Tuesday, April 18, 2017

Concluding Insights

Terri Guillemets said, “A nurse will always give us hope, an angel with a stethoscope.”  I believe in making a difference not only in my patient’s lives but in my Sailor’s lives as well.   I am a new graduate nurse; I graduated from Radford University in May 2016.  I have been a nurse for almost a year (how time flies!)  I absolutely love my job and it is evident every day I show up to work.  I work at a Naval Hospital in Washington State and I love being a nurse on the Multi-Service Ward.  I take such pleasure serving those who have served our country.  Their dependents are so grateful to be at our hospital.  It is an amazing feeling when you can set a positive milieu for the rest of your shift. 
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It can be overwhelming knowing that you can have such a positive impact on those around you.  Whether you know it or not people are always looking at you.  In the military, they say we are in a fish bowl and that someone is always looking so we must be acting professionally at all times.  The junior Sailors are asking me to be their mentors and the senior Sailors are ensuring I am on the right track for success. Becoming someone’s mentor is a huge undertaking.  I am guiding these young paraprofessionals who want to become nurses and doctors; helping them pick colleges and teaching them how to speak to their school advisers.  I am helping them diffuse difficult situations and teaching them how to cope with the stress of being an adult away from home for the first time (which is crucial for these millennials!)  It is an absolute honor to be held in such high regards.
My mentor when I was in high school just passed away last week.  He was my Junior ROTC instructor.  It is unbearable to think of him being gone.  It hurts so much knowing that when I go home on leave I won't be able to hear his voice, I'll be visiting his gravestone. To have such an impact on someones life is amazing.  He guided me the way I am guiding my Sailors. I learned how to do that because of him, he will always be a part of me.
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I am lucky enough to have been able to find my “why” while taking this course. By knowing my why, I will be able to motivate others just by leading my healthy and motivated lifestyle. People will want to emulate me.  My why is to be the very best I can be, to gather others and take them with me.  I want to inspire others and change lives.  I know that I already do that for many of the enlisted personnel and the junior officers. As a leader, I will help others learn their why as well.  It can make life a lot more fulfilling.  I just want to let you know that I enjoyed Simon Sinek so much I purchased all his books! 😊
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             Everything happens for a reason. I have always said this.  Especially when I look back at my career.  I never wanted to go into the healthcare profession but when it came time to go to the recruiter’s office I did not have any other choice.  I wanted to be a pilot but after doing the medical exams they said my eyesight was not good enough.  I sulked for a while but I had to get back up and figure out what to do with my life.  So, I kept my head up and took a leap of faith. I learned that if you fail you need to get back up and keep going because everything happens for a reason. 
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When I found out I was pregnant in Guam I tried getting out of the Navy before my contract was up; I did not want to move my family around every 3 years.  I did not want to raise “military brats”.  The Commanding Officer denied my early out request.  This is another example where everything happens for a reason.  Shortly after that I applied for two officer programs to become a nurse.  If I was going to stay in, I might as well go big!  I was selected for Medical Enlisted Commissioning Program and the Navy paid me to become a nurse while using my GI Bill.  I could not be happier.  I have met some amazing military brats since then and they seem to grow up more outgoing other kids, so I am ok staying in the Navy as a “lifer” now.  Being prior enlisted gives me the knowledge and respect needed in a leader.
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Nursing is always changing. “Change cannot be avoided because it is everywhere, but we can influence its circumstances and consequences” (Porter-O’Grady & Malloch, 2015, p.7).  As nurses, we need to be adaptable since this profession is a revolving door.  The change can be something simple and the beauty is that anyone can make a change.  Jeremy Gutsche said, "Make change happen even if it seems hard."  The easy way is not always the best way.  Sidney Dekker said that "even the smallest cause can create the biggest effect" which resonates with me (2013).  Just because we do something that seems small it could make a huge difference.  We have bulletin boards at work and they were filled with information for us, the staff.  I changed all of them so they would display patient education such as: smoking cessation, diabetes, heart health, healthy foods, mammograms, colonoscopies and so on.  I did not think it was that big of a change but my boss said that many people, whether they are patients or hospital workers, stop to read those boards.  When he compliments me on my hard work I tend to laugh rather than reply with “thank you” and he made that known the other day.  I am not sure why I have a hard time taking compliments but at least it makes me humble and not overly confident.
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Sidney Dekker talked about accountability.  Normally if an error occurs we want to hold those people accountable, it is a natural feeling.  He talks about how "we need to keep accountability and education together to try and solve the gap in the system rather than place blame on someone" (Dekker, 2013).  At work, we have Patient Safety Report’s (PSR) that we submit if there was a medical error, if a patient was injured or if there was a near miss.  This is a great way for people to come forward and talk about these instances in a safe environment because they are anonymous.  As a leader, it is a great way to make changes to prevent those mistakes from happening again.
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As an emerging leader, I now understand that evidence based practice is the foundation of our practice.  Porter-O'Grady said that "Evidence based practice (EBP) is the floor, innovation is the ceiling" and that "EBP strangles new ideas" (AONE Thought Leader: Tim Porter O'Grady).  I completely understand what Porter-O'Grady is talking about because nursing is driven by EBP, and even though you may have a great idea it could be superfluous because if it has not been researched it is hard to make a change.  I recently did some research of my own after realizing that our hospital uses regular red caps for our piggy back IV hubs.  I researched the effectiveness of alcohol impregnated IV caps.  I spoke with the hospitals infection control representative and she mentioned that we had one case of documented infection related to that.  When I approached it with my department head he immediately made the changes.  The sense of feeling valued makes work much more fulfilling.
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When assuming a leadership role, it is assumed that there will be conflict.  That is inevitable.  Knowing how to deal with conflict is the key and that can be very difficult to do.  We do not welcome conflict which is what Jeff Muir explains saying that we would rather live in denial than solve the conflict (Conflict Resolution, 2013).  In the nursing profession if conflicts are not resolved many nurses will just quit and not return to the profession (Swearingen& Liberman, 2004).  Good communication needs to be a priority to improve conflict resolution.  As a leader, I will be open and listen intently without judgement to help resolve any issues at hand.  CrisMarie Campbell and Susan Clarke mention on TEDtalks that we need to be vulnerable in order to resolve it (2015). Brene Brown and our book say the same thing that “vulnerability is not about weakness or incompetence” (Porter-O’Grady & Malloch, 2015, p. 309).  Brene Brown says that, “vulnerability is our most accurate measurement of courage” (2011).
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Knowing that how you approach someone could become a domino effect for your staff could make a huge difference.  If you approach everyone with a positive attitude it could spread, just as if you’re always negative, that can spread as well and create a toxic environment.  I learned a couple years ago not to waste energy on things you have no control over.  This message changed my life.  If someone were to cut me off, what good will it do getting upset over it?  It’s just wasted energy.  I’d rather spend my time being happy and joyful rather than angry and bitter over things I have no control over.  Although if the environment is negative then I will either remove myself from the situation or try to change the subject because it not only affects me but all the other staff as well.

