It was a typical Monday morning with my preceptor and it was my last day with her. We started our day in surgery for four hours to observe how things are done over there. We watched a procedure together. The main objective for this was to help my preceptor understand and observe for herself some of the issues reported to her by some staff and surgeons. She also felt she had to step in to help the director of surgery who was frustrated and stressed out. My preceptor stated that she is there to advocate for her directors and staff, offer logistics to the staff and let them know that she is there for them. She also wants to have a better understanding of issues in order to offer better solutions. She said that she was going to shadow the director for four hours every morning for three days to get a better grasp of all pending issues in order to offer proper solutions. On the first day, she wrote down all the problems she observed. It is just unfortunate I would not be around to observe her find solutions to the problems.
After our visit to the surgery department we came to the office and went through her calendar. The secretary made changes and cancelled some appointments because she was so tight that day. We had a meeting with the director of education on winter internship program. We discussed conducting interviews for interns, interview tools, performance assessment tool, care plan and documentation (ways to help nurses document effectively) and Decisional Involvement Scale. Decisional Involvement Scale is a tool used to assess staff and managers’ degree of decisional involvement and readiness for shared governance. In addition it identifies gaps between staff’s actual and preferred degree of decisional involvement. The nursing leaders use this tool to pinpoint areas into which staffs seek greater input as well as areas in which they would prefer less involvement. They talked about proposed date, readiness, education plan, strategic review, and deadline to submit the share governance for review before the actual meeting. I also had the opportunity to sit in an interview for hiring a new OR Charge Nurse/Supervisor. She was asked a lot of questions and was a nice learning opportunity for me.
I have really enjoyed my management clinical with my preceptor; she is a mentor to me. It has been a challenging and learning experience that has changed my perceptions about those in management. I hope everybody in nursing school gets this management experience.
Tuesday, November 24, 2009
Journal 7
Journal 7
This week was different from the other weeks. There was always something new to learn. As usual we went through our morning routine. We went to bed control meeting. They had issue to discuss concerning a staff who was running temperature, so that department was going to be short. It seems staffing was not very great in the other departments but that department was really short and needed help. The managers sorted out the issue and finally had to transfer a nurse from PCU to help in CSU. We also had another meeting with Care Fusion Associates with the comittee changing their medication system from Mckesson to Pyxis Advance Automated Medication Management System. The Care fusion had to convince the committee why they have to change to Pyxis medication systems. After that, she had a conference call meeting. This was an American Associates of Nursing Conference reviewing the 2010 pathway to excellence. The meeting comprises three nurses. My preceptor was the leader of that meeting. She opened their individual reviewed documents on the computer and reviewed the document together. They based their argument referring to the State of Texas regulatory, pathway to excellence 2009 and Application Manual 2009-Pathway to excellence. They awarded points to each outline and voted on census, if they had different points awarded one had to explain why the point was awarded. At the end she compiled their census sheet together and promised to send the result to them for a preview before sending it for publication. She extended her gratitude to them for their good job done.
After that we had two students from TCU who read their project to selected Managers. One student together with my preceptor talked about Appreciative Inquire (AI). AI has positive transformation to change. AI is a power and fresh approach of the organization and the vision for change. This approach will help to build and redesign the organisation.The student also said that what they like about the hospital is their value of teamwork and revealed that the use of AI will help the hospital to change to meet their vision. He also talked about some core factors that will help the hospital facility to continue to exist such as value each other, be a family, team work, dynamic leadership, MAGNET status and room nutritional services. The other student also talked about improving HCAHPS scores. She also developed a survey tool based on patient satisfaction area identified on HCAHPS with numbering rating. This survey was done on one of the floors. The main objective for this project was to find dimensional ways for pain management using other pain management resources.
We also had lunch that day with their new interns. They shared their experience and the educators shared their evaluation.
This week was different from the other weeks. There was always something new to learn. As usual we went through our morning routine. We went to bed control meeting. They had issue to discuss concerning a staff who was running temperature, so that department was going to be short. It seems staffing was not very great in the other departments but that department was really short and needed help. The managers sorted out the issue and finally had to transfer a nurse from PCU to help in CSU. We also had another meeting with Care Fusion Associates with the comittee changing their medication system from Mckesson to Pyxis Advance Automated Medication Management System. The Care fusion had to convince the committee why they have to change to Pyxis medication systems. After that, she had a conference call meeting. This was an American Associates of Nursing Conference reviewing the 2010 pathway to excellence. The meeting comprises three nurses. My preceptor was the leader of that meeting. She opened their individual reviewed documents on the computer and reviewed the document together. They based their argument referring to the State of Texas regulatory, pathway to excellence 2009 and Application Manual 2009-Pathway to excellence. They awarded points to each outline and voted on census, if they had different points awarded one had to explain why the point was awarded. At the end she compiled their census sheet together and promised to send the result to them for a preview before sending it for publication. She extended her gratitude to them for their good job done.
