It seems to be common knowledge these days that employees at places like Google, Apple and other Silicon Valley success stories enjoy perks that many of us in the healthcare industry can only dream of. Even other companies---like biotechs and others---have learned that small perks can go a long way toward employee well-being and morale. Why don't we healthcare workers---who save lives every day---enjoy even a fraction of these sorts of benefits?
Friday, April 27, 2012
Sunday, April 22, 2012
A Speech for Graduate Nurses
Since this is the time of year when nursing students are preparing for their graduation and entry into our esteemed profession, I am choosing to republish a commencement speech that I delivered at Holyoke Community College on June 23rd of 2005 for my graduating LPN students for whom I had served as lecturer during their course of study. This post is the most popular ever published on Digital Doorway, and it has received over 5,000 pageviews since its first publication. Enjoy.
Tuesday, April 17, 2012
Self Compassion and Empathy
Last night on RN.FM Radio, nurse and well-known author Carol Gino spoke eloquently about the need for nurses to develop self compassion before they can truly experience empathy for their patients. She was so right.
Wednesday, April 11, 2012
Nurses Face the Wounds of War
In a surprising and welcome announcement, 450 nursing schools have pledged to improve and expand training for nurses and nursing students on the "invisible wounds of war", including Post-Traumatic Stress Disorder (PTSD), post-combat depression and Traumatic Brain Injury (TBI).
Tuesday, April 10, 2012
Happy Patients vs Healthy Patients
Recently, I published a blog post entitled "The Disneyfication of Nursing" wherein I examined the relatively new practice of "scripting" nurse-patient interactions, demanding that nurses communicate with patients in a specific manner.
The reality is that hospitals now want to provide care with an eye towards positive scores on patient satisfaction surveys upon which Medicare will soon begin basing some of their payments. While this is an understandable---yet short-sighted--reaction on the part of facilities that receive payments from Medicare, it is clear that there is a slippery slope that may very well backfire when it comes to achieving desired patient outcomes.
The reality is that hospitals now want to provide care with an eye towards positive scores on patient satisfaction surveys upon which Medicare will soon begin basing some of their payments. While this is an understandable---yet short-sighted--reaction on the part of facilities that receive payments from Medicare, it is clear that there is a slippery slope that may very well backfire when it comes to achieving desired patient outcomes.
Wednesday, April 04, 2012
Nursing Students and Self Care
Nursing school is a lot like boot camp. The student nurse is pushed to his or her limits, personal resolve is continually tested, students bond in their misery, and the majority come through the other side with new skills and a new career, perhaps a little worse for wear. But are they fully prepared---to care for themselves?
Wednesday, March 28, 2012
Nurses, Caring, and Oxygen Masks
Nurses are generally very good at caring for others, and many of us fall flat on our faces when it comes to caring for ourselves. So, aren't we going against the popular wisdom of the "oxygen mask theory" when we give and give without meeting our own needs?
Saturday, March 24, 2012
The Disneyfication of Nursing?
A recent article on Boston.com describes efforts by hospitals to offer specialized training to nurses in customer service and courtesy. According to some reports, many hospitals are hiring outside consultants in order to boost customer satisfaction surveys in response to Medicare's new ruling that they will begin basing a small percentage of payments to hospitals in accordance with facilities' "patient experience" scores.
Tuesday, March 20, 2012
Nurses Need Support
The more nurses I talk to, whether in my clinical nursing work or as a coach for nurses, it's increasingly obvious to me that nurses simply need support. While "Nurses Day" and the accompanying flowers, buttons and pens may be nice gestures, Nurses Day and other such celebrations would mean a whole lot more if meaningful support---not platitudes---were offered to nurses who so desperately need it.
Tuesday, March 13, 2012
Gender, Healthcare and Communication
Last night on RN.FM Radio during a discussion with Beth Boynton, the nurse author of "Confident Voices: The Nurses' Guide to Improving Communication and Creating Positive Workplaces", we touched on the subject of gender and its effects on communication. Countless books on communication between the sexes have been written---the ones most readily coming to mind being those by Deborah Tannen, including "You Just Don't Understand" and "That's Not What I Meant"---and I am keen to point out that there is currently no book on the market of which I am aware that specifically discusses the gender aspects of communication within healthcare.
Thursday, March 08, 2012
The Burden of Medical Bills
A recent study released by the CDC (and reported on Medscape and other sites) states the blunt fact that 20% of American households have difficulty paying their medical bills. And the National Center for Health Statistics states that 1 in 5 Americans has lived in a family that could not pay its medical bills in the last 12 months.
Wednesday, March 07, 2012
Tuesday, March 06, 2012
Is True Preventive Care a Reality?
Last night on RN.FM Radio, we were discussing the challenges of delivering true preventive care at a time when the economics of health care often seem to be moving us in the opposite direction. Mountains of research have shown that preventive medicine and interventions can dramatically decrease the cost of health care over time, but it seems that some insurance companies still don't bite the preventive medicine bait.
Saturday, February 04, 2012
On Retreat
Dear Readers,
In our coaching practices, my wife Mary and I consistently talk about the importance of self care and personal well-being, and how crucial this is for us to be most effective out in the world. Without self care, we can't be at our best, and our energy is dissipated and less powerful.
At this time, we are choosing as a couple to "walk our talk" by going on retreat ourselves. We are taking several weeks to rest and rejuvenate away from the workaday world, and we'll return on February 21st.
Until then, I send you my best, and wish you a Happy Valentine's Day. Many blessings to you and yours, now and always.
NurseKeith
In our coaching practices, my wife Mary and I consistently talk about the importance of self care and personal well-being, and how crucial this is for us to be most effective out in the world. Without self care, we can't be at our best, and our energy is dissipated and less powerful.
At this time, we are choosing as a couple to "walk our talk" by going on retreat ourselves. We are taking several weeks to rest and rejuvenate away from the workaday world, and we'll return on February 21st.
