Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days…...

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Professionalism in Nursing Are We Our Own Worst Enemy?

Transcript of Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days…...

Page 1: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

Professionalism in Nursing

Are We Our Own Worst Enemy?

Page 2: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

Love Your Theme!

• From Discovery to Diagnosis

• I’m going to change it up a bit

• From Diagnosis to Discovery!

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Objectives

• Let’s diagnose “professionalism!” What does this really mean?

• Explore our current behaviors—do they reflect professional behavior?

• Define actions we can take to enhance professional behavior in the workplace

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Professionalism

• Professionalism: a word we hear a lot these days…– In nearly every hospital’s mission, vision,

values– Magnet component– One of AONE’s executive competencies– Part of most practice models– A value or guiding principle for most nurses– Often connected with certification– Key rec of the IOM Report on the Future of

Nursing

• What does it really mean?

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Professionalism: Lit Search

• Autonomy– Control of professional activities– Maintaining standards of

practice

• Licensure/Certification: privilege of self regulation

• Body of knowledge– Knowledge & techniques– Educational preparation

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Professionalism Defined

• So that’s it?!

• Standards of practice, a license, a diploma, certification?

• These create a professional practice environment ?

• My problem with this…

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Professionalism Defined

• I believe that all of these are terribly important

• I support every one

• But we are missing something…7

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Professionalism Defined

• Webster’s defines “professionalism” as “the conduct, behaviors or qualities that characterize or mark a profession or a professional person”

• “Being engaged in or worthy of the highest standards of the profession”

• “Doing something with great skill”

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Professionalism Defined

• When we examine the “current conduct & behaviors,” of nurses today, do they reflect true professional behavior?

• Are nurses engaged and practicing in a way that is “worthy of the highest standards of the profession?”

• What prompted the comment I overheard?

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Professionalism Defined

• What do you think?

• If you had to give “nursing professionalism” a grade, what would it be?

• We do a lot well—really well!

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Professionalism?

• Incredibly smart • Unbelievably dedicated• Hard-working• Excellent patient care• Compassionate • Unusually organized• Grace under pressure• Most trusted profession year after year

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Professionalism?

• But WRT professionalism

• We need some work…

• After years of observation, I’ve come up with my own definition of “professionalism…”

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Professionalism Defined

• They say people remember things in “3’s”

• Lit search: autonomy, licensure & certification, body of knowledge

• I have “my 3”

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My Definition of Professionalism

• How do we look?

• How do we talk?

• How do we treat each other?

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How We Look

• Personal observations:– Appearance– Uniforms??!!

• Observations from the patient:– Study done at UVMMC– Erma Bombeck– Patient comments

• Observations from the business world

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How We Look

• As we seek more pt input, they are telling us that appearance is important

• Evidence based study done at VCU: – “The public needs to be able to ID the

nurse; the easiest way to do this is the uniform”

– “Professionalism can be defined by attire; pts believe they are receiving better care if their nurses look professional”

– Multiple accolades on Magnet survey

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How We Look

• Geisinger Med Cen’s new dress code inspired by pt feedback:– Survey discovered they had 70 different

dress code policies! (500 bed hosp)

– RNs’ wore hoodies, leggings, fleece jkts, t-shirts

– Pt sat surveys noted pts didn’t like this– “If we are going to improve the pt

experience, when pts talk, we need to listen, and we did”

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How We Look

• Returning to “white” at the VA

• A hospital in Ohio:– Per hospital guidelines, everyone must

wear underwear– “We forbid extreme hair colors, long

beards and “going commando”– This was on Cleveland’s evening news

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How We Look

• “In the early days at Barrow, all nurses were required to wear a nursing uniform dress & cap to exhibit their professionalism (Fig 1). However, wearing a dress was challenging when providing care to bedridden patients.”

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How We Look

• People make an assessment about you based on how you look…

• It’s the first thing they see!

• How well does s/he take care of her/himself?

• How well will s/he take care of me?

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How We Look

OK, full disclosure!!

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How We Look

Appearance matters!

