Wednesday, August 14, 2013

Who's afraid of the ICU?

Who's afraid of the ICU? - Critical Care Nursing

Organizational Barriers to Professional Development for Nurses - Nursing and Professionalism

Organizational Barriers to Professional Development for Nurses - Nursing and Professionalism

Tuesday, August 13, 2013

Nurses, Are You Afraid of Failure?


by

Dr. Margaret Paul



Failure! Nurses, what do you feel when you think about failure? Inadequate? Unworthy? Unlovable? It is so sad that you might have learned to link failure to your value as a person and as a nurse.

Keep in mind that nursing is all about attitude. It's how you view your failures as opportunities to become a better nurse that will help you succeed. Most people who are successful in their work and their relationships have experienced many failures along their road to success. Thomas Edison, the inventor of the electric bulb, is often quoted regarding failure:

"I have not failed. I've just found 10,000 ways that won't work."

"I am not discouraged because every wrong attempt discarded is another step forward."

"Many of life's failures are men who did not realize how close they were to success when they gave up."

"Show me a thoroughly satisfied man, and I will show you a failure."


If Edison has been afraid of failure, or believed that failure meant he was inadequate, he would never have invented the light bulb!

In order to achieve success in any area of your nursing career, you need to redefine failure. Instead of seeing failure as an indication of your inadequacy or lack of worth, you need to see failure as a stepping-stone to success. Some of the most financially successful people experienced repeated failures.

Walt Disney was a high school drop out who suffered bankruptcy and repeated financial and business disasters.

Milton Hershey, chocolate maker and founder of the famous Hershey Foods Corp., found success only after filing for bankruptcy for his first four candy companies.

Henry Ford filed for bankruptcy for the first car company he started. He didn't succeed until he started his third company, Ford Motor Company.

After P.T. Barnum, American showman, went bankrupt, he joined forces with circus operator James A. Bailey to found Barnum and Bailey's Greatest Show on Earth.

Quaker Oats went bankrupt three times, as did Wrigley from Wrigley's Gum. Pepsi-Cola went bankrupt twice. Other famous companies that also went bankrupt are Birds Eye Frozen Foods, Borden's, and Aunt Jemima.

Albert Einstein did poorly in elementary school, and he failed his first college entrance exam at Zurich Polytechnic.

Winston Churchill had a lifetime of defeats and setbacks before becoming prime minister of England at age 62. All of his greatest accomplishments and contributions came when he was a senior citizen.

Sir Laurence Olivier, one of the greatest actors of the 20th century, tripped over the door sill and fell headfirst into the floodlights the very first time he had ever set foot on the professional stage!

Woody Allen flunked motion picture production at New York University and the City College of New York and failed English at N.Y.U.

Astronaut Ed Gibson flunked first and fourth grades.

Lucille Ball was once dismissed from drama school for being too quiet and shy. (Source: http://www.joesabah.com/dseibert/008.htm)

If these successful people had been afraid of failure, they would never have offered the world their talents. They were able to go on to success because they saw failure as a learning opportunity rather than as an indication of their inadequacy.

Are you ready to change your concept of failure, nurses? Are you ready to let go of worrying about what failure says about you and just learn from it? Are you ready to free your soul to do what you really
want to do?

If the fear of failure is stopping you from doing what you really want to do, I want to encourage you to change your concept of failure. I want to encourage you to let go of your old way of seeing failure and start to envision failures as learning nursing opportunities on the way to success. Just as Thomas Edison did, I encourage you to see every failure as a step forward!

Margaret Paul, Ph.D. is a best-selling author of 8 books, relationship expert, and co-creator of the powerful Inner Bonding® process - featured on Oprah, and recommended by actress Lindsay Wagner and singer Alanis Morissette. Are you are ready to heal your pain and discover your joy? Click here for a FREE Inner Bonding course: http://www.innerbonding.com/welcome and visit our website at http://www.innerbonding.com for more articles and help. Phone and Skype Sessions Available. Join the thousands we have already helped and visit us now!



To Create Nursing's Future, Today's RNs Must Look To Great Leaders of The Past





                           
 by Donna Cardillo, RN, MA







On May 12, the final day of National Nurses Week, we once again will commemorate Florence Nightingale's birthday. It's a good time to reflect on her attributes and attitudes and the actions she used to ignite the evolution of nursing more than 150 years ago.