Until then, I send you my best, and wish you a Happy Valentine's Day. Many blessings to you and yours, now and always.
NurseKeith
Tuesday, January 31, 2012
Internet Radio for Nurses Takes Off!
Our newly birthed internet radio station for nurses---RN.FM Radio---is maturing into a reliable weekly source of inspiration, encouragement, interviews and nursing news that many nurses are flocking to every Monday evening at 9pm EST.
Thursday, January 19, 2012
Book Review: Davis's Drug Guide for Nurses, Twelfth Edition
As always, I begin my book reviews with the disclosure that I did not receive financial compensation of any kind for this review,
but did receive a free copy of this drug guide from Majors Books in order to facilitate the
review process.
--------
Some frequent readers of Digital Doorway will recall that I posted a review of the Nursing 2012 Drug Handbook on November 22nd of last year, and I was quite pleased with the overall layout and presentation of that particular drug guide for nurses. Since I happen to have both the Nursing 2012 Drug Guide and my review of said book in the forefront of my mind, the following review of Davis's Drug Guide for Nurses will be written as I take the differences and similarities between these two recently published drug guides for nurses into consideration.
General layout
The 12th edition of Davis's Drug Guide for Nurses appears to be extremely similar to its brethren, both in size, layout and general offerings.
Both Davis's guide and Nursing 2012 use almost the exact same color scheme for their drug monograph pages, with slight differences in font size and type. I find Nursing 2012 slightly easier on the eye in terms of font choice, but Davis's is also relatively readable without strain.
Drug monograph layout
Comparing drug monograph layout, there is generally little difference between these nursing drug guides, but I will take the time to elucidate several small differences which may or may not have a great impact on the user.
If we consider indications and dosages, I appreciate that Nursing 2012 combines both of these attributes of every drug at the beginning of each drug monograph, clearly delineating the pertinent details for both adults and children. Meanwhile, Davis's guide lists indications first and offers dosages and routes much later in each monograph. Personally, I prefer having the dosages and indications up front as soon as I begin reading about a drug, but the publishers and writers at Davis seem to feel that action, pharmacokinetics, contraindications and precautions, adverse reactions, side effects and interactions come first. I assume it is a matter of personal preference.
The Davis drug guide uses a red maple leaf symbol to specify medications that apply specifically to Canadian clinicians and nursing practice. This is a nice touch, and our Canadian brethren may very much appreciate this attention to detail on their behalf.
While Nursing 2012 uses boldly-lettered "Black Box Warnings" to indicate a warning that necessitates caution and attention, Davis prefers a red "High Alert" warning label.
Both books include the steps of the nursing process within the monographs, warnings regarding interactions of drugs with foods and herbs, and various aspects of IV medication administration.
Drug photographs
Many drug guides now offer photographs of commonly used medications, and this can be an invaluable tool for identification of medications and patient education. Nursing 2012 offers a photo guide to 396 common tablets and capsules. The photographs are full color, life-size, alphabetized, and located in the center of the book. The edges of the pages are shaded a different color so that this section can be handily and quickly utilized.
Davis's Drug Guide offers photographs only of medications with "Tall Man Lettering Changes" which have been recently mandated by the FDA. There are 33 medications with look-alike names and spellings which have now been changed to identify them and reduce confusion and medication errors. Examples of these "Tall Man" lettering changes are CycloSPORINE and CycloSERINE or GlipiZIDE and GlyBURIDE.
While having these mandated changes delineated clearly for readers is an excellent edition that Nursing 2012 lacks, having photographs of only 33 medications compared to the 396 medications displayed photographically in the Nursing 2012 Drug Handbook leaves little room for comparison. Nursing 2012 wins hands down for its use of photographic images.
Of note, the photographs of the "Tall Man" drugs in Davis's book are lumped together with other sections of special information. The edges of the pages of all of these special information sections are shaded with the same color, thus the pages of medication photographs are awkward to find and consequently less than handy.
Digital Offerings
The Davis guide comes with a CD -ROM (compatible with both PC and Mac) that offers an audio library of drug names, a drug search program, updated tutorials on medication errors, wound care and psychotropic drugs, as well as calculators for BMI, metric conversions, IV drip rates, and other features. There is also a free mobile device download of 100 drug monographs and resources available online at DavisPLUS.
Meanwhile, Nursing 2012 delivers access to an online drug advisor, patient teaching sheets, CEUs, as as well as detailed monographs of every drug listed in the book and some medications not included in the print version. This can all mostly be downloaded or viewed on a mobile device. Still, I feel it would behoove the publishers of Nursing 2012 to consider the addition of a CD-ROM in subsequent editions.
The Summing Up
For overall readability, layout and design, I definitely prefer the Nursing 2012 Drug Handbook over Davis's Drug Guide for Nurses, Twelfth Edition. Nursing 2012's inclusion of far more photographic images of medications and its slightly better font choices make it preferable for me, however Davis's inclusion of the CD-ROM, Canadian specifications and "Tall Man" lettering changes mandated by the FDA are also important features to consider.
These two guides are quite comparable, and both offer nurses the information they need in not dissimilar formats and designs. In terms of most of the differences, personal preference may be the deciding factor for many nurses. And for those enamored of the photographic images of drugs, Nursing 2012 is the best choice. Still, a prudent nurse cannot go wrong with either guide, and both will certainly lend themselves to safer care, fewer medication errors, and nurses who have the information they need at their fingertips.
------------
If any readers of Digital Doorway would like a 10% discount on the Davis Drug Guide from Majors Books, please use the code "nursekeith" when checking out. This offer is valid for 30 days. I receive no compensation for sales of this book through Majors Books. This is simply a gift to my readers from me, and a thank you from Majors Books for the review.