                  Joseph Grenny (2015) said that “The way you act is influenced by how you feel.”  He talks about the story we tell ourselves can completely change how we think and respond to people. After listening to this talk I will notice how I feel before reacting.  Growing up, my parents always said, “Think before you speak” which goes along the same lines.  I am bad at this, and in order to be a good leader I need to bite my tongue and mull things over a bit before responding.  He talks about how most people need to choose between telling the truth and keeping a friend.  I’ve been in this predicament before and have always chosen to tell the truth with the thought that, “If it were me, I would want to know.”  We are still friends.  Most of my friends will describe me as blunt and honest. 
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            The challenges I have faced throughout my life will guide me to be an exceptional leader.  I will push people to see what they cannot and guide them like others have guided me.  I believe I am a Digital Age leader.  I am adaptable and flexible.  When I was checking into this hospital I begged to be in Labor and Delivery but the Director of Nursing Services told me that because I was a new nurse I had to learn nursing skills on the Multi-Service Ward.  After a little disappointment, I adapted and welcomed the experience with open arms.  I am grateful for this opportunity because I absolutely love it (Porter-O'Grady & Malloch, 2015).
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In conclusion, knowing that you cannot please everyone will make your job a little easier.  When I first got into leadership, I tried my very hardest to please everyone.  “Once you get that it truly is impossible to please everyone, you being to live purposefully, trying to please the right people” (Cloud, 2014).  I finally realized that I can’t and no one can. A huge weight was lifted off my shoulders.  This class gave me so much insight with leadership and knowing who I really am as a person and leader.