After that we had two students from TCU who read their project to selected Managers. One student together with my preceptor talked about Appreciative Inquire (AI). AI has positive transformation to change. AI is a power and fresh approach of the organization and the vision for change. This approach will help to build and redesign the organisation.The student also said that what they like about the hospital is their value of teamwork and revealed that the use of AI will help the hospital to change to meet their vision. He also talked about some core factors that will help the hospital facility to continue to exist such as value each other, be a family, team work, dynamic leadership, MAGNET status and room nutritional services. The other student also talked about improving HCAHPS scores. She also developed a survey tool based on patient satisfaction area identified on HCAHPS with numbering rating. This survey was done on one of the floors. The main objective for this project was to find dimensional ways for pain management using other pain management resources.
We also had lunch that day with their new interns. They shared their experience and the educators shared their evaluation.
Thursday, November 12, 2009
Mid-Semewster Self_Review and Analysis
Mid- Semester Self-Review and analysis
2 course clinical objectives
Inspired a shared vision
This clinical experience with my preceptor has given me the opportunity to learn a lot from management. This learning process has improved my leadership skills and changed my perception about managers. My preceptor engaged me in diverse activities and emphasized that establishing a vision is an important leadership skill. This envisioning goal as clearly was explained to me by my preceptor is a pathway to built excellence in nursing. My preceptor believes that every leader should have vision and have the right people to meet the goals of the vision. She believes that leaders inspire a shared vision that requires envisioning goals and enlisting others in a common goal. The leader breathes into the vision through vivid language and expressive style. People must believe that the leader understands their needs and have their interest at heart. The envisioning goal requires having trustful relationships, shared information and agreement on mutual expectation. I also learnt that our vision as nurses is focused on the fact that patient care is why we became nurses. Exceptional leader skills are important function of leading. Visioning gives direction to accelerate change. Being a leader calls for an executive who believes in the power of caring for others and who have a vision for nursing.
Nurse and Client advocate
I have also increased my knowledge and skills in staff and patient advocacy which are important components of our nursing professional. I have gained a lot of insight in advocating for patient and staff. My preceptor went round every morning talking to staff and patients to see how they were doing. She changes systems to meet the needs of others and shows respect, equality and dignity for others. I also learned some keys to help me become a successful nurse advocator by developing skills in referring and engaging patients, acquiring knowledge, accessing systems and collaborating with other healthcare providers. This will in turn promote safety and effective quality care for patients.
2 Personal clinical objectives
One of my primary personal objectives is gaining insight into the pathway of excellence skills. I observed my preceptor working hard to build on the pathway to excellence. She uses her strategic planning process to provide directions for operational activities of the organization. She stated that most team members have been in the organization for many years and did not visibly demonstrate a clear pathway built on a vision for nursing. As nurse we have opportunities to make a difference by planning new strategies for the future. She is proactive, innovative and vision oriented; she works hard to change policies and procedures to increase patient safety and satisfactions. I agree with her that our vision is focused on the fact that patient care is why we become nurses.
My other objective is learning leadership skills by incorporating effective time management to achieve personal and professional goals. My preceptor had a calendar with the goals of the day. She explained to me how she plans for the day by setting goals for the day, prioritizing and managing time. She also made room for side distractions. Although she has a very busy schedule with meetings here and there, she is able to walk everyday around some floors or departments to see how they are doing unless she is not in the building. She told me that talking and touching people make a difference in her life and reduces stress.
Overall review of personal objectives
Overall I want to become an effective leader and a team player. So far from my clinical experience, I have learnt the importance of teamwork. Leadership is team effort and collaboration is to master team skills in partnership with others in the team to function well. My preceptor who is my mentor promotes positive attitudes and good communication. She inspires others and has created a trusting climate. There is mutual respect for her and the staff. Kouzes and Posner states that “ when leadership is understood as a relationship founded on trust and confidence, people take risks, make change, and keep programs, organizations and movement alive.”
How this has fostered my professional growth
This whole learning experience has helped me gain insight to the management world. My preceptor has inspired me to be more proactive, vision directed, creative and very oriented to change. I have learned skills to aid me in my professional journey to gain more confidence and competency when addressing healthcare issues. I learnt from my preceptor to seek more opportunities for professional growth, expand my knowledge and have a vision. She stated that “Being a leader in today’s environment calls for an executive who believes in the power of caring for others and who has a vision for nursing.”