That said, the first commenter on this post who can tell me the name of two famous nursing theorists and their main theories of nursing will win a copy of Davis's Drug Guide for Nurses from me! The winner will be announced within the "comments" section, and that individual will need to send their mailing address to kc@nursekeith.com.
--------
Some frequent readers of Digital Doorway will recall that I posted a review of the Nursing 2012 Drug Handbook on November 22nd of last year, and I was quite pleased with the overall layout and presentation of that particular drug guide for nurses. Since I happen to have both the Nursing 2012 Drug Guide and my review of said book in the forefront of my mind, the following review of Davis's Drug Guide for Nurses will be written as I take the differences and similarities between these two recently published drug guides for nurses into consideration.
General layout
The 12th edition of Davis's Drug Guide for Nurses appears to be extremely similar to its brethren, both in size, layout and general offerings.
Both Davis's guide and Nursing 2012 use almost the exact same color scheme for their drug monograph pages, with slight differences in font size and type. I find Nursing 2012 slightly easier on the eye in terms of font choice, but Davis's is also relatively readable without strain.
Drug monograph layout
Comparing drug monograph layout, there is generally little difference between these nursing drug guides, but I will take the time to elucidate several small differences which may or may not have a great impact on the user.
If we consider indications and dosages, I appreciate that Nursing 2012 combines both of these attributes of every drug at the beginning of each drug monograph, clearly delineating the pertinent details for both adults and children. Meanwhile, Davis's guide lists indications first and offers dosages and routes much later in each monograph. Personally, I prefer having the dosages and indications up front as soon as I begin reading about a drug, but the publishers and writers at Davis seem to feel that action, pharmacokinetics, contraindications and precautions, adverse reactions, side effects and interactions come first. I assume it is a matter of personal preference.
The Davis drug guide uses a red maple leaf symbol to specify medications that apply specifically to Canadian clinicians and nursing practice. This is a nice touch, and our Canadian brethren may very much appreciate this attention to detail on their behalf.
While Nursing 2012 uses boldly-lettered "Black Box Warnings" to indicate a warning that necessitates caution and attention, Davis prefers a red "High Alert" warning label.
Both books include the steps of the nursing process within the monographs, warnings regarding interactions of drugs with foods and herbs, and various aspects of IV medication administration.
Drug photographs
Many drug guides now offer photographs of commonly used medications, and this can be an invaluable tool for identification of medications and patient education. Nursing 2012 offers a photo guide to 396 common tablets and capsules. The photographs are full color, life-size, alphabetized, and located in the center of the book. The edges of the pages are shaded a different color so that this section can be handily and quickly utilized.
Davis's Drug Guide offers photographs only of medications with "Tall Man Lettering Changes" which have been recently mandated by the FDA. There are 33 medications with look-alike names and spellings which have now been changed to identify them and reduce confusion and medication errors. Examples of these "Tall Man" lettering changes are CycloSPORINE and CycloSERINE or GlipiZIDE and GlyBURIDE.
While having these mandated changes delineated clearly for readers is an excellent edition that Nursing 2012 lacks, having photographs of only 33 medications compared to the 396 medications displayed photographically in the Nursing 2012 Drug Handbook leaves little room for comparison. Nursing 2012 wins hands down for its use of photographic images.
Of note, the photographs of the "Tall Man" drugs in Davis's book are lumped together with other sections of special information. The edges of the pages of all of these special information sections are shaded with the same color, thus the pages of medication photographs are awkward to find and consequently less than handy.
Digital Offerings
The Davis guide comes with a CD -ROM (compatible with both PC and Mac) that offers an audio library of drug names, a drug search program, updated tutorials on medication errors, wound care and psychotropic drugs, as well as calculators for BMI, metric conversions, IV drip rates, and other features. There is also a free mobile device download of 100 drug monographs and resources available online at DavisPLUS.
Meanwhile, Nursing 2012 delivers access to an online drug advisor, patient teaching sheets, CEUs, as as well as detailed monographs of every drug listed in the book and some medications not included in the print version. This can all mostly be downloaded or viewed on a mobile device. Still, I feel it would behoove the publishers of Nursing 2012 to consider the addition of a CD-ROM in subsequent editions.
The Summing Up
For overall readability, layout and design, I definitely prefer the Nursing 2012 Drug Handbook over Davis's Drug Guide for Nurses, Twelfth Edition. Nursing 2012's inclusion of far more photographic images of medications and its slightly better font choices make it preferable for me, however Davis's inclusion of the CD-ROM, Canadian specifications and "Tall Man" lettering changes mandated by the FDA are also important features to consider.
These two guides are quite comparable, and both offer nurses the information they need in not dissimilar formats and designs. In terms of most of the differences, personal preference may be the deciding factor for many nurses. And for those enamored of the photographic images of drugs, Nursing 2012 is the best choice. Still, a prudent nurse cannot go wrong with either guide, and both will certainly lend themselves to safer care, fewer medication errors, and nurses who have the information they need at their fingertips.
------------
If any readers of Digital Doorway would like a 10% discount on the Davis Drug Guide from Majors Books, please use the code "nursekeith" when checking out. This offer is valid for 30 days. I receive no compensation for sales of this book through Majors Books. This is simply a gift to my readers from me, and a thank you from Majors Books for the review.
That said, the first commenter on this post who can tell me the name of two famous nursing theorists and their main theories of nursing will win a copy of Davis's Drug Guide for Nurses from me! The winner will be announced within the "comments" section, and that individual will need to send their mailing address to kc@nursekeith.com.
Wednesday, January 18, 2012
Seven Years of Digital Doorway
Well, it may seem like a blink of an eye at times, but Digital Doorway has been alive and well for seven years today, born from a simple suggestion by my prescient brother as we sat in front of the woodstove on a snowy New England night. I can hardly believe that so much time has passed since that January day when I dived headfirst into the blogging world with no idea of where I was going or, honestly, what I was doing.