References

Brown, B. (2010, June). Retrieved April 02, 2017, from https://www.ted.com/talks/brene_brown_on_vulnerability

Cloud, H. (2014, June 24). 10 Things Successful People Never Do Again. Retrieved April 07, 2017, from http://www.success.com/article/10-things-successful-people-never-do-again

Conflict Resolution. (2013). Retrieved March 12, 2017, from https://www.youtube.com/watch?v=KY5TWVz5ZDU

Grenny, J. (2015, September 10).  Mastering the art of crucial conversations.  Retrieved from https://www.youtube.com/watch?v=-56_auKiKfA.

Gutsche, J. (2017, January 18). Disruptive Innovation Keynote Speaker Jeremy Gutsche on Trends & Change. Retrieved April 15, 2017, from https://www.youtube.com/watch?v=J7B9xvzawmY&feature=youtu.be

Porter-O'Grady, T. & Malloch, K. (2015). Quantum leadership: Building better partnerships for sustainable health (4th ed.).

Swearingen, S., & Liberman, A. (2004). Nursing generations: an expanded look at the emergence of conflict and its resolution. Health Care Manager, 23(1), 54-64.

Dekker, S. (2013, May 29). Just Culture. Retrieved March 27, 2017, from https://www.youtube.com/watch?v=gKqYMpWZbV8

Sunday, April 9, 2017

Healthy Organizations


  • Ann Voskamp

    • I’ve spoken of my mothers and my broken relationship before and I’ll speak of it again.  I am heartbroken when I see good moms and see how our relationship SHOULD be.  I yearn for that.  But I know that will never happen.  Even when I broke down, opened my whole soul to her, my heartache and disappointment of what I wish she could be, how she should be; nothing changed.  But after I got everything off my chest I felt lighter. I felt better.  I know I cannot change the person she is.  I only have control over my own actions.  I vowed to be a better mom and grandmother.  I always learn the most on how NOT to be when I see what I do not like.  Ann Voskamp (2016) said “maybe our hearts are made to be broken to let the love in.”
  • Anger Profile Survey

    • I feel like the Anger Profile Survey accurate depicted how I handle anger.  I am a “leaker”. It made me laugh when it said “Angry? Not me. Well, maybe just a little” (Ingram & Johnson, 2009).  After going through the list of reasons I’m afraid of anger, fear of making a fool out of my self definitely hits the nail on the head.  I am always worried about looking like a fool!  I don’t however make excuses, procrastinate or become negative.
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  • Dave Moen’s TedTalk


    • Dave Moen (2012) went into a battered wife’s room and told her that she needs to leave her husband or else he’s going to kill her.  It was something that is so obvious to us and it was obvious to her as well, and she tried to leave and make her life better but it wasn’t working.  I feel like that happens a lot in our practice where we judge patients and we tell them things like, “You NEED to get your diabetes under control” and they know that, but they just can’t.  It’s not that they don’t know it’s killing them slowly but they enjoy eating those things that they shouldn’t and they’d rather live that life then one with healthy foods and exercise. 


