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In-Side-Out and Up-Side-Down

In-Side-Out and Up-Side-Down

07/26/2010

  It has been just about a month since I last made an entry and announced that I was making a major move. I’m in the process of settling-in: not settled. I have learned a lot about myself in this process, and bits and pieces about a whole lot of other “things.” For instance, t[...]

  It has been just about a month since I last made an entry and announced that I was making a major move. I’m in the process of settling-in: not settled. I have learned a lot about myself in this process, and bits and pieces about a whole lot of other “things.” For instance, there are “things” in life that are pretty absolute. “Things” that don’t co-exist: night and day, up and down, in and out, front and back, life and death... Play with that for awhile and you will realize that you cannot mix and match, you must choose. So, here is my new dilemma: IN-patient and OUT-patient! Hello brain-freeze! Hello melt-down! Hello, Alice! Am I in-side-out or up-side-down? And, where is that Walrus when you need to “talk of many things!”

Comfort zones are wonderful places. That zone might exist in the midst of chaos but it is what one knows and it is OK. Somehow you make it work almost to the point of discomfort. Since man landed on the moon, I have been an IN-patient, multi-specialties nurse except for a clinic stint somewhere in the 70’s. When I abruptly moved, I went all OUT and entered the OUT-patient zone: initially, a new type of chaos for me. I think after comparing IN and OUT to the point of driving my preceptor totally daft, we have settled on this as the trigger point: “Dorothy, you are not in Kansas anymore!”

In reality, this has been a whirlwind month. I have been challenged. I am learning something new every day. (A word to new grads: We survive! We are resilient.) I am having fun. I enjoy the people I have met and I have embraced a wonderful new patient population. Synergy is alive and well on my radar. Out-patient Synergy! WOW! And, I used to think I knew something about blood... merely a drop in the bucket! It is exciting OUT here. The challenge for me is that I’m not IN there.
 
So, I have moved my cheese. Literally. During this change, I decided I would try new cheese with my new move. I have discovered a magnificent stout Stilton-blue from Britain and a fabulous slice of nursing in a remote corner of the basement in Methodist Hospital.
 
Sherry
 
Sherry Holden, BSN, RN
Associate Partner, 4South, IU Hospital
 
To be a registered nurse at Clarian, visit RN Job Opportunities Indiana.

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Mon, 26 Jul 2010 14:05:35 +0100

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Teamwork Promotes Safe and Ethical Behavior

Teamwork Promotes Safe and Ethical Behavior

07/17/2010

When was the last time you tried to name Disney’s Seven Dwarfs? (Doc, Grumpy, Dopey, Sneezy, Sleepy, Bashful and Happy.) It’s a safe bet the Seven Dwarfs knew each other’s names, and Snow White learned them pretty quickly. The dwarfs had to rely on each other, and Snow White had to[...]

When was the last time you tried to name Disney’s Seven Dwarfs? (Doc, Grumpy, Dopey, Sneezy, Sleepy, Bashful and Happy.) It’s a safe bet the Seven Dwarfs knew each other’s names, and Snow White learned them pretty quickly. The dwarfs had to rely on each other, and Snow White had to rely on them. They were, in essence, a team, in part because of established obligations of fidelity.

Like the fictional world of Disney, our very real world of health care involves obligations of fidelity. These obligations arise whenever a health care professional establishes a significant relationship with someone else, usually a patient. Fidelity establishes a commitment to another person, a promise to be faithful and loyal. Obviously we need to establish this relationship with patients, but what about establishing one with our teammates?

We all know that our teams look different this time of year. July is a difficult time. The hospital is flooded with new interns and residents typically just after an influx of newly graduated nurses. We haven’t had a chance to get to know each other or establish relationships. A recent study reviewed deaths from medication errors and found a 10 percent spike in these events in teaching hospitals in July. The authors of the study hypothesized that part of the explanation for this was that medical residents operate more independently than on a team.

Anyone who has ever been involved in a medication error knows that an entire team is involved in the administration of medication, not just the physician. An intervention to improve patient safety offers a simple, reasonable opportunity for us to address the “July effect.” It’s called the activation phenomenon.

Better teamwork is observed when people on a team take the time to introduce themselves to each other. When people know the names of others on the team, they are more likely to speak up if they see a problem.

Take the time to establish a relationship with members of your new team. Introduce yourself and make sure your teammates know you are committed not just to patients, but also to the success of the team. Formally establishing fiduciary relationships with each other in support of safe, quality patient care promotes ethical practice.

Lucia D. Wocial, PhD, RN
Clarian Health Nurse Ethicist

To be a registered nurse at Clarian, visit Registered Nursing Position Indiana.

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Sat, 17 Jul 2010 03:58:27 +0100

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