Tag Archives: Nurses

Corporate America Nurse …What Changes Can You Expect

When a nurse is working in corporate America, changes are bound to be evident, from what the nurse was used to at the hospital.  When nurses take on the this role, they have higher skill sets in the business world than in the clinical world since they do not practice and they may not feel confident providing care. The role of a nurse manager in the clinical setting when she is managing the business aspect can be very confusing for nurses.  This is because their training is that of a nurse and possibly they received their MBA to manage an office, however when put in a clinical situation, due to less involvement clinically, they lose their clinical awareness.

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In some places, there are many nurse managers that are in this manager role and there is very little clinical involvement.  The clinical they may get to do as a manager is when they go out in the field quarterly with staff or when they do chart audits.  Some nurses  maintain their  clinical skills because they choose to be more involved in their staff’s patients, looking at their diagnosis and medications right along with the staff to be able to keep up with what is changing medically.  Some managers are quite content with the non-nursing role.

This makes it very difficult at times dealing with a manager that is a transactional leader.  Transactional leadership is a style of management when  the leader promotes compliance from their staff through rewards and punishments.  it is an antiquated method of management, where mostly punishments are used.  After awhile the leader loses their staff due the rigidity of management.   A transactional leader will not allow the status quo to change and when a nurse brings up evidenced based nursing approaches to help the staff, they may be quickly dismissed as this is not part of what a manager does. Some managers are  told constantly that they are a manager and have to think like one, not like a nurse that is doing clinical. It sounds like a power struggle of the titles.

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Marchionni, C., & Ritchie, J. (2007, January 25). Organizational Factors that Support the Implementation of a Nursing Best Practice Guideline. Journal of Nursing Management, 16(), 266-274. http://dx.doi.org/10.1111/j.1365-2834.2007.00775.x

Rubenfeld, M. G., & Schaeffer, B. (2014). Critical Thinking Tactics for Nursing Achieving the IOM Competencies (3rd ed.). [P2BS-11]. Retrieved from http://online.vitalsource.com/books/9781284059571

 

Rosie Moore, RN BSN, LNC

Feeding Readiness for Preemies

One of the most exciting moments for a parent of a NICU baby is when you can start feeding the baby from the bottle. Most are not able to do the breast feeding due to the difficulty latching on, but what a joy to feed your baby even if by bottle whether it is your breast milk or specialized formula.  There are different opinions in the medical community around feeding readiness.    My passion for the neonatal intensive care unit arose from having a premature infant myself.  My son was given breast milk initially via NG Tube until he was ready to try a bottle.  Initially the bottle feeding was started once per day and increased and they would leave the bottle feeding for when the parents were there to feed the baby to create that bonding experience.  One day  I arrived at the NICU on a weekend ready to spend the entire day with my son.  I was excited to feed him several times per day, but I was greeted by the shift nurse telling me that I was doing it wrong.  She took over the feeding entirely and when the rest of the feedings occurred that day, she took over stating that I was making the baby aspirate due to my inexperience.  I was only allowed to hold him.  When change of shift occurred she said okay time to go, I stated that we were in a private room and the nurses close the door so that we do not have to leave during change of shift.  We were in a private room because at one point the baby had developed a hospital borne infection called serratia and would remain in a private room until discharge.   Staying in the room was an arrangement that I made with upper management due to the fact that I worked full-time as did my husband and we did not have much visit time with him during the week.  She proceeded about her business and ripped the baby right out of my arms.

 

I cried for days until Monday came and I made a complaint to my head nurse who assured me that this was documented in my chart right on the front that I was allowed to stay whenever I needed to. She showed me the chart and stated that she would speak to the nurse about her abruptness.  The weekend nurse apologized to us a few days later, but by then my feelings were already crushed.   It was later discovered that the baby was aspirating even when he was fed via g-tube it had nothing to do with how I was holding or feeding him.  It was inevitable.  In the end, it was decided that the baby would have a Mickey G-tube inserted surgically for feedings to expedite his discharge to home.

As nursing professionals we need to be sensitive to the needs of our patients and their families.  We should always read the chart prior to walking in the baby’s room and talking with the family to see if there are any new changes since last you saw the baby. How could the nurse that  was in charge of my baby rip him right  out of my hands and ask us to leave.? When you look at how he was being fed here vs those those nurses that truly cared about bonding .

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These nurses were Kaleb’s primary day and night nurses…sheer joy to watch nurses caring about their patients….

 

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Written by Rosie Moore, RN, BSN, LNC

Why Do Nurses Become Complacent

A question arose from the Article called ” Challenges That Parents of a Preemie Face”

Question from Reader:

Why do you think that some nurses even myself become complacent to what is happening in our work environments and that we do not always critically think outside of the medical treatments we provide?

Answer to Reader:

Thank you for reading the article “Challenges That Parents of Preemie Face.” In answer to your question, nurses and healthcare staff become complacent in their environments because it is a job and the passion is lost allowing the nurse to move through the motions.  We are all guilty in many professions, not just nursing, of treating people matter of fact and we forget it may be our hundredth experience, but it is their first experience, no matter what the experience is. When we approach any person, especially in our nursing experience, we have to approach them with kindness and passion. We as nurses cannot continue to eat our young and continue to treat our patients as if we need to move on to our next task. Our body language, tone of voice and facial expressions, give away our genuineness.  We are all busy, but we have to put that aside and go back to compassion and empathy, thinking about how we want to be treated in this situation if we were in it.  We have to utilize our critical thinking to see what level of care that parent needs to get through this situation at hand.

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Written by Rosie Moore, RN, BSN, LNC