When Digital Doorway launched, it was not clear to me that it would be a blog mostly about nursing. Although my online moniker at the time was indeed "Nurse Keith", I had no notion of branding, hadn't heard of SEO (Search Engine Optimization), and the blogosphere was an enormous and cavernous unknown.
Over time, Digital Doorway began to distill itself into a somewhat more cohesive entity, and 1520 posts later, it has become one of the more well-known blogs in the nursing blogosphere,. Yes, it's garnered a fair amount of attention and notoriety over time, although it's still somewhat small potatoes compared to the blogging giants out there. (You know who you are!)
Back in the day, I didn't know about keywords and never gave much thought to such things. In all actuality, I still don't write my posts with keywords in mind, and I just let my blog's relative influence online do the job. However, with hundreds of backlinks that point here to Digital Doorway, it's a given that my writing will have a moderate audience out there in blogland. That said, with my new mentors, colleagues and friends over at RN.FM Radio, keywords, SEO and such animals are now making their way into my lexicon and writing practice, and as we grow RN.FM Radio and its cousin LLC, Unbound Media Group, our presence online as coaches, bloggers and nurse entrepreneurs is sure to grow. And no doubt that Digital Doorway will itself benefit from that vertical and horizontal expansion.
As NurseKeith.com continues its slow and steady launch, Digital Doorway is becoming the repository of much more focused thoughts on nursing, the profession's present and future, new books on nursing. and the impact that coaching can have on nurses' lives, among other topics of note. I look forward to continuing to deliver quality content that's informative, timely, and easy to read (and perhaps periodically entertaining).
Thank you for supporting Digital Doorway. Thanks for reading, thanks for the many comments, for following me on Facebook and Twitter, and for the encouraging words I've received since launching NurseKeith.com.
Yes, it's been a long, strange trip, and I have a feeling 2012 will be no different. Come along for the ride, and let's see what the next seven years brings!
When Digital Doorway launched, it was not clear to me that it would be a blog mostly about nursing. Although my online moniker at the time was indeed "Nurse Keith", I had no notion of branding, hadn't heard of SEO (Search Engine Optimization), and the blogosphere was an enormous and cavernous unknown.
Over time, Digital Doorway began to distill itself into a somewhat more cohesive entity, and 1520 posts later, it has become one of the more well-known blogs in the nursing blogosphere,. Yes, it's garnered a fair amount of attention and notoriety over time, although it's still somewhat small potatoes compared to the blogging giants out there. (You know who you are!)
Back in the day, I didn't know about keywords and never gave much thought to such things. In all actuality, I still don't write my posts with keywords in mind, and I just let my blog's relative influence online do the job. However, with hundreds of backlinks that point here to Digital Doorway, it's a given that my writing will have a moderate audience out there in blogland. That said, with my new mentors, colleagues and friends over at RN.FM Radio, keywords, SEO and such animals are now making their way into my lexicon and writing practice, and as we grow RN.FM Radio and its cousin LLC, Unbound Media Group, our presence online as coaches, bloggers and nurse entrepreneurs is sure to grow. And no doubt that Digital Doorway will itself benefit from that vertical and horizontal expansion.
As NurseKeith.com continues its slow and steady launch, Digital Doorway is becoming the repository of much more focused thoughts on nursing, the profession's present and future, new books on nursing. and the impact that coaching can have on nurses' lives, among other topics of note. I look forward to continuing to deliver quality content that's informative, timely, and easy to read (and perhaps periodically entertaining).
Thank you for supporting Digital Doorway. Thanks for reading, thanks for the many comments, for following me on Facebook and Twitter, and for the encouraging words I've received since launching NurseKeith.com.
Yes, it's been a long, strange trip, and I have a feeling 2012 will be no different. Come along for the ride, and let's see what the next seven years brings!
Sunday, January 15, 2012
NurseFriendly on RN.FM Radio!
Just a reminder that tomorrow, January 16th, 2012, Andrew Lopez of Nursefriendly.com will be our guest on RN.FM Radio. Andrew is the consummate connector and promoter of nurses, and we look forward to his appearance on RN.FM Radio! Tune in or listen to the archived show afterwards.
Also, please take a peek at our new RN.FM Radio website! It's growing by the day!
"See" you there!
Wednesday, January 11, 2012
Book Review: "Confident Voices" by Beth Boynton
A note to the reader: As always, I have received no remuneration for
posting this book review. As a point of disclosure, I did, however,
receive a free copy of the book from the author in order to facilitate
the review process.
"Confident Voices: The Nurse's Guide to Improving Communication and Creating Positive Workplaces", was published in 2009 by Beth Boynton, RN, MS and edited by Bonnie Kerrick, RN, BSN.
Summary
In Confident Voices, Boynton strives to give nurses the understanding and skills to navigate the workplace in a way that fosters improved communication, healthier workplaces and a more supportive and safe environment for them and their colleagues. Boynton achieves her goal, and delivers information that is useful, well-organized, easy to digest, and potentially possible to put into practice immediately.
The book walks the reader through three distinct sections covering various topics of interest to the nurse who wishes to work in an environment that supports positive relationships and respectful communication.
Part I addresses workplace dynamics, and identifies the characteristics of toxic workplaces, and delves into theories that explain human behavior, especially in the context of the workplace. Organizational culture is explained and dissected, and workplace violence---be it physical, verbal or emotional---is also addressed.
Part II is focused on "building assertiveness and respectful listening skills" and explores "strategies for creating organizational cultures where effective communication and respectful relationships can thrive".
Part III integrates the theories, insights and skills covered in Parts I and II in the context of nurses' experiences which were gleaned from interviews with nurses in the field. Common toxic behaviors are described and various revisions of the encounters in question are offered as examples of improved communication and healthier outcomes for all involved.