Nightingale was tough and outspoken. She was an excellent communicator, persuasive and effective in making her point. She was well educated, socially savvy, politically active and an adept networker. Nightingale was fiercely passionate about her work and the value of nursing, and used the power of her connections to move nursing forward. She didn't blame anyone for the social barriers she encountered nor did she try to figure out why they existed. She just broke through them and kept right on going. Nightingale did groundbreaking research and revolutionized not just nursing care but healthcare as a whole. She had vision, determination, confidence and a strong sense of self.

To keep the nursing profession strong, today's RNs must embody these traits. Unfortunately, I hear some nurses complain that no one respects us, that we don't have any power and that we are our own worst enemies. They focus on what they perceive as nurses' and nursing's weaknesses. We need to stop complaining and fully embrace Nightingale's qualities to make nursing a force with which to be reckoned.

Why is this so important now? With inevitable healthcare reform, the Institute of Medicine's report on nursing's future and the nation's changing demographics and healthcare needs, nurses are poised to take on an even bigger and more significant role in healthcare. This may be one of the greatest opportunities we've ever had to be healthcare leaders.

It may seem daunting to be a force of change. Think of the great changers like Martin Luther King Jr., Mahatma Gandhi and Nightingale. Change wasn't granted to them; they grabbed it using their social and political skills, their passion and their steadfast belief in their mission.

So what would happen if nurses dug down deep and tapped into our personal power and strength? What if we channeled Nightingale and all of the other strong, empowered, determined nurses who came before us such as Mary Breckinridge, Susie Walking Bear Yellowtail, Clara Louise Maass, Luther Christman and Mary Eliza Mahoney? They fought obstacles and prejudices, and in spite of great odds, found ways to make remarkable strides and leave their marks on the world. Each forged his or her own path to accomplish what needed to be done for the greater good. This is our legacy. We owe it to our nursing predecessors and ourselves to live up to their ideals.

Take this chance to revive the pioneering spirit of our nursing forebearers. Create a new nursing reality with new roles and new healthcare models that will generate a healthier future for the planet.

Let's use Nurses Week to channel Nightingale's power, passion and pride in nursing and put it into practice. Look out world, here come the nurses!


Copyright Gannett Healthcare Group (www.nurse.com). All rights reserved. Used with permission.

Voluntary Turnover among Nurses in Kuwait



 Dr. Muhammad Alotaibi

Voluntary turnover rates are high among staff nurses working in Kuwaiti hospitals. It is a major problem, costly and it is presumed to impact on the quality of nursing care delivered. Many researchers have identified factors that influenced voluntary turnover among nurses. These factors included job stress as a result of job burnout (Robinson et al. 2003), job dissatisfaction (Dworkin 2002), dissatisfaction with salary or benefits (Apker et al. 2003), organizational climate of the hospital (Gormley 2003), poor nurse–physician relationships (Rosenstein 2002), workplace bullying (Hamilton & Pearce 2003). A major reason for nurses’ turnover is the perception of a lack of professional respect and recognition by hospital administrators, doctors and the broader community. Doctors are viewed as the only credible professional voice in health and nurses are merely handmaidens even though they are highly trained employees who outnumber doctors fourfold (Lumby 2004).

A few years ago I conducted a study on voluntary turnover among nurses working in Kuwaiti hospitals (Alotaibi, 2008). This study is considered as the first on nurses turnover in Kuwait. The two aims of this study were to (1) find out if nurses resignations in Kuwaiti hospitals could be ascribed to failure in the recruitment process and (2) examine the feelings of nurses who resigned. Two sets of exit interviews with 60 nurses who had resigned were conducted. The results showed that no evidence emerged that any false information or misleading information was provided except for the salary adjustments. The real insight lay in what might not have been said in the recruitment interviews. While feelings of discontent emerged in the interviews relating to the loss of income, the greatest source of complaint related to the failure of managers to solve the evident problems.

I believe that high rate of voluntary turnover is a very big issue. It requires more attention from administrators and policy makers in Ministry of Health in Kuwait because of its potential consequences in terms of the quality of nursing care delivered.

References
Alotaibi, M. (2008) Voluntary turnover among nurses working in Kuwaiti hospitals. Journal of Nursing Management 16, 237–245

 Apker J., Ford Z.W.S. & Fox D.H. (2003) Predicting nurses organizational and professional identification: the effect of nursing roles professional autonomy, and supportive communication.
Nursing Economics 21 (5), 226–232.

