharge instructions. My preceptor stated there will be a lot of changes made in the ER department but they will be priortized and not done all at once. I also had the opportunity to assist my preceptor in done statistics paper on the ER holding patients and their holding time. It was quite interesting.
What I really admire about my preceptor is that he is a team player and a motivator. Due to the swine flu pandemic, the ER has been extremely busy. My preceptor was on the floor helping the nurses transport patients, putting triage patients into the computer, reassessing patients, etc. I have been an ER nurse for 9 years and I have never seen a director step in and help out the staff the way that he did. To give you another example, one of the nurses came to him and said they were out of cups and one of the patients was requesting some water. Instead of my preceptor delegating that task to someone, he told the nurse that he will go to the cafeteria and get some cups because the staff would be more useful staying in the ER to help the patients. I know this may sound like something minor but it spoke volume to me.
After interviewing my preceptor this week, I was sharing my thoughts about this course with my preceptor about how I am truly enjoying seeing the management side of nursing and it has really broaden my knowledge about why things are thing in the ER department (since I am an ER nurse) and the hospital organization. He stated that he had no clue about management and leadership when he graduated from the BSN program. He stated they only offered a leadership course and how he wish they offered clinicals for management in addition to the other clinicals. Looking forward to next week.
I had a really productive week with my preceptor. I had the opportunity to attend an ER staff meeting on Tuesday. There were several initiatives discussed in the meeting. Some of them were the Door to Balloon time on STEMI patients. These are Cath Lab patients that are needing stents placed. DRMC's goal is 45 minutes and they actually had a door to balloon time of 28 minutes on Monday! That was exciting to hear. They are also implementing online scheduling. The staff can view the schedule on the internet, including in the privacy of the home. One of the biggest issues discussed was patient satisfaction scores. DRMC patient satisfaction score is currently below satisfaction and the new director (which is my preceptor) is actually implementing new ways new improve those scores. He discussed customer satisfaction, where the nurse acknowledges the patient by name when entering the room and then the nurse gives them their name, credentials, and years of experience. When patients are discharged the nurse thanks them for choosing DRMC in addition to giving them their discharge instructions. My preceptor stated there will be a lot of changes made in the ER department but they will be priortized and not done all at once. I also had the opportunity to assist my preceptor in done statistics paper on the ER holding patients and their holding time. It was quite interesting.
What I really admire about my preceptor is that he is a team player and a motivator. Due to the swine flu pandemic, the ER has been extremely busy. My preceptor was on the floor helping the nurses transport patients, putting triage patients into the computer, reassessing patients, etc. I have been an ER nurse for 9 years and I have never seen a director step in and help out the staff the way that he did. To give you another example, one of the nurses came to him and said they were out of cups and one of the patients was requesting some water. Instead of my preceptor delegating that task to someone, he told the nurse that he will go to the cafeteria and get some cups because the staff would be more useful staying in the ER to help the patients. I know this may sound like something minor but it spoke volume to me.
After interviewing my preceptor this week, I was sharing my thoughts about this course with my preceptor about how I am truly enjoying seeing the management side of nursing and it has really broaden my knowledge about why things are thing in the ER department (since I am an ER nurse) and the hospital organization. He stated that he had no clue about management and leadership when he graduated from the BSN program. He stated they only offered a leadership course and how he wish they offered clinicals for management in addition to the other clinicals. Looking forward to next week.
Tuesday, September 22, 2009
First week of Clinicals
Hello everyone,
Well , I started clinicals yesterday at DRMC with S.D., the ER Director. We went over staffing for the emergency department and he explained how the ER is staffed on a daily basis. I also attended two meetings with him on yesterday. First, we met with the HR Director because there are a couple of employees who have been abusing the attendance policy. S.D. was Interim Director for a couple of weeks and was just offered the position full time on last Friday. He stated that the manager before him was very relaxed about the attendance policy and never address these issues with the employees. There are actually a couple of employees who should be fired based on their excessive absences and tardiness. The HR Director informed S.D. to have a meeting with the ER staff and advised them that they are all starting over on a clean slate with their attendance and the attendance policy will be in place effective immediately because it would not be fair to fire any employees regarding their attendance because the previous manager did not communicate this issue with them. I also had the opportunity to attend a trauma meeting. DRMC is actually trying to become a level 3 trauma center and the meeting involved the criteria for meeting level 3 requirements, including documentation.
