Tuesday, April 19, 2011

Vital Signs for Nursing; Changing The Culture Saves Lives & Reduces Costs

By Robert Sampson, RN, CEO
Certified  Digital Signage Network Expert

Recently, while researching evidenced based content for RN Vital Signs (3), we learned some very important lessons.. Such as, why specific changes in nursing culture and behavior should be a high priority and objective of  every hospital  administrator and nurse executive. Changing well engrained behaviors is a challenge, but achieving that objective has significant impact on  personal and professional lives of nurses, patient safety, service and the cost of operating a hospital.

According to her on line American Nursing Association article "Lateral Violence: Nurse Against Nurse"  Patricia A. Rowell, PhD, RN (1)  stated her summary,  "Violence in the nursing workplace has a demoralizing presence. The fact that nurses are visiting violence on their nursing colleagues should raise a red flag to the nursing profession and nurse employers that something is wrong – very wrong. Regardless of the theoretical approach embraced, the story is the same – nurses are being demeaned, traumatized, and turned off to the profession. They are being abused and/or abusing others."

CNtv's RN Vital Signs (3) is a smart management and  budgeting choice for prioritizing effective methods of education  that can reduce and  eliminate the high costs associated with Lateral Violence (LV). Karen M. Stanley, RN, MS, PMHCNS revealed sobering statistics regarding the significant impact of LV on hospital budgets, staff retention/morale/practice and patient safety in her paper,   "The High Cost of Lateral Violence in Nursing." (2). Such as:

Cost: Pain and $$$
Who Pays For The Cost?
  • Muccigrosso, 2010; ONPI, 2006; TJC, 2008 Institute of Medicine of the National Academies 2006 Report:
    •  1.5 million patients are harmed by medication errors each year
    • 3.5 billion dollars = extra medical costs of treating drug-related injuries each year
      This figure does not take into account lost wages and productivity or additional health care costs

Problems with patient safety are related to problems with communication  
  • “Let‟s Talk” –Healthy Conversations for Safer Healthcare Theme for 2010 National Patient Safety Awareness Week 

Nurse Turnover Costs: Adjusting for Inflation
  • A 2002 study of turnover costs in a large, acute care hospital revealed: 
    • $62,000 –67,000 per RN
  •  Turnover costs per RN for FY 2007
    • $82,000 –88,000
    • Inflation-adjusted dollars from FY 2002 data
    • If filled with an experienced RN with shorter new hire learning curve
    • 32% overall increase from 2002 to 2007

 Impact of LV and VV on Nurse Retention
  • Average turnover rates: 
    • 8.4% clinical practicing nurses 
    • 27.1% first-year nurses voluntary turnover (PricewaterhouseCoopers‟ Health Research Institute, July 2007)

  • New graduate turnover: 
    • 60% leave first job within 6 months because of LV (Griffin, 2004)
    • 30% left job in first year; 57% left by the second year (Bowles & Candela, 2005)
    • 20% leave the nursing profession because of LV (Griffin, 2005)
  • Nurses intent to leave: 
    • Bullying: a significant determinant of intent to leave (Simons, 2008)
    • Workplace bullying: significantly associated with intent to leave one's current job and nursing (Johnson & Rea, 2009)
Changing The Culture Saves Lives & Reduces Costs

Craig R. Sellers, PhD, RN, ANP-BC states in his review of  Kathleen Bartholomew's RN, MN, monograph Ending Nurse-to-Nurse Hostility (6),  "... I found the discussions, cue cards, sample questionnaires, ideas for innovative programs, and strategies for managers and other organizational leaders to be hopeful and encouraging for our profession. "

"The reader is provided with a number of strategies for addressing hostility: 
  • acknowledge the problem of horizontal hostility and bring it to light; 
  • create a reflective, narrative community; 
  • nurture our young colleagues; 
  • intervene with dueling shifts and units; 
  • develop a unit philosophy; 
  • provide in-services on assertiveness and confrontation skills; 
  • role-model excellent behavior; and 
  • consider applying for ANCC Magnet Status. 

The book also contains continuing nursing education quizzes for CEU credits..."

Craig concludes his review with a comment about a quote from Bartholomew, '...In the end, Bartholomew asserts that, although tackling the problem of horizontal hostility surely begins with each of us,'  "change simply will not happen unless nursing leadership takes on the challenge and the responsibility of making it happen" (p. l81)..."