Discussion
Toxicity in the workplace is an important subject rarely given its due, and Boynton succeeds in communicating her mission clearly in this very useful book. We all know that the health care system is suffering from various forms of overload and dysfunction, and the result for nurses is that we often feel powerless in the face of old patriarchal systems of organization, entrenched methods of communication, and hierarchical relationships that apparently strip us of our power and leave us literally speechless in the face of workplace violence, bullying, top-down management, and organizational failure.
Boynton gives nurses concrete examples of common situations wherein nurses can practice their assertiveness and respectful communication skills. She also provides practical tools for nurses within a theoretical framework that takes into consideration the characteristics of toxic workplaces, the ways in which workplace violence impacts nurses, and how effective communication can cut through the static to a place of greater clarity, personal empowerment, and professional satisfaction.
In a future edition of "Confident Voices", I would like to see the author make use of a more diverse selection of real-life scenarios in order to address potential gender and power issues that her examples fail to take into consideration.
Suggestions
The nurse interviews used in the book to illustrate Boynton's thesis all feature female nurses who are interacting with male physicians in the hospital setting. While this gender dynamic may be common (and may be a deeply and culturally embedded knee-jerk reaction when we think of "nurse and doctor") there are now a plethora of female physicians working alongside male nurses, and male nurses working alongside male physicians.
Additionally, it would be interesting to explore workplace dynamics when we consider male and female nurses working together, as well as combinations of male nurses alongside male nurses, and female nurses collaborating with female doctors. It could also be enlightening to explore the dynamics of workplace violence, bullying and communication when considering comparisons between male and female supervisors and administrators, and the ways in which gender differences impact communication in health care. Several books have been written about the effects of feminism on the nursing profession, most notably "Daring to Care: American Nursing and Second-Wave Feminism" by Susan Gelfand Malka. Perhaps an exploration combining the effects of feminism on nursing and changes in communication would be an interesting follow up to "Confident Voices".
Within "Confident Voices", Boynton also does not address cultural, ethnic and racial differences in communication that could greatly impact nurses and those who work in health care institutions. Asians, Native Americans, Hispanics and other groups may have cultural practices and norms vis-a-vis communication that differ widely from white American culture. From eye contact to body language, communication in the workplace also needs to take these differences into consideration.
My Recommendation
Overall, I would highly recommend "Confident Voices" to any nurse who wishes to improve his or her own communication skills, share those skills with colleagues, and attempt to understand organizational culture with an eye towards creating positive workplaces for all concerned.
On the Radio
Beth Boynton will be appearing as a guest on RN.FM Radio: Nursing Unleashed on March 12th, 2012 at 9pm EST. Please tune in and you will be able to call into the show and ask Beth questions about her work as a nurse, writer, and workplace communication expert.
--------------
"Confident Voices: The Nurse's Guide to Improving Communication and Creating Positive Workplaces", was published in 2009 by Beth Boynton, RN, MS and edited by Bonnie Kerrick, RN, BSN.
Summary
In Confident Voices, Boynton strives to give nurses the understanding and skills to navigate the workplace in a way that fosters improved communication, healthier workplaces and a more supportive and safe environment for them and their colleagues. Boynton achieves her goal, and delivers information that is useful, well-organized, easy to digest, and potentially possible to put into practice immediately.
The book walks the reader through three distinct sections covering various topics of interest to the nurse who wishes to work in an environment that supports positive relationships and respectful communication.
Part I addresses workplace dynamics, and identifies the characteristics of toxic workplaces, and delves into theories that explain human behavior, especially in the context of the workplace. Organizational culture is explained and dissected, and workplace violence---be it physical, verbal or emotional---is also addressed.
Part II is focused on "building assertiveness and respectful listening skills" and explores "strategies for creating organizational cultures where effective communication and respectful relationships can thrive".
Part III integrates the theories, insights and skills covered in Parts I and II in the context of nurses' experiences which were gleaned from interviews with nurses in the field. Common toxic behaviors are described and various revisions of the encounters in question are offered as examples of improved communication and healthier outcomes for all involved.
Discussion
Toxicity in the workplace is an important subject rarely given its due, and Boynton succeeds in communicating her mission clearly in this very useful book. We all know that the health care system is suffering from various forms of overload and dysfunction, and the result for nurses is that we often feel powerless in the face of old patriarchal systems of organization, entrenched methods of communication, and hierarchical relationships that apparently strip us of our power and leave us literally speechless in the face of workplace violence, bullying, top-down management, and organizational failure.
Boynton gives nurses concrete examples of common situations wherein nurses can practice their assertiveness and respectful communication skills. She also provides practical tools for nurses within a theoretical framework that takes into consideration the characteristics of toxic workplaces, the ways in which workplace violence impacts nurses, and how effective communication can cut through the static to a place of greater clarity, personal empowerment, and professional satisfaction.
In a future edition of "Confident Voices", I would like to see the author make use of a more diverse selection of real-life scenarios in order to address potential gender and power issues that her examples fail to take into consideration.
Suggestions
The nurse interviews used in the book to illustrate Boynton's thesis all feature female nurses who are interacting with male physicians in the hospital setting. While this gender dynamic may be common (and may be a deeply and culturally embedded knee-jerk reaction when we think of "nurse and doctor") there are now a plethora of female physicians working alongside male nurses, and male nurses working alongside male physicians.
Additionally, it would be interesting to explore workplace dynamics when we consider male and female nurses working together, as well as combinations of male nurses alongside male nurses, and female nurses collaborating with female doctors. It could also be enlightening to explore the dynamics of workplace violence, bullying and communication when considering comparisons between male and female supervisors and administrators, and the ways in which gender differences impact communication in health care. Several books have been written about the effects of feminism on the nursing profession, most notably "Daring to Care: American Nursing and Second-Wave Feminism" by Susan Gelfand Malka. Perhaps an exploration combining the effects of feminism on nursing and changes in communication would be an interesting follow up to "Confident Voices".