Today, I had the opportunity to attend a performance improvement meeting. All of the directors from the various hospital units are required to present a performance improvement project. It was very interesting. The nurses presented data that was evidenced based. I learned a lot in this particular meeting. I must admit, prior to this meeting, I actually thought that statistics and the research class was a waste of time. I didn't think I would be using that information because I haven't in my 9 years of nursing. I am actually seeing a whole different side of nursing and I am excited about learning new information. I know this will make me a stronger, more confident nurse. Who knows, I may want to go into management after graduation. Well shall see.
Well , I started clinicals yesterday at DRMC with S.D., the ER Director. We went over staffing for the emergency department and he explained how the ER is staffed on a daily basis. I also attended two meetings with him on yesterday. First, we met with the HR Director because there are a couple of employees who have been abusing the attendance policy. S.D. was Interim Director for a couple of weeks and was just offered the position full time on last Friday. He stated that the manager before him was very relaxed about the attendance policy and never address these issues with the employees. There are actually a couple of employees who should be fired based on their excessive absences and tardiness. The HR Director informed S.D. to have a meeting with the ER staff and advised them that they are all starting over on a clean slate with their attendance and the attendance policy will be in place effective immediately because it would not be fair to fire any employees regarding their attendance because the previous manager did not communicate this issue with them. I also had the opportunity to attend a trauma meeting. DRMC is actually trying to become a level 3 trauma center and the meeting involved the criteria for meeting level 3 requirements, including documentation.
Today, I had the opportunity to attend a performance improvement meeting. All of the directors from the various hospital units are required to present a performance improvement project. It was very interesting. The nurses presented data that was evidenced based. I learned a lot in this particular meeting. I must admit, prior to this meeting, I actually thought that statistics and the research class was a waste of time. I didn't think I would be using that information because I haven't in my 9 years of nursing. I am actually seeing a whole different side of nursing and I am excited about learning new information. I know this will make me a stronger, more confident nurse. Who knows, I may want to go into management after graduation. Well shall see.
Friday, September 18, 2009
Ready for Clinicals
Well, I have had a productive 2 weeks with setting up my clincal hours. Last week I called the Emergency Department at Denton Regional Medical Center and I spoke with the ER Director, Scott in regards to my clinicals. He was more than happy to be my preceptor. Next I had to meet with the clinical educator to fill out hospital paperwork and a background check was required prior to me starting clinicals. It took approximately three days and everything came back fine. Today, I met with Scott for the first time to go over my hours and for him to sign the preceptor form. I finally faxed everything in (Praise God). Now I am ready to begin my clinicals on Monday. I am excited about this particular clinical because I will be exposed to a totally different area of nursing. Wish me luck. Have a great weekend everyone.
Wednesday, September 2, 2009
1st week of school
Hello everyone,
My name is Angela Anthony. I am 35 years old and have been an emergency room nurse for 10 years. This is the first week of school and i just wanted to create my first blog. I am so excited about graduating this semester. I also just had my first child last wednesday, so this semester is going to be challenging and rewarding for me. Everyone keep me in your prayers and I wish all of you much success in this course.
My name is Angela Anthony. I am 35 years old and have been an emergency room nurse for 10 years. This is the first week of school and i just wanted to create my first blog. I am so excited about graduating this semester. I also just had my first child last wednesday, so this semester is going to be challenging and rewarding for me. Everyone keep me in your prayers and I wish all of you much success in this course.
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