2 course clinical objectives
Inspired a shared vision
This clinical experience with my preceptor has given me the opportunity to learn a lot from management. This learning process has improved my leadership skills and changed my perception about managers. My preceptor engaged me in diverse activities and emphasized that establishing a vision is an important leadership skill. This envisioning goal as clearly was explained to me by my preceptor is a pathway to built excellence in nursing. My preceptor believes that every leader should have vision and have the right people to meet the goals of the vision. She believes that leaders inspire a shared vision that requires envisioning goals and enlisting others in a common goal. The leader breathes into the vision through vivid language and expressive style. People must believe that the leader understands their needs and have their interest at heart. The envisioning goal requires having trustful relationships, shared information and agreement on mutual expectation. I also learnt that our vision as nurses is focused on the fact that patient care is why we became nurses. Exceptional leader skills are important function of leading. Visioning gives direction to accelerate change. Being a leader calls for an executive who believes in the power of caring for others and who have a vision for nursing.
Nurse and Client advocate
I have also increased my knowledge and skills in staff and patient advocacy which are important components of our nursing professional. I have gained a lot of insight in advocating for patient and staff. My preceptor went round every morning talking to staff and patients to see how they were doing. She changes systems to meet the needs of others and shows respect, equality and dignity for others. I also learned some keys to help me become a successful nurse advocator by developing skills in referring and engaging patients, acquiring knowledge, accessing systems and collaborating with other healthcare providers. This will in turn promote safety and effective quality care for patients.
2 Personal clinical objectives
One of my primary personal objectives is gaining insight into the pathway of excellence skills. I observed my preceptor working hard to build on the pathway to excellence. She uses her strategic planning process to provide directions for operational activities of the organization. She stated that most team members have been in the organization for many years and did not visibly demonstrate a clear pathway built on a vision for nursing. As nurse we have opportunities to make a difference by planning new strategies for the future. She is proactive, innovative and vision oriented; she works hard to change policies and procedures to increase patient safety and satisfactions. I agree with her that our vision is focused on the fact that patient care is why we become nurses.
My other objective is learning leadership skills by incorporating effective time management to achieve personal and professional goals. My preceptor had a calendar with the goals of the day. She explained to me how she plans for the day by setting goals for the day, prioritizing and managing time. She also made room for side distractions. Although she has a very busy schedule with meetings here and there, she is able to walk everyday around some floors or departments to see how they are doing unless she is not in the building. She told me that talking and touching people make a difference in her life and reduces stress.
Overall review of personal objectives
Overall I want to become an effective leader and a team player. So far from my clinical experience, I have learnt the importance of teamwork. Leadership is team effort and collaboration is to master team skills in partnership with others in the team to function well. My preceptor who is my mentor promotes positive attitudes and good communication. She inspires others and has created a trusting climate. There is mutual respect for her and the staff. Kouzes and Posner states that “ when leadership is understood as a relationship founded on trust and confidence, people take risks, make change, and keep programs, organizations and movement alive.”
How this has fostered my professional growth
This whole learning experience has helped me gain insight to the management world. My preceptor has inspired me to be more proactive, vision directed, creative and very oriented to change. I have learned skills to aid me in my professional journey to gain more confidence and competency when addressing healthcare issues. I learnt from my preceptor to seek more opportunities for professional growth, expand my knowledge and have a vision. She stated that “Being a leader in today’s environment calls for an executive who believes in the power of caring for others and who has a vision for nursing.”
Monday, November 2, 2009
Journal 6
Journal
This week was very exciting with my preceptor. This was the first time we had our clinical on Friday. There is always something new learn from her. She is a very busy but focused person who tries to meet her goals in spite of the side distractions. She makes room for all the side distractions. She first went through her emails and talked through it with me. She told me of section on her mails classified as "You have a task". This include request from staff on pay change, bonus, change of status and budgeting. J.M. needs to approve or disapprove the request. She further explained that any supplies over $100.00 amount must be approved by her. She stated that this helps her to keep her eyes on everything that is going on. She made calls right away as she read the emails. J.M termed this as real multitasking. On Fridays she goes over her daily calendar with her- to-do list to see what she might have missed during the week. She prepares for the following weeks meeting and her agenda as well. She also talked about the directors meeting the following week.