Within "Confident Voices", Boynton also does not address cultural, ethnic and racial differences in communication that could greatly impact nurses and those who work in health care institutions. Asians, Native Americans, Hispanics and other groups may have cultural practices and norms vis-a-vis communication that differ widely from white American culture. From eye contact to body language, communication in the workplace also needs to take these differences into consideration.
My Recommendation
Overall, I would highly recommend "Confident Voices" to any nurse who wishes to improve his or her own communication skills, share those skills with colleagues, and attempt to understand organizational culture with an eye towards creating positive workplaces for all concerned.
On the Radio
Beth Boynton will be appearing as a guest on RN.FM Radio: Nursing Unleashed on March 12th, 2012 at 9pm EST. Please tune in and you will be able to call into the show and ask Beth questions about her work as a nurse, writer, and workplace communication expert.
Monday, January 09, 2012
RN.FM Radio Launches Today!
Today, on Monday the 9th of January, 2012 at 9pm EST, RN.FM Radio will launch its inaugural broadcast on Blog Talk Radio. RN.FM Radio is the newest voice to emerge vis-a-vis the cutting edge of the nursing profession, and RN.FM Radio will bring to the airwaves the most diverse mix of entrepreneurs, bloggers, coaches, writers and thought leaders within the nursing community.
The show will be hosted by myself, as well as Anna Morrison of I Coach Nurses, and Kevin Ross of Innovative Nurse. As nurse entrepreneurs, our mission is to forge a new vision of nursing and what it means to be a nurse in the 21st century.
Upcoming guests will include:
*Andrew Lopez of NurseFriendly.com on January 16th
*Laurel Lewis, Hospice Nurse and host of Death and Dying Dinner Parties in the Los Angeles area on January 23rd
*Annette Tersigni, The Yoga Nurse on January 30th
........and many more thought-provoking and inspiring nurses!
Please tune in tonight, January 9th at 9pm EST on Blog Talk Radio, or listen to the archived shows afterwards. All shows will include the opportunity for listeners to call in and offer questions or comments, or participate in live chats with other listeners.
Please watch for the launch of our website, RNFMRadio.com, and you can also connect with us on Facebook and Twitter!
RN.FM Radio is the new voice of nursing. Join us as we forge a new vision of nursing in the 21st century!
The show will be hosted by myself, as well as Anna Morrison of I Coach Nurses, and Kevin Ross of Innovative Nurse. As nurse entrepreneurs, our mission is to forge a new vision of nursing and what it means to be a nurse in the 21st century.
Upcoming guests will include:
*Andrew Lopez of NurseFriendly.com on January 16th
*Laurel Lewis, Hospice Nurse and host of Death and Dying Dinner Parties in the Los Angeles area on January 23rd
*Annette Tersigni, The Yoga Nurse on January 30th
........and many more thought-provoking and inspiring nurses!
Please tune in tonight, January 9th at 9pm EST on Blog Talk Radio, or listen to the archived shows afterwards. All shows will include the opportunity for listeners to call in and offer questions or comments, or participate in live chats with other listeners.
Please watch for the launch of our website, RNFMRadio.com, and you can also connect with us on Facebook and Twitter!
RN.FM Radio is the new voice of nursing. Join us as we forge a new vision of nursing in the 21st century!
Tuesday, January 03, 2012
National Nurse Act of 2011 Signatory Letter
The following letter is being sent to all members of Congress to enlist their support of The National Nurse Act of 2011. If you would like to be a signatory to this letter, please contact Terri Mills, President of the
National Nursing Network Organization, whose contact information is listed below.
-----
To The Members of the United States Congress:
We,
the undersigned, urge you to support HR 3679 The
National Nurse Act of 2011. This legislation
would designate the Chief Nurse Officer of the U.S. Public Health Services
as the "National Nurse for Public Health" to elevate the authority
and visibility of this position. Chronic conditions such as diabetes, asthma,
obesity, and others pose the single greatest threat to the health of Americans
and our nation's economy. Nurses provide key services for the prevention and
management of these conditions and this legislation is necessary
to support further work needed to promote prevention, improve
outcomes, and guide national, state and local efforts in addressing
the nation's health.
This
is the ideal time to make a National Nurse for Public Health a reality.
The current administration and Congress have a clear commitment to wellness
promotion and illness prevention. There is convincing evidence that the
health of our country can be dramatically advanced by deploying our greatest
and most trusted national health resource, America's nurses. Establishing a
National Nurse for Public Health would be a practical step forward in publicly
acknowledging the need for a focus on wellness and prevention.
This legislation would provide the nation with
a trusted professional representative from nursing to kickoff
the move to prevention in whatever form of health-care system our
lawmakers deliver.
The
National Nurse for Public Health would provide a visible nurse leader to
advocate for enhanced prevention efforts for all communities. Further, we
recognize the potential of having the National Nurse for Public Health as a
representative who would meet with health care leaders
to determine ways to address continued health disparities and
poor health literacy.
We,
as organizations and individuals, support this legislation as a means to
achieve the goals of better health, decreased health disparity and improved health
literacy and look forward to working with you on this important issue. We
applaud your efforts in highlighting the important contribution of nurses
and in your advocacy of improvement of the nation’s health. We strongly
urge your support of The National Nurse Act of 2011.
Thank you for your consideration and please call upon us if we
can be of further support as this bill moves forward.
Teri
Mills MS, RN, CNE
President
National Nursing Network Organization
503-320-2385
Monday, January 02, 2012
What We Leave at the Door
As nurses, when we are preparing to walk into an exam room, a hospital room, or a patient's home, we bring with us a veritable toolbox of skills, ranging from biopsychosocial analysis to keen physical assessment skills. We are trained to look at the whole patient, the family system, and the multifaceted aspects of patients' lives.
However, we can also walk through that door with judgments, suspicions, preconceived beliefs, fears, projections, and a host of other "baggage" that may or may not serve the therapeutic relationship---nor our patient's chances of healing.
