What makes your day? A study of the quality of worklife of OR nurses

From data obtained in this study, the weak or negligible influences on the quality of worklife of OR nurses are: Organizational Structure Leadership, and Organizational Learning. Things that matter to OR nurses and that influence their quality of worklife are: Collaborative Decision-Making, Multiskilled Workers, Change, Organizational Culture, Locus of Control; and the most important influence of all- Teamwork. So, now when the question is asked "What Makes Your Day?" The answer is clear--at the end of the day, it all boils down to the most fundamental of all answers--People! People are involved in collaborative decision-making, multiskilled workers, change, organizational culture, locus of control, and teamwork. These People include the OR nurse, who is involved in collaborative decision-making and all the other items that affect your daily work environment. The people you collaborate with, the people you interact with in the organization, and the people that make up the team--you and everyone around you are responsible for that magic ingredient--Teamwork. What you say, what you do, and how you behave makes all the difference in the daily worklife of your colleagues. Each and every comment and interaction contributes to the efficiency and effectiveness of the team. Each and every day from this day forward, remember this--remember how important your role is in building a strong and effective team. At the recent AORN Congress, Joan Rivers shared a favourite saying with us: "The past is history, The future a mystery, Today is a gift from God, that is why it is called the present." Today is all that we really have--let us make the best of each and every day as we continue to respect and value each member of the team. Teamwork--our building block of the future--yours, mine, and every other member of the surgical team. Each member can make an enormous contribution--we only need to believe that the "best is yet to be--the best resides in me". Yes, we can do our part in making our workplace a good one. But we can only do so much. It's time for governments, administrators, and managers to examine the work environment, to identify the kinds of things that motivate nurses to get up in the morning and go to work, and what makes that workplace pleasant enough that they are happy to stay there. We are hearing about nursing shortages across Canada and the United States. Recruitment and retention strategies are returning to hospitals. Besides "sign-on" bonuses, it is time for governments and administrators to examine the culture of the workplace. Questions that must be answered: Are nurses included in decisions made? Do nurses have what they need to work with? Are they given a reasonable workload? Are nurses part of a team that values them and their unique contribution to patient care? In the words of Senator Lucie Pépin (1999): "We must turn our anger first, into passion, then into action. A hostile or unpleasant workplace must not be tolerated!" With confidence we must be assertive as we look to improve our work environment. Yes, we can do our part, but now it is time for the other stakeholders to pay attention!     

What's in a name--or shape?

What does your organization chart look like? What titles do your various managers hold? For all of you who have spent so many serious hours developing organizational structures and lines of authority, the author asks you to sit back, relax, and take a break.     

Renovation of a twelve-room OR suite

Managing the renovation of an operating room is both challenging and rewarding. Good organizational and negotiating skills are needed for dealing with all of the various individuals and groups you will encounter as the project unfolds. Developing an operational plan will assist you to ensure your department continues to function in an organized and efficient manner throughout the project.     

Writing organization and funder profiles for a grant proposal

Writing profiles that catch the uniqueness of your organization and of the foundation from which you would like to receive a grant are essential to developing the right fit between the organization and funder. This author, an experienced grant writer, describes how to write both an organization and a foundation profile that will guide you in successfully raising money for an innovative project.     

Looking closer: forensic nursing

With a keen eye, you can foster comprehensive care to victims; protect your organization from allegations of abuse, negligence, and malpractice; and offer a care environment that recognizes the complexities of our current society.     

Demystifying the clinical nursing research process: the literature review

The literature review is a critical step in designing and conducting a credible study. It might seem tedious at first, but your own ideas will become better developed and thoughtful as you critique what other researchers have done. It will make your study stronger. Thus, don't skim over this part of the process. A good literature review will make the next steps easier. It will also assure that you are studying an important area, that the outcome has clinical importance to your patients, and that writing and reporting the results will be easier.     

Research in physical medicine and rehabilitation. XI. Research training: setting the stage for lifelong learning

This is the summary article in our research series. We have attempted to provide useful information for persons at all levels of research training, from the student to the clinician with a collaborative but not active role, to the new clinical researcher, to the experienced faculty member. But there is much more to be learned than can be presented in a short series of articles. From this series, you should be able to make a reasoned choice about what role in research you would like to take, and seek to maintain or upgrade your research skills to accomplish that. The previous articles, exercises and references presented will guide you in independent study. The focus of this article is to help you choose an environment in which you can continue to learn and develop. Although the "ideal" place as described here may never exist, no institution is totally devoid of research possibilities and you can use this article to help seek or develop local resources you may not have considered. By extracting questions and clues from people around you, you stimulate them to "think research" even if a formal program is absent; at the least, you can ally yourself with a nearby institution which has researchers in other clinical specialties or areas of basic science. Each organization is obviously different, having different strengths and resources. It is up to each chairperson to decide what proportion of limited resources should be invested in research. Once this decision is made, it is the initiative of the individual faculty members that will make a productive department.     