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How We Talk/Our Language

• Constantly complaining…

• “Just the Nurse” syndrome

• The way we describe nursing

• The language we use

• The stories we tell

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How We Talk/Our Language

• “Graveyard shift on the stairway to heaven”• “Done my time & I want out”• “Hate this stupid job”• Trenches• Frequent flyer/PIA• 5 more “dumps” from the ED• Floor nurse/Scut work • Swearing & nasty language • Slander on Facebook• “We are crazy busy”

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How We Talk/Our Language

• How about here?

• What are some of your favorite terms or sayings?

• Sometimes I worry that they are such a part of our culture, we don’t recognize them as negative or unprofessional

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Our Actions & Behaviors

• Let’s talk about “the conduct, behaviors or qualities that characterize or mark our profession”

• Can our behavior be described as “worthy of the highest standards of the profession?”

• Our actions & behaviors worry me the most…

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Our Actions & Behaviors: What We Say

• Theory, Foundation, Tradition:– Florence Nightingale to Jean Watson

– Relationship based care (CHCM)

– Patient centered care (IOM)

– TCAB (RWJ)

– Quality & safety are paramount

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Our Actions & Behaviors: What We Say

General Hospital• “Our Mission is to provide the very best

care and patient experience…”

• Our Values:– Compassion Respect– Dignity Teamwork– Integrity Excellence

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What You Say: Mission

• “We are committed to furthering the healing ministry of Jesus. We dedicate our resources to:– Delivering compassionate, high-quality,

affordable health services;– Serving and advocating for our sisters and

brothers who are poor & disenfranchised;– Partnering with others in the community to

improve the quality of life.”

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What You Say: Vision

• Vision: “A vibrant, national health care system known for service, clinical excellence, standing in partnership with patients, employees, and physicians to improve the health of all communities served.”

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What You Say: Values

• Dignity - Respecting the inherent value and worth of each person.

• Collaboration - Working together with people who support common values & vision to achieve shared goals.

• Justice - Advocating for social change and acting in ways that promote respect for all persons and demonstrate compassion for our sisters and brothers who are powerless.

• Stewardship - Cultivating the resources entrusted to us to promote healing and wholeness.

• Excellence - Exceeding expectations through teamwork and innovation.

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What We Do!

• We are saying the right things

• But there is a giant disconnect between what we say

• And what we do

• We have to fix this…36

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Our Actions & Behavior: The Hope

• Everyone pulling for the same thing

• Trust among all players

• A supportive environment

• Open honest communication

• Respect for all persons

• Standing in partnership to improve health

• Working together to achieve shared goals

• Exceeding expectations through teamwork

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Our Actions & Behaviors: The Reality

• Specialty silos & elitism

• Devaluing the profession

• Nitpicking & backbiting

• Naming, blaming, shaming

• Ugly gossip & slander

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Our Actions & Behaviors: The Reality

• Comments made on patient satisfaction surveys

• How we treat students

• How we treat seasoned nurses!

• The absence of team behavior at a time when we need teamwork more than ever…

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Quality

Service

Workflow

TeamworkMorale

Safety

Retention

It Affects Everything…

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Communication

Satisfaction

Productivity

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Our Actions & Behaviors: The Reality

• These behaviors don’t reflect our mission, our vision or our values

• Nor do they reflect “the highest standards of the profession”

• They are certainly not the “conduct and behaviors we want to characterize the profession of nursing”

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Our Actions & Behaviors

• NEVER has it been more important for nurses to band together in support of one another:

– Current challenges in nursing– Healthcare reform– Future supply and demand– The work we are doing…– The future of the profession

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Nursing Is Getting A Lot of Help

• Congressional initiatives• State legislative initiatives• Medical societies• School incentives• Hospital actions• Johnson & Johnson ads• Department of Labor• Gallup poll• The Institute of Medicine & Inst for H/C Imp• The Joint Commission

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Nursing Is Getting A Lot of Help

• What do you notice about this list?

• Where are WE in this push to improve things?

• When will we stop being our own worst enemy?

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Nursing Is Getting A Lot of Help

• No matter how much help we get from others

• Nursing will never be changed from “the outside”

• WE are the only ones who can change this

• So, what is YOUR part in creating a more professional practice setting?

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TOCREATE AMOREPROFESSIONAL CULTURE!!