  • Fred Lee

    • Fred Lee shed light on how patients perceive blood draws.  Its simple acts that we do every single day in practices that have become second nature to us as healthcare providers.  We often forget how our patients might feel about certain procedures that we do.   It was eye opening to watch and made me realize I need to do more explaining as I do things, no matter what is it.  I always make small talk with my patients so that was nothing new, but I do see in some people the “scripts” that they have and stick to most of the time. I sent this to some of the corpsmen I work with because it think everyone forgets that our job is to take care of patients as a whole.
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  • “Crucial Conversation”

    • Joseph Grenny (2015) said that “The way you act is influenced by how you feel.”  He talks about the story we tell ourselves can completely change how we think and respond to people. After listening to this talk I will notice how I feel before reacting.  Growing up, my parents always said, “Think before you speak” which goes along the same lines. 
    • He talks about how most people need to choose between telling the truth and keeping a friend.  I’ve been in this predicament before and have always chosen to tell the truth with the thought that, “If it were me, I’d want to know.”  We’re still friends.  Most of my friends will describe me as blunt and honest. 
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  • Simon Sinek

    •   I am a millennial but I’m on the cusp being born in 1984 J although I feel like I understand completely and can relate to most of what Simon Sinek has said.  It’s crazy how he talks about social media as an addiction such as drug abuse and alcoholics.  I didn’t grow up with cell phones in high school and I can’t imagine doing so.  I would have been so distracted!  My husband and I vowed to not give our children a cell phone until they can afford it themselves.  Will we be the bad parents because everyone will have one but them?  
    • Simon says that we’re so obsessed with instant gratification that things like love and job satisfaction aren’t there (2016).  Those take time and patience and hard work and it’s not instantaneous.  I am guilty of having Amazon Prime to get 2-day shipping and to binge watch shows.  After listening to his talk I instantly went on Amazon to look for his book to purchase.  He is an amazing speaker who can hold all my attention (which is hard to do!)
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  • Matt Abraham

    •   I have taken Public Speaking two times to try and help with my public speaking anxiety and it hasn’t really helped me.  Listening to Matt Abraham talk about effective communication was helpful.  I enjoyed how he started out with a question and he said to treat it more as a conversation rather than a presentation. I’m going to use those techniques next time I have to speak publically.

  • "Are you a toxic nurse?"

    • After reviewing the Toxic Nurse test I have realized that I know some of those scenarios and I’m usually the one trying to defuse the situation than feed it.  I answered no to all of the questions; therefore I am not toxic (thank God!)  There is one older nurse who works with me and she’ll say things like, “management doesn’t care about us on night shift, if I fall asleep driving home they’d just look for a replacement and not care” which is so heartbreaking.  It’s hard to turn that around into a positive moment but I always try.  She’s a good nurses and a great educator but she is just so negative (Dellasega & Volpe (n.d.).





 
References
Abraham, M. (2014, December 4).  Think fast, talk smart: Communication techniques.  Retrieved from https://youtu.be/HAnw168huqA.
Dellasega, C. & Volpe, R. L. (n.d.) Could you be a toxic nurse?  From toxic nursing: Managing bullying, bad attitudes, and total turmoil (ISBN: 9781937554422). 
Grenny, J. (2015, September 10).  Mastering the art of crucial conversations.  Retrieved from https://www.youtube.com/watch?v=-56_auKiKfA.
Ingram, C. & Johnson, B. (2009). Overcoming emotions that destroy: Practical help for those angry feelings that ruin relationships.
Mohen, D. (2012, August 9).  The future of patient-centered care.  Retrieved from https://youtu.be/hUsyuloD198.
Porter-O’Grady, T. & Malloch, K. (2015).  Quantum leadership: building better partnerships for sustainable health.  Burlington, MA:  Jones & Bartlett Learning
Sinek, S. (2016, December 28).  Millennials in the workplace.  [You Tube Video].  Retrieved from  https://youtu.be/5MC2X-LRbkE.
Voskamp, A. (2016, October 18).  The broken way.  [You Tube Video].  Retrieved from https://youtu.be/wIBvu_udMqA


 