J.M had a phone meeting with the chief medical staff in charge of surgery about a corrective measure to prevent it from happening again. After that we went for the usual staff meeting and walked around med-surge 5, surgery, endoscopy, Human resources and ER. At surgery she had a brief meeting with the director of surgery concerning staff not clocking in for lunch breaks. She expressed to the director nobody is clocking at her department. She feels every staff should take her lunch break, clock out and in. J.M. insisted that is required by policy to punch in/out for lunch. They want to improve healthy staff environment, she further stated that this change is prevalent now. She asked the director what she can do differently for staff at surgery to take lunch. After that, she explained the impact of staff no clocking in for lunch on budget. It also increases FTE (Full Time Equivalent), which she stated is the number of hours a employee works. She further explained a couple of key figures one has to know with FTE. She lives with this number all the time in order not to go over budget. If the FTE goes over, she needs to justify that over hours she used. She also mentioned EEPOB (Employee Equivalent per occupied bed) which is a formula they used based on inpatient/out -patient factor to help them stay within their budget. She concluded that nursing hours per day is where the productivity falls and managing is all about budgeting. Budgeting include operating services, staffing and supplies. The CNO has a developmental plan that builds and helps some of the directors who has budgeting as a weakness. They also offer continues education on budgeting for them. She said developed her budgeting skills over time along with her experience from holding different managerial positions. This really changed my attitude towards clocking in for lunch. Somebody has to render accounts for all the hours used in the hospital. She also told me that she wants to develop an oncology floor and was in the processes of contacting other people for resources to help with this new vision.
Finally I commended her ability of knowing most of the staff and the way she greets and interacts with them during the day. I shared with a comment made by one of from my course mates; "a CNO greeting all the time, she might have a huge morale". She replied that during her nursing days she never got to see the CNO or her manager but it is important for her to talk to people, happiness comes from following your passion. She stated that when she is over stressed, talking and touching people motivate her to keep up with whatever she is doing. She ended that this helps in building good staffing and good resources.
This week was very exciting with my preceptor. This was the first time we had our clinical on Friday. There is always something new learn from her. She is a very busy but focused person who tries to meet her goals in spite of the side distractions. She makes room for all the side distractions. She first went through her emails and talked through it with me. She told me of section on her mails classified as "You have a task". This include request from staff on pay change, bonus, change of status and budgeting. J.M. needs to approve or disapprove the request. She further explained that any supplies over $100.00 amount must be approved by her. She stated that this helps her to keep her eyes on everything that is going on. She made calls right away as she read the emails. J.M termed this as real multitasking. On Fridays she goes over her daily calendar with her- to-do list to see what she might have missed during the week. She prepares for the following weeks meeting and her agenda as well. She also talked about the directors meeting the following week.
J.M had a phone meeting with the chief medical staff in charge of surgery about a corrective measure to prevent it from happening again. After that we went for the usual staff meeting and walked around med-surge 5, surgery, endoscopy, Human resources and ER. At surgery she had a brief meeting with the director of surgery concerning staff not clocking in for lunch breaks. She expressed to the director nobody is clocking at her department. She feels every staff should take her lunch break, clock out and in. J.M. insisted that is required by policy to punch in/out for lunch. They want to improve healthy staff environment, she further stated that this change is prevalent now. She asked the director what she can do differently for staff at surgery to take lunch. After that, she explained the impact of staff no clocking in for lunch on budget. It also increases FTE (Full Time Equivalent), which she stated is the number of hours a employee works. She further explained a couple of key figures one has to know with FTE. She lives with this number all the time in order not to go over budget. If the FTE goes over, she needs to justify that over hours she used. She also mentioned EEPOB (Employee Equivalent per occupied bed) which is a formula they used based on inpatient/out -patient factor to help them stay within their budget. She concluded that nursing hours per day is where the productivity falls and managing is all about budgeting. Budgeting include operating services, staffing and supplies. The CNO has a developmental plan that builds and helps some of the directors who has budgeting as a weakness. They also offer continues education on budgeting for them. She said developed her budgeting skills over time along with her experience from holding different managerial positions. This really changed my attitude towards clocking in for lunch. Somebody has to render accounts for all the hours used in the hospital. She also told me that she wants to develop an oncology floor and was in the processes of contacting other people for resources to help with this new vision.
Finally I commended her ability of knowing most of the staff and the way she greets and interacts with them during the day. I shared with a comment made by one of from my course mates; "a CNO greeting all the time, she might have a huge morale". She replied that during her nursing days she never got to see the CNO or her manager but it is important for her to talk to people, happiness comes from following your passion. She stated that when she is over stressed, talking and touching people motivate her to keep up with whatever she is doing. She ended that this helps in building good staffing and good resources.
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