Page 46: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

#1 Be A Great Team Member

• For as long as I’ve been a nurse, clinical excellence has trumped everything else…

• Clinical excellence is really important

• But it’s not enough

• You need to be clinically proficient AND a great team member 48

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#1 Be A Great Team Member

• Every nurse has specific strengths, skills & talents in addition to their clinical skills!

• You need to ID those strengths & use them to make work better/easier/more prod

• Everyone contributes to making the team/unit better!

• Your work is a team effort and not an individual assignment

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Page 48: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

#1 Be A Great Team Member

• Nursing is a team sport!!!

• It cannot be “us” vs. “them” any more

• IT HAS TO BE “WE”

• Once everyone understands this, there will be no problem we can’t solve!

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#1 Be A Great Team Member

• Find solutions, not just problems

• Help those who struggle

• Don’t name, blame, shame, moan, groan…

• Support your colleagues

• BE IN A GOOD MOOD!!!51

Page 50: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

#1 Be A Great Team Member

• “Teamwork remains the ultimate competitive advantage, because it is so powerful and also, so rare.”

• “If you could get all the people in an organization rowing in the same direction, you could dominate any industry, in any market, against any competition, at any time.”

Lencioni, The 5 Dysfunctions of a Team

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#1 Be A Great Team Member

• When we make excellence in teamwork as important as clinical excellence, we will change our world

• And there will be no problem that we can’t solve…

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#1 Be A Great Team Member

• So how about you?!

– What does your team behavior look like?

– Is teamwork on your evaluations?

– Does it get the same wt as the clinical mark?

– What are you going to do to improve teamwork in your area?

Page 53: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

#2 Change Your Language

• Keep your ears open for unprofessional language and point it out

• Don’t ever say “just a nurse”

• If you can’t say something nice, don’t say anything

• Stop gossip when you hear it

• Make it fun

Page 54: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

#2 Change Your Language

• Stop talking about being busy

• Stop flying around like your hair in on fire

• Stop talking about how awful everything is

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Page 55: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

#2 Change Your Language

• Have a ready response when someone asks you about your work

• We are great story tellers!

• Tell the stories about the incredible things you do…

Page 56: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

#2 Change Your Language

• Stories paint a picture of what you do, and how you feel about it…

• They tell other people what moves/motivates you

• They help keep you proactive

• They are the antidote to our negative language 58

Page 57: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

Some Shining Examples

• The nurses who saved the Mom’s life

• The nurse who saved my brother’s life

• “Amazing Grace”

• The NICU Dad

• Your story… 59

Page 58: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –
Page 59: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

#3 Look Like the Professional You Are

• How about your appearance?

• When you look in the mirror in the morning, what is the image that stares back at you?

• Are you proud of the way you look—or do you not really think about it?

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Page 60: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

#3 Look Like the Professional You Are

• Does your appearance exhibit your professionalism?

Page 61: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

#3 Look Like the Professional You Are

• Sometimes nurses tell me that appearance has nothing to do with how good they are

• I know that—but that’s not the issue

• It’s about what your patients see, and their family members, and others on the healthcare team!

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Page 62: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

#3 Look Like the Professional You Are

• I want you to look like the dedicated, compassionate, intelligent, incredible professionals that you are!

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Page 63: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

The Challenge

• Creating a more professional culture lies squarely in our hands

• Nursing will be changed from the inside out

• By people who are passionate about creating a different future

• And say we CAN and we WILL create a different culture

Page 64: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

Summary

• For the rest of the day you are going to hear all kinds of wonderful things about how to improve your neuroscience skills

• That is so important

• I hope you also realize that once we diagnose what real professionalism looks like

• We will discover the true power of nursing

Page 65: Professionalism in Nursing...Professionalism • Professionalism: a word we hear a lot these days… – In nearly every hospital’s mission, vision, values – Magnet component –

ENJOY YOUR DAY!

Ginny [email protected]

ginnybeeson.com

mailto:[email protected]

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Assessment of medical professionalism using the Professionalism … · 2020. 7. 14. · RESEARCH ARTICLE Open Access Assessment of medical professionalism using the Professionalism

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