Friday, April 7, 2017

Emotionally-Competent Leadership

Brene Brown
    • Hearing her talk about worthiness and shame and being able to connect with people was really enlightening.  I can relate to this with my mother and my relationship.  My whole childhood, even today, I felt like I wasn’t ever good enough in her eyes.  She always made me feel unworthy and shameful and because of that we don’t have the connection most parents have with their children.  My father on the other hand puts me on a pedestal and always tells me how proud he is of me.  Somehow, I was able to grow and better myself through the years and I was able to be vulnerable, as Brene Brown says, “say I love you first” (2010).  I told my boyfriend I loved him before leaving for boot camp.  I took that plunge not know what the future holds because I was leaving for 6 months.  After those 6 months, I came home and we got married right away and we’re happier than ever.  Brene Brown and our book say the same thing that “vulnerability is not about weakness or incompetence” (Porter-O’Grady & Malloch, 2015, p. 309).  Brene Brown says that, “vulnerability is our most accurate measurement of courage” (2011).
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18 Behaviors
    • My top 3 brightest characteristics of emotional competence are:
1.     I am curious about the people around me.  I was talking to one of the corpsmen about his life and what he wanted to do with it and all the sudden he said, “Ma’am, why do you care so much about us?” and it nearly broke my heart.  Why wouldn’t I care about them?
2.     Not only do I embrace change, I am usually the one making the changes!  Just this week I changed over our IV caps to alcohol impregnated caps (and boy am I hearing the scuttle butt from that one!) but in the end it's about patient safety, not about "we've been doing it like that for years."
3.     I am very difficult to offend.  Most people make fun jabs at me just I just laugh along with them.  If you can’t laugh with them, what’s the point?  Life’s too short!
    • My 3 areas of improvement are:
1.     I need to understand my emotions more.  I’m one of those people who will say “I feel like poop” instead of saying something like, “I’m feeling downtrodden” but this could be because I have a toddler at home as well. 😊
2.     I am terrible when it comes to saying no to people.  I will let everything pile on top and still manage to get it all done.  My boss finally came to me and told me I wasn’t allowed to take on any more responsibilities because I have too much already.  On top of my job, collateral duties, hospital duties, getting my master’s degree, and having a family, I just found out I’m pregnant!  So now I’m juggling all of this while extremely tired AND nauseous 😊
3.     I normally have a hard time letting go of mistakes.  I learn from my mistakes but boy oh boy do I let them linger and haunt me for some time.
(Bradberry, 2015).


Henry Cloud 

Henry Cloud’s second point was doing “anything that requires them to be someone they are not” which for me is not true (2014).  As I was growing up people always used to tell me I’d be a good nurse.  I NEVER thought I’d end up in healthcare, I fainted at the sight of blood! (Don’t worry, I don’t anymore!)  I finally didn’t know what to do with my life so I joined the Navy, they made me a Corpsmen and I couldn’t be happier where I am today.  Everything happens for a reason.
I agree 100% when Henry Cloud says, “Once you get that it truly is impossible to please everyone, you being to live purposefully, trying to please the right people” (2014).  When I first got into leadership, I tried my very hardest to please everyone.  Finally, I realized that I can’t, no one can. A huge weight was lifted off my shoulders.


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 Simon Sinek

I am lucky enough to serve my country and I can relate to what Simon Sinek talks about in the beginning of this webcast because I work with brothers and sisters.  I think the bond is a little more when you’re deployed or overseas but either way, we’re all away from our families and where we grew up.  We all volunteered to serve our country and the comradery we share because of that is beautiful.  We don’t even have holidays alone, because we’re always together, ensuring no one is left behind.  Simon Sinek says that, “We are social animals and we respond to the environments we’re in and leaders are responsible for building that environment” (2016).  Our Department Head on the ward is energetic, he’s compassionate and you can really tell that he cares about everyone who works there. 
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Rethinking Thinking

I learned a couple years ago not to waste energy on things you have no control over.  This message changed my life.  If someone were to cut me off, what good will it do getting upset over it?  It’s just wasted energy.  I’d rather spend my time being happy and joyful rather than angry and bitter over things I have no control over.