Dworkin R.W. (2002) Where have all the nurses gone? Public Interest 148, 23–37

 Gormley D.K. (2003) Factors affecting job satisfaction in nurse faculty: a meta-analysis. Journal of Nursing Education 42 (4), 174–178

 Hamilton N. & Pearce L. (2003) A question of respect. Nursing Standard 17 (45), 14–16.

 Lumby J. (2004) Unheard cries from within the hospital. Sydney Morning Herald 11, 15.

 Robinson J.R., Clements K. & Land C. (2003) Workplace stress among psychiatric nurses. Journal of Psychosocial Nursing and Mental Health Services 41 (4), 32–43.

 Rosenstein A.H. (2002) Nurse-physician relationships: impact on nurse satisfaction and retention. American Journal of Nursing 102 (6), 26–34


The Future of Nursing


 

 
Donald Wood





I want to talk to you about something that inflames more passion for nursing future than just about anything I can think of - the educational requirements for initial entry into nursing practice.

This subject has been bandied about for many years. When I first entered nursing school, a two-year associate nursing degree program, people were predicting the end of the associate degree programs. Rumor had it that a two-year graduate would become a technical nurse while the four year or BSN nurses would retain the title of professional nurse. That was over forty years ago.

Many things in life have progressed since that time back in 1971. The discussion about the entry education into our profession has not.

Nursing, as a profession, has made the decision to avoid making a decision on this subject. We, as a profession, are on the verge of becoming what others envision us to be. We are about to be told by 50 different state legislatures what our entry to practice requirements are to be. We are abdicating one of our basic roles as a profession to a group of people totally outside of nursing.

Many other healthcare professions have taken it upon themselves to advance their educational requirements for entry into practice without harming the ability of their established practitioners to practice. You only have to look to such groups as pharmacists, physical therapists, and audiologist for examples of this progress.

I’m not degrading or belittling those nurses who are currently practicing with diplomas or an associate degree. My educational background is an associate degree in nursing and a diploma in nurse anesthesia. What I am talking about is the future of nursing.

When we look at many of the complaints from nurses today, lack of respect or not being accepted as a peer, I can’t help but to think about the educational disparity between almost 50% of practicing nurses and those other professions we work with. If we are to become the dominant healthcare force that we are capable of being, we must, as a profession, change the entry level for practice into nursing. Start thinking beyond today; start thinking of the future of our nursing profession.

About the Author: Donald Wood ARNP, CRNA has administered all types of anesthesia to patients from three days to 104 years old. For seventeen years, Donald was the lead CRNA in a busy labor and delivery unit. During this time he administered over 10,000 spinal and epidural anesthetics and delivered one baby. He has also served 15 years as a member of the U.S. Air Force, attaining the rank of Lt. Colonel. Most of his work centered on disaster relief and rescue operations.

 

Men Daring To Care: A Challenging Culture Stereotype in Nursing


 

Warda A. Al Amri

Oman Nursing Institute

 

 


There are many jobs that tend to draw men to them and there are others which attract more women. It has been noted that men face more challenging roles than females in caring jobs such as teaching and nursing. In the past men who go into nursing realize that it’s a profession that has been dominated by women for such a long time, so if they don’t get along with women well, it’s not a good profession for them. A lot of men were not able to deal with situations in which women were their supervisors and because men are sometimes stronger than women they often got stuck more with turning patients. At present there are changes in the health care work force than was in the olden days and both genders share the domination of the profession (McMurry 2011).
The image of men in nursing is actually not well addressed in the media. Culture stereotype has always feminized nursing as a result of media influence. “Meet the Parents” is a movie that exemplifies this. In the movie a guy was asked about his occupation by the parents of his wife-to-be and when he said he was working in a hospital they thought he was a doctor and were shocked when he told them that he was a nurse! The parents thought that the guy was weird for choosing nursing as a currier. The reasons behind choosing nursing as a currier are most of the time multifactorial.  Feeling the call for duty to serve others and to advocate for patients’ care is one of the factors that influence men into becoming nurses. Actually the guy in this movie joined nursing because he liked and wanted it though his high school scores were high enough to get him in a medicine college. Male nurses are interested in not only self- and patient empowerment but also the empowerment of the nursing profession. Literature gives a sense that male nurses feel unhappy because they are a minority in a predominantly feminine profession (Brown 2009).