Clinical trials IV Planning the study

This article describes the Method section, which explains how You are going to answer' your Aims, i.e., how you. are planning to do your research. The main issues that have to he considered are who you are going to include in the study, and why; selecting a method of measurrment that will be.sensitive and accurate enough to pick up any change due to your intervention; and haul to design thr.sludy so that you can be certain that it was your intervention that caused arty observed change.     

Chief nursing officer to chief executive officer: lessons learned

As health care in the United States continues to evolve, more chief nursing officers are moving to the role of chief executive officer. This article describes lessons learned from a chief nursing officer who is currently serving as a chief executive officer of an academic medical center. Eight lessons are described followed by reflective questions encouraging the reader to reflect and begin to internalize the experiences of the past role of a chief nursing officer and their applicability to the potential future role of a chief executive officer. The eight lessons explored are as follows: (1) you know more than you think you know; (2) nursing is part of the picture, not the whole picture; (3) relationships matter; (4) trust your gut; (5) if you do not have the right team, change it; (6) simple is better; (7) use your accountability to the board to accomplish your goals; and (8) to serve the organization well, you must keep yourself at your personal best.     

Creating a successful daily home hemodialysis program.

The literature supports that patients on daily hemodialysis do much better overall. They tolerate dialysis better, have less complications and less fluid to remove, their appetites are better, they have more energy, and they have greater blood pressure control. Patients with cardiovascular disease who cannot tolerate the rigor of conventional, three times a week dialysis do better on daily hemodialysis. Here are quotes from just a few patients dialyzing at home: "I no longer experience the large energy swings and the night cramps as I did with in-clinic dialysis." (Delores: 74 years) "I've been on dialysis for 26 years, and for 26 years I haven't felt good. But now my friends and family are seeing a real change in me because I'm excited, I'm feeling better." (Richard: 48 years) "Instead of spending time with the nurse, I can spend time with my husband and I have more energy. I think it is because I'm dialyzing 6 times a week." (Sharon: 52 years) Short, daily at-home dialysis helps patients reclaim a more normal life. You and your colleagues will be able to see dramatic improvements very soon after sending them home, leading to a greater chance of rehabilitation. Most importantly, if you choose to develop a daily home hemodialysis program, you should consider yourself and the team very special. You will be among the first clinics in the country to introduce and implement a unique and needed change in the renal arena. As this article outlines, it may not be easy at first, but you will find it to be one of the most rewarding nursing experiences you have had in your career.     

Research design conferences: guidelines for investigators and graduate students

Meticulous preplanning will lead to a beneficial design conference and a concise successful research proposal. Selection of the best experts for the conference, organization, and a flexible conference schedule can create a profusion of ideas, enhance discussion, and allow weak areas in the proposal to be identified and strengthened. A design conference can be a delightfully rewarding strategy for investigators, research teams, or graduate students. A successful conference will be accomplished if you adhere to the following steps: 1. Have at least two design conferences while you are preparing your research proposal--more if you feel that you need them. 2. Identify and invite the best experts possible from inside and outside your institution to discuss your questions. 3. Prepare a draft of your proposal as well as a list of your questions and give these to your experts at least 1 week in advance so they can prepare for the design conference. 4. Tape-record the discussion at the design conference along with taking written notes. 5. After the conference, review the tapes and notes and revise the proposal accordingly.     

Routes to modify the impact of stress]

The combined effects that daily frustations and tensions have upon you depend, among other factors, on the evaluation you make of the importance of your needs as well as your confidence in your abilities. This effect is equally dependent upon your evaluation of the availability, quality and adequacy of your support system. To minimize the effects of stress, it is important to develop your internal and external resources. Stress management requires more than learning relaxation techniques. It demands the development of certain attitudes that will eventually influence your entire life. This includes the development of a realistic perception of situations and demands the realization that you can only do your best, keeping in mind your knowledge, and resources as well as the context of the moment. Stress management is time management. The management of your energies is related to your resources, your values, your needs and your priorities. The bottom line is the management of your life. Daily, nurses confront the challenge of discovering their own way of gathering information, of resolving problems, of planning pleasant activities, of benefiting from those surrounding them, as well as generating ideas, thoughts and emotions. Caring for patients must also include taking care of one's self.     

Error reduction in the New World. How we can improve the level of safety for everyone in our operating rooms

In order to do no harm, ask yourself and your colleagues the following questions: Is our environment safe? Does staff follow all safety measures? Do physicians and visitors follow safety rules? Is every staff member aware of their role in safety for all? Is there an effective staff/leader safety inspection team in place and functioning effectively? Are all reasonable recommendations implemented? Have the errors been reviewed in detail? If so, what were the results and what changes were made? Is self-reporting encouraged without repercussions? Do you know what your error rates are, what the root causes were, which systems were lacking, and how they have been modified? Needless to say we have a great deal of work to do and many challenges to overcome if we are to decrease our risk of error. But where to start? Do a critical analysis of the current system and, on a daily basis, focus on improving some small piece of the safety network that will have a lasting impact. The commitment and participation of staff, strong visible leadership, and accountable, well-trained individuals and teams will all be major contributors to a safe environment.     