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If you were to ask a coworker, “What’s it like to sit on the other side of me?” what would he or she say?
I think my coworker would say that I am competent, yet not afraid to ask questions.  I'm humble yet have a confidence about me.  They have told me before that they could see me in ten years coming back to our hospital as a Captain in the Navy and overseeing the hospital.  They see leadership in my future.  They respect me for working as hard as I have to get to where I am today and that I’m not slowing down.  They see me as a solid role mode. I am proud of who I've become.


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References

Bradberry, T. (2015, April 28). 18 Behaviors of Emotionally Intelligent People. Retrieved April 05, 2017, from http://time.com/3838524/emotional-intelligence-signs/

Brown, B. (2010, June). Retrieved April 02, 2017, from https://www.ted.com/talks/brene_brown_on_vulnerability

Cloud, H. (2014, June 24). 10 Things Successful People Never Do Again. Retrieved April 07, 2017, from http://www.success.com/article/10-things-successful-people-never-do-again

Porter-O'Grady, T. & Malloch, K. (2015). Quantum leadership: Building better partnerships for sustainable health (4th ed.).

Sinek, S. (2016, June 07). Retrieved April 08, 2017, from https://www.youtube.com/watch?v=NzBqJNh8z2U



Monday, March 27, 2017

Errors as Opportunities



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Growth while moving through the process of hardship.
    • There is a new nurse on our ward who isn’t grasping things as easily as most of us.  He becomes overwhelmed and anxious very easily.  Many of us coddled him and “protected” him for so long.  One day he had a breakdown and declared to all of us that he felt “unsafe.”  I had to be the one to inform our boss because when we have people’s lives in our hands – one cannot feel “unsafe.”  Maybe if we didn’t try to protect him so much, maybe if he stayed on orientation a little longer, maybe if we tried to help him in other ways this wouldn’t have happened. He went back on orientation for a couple months and just started back on the ward working independently.  It's helped him immensely
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Learning from our mistakes

I learn the MOST from my mistakes.  I’ve made a medication error (nothing terrible, Claritin was given at the wrong time) but I had to put in a Patient Safety Report (PSR) which is a non-punitive way of trying to make sure that mistake doesn’t happen again.  That would have been considered a “sloppy mistake (which) happen(s) when we're doing something we already know how to do, but we do it incorrectly because we lose concentration” (Briceño, 2015).  Since then, I’ve double and tripled checked my medication before giving them.  When I told my boss about it, I felt terrible, but he told me not to beat myself up over it and to learn and grow from this.   


Mandatory error reporting requirements.
    • At my facility, we have a Patient Safety Reporting (PSR) system.  Like I said above, it’s a non-punitive, anonymous, reporting system.  Near misses, medication errors and anything that could harm a patient is supposed to be reported.  It’s to bring light to situations that could have been prevented and to try to find a way to correct it so it doesn’t happen again.   Our text book talks about public error reporting which “care providers may be unwilling to declare their errors, particularly minor one” out of fear that they’ll get in trouble (Porter-O’Grady & Malloch, 2015, p. 358). 

