Marie Manthey: Professional Practice

Storytelling and Problem Solving

Wed, 17 Jan 2007 21:39:42 GMT

Staff nurses and nurse managers tell me they really like Crucial Conversations as a guide in managing morale problems. Here's the deal: morale problems are always caused by problems in interpersonal relations among the staff. This book gives very specific and useful advice about how to talk about important issues/behaviors that are a problem among co-workers. Everyone has to handle these issues for themselves. It usually doesn't work to expect the nurse manager to step in and solve problems at the staff nurse level. The more each individual develops the skill of managing their own relationships successfully, the healthier a unit's morale will be. The manager's job is to help the staff develop the skill to talk about difficult situations skillfully, so that a solution can be reached that doesn't make the situation worse.

Then, send us your stories about handling difficult situations. You never know when your experience will be a 'teachable moment' for someone else struggling with a similar problem.

I especially invite veteran nurses to share their stories. We are losing wisdom and a sense of our own history as the Baby Boomers begin to retire.

What is on Your Mind About Nursing Right Now?

Mon, 08 Jan 2007 17:43:02 GMT

It is my New Year's resolution to post to this blog more regularly.

Join me. Make it your resolution to comment on my writings.

Start today.

What is on your mind right now about nursing as you are reading this blog?

Just click on the blue “comments” link below this post and share your thoughts, concerns, hopes and fears. Others might want to comment. I know I will.

In the meantime, see what I am currently thinking about nursing as well as some of what I am hearing.

Building Professionalism: Trust and Risk Taking

Mon, 14 Aug 2006 17:43:36 GMT

M. B., a nurse from Alberta emailed me with some comments about professionalism:

"I highly value the principles of professionalism but find in some workplaces and amongst some nursing colleagues that this has varying connotations and meanings. I have put this question to various professionals in health care and some exclaim that it does not truly exist. The more I search I have come to realize that professionalism in an institution is largely dependent on leadership's belief and value of professionalism.

"The extent of the leadership's belief is reflected in how professionalism is exercised and maintained in culture of that work environment. If this belief is low, then any kind of behavior is acceptable in that work environment. If it is high, then that the culture will be of mutual respect and high trust. This indeed would be the ideal workplace but I am afraid I have been exposed to both in my life time career, thus far. The first is "hell", the second is "heaven".

Using licensure to create role clarity

Fri, 04 Aug 2006 17:52:31 GMT

Jean Harry feels that the term "ratios" is troublesome:

I agree that the "ratios" is misleading....and that the variety of entry points into practice is increasingly confusing. We need to analyze work complexity in terms of knowledge and skills needed for safe Nursing Interventions in a particular patient population that are sophisticated enough that also take into account the workplace relationships that impact utilization of support staff. I think that by going back to the basics over and over again (knowledge and skills coupled with effective interpersonal relations)....rather than trying to differentiate by broad credentialing, we will be able to see the forest for the trees.

Nurses have an amazing capacity to do more!

Fri, 24 Mar 2006 18:56:44 GMT

I know if I said this in a speech before an audience of nurses, many would get angry, and some would probably walk out. And yet, it is a statement I believe to be true. Not all nurses. Not in all work situations. Not all the time.

Claiming our authority.

Mon, 13 Mar 2006 20:01:00 GMT

Some days, I am deeply concerned about nursing: we are not helping in the way that we could be. The average RN does not get to make decisions about the kind, degree and amount of nursing care our patients get. That should be the first item on any staff nurse job description.

We need to claim our authority.

We need to stop using "assessment" and other mealy mouthed words that allow us to avoid talking about authority and responsibility.

Some Fundamentals

Fri, 10 Mar 2006 21:31:55 GMT

My friend and colleague, Mary Koloroutis, is working on a field guide to Relationship-Based Care. She has been looking over some of my old writings and asking me questions, trying to clarify some fundamental concepts. As we talked, I realized it is important to review those fundamentals every so often.

So, here is what I shared with Mary about Articulated Expectations and Authority.

The Role of LPNs

Mon, 16 Jan 2006 19:44:30 GMT

Here's my two cents worth on the subject of LPNs.

Strategic Problem Solving at the Staff Nurse Level

Tue, 13 Dec 2005 16:00:17 GMT

What is Wrong with this Picture?

Several times a week, in hospitals all over, system or another breaks down...requiring a staff nurse to 'fix' the problem so a 'patient won't suffer' from the breakdown. Maybe it’s pharmacy sending the wrong drug....or not sending it on time....or a late tray that never arrives for a hungry patient....or the transporter arriving without a wheelchair to take a patient for a test.....you know the situations.

Time after time, nurses stop what they are doing to 'fix' the problem. Eventually their frustration mounts to the point they tell their nurse manager that something needs to be done.

What would Nightingale do?