In my own work, I have witnessed patients and their families engaged in drug addiction, prostitution, child neglect, elder abuse, financial exploitation, and numerous other social conditions or actions that could often make my skin crawl. I also witnessed patients simply making poor choices, living in squalid conditions, refusing treatment, and otherwise choosing chaos over order, illness over health, and hell over healing.
When possible and necessary, I would intervene, and sometimes that meant calling the police or the local protective service organization. Sometimes it meant just listening and trying to get to the root of the behavior. At others, it was a call to a therapist, a psychiatrist, or a drug counselor.
No matter the situation, we health care providers bring to the situation our own life experiences, our own traumas, and a unique personal history. In this line of work, transference and projection are not just quaint vocabulary terms memorized during a requisite Psych 101 class, and if you're a nurse and you can't tell me what projection and transference are, then it's time to do some brushing up. (Perhaps that Psych 101 textbook is still in your garage somewhere.)
No matter where you are in the course of your career, you are subject to the same psychological forces as a novice nurse, and at times it is exactly our experience as seasoned nurses that can harm us the most. Cynicism, jadedness, and a sense of "I've seen it all before" can actually get in the way of our seeing the patient for who they are in the first place, so looking beyond our experience with fresh eyes and an open heart can work wonders for actually "seeing" the patient or situation in front of our very noses.
Before you walk in that door, think about what it is that you bring to the therapeutic relationship and the situaton at hand. What is the baggage that might get in the way? What are the stresses and worries from outside of work that need to be set aside? And once you're in that room, keep a sharp eye out for those projections, that sneaky transference, and the judgments that undermine your ability to be objective and most clinically effective.
And remember to ask yourself: What am I bringing to this encounter? What are the skills that I most need to activate at this time? And what do I need to leave outside that door?
However, we can also walk through that door with judgments, suspicions, preconceived beliefs, fears, projections, and a host of other "baggage" that may or may not serve the therapeutic relationship---nor our patient's chances of healing.
In my own work, I have witnessed patients and their families engaged in drug addiction, prostitution, child neglect, elder abuse, financial exploitation, and numerous other social conditions or actions that could often make my skin crawl. I also witnessed patients simply making poor choices, living in squalid conditions, refusing treatment, and otherwise choosing chaos over order, illness over health, and hell over healing.
When possible and necessary, I would intervene, and sometimes that meant calling the police or the local protective service organization. Sometimes it meant just listening and trying to get to the root of the behavior. At others, it was a call to a therapist, a psychiatrist, or a drug counselor.
No matter the situation, we health care providers bring to the situation our own life experiences, our own traumas, and a unique personal history. In this line of work, transference and projection are not just quaint vocabulary terms memorized during a requisite Psych 101 class, and if you're a nurse and you can't tell me what projection and transference are, then it's time to do some brushing up. (Perhaps that Psych 101 textbook is still in your garage somewhere.)
No matter where you are in the course of your career, you are subject to the same psychological forces as a novice nurse, and at times it is exactly our experience as seasoned nurses that can harm us the most. Cynicism, jadedness, and a sense of "I've seen it all before" can actually get in the way of our seeing the patient for who they are in the first place, so looking beyond our experience with fresh eyes and an open heart can work wonders for actually "seeing" the patient or situation in front of our very noses.
Before you walk in that door, think about what it is that you bring to the therapeutic relationship and the situaton at hand. What is the baggage that might get in the way? What are the stresses and worries from outside of work that need to be set aside? And once you're in that room, keep a sharp eye out for those projections, that sneaky transference, and the judgments that undermine your ability to be objective and most clinically effective.
And remember to ask yourself: What am I bringing to this encounter? What are the skills that I most need to activate at this time? And what do I need to leave outside that door?
Saturday, December 31, 2011
Nurse Keith Coaching is Born!
In the last few days, my new website and coaching venture was officially birthed! Nurse Keith Coaching is now live, and the process of making it a reality has paid off! There has been a great deal of support from my community of friends, family and colleagues. Now the task is spreading the word that I am now available to provide professional coaching for nurses and nursing students who want more out of their lives and their careers.
As I say on my website:
As nurses, we spend a great deal of time caring for others and precious little time caring for ourselves. Our work can be all consuming, and in that process we can easily lose touch with our own health, happiness, and sense of balance. Toxic workplaces, heavy workloads, stressful work conditions, mandatory overtime and unhappy, cynical colleagues can all leave us feeling undermined in our attempts to be healthy and happy in our work and at home.
Nurses are caregivers, but we can only provide the best care when we are also taking care of ourselves properly. Exercise, nutrition, weight loss, stress management, leisure and fun, work-life balance, spirituality, financial prudence, relationships—all of these aspects of our lives impact our ability to be at our best when we engage in our work.
My skills allow me to hold space for where you currently are in your life, but also to challenge you to dig deeper and find the places where you still want to grow.
So, please stop by NurseKeith.com, visit and "Like" my Facebook page, and let me know how I might be of service to you.
As I say on my website:
As nurses, we spend a great deal of time caring for others and precious little time caring for ourselves. Our work can be all consuming, and in that process we can easily lose touch with our own health, happiness, and sense of balance. Toxic workplaces, heavy workloads, stressful work conditions, mandatory overtime and unhappy, cynical colleagues can all leave us feeling undermined in our attempts to be healthy and happy in our work and at home.
Nurses are caregivers, but we can only provide the best care when we are also taking care of ourselves properly. Exercise, nutrition, weight loss, stress management, leisure and fun, work-life balance, spirituality, financial prudence, relationships—all of these aspects of our lives impact our ability to be at our best when we engage in our work.
My skills allow me to hold space for where you currently are in your life, but also to challenge you to dig deeper and find the places where you still want to grow.
So, please stop by NurseKeith.com, visit and "Like" my Facebook page, and let me know how I might be of service to you.
