Thursday, June 12, 2014

Where Do You Take Your Career as an Older Nurse?

Ugh I guess I have to admit I'm an older nurse now. My current role as QI (for hospice) automatically makes me one of the people you love to hate, but I always hope I don't come off as old and outdated like some of those "older" nurses we always hated and hoped would retire SOON -- like today!

I left hospital nursing behind me years ago and became a home health nurse which I dearly loved. It gave me freedoms, yet responsibility and a need to be able to work with little supervision. This required a strong work ethic and the ability to work autonomously. I finally felt like a real nurse who could actually spend time educating and helping patients. Today I work part time as the traveling QI analyst for 4 hospice offices.

Nurse Blog Carnival - The Nerdy Nurse - 300x300As I began to age, and to slow down I needed more of a set schedule in my life.  I entered the realm of management. I have had many roles mostly at the lower level, to suit my personal preferences and needs. I've also been in upper management, but I don't need that hassle and responsibility now!

Management in nursing takes a lot of patience, a lot of creativity, and willingness to lead. We had great leadership classes in my BSN program, but way back when, they weren't relevant. Although I could draw from that knowledge base, it wasn't until I took some leadership courses and spent some time reflecting on my strengths and weaknesses that I feel I was truly able to be the leader I wanted to be.

The other side of that coin is that unless you are the top boss, you still have struggles with those above you who want to do things their way. And often they want to micro manage you. Or if you take a moment to think before you answer; they answer for you and think you to be an idiot. And then micromanage even more! (Too bad they didn't take the time to truly evaluate the skills and value.) You have to play the politics and let a lot of irritating things slide off your back in any role and this is no different.

Nursing management is not for everyone and I wouldn't necessarily recommend it to all. But it is a role that as you get older, takes you away from the trenches and the adrenalin rush that begins to haunt you and feel like it will actually kill you. You find a chance to slow down while still being relevant and helping to mentor new nurses entering the field or niche.

Other career paths for older nurses to consider as they need to leave the more physical work to the younger crowd include staff development and education, infection control and nursing informatics. Medical coding and quality assurance are growing areas especially in home health and hospice.

Leaving the bedside behind will require some research and further education along with sticking your neck out there to make a move from your comfort zone. There are rolls for nurses in the future that we don't even see now.  Hopefully they will take advantage of the knowledge base older nurses have to give and there will be many new roles for older nurses as well.

Hopefully one day soon I will be able to leave the day job behind and focus entirely on my writing. Many nurses have started blogs and written books to fill a niche the same as I have done. We all have learned to mesh the writing with our day jobs.  If you like to write; share your story with others. Help them to find their way in the profession and share your insights.  Older nurses are a wealth of knowledge and information and should not be cast aside. Working smarter, not harder begins with listening to older nurses so you don't keep trying to reinvent the wheel.


Monday, June 2, 2014

Help Nurses Thrive in Their Roles with Ongoing Feedback

Nursing is and always will be challenging. Nurses hold people's lives in their hands and to continue to be great nurses, we must always strive to improve the quality of care we provide. That isn't easy if we don't have proper feedback, and the information necessary to help us improve. Feedback is essential to helping nurses thrive and grow in their roles. 

Ever Changing Regs and Challenges
In today's healthcare environment we meet many challenges everyday that perhaps didn't exist even a few months ago. One major goal no matter what your niche, is to reduce costs while maintaining quality. The challenge then becomes how to work smarter and not harder because reducing costs can also translate to cutting staff.  That works only if you have the buy-in of everyone, and the information to help staff understand the what and why.

In home health and hospice, for example, Medicare drives the ship and regs change frequently. If we don't help staff understand the purpose and the effects of those changes, we don't get the buy-in we need to be successful. Hospitals have gone through many changes in the past few years as well. The key element is meeting reimbursement and providing quality care,

Reducing Readmission and Avoiding Never Events
Never events and reducing hospital readmission are but two huge issues incorporating continuous quality improvement and revising patient care delivery. Both are directly tied to reimbursement. And that is only going to get more difficult to achieve. It's a perfect situation for performance improvement and the data feedback from Medicare provides some of the best evidence of successes and failure.

As part of the continuum of care, home health and hospice have to pick up the ball and run with it. The goal always to help patients assume responsibility for their own health status and improve their outcomes. If we can help patients maintain a status quo and prevent complications, we will see a tremendous improvement in health status over all along with a significant reduction in healthcare costs. To accomplish this, nurses have to spend more quality time with patients providing patient education. And they need feedback to help them understand and improve their patient education skills. It's a paradigm shift from doing for the patient to helping him do for himself. In some realms this has taken place much faster than others. And it's not difficult to imagine that some nurses have resisted the change with all their might, while others have welcomed the challenge.

Collaboration with HR, Staff Development and QI
Nurses are typically over achievers and will strive to meet and exceed expectations, but it's imperative they have the information and the education to improve their skills to meet these needs and goals. Nurses need to be kept aware of the outcomes from data being collected for reimbursement purposes and how their individual participation helps or hinders. This is a process for HR and the staff education department to collaborate along with quality improvement. The data is readily available, the feedback needs to be derived and disseminated. Talent management software is just one of the possible solutions for storing and reporting feedback.

With information and feedback, nurses will rise to the challenge and prove they are the backbone of the healthcare industry. Nurses will feel accomplished and thrive in their roles. There will be a reduced turn over of staff and patient outcomes will improve.