A letter to fellows: transitioning from training into practice in uncertain times

The end of training marks the beginning of learning. Moving into practice is exciting, and there are good opportunities. Although there is still a great deal of uncertainty with the economy, you have a skill set that is in demand. By understanding your real priorities, being deliberate and organized in your search, and being willing to extend outside your comfort zone, you will find a practice that fits you. Each person has an ideal practice. Choose your new practice setting with your eyes wide open, especially regarding new changes that are expected with health care reform.     

Do you want to be an author? Ten steps for successful writing.

At some point in our lives, we often envision ourselves in other roles. Being an author is usually a fleeting thought. Nurses have the opportunity to share their professional expertise, the latest research information, or stories of human kindness and compassion. You may often intend to write, but lose the motivation when you think that you are not really capable. Although you may never attain the level of Shakespeare, James Joyce, or Mark Twain, you can still have the satisfaction of seeing your article in print. All it takes is a little organization. This article provides an overview of 10 steps to help you get started with writing. These simple key points may not get you the Pulitzer prize, but they can get you started on a new hobby and facilitate important contributions to our nursing discipline through the written word.     

Advancing beyond the average: the importance of mentoring in professional achievement

The profession of respiratory care is founded on rigorous scientific research, which in turn depends on rigorous training in research methods. Only a small part of that training is from written and audiovisual materials; the most important aspects of becoming a respiratory researcher are learned from. Becoming a thoroughly-involved respiratory care professional, then a researcher, and then a mentor is challenging but rich with the rewards of contributing to the advancement of science and, thereby, to the care and comfort of our patients. Becoming a respiratory researcher begins with. Only those with a burning desire to excel, to discover truth, and to contribute to the advancement of the profession will persevere through the setbacks and bring a research project to final fruition. The second requirement for long-term success is learning to maintain between enthusiasm and realism. It is crucial to avoid taking on more than you can realistically do, and it is necessary to devote adequate time to your family and/or non-work-related pursuits and recreation. The third aspect of becoming a contributor to respiratory care research is rigorous and ongoing education in the of respiratory care, the methods of medical research, and the basic sciences and mathematics that underlie the profession, including some calculus, engineering physics, and statistics. You must understand research design, critical analysis of research, and numerous aspects of presentation, including clear writing and concise speaking. The fourth aspect is : you must have a strong commitment to obtaining accurate, reproducible, and meaningful data. You must sustain strong attention to detail; mentors are essential because they teach the needed discipline, the required measurement skills, and how to select the appropriate equipment with which to conduct the research. is the fifth aspect. In addition to planning and using your time wisely, you must learn what are realistic expectations about how long a project will take, when to ask for help, and when to stop because you have reached your physical or mental limit and you need to rest and devote some time to your nutrition and recreation. The sixth aspect is : having achieved the basic skills and gained a fair amount of experience, your efficiency improves and you begin to achieve more in a day; you begin to start mentoring others; you can confidently and quickly handle multiple projects; if you don't know the answers you know where to find them; you are seen as an authority and people ask you for consultations and presentations and to participate in committees. The final aspect is, meaning that your practice of respiratory care reaches a level at which you meet challenges for which you feel you have no response in memory and yet you succeed.     

Everyday EMS leadership

As EMS professionals, you influence others every day by your actions, knowledge and the way you communicate. You lead teams in critical moments in people's lives; you make a difference. Your attitude, the manner and effect of your communication and your actions will determine whether you will influence people and become a true leader. Become a better paramedic/EMT and leader by ensuring that your influence on others is positive rather than negative. No matter who you are or your position, start today to build your team, put others first and follow your vision.     

Choosing a master's program in critical care

This article has presented information to assist you in selecting a master's program that best suits your interests and needs. You should plan your education and career with the above information in mind. Regardless of which program you select, graduate school is an exciting experience that will provide you with numerous opportunities as you continue in your nursing career.     

When did you last talk with your legislators?

January 2003 marked the beginning of the 108th Congress. If you have not yet spoken with your federal legislators about nurse practitioners (NPs), now is the time to do so. As legislators begin introducing new bills for this session of Congress, it will be important for NPs to inform their legislators about problems and issues facing them and their patients that need to be addressed.
If you have never talked with your legislators, you will want to make an appointment the next time he or she comes home. Most legislators have offices in a centrally located town in their district or, in the case of senators, in the capital and in the larger metropolitan areas of the stat represent. A call to "Telephone Information" should help you to locate their offices and local phone numbers. If you have difficulty finding them, the League of Women Voters or your local Republican and Democratic headquarters should have the information you need. If you have visited your legislator, let them know that you have spoken before and that you would like to talk again. If you had a previous successful interaction the legislator may remember you with pleasure and will want to meet with you again.
If possible, when visiting your congressperson, take a group of NPs with you. Be sure to let the staff know that you are a constituent. Legislators are elected to represent the people in their electoral district in government. As a result, they are particularly interested in the concerns of the population responsible for putting them in office.