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Leadership and conflict
    • My current leaders are amazing.  If there is a problem they don’t play sides and they talk like they’re on the same level as you.  They don’t act as if they’re above you.  I’ve had other leadership talk to me like a child, like they’re better than me, by demeaning myself and others.  Just like I learn the most from my mistakes, I learn the most from poor leadership – how NOT to act.  I want to incorporate the SWOT approach that Nate Guyton wrote about in American Nurses Today journal.  SWOT stands for strengths, weaknesses, opportunities, and threats. “Provide employees with a copy of the SWOT document you complete when conducting their 3-month 1:1 meeting; be sure to write specific goals and dates for when they must be accomplished” (2012).
Gawande “how do we heal medicine/healthcare.”
    • It’s amazing how expensive our healthcare has become.  I don’t notice it because I’m active duty so my family and I don’t have to worry about medical bills.  But I hear it from my family and friends how terrible their medical bills have become.  I agree with Gawande about us all being “pit crews” with our check lists.  If there is a check list, then important things are less likely to get lost or overlooked (Gawande, 2012).
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Value in healthcare services
    • We need to start “blending the cultures of finance and health care…it can be made somewhat manageable if everyone understands the common ground shared by finance and health professionals” (Porter-O’Grady & Malloch, 2015, p. 367).  If I were to measure the value of healthcare services it would be patient safety and if patients were leaving the hospital in better condition than when they entered the hospital. 
‘Sharp end/blunt end’ theoretical approach in healthcare organizations
      • We have that kind of hierarchy of “sharp end/blunt end” in the military.  I haven’t noticed them interfering with our patient care but they will interfere with the military staff. Some days we must come in at 0600 instead of 0645 so we can attend military training.  That means we’re up earlier and at the hospital longer leaving staff exhausted.
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Stacking/peeking/prioritizing 
      • I as a novice nurse I usually write down what needs to be done at what times so I don’t miss a medication, vital signs or pain reassessments.  When something comes up and creates waves I pause and think.  I ask questions.  When I finally stop asking questions is when I’ll be able to say, “OK, I got this.” I never heard of “stacking” but cannot wait to try it the next time I work.  Pat Ebright talks about how every nurse stacks; they make a list of priorities and when something else comes up we restack (2010).

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Reducing continuous interruptions
    • One way to limit interruptions is having “No Interruption Zone” by the medication carts.  I’ve also seen signs that nurses wear around their necks when they're in the middle of administering medication this way no one interrupts them from point A, the med cart, to point B, the patient. There are many interruptions at my work.  The other day a corpsman was talking to me while I was removing medications and I reminded him that I was removing medications and he was distracting me.  He left so I could concentrate.
Just Culture
    • Sidney’s Dekker said that "even the smallest cause can create the biggest effect" which resonates with me (2013).  Just because we do something that seems small it could make a huge difference.  We have bulletin boards at work and they were filled with information for us, the staff.  I changed all of them so they'd display patient education such as: smoking cessation, diabetes, heart health, healthy foods, mammograms and so on.  I didn't think it was that big of a change but my boss said that many people, whether they're patients or hospital workers, stop to read those boards.  
    • Sidney also talked about accountability.  Normally if an error occurs we want to hold those people accountable, it's a natural feeling.  He talks about how "we need to keep accountability and education together to try and solve the gap in the system rather than place blame on someone" (Dekker, 2013).
Staffing levels

This is interesting; because I'm in the military it usually takes a long time to get more staffing.  I'm not even sure how the process works but I know it's a long process of the big bosses talking to Navy manpower to try and get more billets where they're needed.  We can't even hire civilian nurses right now because our president put a hiring freeze in effect.  We are fat staffed right now but before I got there they were very understaffed and the Department Head was working the floor almost every day.


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References

Briceño, E. (2015). Mistakes Are Not All Created Equal. Retrieved March 26, 2017, from http://blog.mindsetworks.com/blog-page/home-blogs/entry/mistakes-are-not-all-created-equal
Dekker, S. (2013, May 29). Just Culture. Retrieved March 27, 2017, from https://www.youtube.com/watch?v=gKqYMpWZbV8
Ebright, P. (2010, January 29). Retrieved March 27, 2017, from https://www.youtube.com/watch?v=IVHbty3iI9k
Gawande, A. (2012, March). Retrieved March 27, 2017, from https://www.ted.com/talks/atul_gawande_how_do_we_heal_medicine
Guyton, N. (2012). Nine principles of successful nursing leadership. American Nurse Today7(8), 2p.
Porter-O'Grady, T. & Malloch, K. (2015). Quantum leadership: Building better partnerships for sustainable health (4th ed.).