There is not much basic difference between men and women when it comes to nursing and the important thing to focus on is the challenges they both face in this currier. Nursing shortage is a critical issue worldwide placing the profession in crisis. More than 581,500 new RN positions will be created through 2018 as a projected by workforce analysts with the Bureau of Labor Statistics (BLS) stated in December 2009 (aacn, 2010).

A national sample survey in 2008 by the Health Resources and Service Administration stated that 7.1 percent of the estimated 2,596,599 registered nurses in the United States men. According to health report statistics in Oman as of 31 Dec 2009 the nursing manpower in the Ministry of Health was 9,753 out of which 6,449 are Omani (66%). The total percentage of male nurses in Oman (10.2%) have slightly decreased compared to the year 2000 when it was 11.2% but the percentage of Omani male nurses have increased from 60.3% in 2000 and 78.3% in 2009 (Table 2). The ratio of distribution is on the average of 30.7 nurses for every 10,000 of the population and this is still not considered sufficient if we looked at the total population of the country which is 3,173,917 (MOH, 2009).

           

Table 1: Nursing manpower in the Ministry of Health 2009
Omanis
 
Non-Omanis
 
Total
Male
Female
Total
 
Male
Female
Total
 
Male
Female
Total
780
5,669
6,449
 
216
3,088
3,304
 
996
8,757
9,753

 

Table 2: MOH Male Nurse by Nationality
2000
 
2009
Omani
Non-Omanis
Total
 
Omani
Non-Omanis
Total
449
295
744
 
780
216
996

 
One of the problems faced by masculinity in nursing is actually the hiring process and opportunities provided to the male nurse while on the job. The dissatisfaction caused by this issue may lead to increased resignation from the profession. There is a need for strategies to increase the retention rates of nurses in this profession. According to Analysis of the 1992–2000 National Sample Surveys of Registered Nurses by Sochalski (2002) on rates of nurses leaving nursing there was a significant difference between men and women dropping out within only 4 years after graduation with a percentage of 7.5 for men nurses. Nursing Management Aging Workforce Survey by the Bernard Hodes Group reported that 55% of surveyed nurses intends to retire between 2011 and 2020 and the majority of them were Nurse Managers (aacn, 2010).

In Oman nurses graduating from MOH’s nursing institutions do not face a problem in recruitment because they are guaranteed a position once they enrolled in the nursing program. The author conducted a survey on the intended length of stay in the profession after graduation. Participants were third year nursing students (final year) in the academic Year 2009-2010 at Oman Nursing Institute. The survey didn’t require revealing any identity except the gender and it showed significant findings.  The total number of students involved in the survey was 82; the actual total is 85 but 3 students were absent.  Out of the 82 student 14 were male and 68 were female. For the male student 50% of them intend to stay in nursing for a maximum of 5 years only whereas 22.1%  of the female students wanted to remain for more than 20 years in the profession. Some of the factors that influenced the decisions of these students were better salaries in other jobs, looking for working hours that are more convenient to them and their families, and disappointment in that nursing lacks opportunities for promotions and leadership (especially for men). Under these circumstances the revitalization plan of any nursing workforce should have strategies that focus on retention and working conditions (Rajapaksa, 2009)

 

Table 3: The Period of Time That Third Year Students Intend to Stay in Nursing After Graduation 
Year
Female (n=68)
Male (n=14)
Both Gender (n=82)
2-5 Years
20.6%
50%
26%
6-10 Years
34 %
7.13%
30%
15 Years
10.3%
-
9%
20 Years
6%
21.43%
10%
Over 20
22.1%
14.3%
21%
Didn’t Know
6 %
7.14%
5%

 
In many countries male nurses are denied the opportunity to work in some areas in hospitals, such as labor, delivery, or nursery units and the same is in Oman. The influence behind such a regulation is not related to the trustworthy of male nurses’ care, capabilities or ethics but it is mainly due to religious and cultural limitations. In Islam, women are not supposed to be exposed to the opposite gender for medical reasons except if there was no female available. It intended to preserve the integrity, dignity of women and maintain their personal zones intact.  All female units (medical, surgical and maternity) in hospitals in Oman are under the care of female nurses therefore the presence of a male in those areas is seldom. Even areas of high demand for critical and immediate care where both genders actually work together such as the Intensive Care Unit (ICU) and the Accident & Emergency (A&E) are also subjective to these roles except for cases of insufficient female nurses on a duty.

