Thank you to all of the nurses who sent us their words of wisdom on how they deal with work-related stress. We are compiling these tips into a toolkit specifically for nurses. This project is under development.
I need your help. We’ve been struggling with something here at the Josie King Foundation. Here’s the deal: we are creating a toolkit for nurses, something that will help nurses cope with the stresses of the job, something that will make their days a little better, something that will let them know how much we appreciate them. I know lots and lots of nurses. I’ve seen them at work in hospitals around the country. I’d like to think that I sort of have a notion as to what it must be like to be a nurse, but the truth of the matter is- I don’t REALLY know.
So, I am asking all of you wonderful nurses to help. Here’s what I’m looking for: quick tips on how to cope with the challenges of being a nurse. What do you do that helps you do your job well? What have you discovered that helps you deal with stress? It could be anything like:
- “Once a week I buy fresh flowers to put in the nurses’ snack room.” – Sandy K., RN, Grand Rapids, MI
- “When I come home after a long day on the job, I like to bake cookies with my eight-year-old.” – Sue S., RN, BSN, Tampa, FL
- “I just started walking for forty minutes every day with my neighbor. It really helps clear my head, and my jeans fit a little better.” – Tamara M., RN, Houston, TX
Please post your tried and true tips below. You can also email your tips to firstname.lastname@example.org. We want to collect and share your great ideas with other nurses. If you would like to, please include your city and state, too.
I’ll be sure to share updates on this project as it progresses, but right now we need as many tips as possible from nurses. Spread the word to your nursing friends and colleagues, and have them post their tips, too.
Thanks so much for your help with this, and for all of your hard work with patients,
It’s Patient Safety Week- a time to reflect on all of the great patient safety projects and initiatives that have been under way. So many people have done so much to make our hospitals safer and for that I am forever grateful. But this is also a week to look ahead towards an even safer, better health care system. From what I can see, we have come a long way, but the journey is not over yet. There is work to be done.
- If you are a caregiver, keep focusing on improving how you communicate with your co-workers and patients. Even if your team communicates well, the nature of team work is one of continual change, and it helps to check in every now and then to make sure everything is still working well.
- If you are a student, keep learning about patient safety and preventing medical errors. Ask your professor or mentor about the changes they have seen with regard to medical errors since they started practicing.
- If you are a patient or family member, thank your health care team for incorporating patient safety techniques into their daily routine.
The first time that I ever spoke to a room full of medical students was a few years ago at Johns Hopkins. I told them Josie’s story and at the end of the talk I asked them if they had ever head of the Institute of Medicine’s report “To Err is Human”. No one raised their hand. I remember feeling shocked that these students- who were taught how to cure diseases, deliver babies and mend broken bones- were not being told about one of the leading causes of death in our country- medical errors. The more medical and nursing students to whom I talked, the more I realized that it was indeed a rarely discussed topic. I found this frustrating and confusing. Since then I have tried to talk to as many medical and nursing students as I can. These young minds are the next generation, and if I could make a tiny difference in how they would care for their patients by sharing Josie’s story then I was going to do it.
When Josie was first in the hospital, I kept a journal. It helped me remember everything that was happening, everything we had to do. It helped me release some of the stress. When she died I continued to write. I wrote and I wrote and I wrote. I had to get my sadness, my anger out. It was one of the things that really helped me.
As I ventured into the health care industry, I continued to write off and on. One day I realized that I had what looked to be a book in the making and so I showed it to a few people. They told me to find a book agent, so I did. My agent told me I could get a book deal, and I did. Two years ago I signed with Grove/Atlantic, a publisher in New York. Since then I have been working on the book pretty much full time.
The book is called Josie’s Story. It is about how our family once was. It is about Josie’s death and how we struggled to survive. It is about making the decision to either let the grief and anger destroy me or do something positive, something for Josie. It is about the search for religion, the search for understanding what it means to forgive and the search for the reason why. The book is about my journey into a world I knew nothing about, the health care industry. It is about the wonderful doctors, nurses and other health care providers I have met along the way and the amazing hospitals that have invited me – in my small way – to help them become safer. But most importantly the book is about all of the wonderful things that have come from Josie’s death. Josie’s Story will be in bookstores in September 2009.
I continue to accept speaking invitations. Starting in early September, we will be able to have book signings after the speeches. If you are interested in learning more about speeches and book signings, click here. Of course, you can always email any questions about speaking requests to email@example.com. We will get right back to you.
As we get closer to our publishing date we will have more details to share.
One final note- a portion of the proceeds from the book will go to support the Josie King Foundation.
Thanks- as always- for your interest and support.Read More
There is a great new book out there for patients and their families. It is called Questions Patients Need to Ask. Dr. David Shulkin, CEO of Beth Israel Medical Center in New York City, wrote it with the hopes that it would help patients and their families get safe care and be as informed as possible when in the hospital. Dr. Shulkin has been on the front lines of the patient safety movement for years now, and is truly passionate about patient safety.