Here are some examples of lateral violence listed in Bartholomew's monograph:
  • Overt: Name-calling, bickering, fault-finding, backstabbing, criticism, intimidation, gossip, shouting, blaming, using put-downs, raising eyebrows, etc.
  • Covert: Unfair assignments, sarcasm, eye-rolling, ignoring, making faces behind someone’s back, refusing to help, sighing, whining, refusing to work with someone, sabotage, isolation, exclusion, fabrication, etc.
In addition to RN Vital Signs, CNtv recommends two online personal and professional development adult education courses that address the issues and behaviors related LV in Nursing. These affordable subscriptions offer self paced lesson plans, videos and optional sponsored seminars for your entire nursing staff.

CNtv leverages your precious education dollars with proven technology and content,  by  reinforcing  the education and beneficial behavioral changes in nursing  culture. Contact CareNetTV.com, Inc and learn more about how our Multimedia Digital Signage and  RN Vital Signs can assist your strategic planning. Please visit our healthcare education partners website and review their offers.

Tuning In to the Body
Aikido Conscious Body Wisdom  
by Jerry Green

The Ten Lessons are arranged in an order for optimal learning. After learning the basics elements of body-wisdom, you identify your own somatic predispositions for responding to verbal pressure, and identify their relationship to how your mind thinks when engaged in word-wars. There’s physical pressure and there’s verbal pressure. Because they are closely related, we are studying mediation and Aikido together.

Then you practice grounding and centering, finding your core and learning to engage with physical pressure in a confident and relaxed manner. The final lessons reestablish the mental connections by putting words to your newfound body wisdom. This is reverse body-language. You will learn to speak your body-wisdom and you transform adversity in arguments and disputes into understanding, connection and collaboration. (4)

Qigong and Tai Chi Easy Can Help You Stay Healthy
Relaxed And Alert
by Kathy Levac, RN MS

People do Qigong or Tai Chi to maintain health, heal their bodies, calm their minds, and reconnect with their spirit. When these three aspects of our being are integrated, it encourages a positive outlook on life and helps eliminate harmful attitudes and behaviors. It also creates a balanced life style, which brings greater harmony, stability, and enjoyment.  Additionally, Yoga for Seniors is a wonderful exercise.

Kathy Levac Health and Wellness Enterprises LLC was founded in 2002 by Kathleen A. Levac RN MS. She is a respected author and national speaker with over 20 years of experience in health care and helping people improve their lives. Hear about her journey to a healthy living lifestyle!  (5)

(1) ANA Web "Lateral Violence: Nurse Against Nurse"  Patricia A. Rowell, PhD, RN

(2)  The High Cost of Lateral Violence in Nursing Karen M. Stanley, RN, MS, PMHCNS-BC

(3) RN Vital Signs displays CNTV evidenced based content for  the application and benefits  of  networked digital signage in nursing workstations. RN Vital Signs is indicated when prioritizing effective methods and budgets for all types of nursing education. RN Vital Signs  can promote and reinforce Personal & Professional Development Seminars and online learning programs with CNtv Networked Digital Signs for nursing workstations. 

(4) Body Wisdom in Communication and Conflict Resolution
Jerry Green, Greener Mediations, www.GreenerMediations.net , (707) 824-4344, Body Wisdom in Communication and Conflict Resolution in ten lessons online. TUNING IN to the Body: Aikido Conscious Body Wisdom includes Aikido Walking with George Leonard and an introduction by Wendy Palmer. It’s for everyone who values grounded and centered attitudes in the face of pressure.

(5) Relaxed And Alert; Qigong and Tai Chi Easy Can Help You Stay Healthy
Kathy Levac, RN MS Relaxedandalert.com info@relaxedandalert.com www.health-wellness-energy.com Copyright 2011. Kathy Levac Health and Wellness Enterprises LLC was founded in 2002 by Kathleen A. Levac RN MS. She is a respected author and national speaker with over 20 years of experience in health care and helping people improve their lives. Hear about her journey to a healthy living lifestyle!.

(6) Bartholomew, K. . Ending nurse-to-nurse hostility: Why nurses eat their young and each other by Craig R. Sellers, PhD, RN, ANP-BC . Marblehead, MA: HCPro. "Although Kathleen Bartholomew's monograph Ending Nurse-to-Nurse Hostility was published a few years ago, sadly, the topic she covers remains relevant."

1 comment:

  1. I was unaware that nurse on nurse violence even existed. Considering how closely medical staff works together, I'm not surprised. It sounds like you have some good recommendations that will help people. You and your company do good work Robert.