Effective profile of the nursing profession can be advanced as a whole if there would be a genuinely advanced interest of both genders toward the profession. Male nurses are advices to find strength in numbers, for example joining national or international organizations that support men in nursing. Interacting with others allows sharing of experiences and concerns while bringing hope and motivation for a bright, professional and successful future.  Some examples of these organizations are the Nursing and Midwifery Council (Oman), the American Assembly of Men in Nursing, Sigma Theta Tau International and many others. Another way of advancing the non-biased nursing profile is to find support from one’s own fellow workers; both female and male.

One of the factors placing masculinity nursing image with challenges is the thought that male nurses are not given equal opportunity to move up in the ranks or are being denied equal employment opportunities. In Oman there are many examples of male figures that have accelerated and defeated this meth; they have accelerated through the concrete ceiling of promotion even held leadership and managerial positions. They were the pioneers of male nurses in Oman such as Mr. Hamood Al Kharusi; furmer Dean of Oman Nursing Institute and Chair of the Council of Nursing Institutes currently officiates as the director of the Directorate General of Education and Training (DGET), Mr. Abdullah Al Rubaiey, Dean of Oman Specialized Nursing Institute, and Mr. Mohammed Al Riyami; former Dean of Muscat Nursing Institute and currently a Consultant of Nursing Education at the (DGET). In addition, there are also the young Omani male nurses who were also successful in holding leadership positions such as Mr. Majid Al Muqbali; Director of Nursing and Midwifery Affairs at the MOH, and many others.

The traditional stereotype can be broke through projecting a good and efficient advertisement of the image of nursing in the different types of media. There is a need to recruit more male nurses to the profession due to the shortage of male nurses in the clinical setting as presented earlier. It is recommended to encourage more men/ to advertise for the profession among the male students/ community/ school (Advertising, Promoting the benefit of nursing to men, showing examples of role models). And having said that nursing institutions should have a goal set to attract more men into nursing, for example it should be one of the infrastructure plans that “in 3 Years we will have 30% of our intake to be male” and once the goal is set an action plan could be prepared to address the specific goal and achievement strategies (Gorgos 2002).

On the other hand, decision makers, manager and leaders should be working toward improving or increasing job satisfaction. Every nurse should to be concerned about their basic human labor rights and empowering not only themselves or their patients but also the profession. If this is to be accomplished successfully nursing shortage would not be a critical issue as it is today.  Last but not least, male nurses can overcome negative perceptions by addressing them, therefore; there is a need for further researches addressing gender inequalities and gender-based reservations.

References:

1.      American Association of Colleges of Nursing (2010).  Nursing Shortage. Retrieved April 11, 2011, from http://www.aacn.nche.edu/media/factsheets/nursingshortage.htm

2.      Brown, B. (2009). Men in Nursing: Re-evaluating Masculinities, Re-evaluating gender. Journal of Contimp Nurse, 33(2):120-9.

3.      Gorgos, D. (2002). Why Are There So Few Male Nurses? Journal of Dermatology Nursing, 14(5): 340-341.

4.      McMurry, T. (2011). The Image of Male Nurses and Nursing Leadership Mobility. Nursing Forum, 46(1): 22-28.

5.      Ministry of Health (2009). Annual Health Report 2009. Retrieved March 29, 2011, from http://www.moh.gov.om/nv_menu.php?fNm=mgl/mgl.html

6.      Rajapaksa, S & Rothstein, W. (2009). Factors That Influence the Decisions of Men and Women Nurses to Leave Nursing. Nursing Forum, 44 (3): 195-206.

7.      Sochalski, J. (2002). Trends: Nursing shortage redux: Turning the corner on an enduring problem. Health Affairs, 12 (4): 157-164.

8.      U.S. Department of Health and Human Services; Health Resources and Services Administration. The Registered Nurse Population: Findings from the 2008 National Sample Survey of Registered Nurses. Retrieved on April 11, 2011, from http://bhpr.hrsa.gov/healthworkforce/rnsurvey/2008/

 

Monday, March 25, 2013

مقابلتي مع جريدة الوطن: المعلومات الصحية في المساعد: نطمح بالاعتراف الدولي الأكاديمي واستحداث الماجستير