On Wednesday the Josie King Foundation and the Johns Hopkins Hospital Department of Nursing recognized nine nurses, one clinical technician and one support associate for their work in patient safety at Hopkins Hospital. These professionals were nominated by peers in their unit for their outstanding work and are true patient safety heroes. I’d like to introduce them:
Maxine has taken a special interest in preventing hospital-acquired infections. She is what the literature calls a “positive deviant”- someone who does the right thing and is an agent for good. She single handedly advocated for two new practices in the Neuro Critical Care Unit: 1) using a fresh rag to clean each separate piece of equipment in isolation rooms and 2) requiring terminal cleaning of the patient’s room once they were taken out of isolation. We know from lab cultures that Bell-Trusty has reduced the prevalence of multi-drug resistant organisms on her unit. While we often worry that the “bugs” are winning, Maxine has won the battle in her unit.
After a serious event involving a monitor alarm in 2006, Kelly’s unit set out to improve the safety of patients on physiologic monitors. They determined that 27,000 alarms were set off on their 15-bed unit every 24 hours- that’s one alarm every three seconds. Creighton worked with her committee and the Clinical Engineering team to improve the situation, reducing “nuisance alarms” by 26%. Kelly literally took the noise out of the system, so that nurses could respond more quickly to patients in trouble.
her unit. She found inexplicable changes in a number of patients’ sodium values. So she followed her instincts (and her intellect) that something was wrong with the laboratory findings being reported in a large series of patients. Working with the lab, an investigation found that more than forty patients in the Cancer Center had incorrect sodium calculations made. But thanks to Henderson’s astute observation and quick action, only one patient was treated for the incorrect results (without any adverse effects).
Vicki championed doing “re-vitals”- that is reassessing patients in the emergency department. In the past two years, she identified significant changes in patients. One was having a heart attack, and the other a stroke. Because of Vicki, these two patients received the required treatment from the heart attack team and the brain attack team earlier than they would have. When minutes count, Jackson’s vigilance was life-saving.
Sara is a new graduate who joined Hopkins in March 2008 and she has already demonstrated an aptitude for promoting the safety and well-being of the very ill patients under her care. For example, Nakamoto discovered that a pre-mixed IV solution had one medication label applied over another label. The IV bag actually contained the solution noted on the hidden label, and this drug was contraindicated for the patient. Nakamoto’s patient had impaired renal funcation with only one kidney, and could have suffered significant complications had the drug been administered. For this patient, Sara was a hero.
Working the tail end of the night shift, Liza was preparing a surgical patient as the first case for the operating room one morning. The patient complained of not feeling well. Liza assessed the patient, whom she identified as having symptoms indicative of an impending stroke. She organized the ophthalmology team and facilitated the patient’s transfer to the Emergency Department where the required treatment was rendered in a timely fashion. Her quick assessment and critical thinking provided an immediate intervention so that the patient with an impending stroke was managed in a controlled environment.
The Hospital has been implementing an electronic provider order-entry system requiring all physicians to enter their orders online, and all nurses to document administration of medications in an electronic record. While the system was designed to be safer than paper-and-pencil versions, it was not fail safe. Robertson orchestrated the collaboration between physicians and nurses that was needed to develop the order sets, and implemented the change across the Department of Surgery. Many safety issues have arisen during this process. Robertson monitors these, and drives safety issues to the top of the priority list for system modifications. While many of our safety heroes have prevented individual patients from being harmed, Robertson is working to make the whole system safer.
On a unit where children and adolescents are treated for psychiatric illnesses that cannot be managed safely out of the hospital, security is a critical concern. Gloria Scott worked with the Pediatric Safety Team to add a security officer to the unit. The lay security officer could maintain a presence at the front door; identify visitors to determine if they are authorized; check visitors’ belongings; and lock away valuable or unacceptable items. However, the security officer was also needed to help with patients in a clinically appropriate manner. Scott explained the unit to the officer, taught the officer how to handle patients, and otherwise implement this new role.
Because of Scott, the environment is secure and the patients are safer.
The stories about Melinda are legion. In summary, she “sees” problems and fixes them. To give one example, Walker recognized a set of safety concerns in the electroconvulsive therapy (ECT) suite. She subsequently prepared a 30-minute educational program covering how to prepare patients for ECT; transport anesthetized patients safely; and maintain a smooth flow of patients through the recovery phase. Her educational program has been incorporated into the annual review that all RNs must complete. Walker is a safety hero for preventing harm from befalling
(Thanks to Hopkins for providing the safety heroes’ stories!)Read More
Energized from the previous night’s meeting with the HCA folks, I took a cab to the John F. Kennedy Library to a conference put on by Blue Cross Blue Shield of Massachusetts (BCBSMA). The conference was titled “In Pursuit of Health Care’s Holy Grail: The Quality Movement That is Transforming Health Care”.
I flew to Boston on Monday, September 16, for a conference put on by Blue Cross Blue Shield of Massachusetts, which was to be held the next morning. Earlier in the week Jim Conway from the Institute for Healthcare Improvement contacted me and told me about a group in Boston that was doing some interesting things in the patient safety advocacy vein. He suggested that we meet.
- mandatory reporting of all hospital-acquired infections
- mandatory reporting of all “never events”
- creation of rapid response methods at all hospitals
- creation of patient/family councils at hospitals.