Tuesday, December 27, 2011
Nursing and Transformation in the New Year
As the dawn of 2012 beckons, I hold a new vision for the nursing profession.
Along with the rest of large segments of humanity, nurses are waking up. Nurses are realizing that the old paradigms no longer apply, and that the vestiges of Old World thinking (when it comes to nursing and medicine) are dying as we speak. Health care must be transformed, and since nurses are the largest segment of the American health care industry (and perhaps in the world), we nurses could indeed "occupy" health care in a way that could potentially turn the entire industry on its head. The political will of nurses will be tested, and I am encouraged by the rumblings that I hear as I put my ear to the virtual tracks.
Contrary to popular images propagated by the media (in Hollywood, television, the news, and other sources), nurses are not handmaidens to doctors, sex kittens in white uniforms, or background characters who simply serve as foils to George Clooney and other TV doctors. (Although we may notice on close inspection that only actors who play doctors on shows such as "ER" ever seem to move into the limelight.) Nurses are more than this, whether the media wish to portray us realistically or not.
As usual, nurses have ranked as the most trusted professionals in the United States yet again in the most recent Gallup poll. This is the 12th time out of 13 years that nurses have earned this honor from the American people. The only occasion when nurses were not the number one most trusted professionals was in 2001 when firefighters earned that top spot following their heroic efforts in the aftermath of the September 11th terrorist attacks.
From my own perspective, one way for nurses to be more effective is to be more vigilant in their own self care. That's why I have decided to offer my own coaching services for nurses to assist them in living the healthiest and most satisfying lives possible. Nurses can impact the health care industry when they are healthy and balanced. Thus, preventing burnout and adopting a healthy lifestyle can have a far reaching impact on patients, fellow nurses, other colleagues, and beyond.
I am proud to be a nurse, and I can see that the nursing industry is still in it infancy when it comes to embracing change, championing that change, and subverting the dominant paradigms that keep nurses and nursing care relegated to the past rather than focused on the future. Still, I'm hopeful, optimistic and looking forward to the ways in which nursing---and the world at large---will transform in 2012. These are momentous times, and we have only seen the tip of the iceberg as Americans---and people all over the world---wake up to the many disparities that are crying out for transformation. Nurses can lead the way in health care, and I hope to be part of the actions and conversations that bring that transformation into being.
Along with the rest of large segments of humanity, nurses are waking up. Nurses are realizing that the old paradigms no longer apply, and that the vestiges of Old World thinking (when it comes to nursing and medicine) are dying as we speak. Health care must be transformed, and since nurses are the largest segment of the American health care industry (and perhaps in the world), we nurses could indeed "occupy" health care in a way that could potentially turn the entire industry on its head. The political will of nurses will be tested, and I am encouraged by the rumblings that I hear as I put my ear to the virtual tracks.
Contrary to popular images propagated by the media (in Hollywood, television, the news, and other sources), nurses are not handmaidens to doctors, sex kittens in white uniforms, or background characters who simply serve as foils to George Clooney and other TV doctors. (Although we may notice on close inspection that only actors who play doctors on shows such as "ER" ever seem to move into the limelight.) Nurses are more than this, whether the media wish to portray us realistically or not.
As usual, nurses have ranked as the most trusted professionals in the United States yet again in the most recent Gallup poll. This is the 12th time out of 13 years that nurses have earned this honor from the American people. The only occasion when nurses were not the number one most trusted professionals was in 2001 when firefighters earned that top spot following their heroic efforts in the aftermath of the September 11th terrorist attacks.
From my own perspective, one way for nurses to be more effective is to be more vigilant in their own self care. That's why I have decided to offer my own coaching services for nurses to assist them in living the healthiest and most satisfying lives possible. Nurses can impact the health care industry when they are healthy and balanced. Thus, preventing burnout and adopting a healthy lifestyle can have a far reaching impact on patients, fellow nurses, other colleagues, and beyond.
I am proud to be a nurse, and I can see that the nursing industry is still in it infancy when it comes to embracing change, championing that change, and subverting the dominant paradigms that keep nurses and nursing care relegated to the past rather than focused on the future. Still, I'm hopeful, optimistic and looking forward to the ways in which nursing---and the world at large---will transform in 2012. These are momentous times, and we have only seen the tip of the iceberg as Americans---and people all over the world---wake up to the many disparities that are crying out for transformation. Nurses can lead the way in health care, and I hope to be part of the actions and conversations that bring that transformation into being.
Wednesday, December 21, 2011
RN.FM Radio is Coming!
On January 9th, 2012, several esteemed nurse entrepreneurs and I will officially launch RN.FM Radio: Nursing Unleashed, a new internet radio station on Blog Talk Radio!
Our
mission is to shake up the nursing profession and blow the roof
off of the idea of a nurse as just a humble bedside servant. We're here
to prove that you can be a nurse, be ultra-savvy and innovative, make a
huge difference in patients' and other healthcare providers' lives, and
improve your own life and experience of the profession of nursing, all
at the same time.
We want to support bedside nurses in
re-engaging their creativity and innovation to generate solutions to
today's complex healthcare challenges, thereby improving patient and
healthcare provider experience, while also elevating their own status,
well-being and income as business owners and entrepreneurs.
RN.FM Radio will be hosted by Kevin Ross of Innovative Nurse, Anna Morrison of I Coach Nurses, and yours truly. I am so lucky to be collaborating with these two nurse entrepreneur and blogger powerhouses!
Our inaugural broadcast will air at 9pm EST on Monday, January 12th, 2012 and every Monday thereafter. We plan to feature engaging and lively interviews with prominent nurse entrepreneurs, bloggers, writers, researchers, activists and thought leaders from the nursing world.
You can find us on Facebook, follow us on Twitter, or join us on Monday evenings (or listen to our podcasts and archived shows) beginning January 9th as we forge a new vision of the future of nursing! See you there!
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