The Article: Effken, J. A., Verran, J. A., Logue, M. D., & Hsu, Y. (2010). Nurse managers’ decisions: Fast and favoring remediation. Journal of Nursing Administration, 40(4): 188-195.

Big Idea: This article explores how 10 nurse managers within three Arizona hospitals made decisions regarding a quality issue on their respective units.

Survey Says!: The researchers found the nurse managers, who varied in age, years of experience, and educational background, did not use decision tools to aid their thinking and often skipped over the nursing process entirely. Rather, the managers jumped from the problem to the solution, which typically involved remedial education for the unit staff, with little or no data to guide their thinking.

Quotable: “Generally nurse managers are at the center of the action and are the “go-to” people when organizational leaders want something implemented. They are expected to identify problems and design and implement innovations that will help their units achieve targeted patient care outcomes while increasing efficiency and holding down costs [references]” (p. 188).

“Nurse managers do not make decisions in a vacuum. Organizational culture, top managerial support, and even adequate staffing can affect decision making [references]. Time constraints encourage nurse managers to make decisions very quickly, so it is not surprising that they take the kind of short cuts we observed. These short cuts may save time initially; but if the results are suboptimal, the time saved may be lost later on” (p. 195).

So What?: The authors explored this topic as they worked to develop a Dynamic Network Analysis Decision Support tool (DyNADS). It is an interesting article as it discusses the decision-making processes of both novice and expert nurses and points out the opportunity for systems changes in addition to remedial education had the nurse managers used decision tools to aid their thinking. The decision ladder method to identify nurse managers’ thinking “steps” was quite intriguing, as well, and I am considering using it as I make decisions in the future.

One of my new favorite blogs is Kind Over Matter. I found it this past weekend as I was searching for free lunchbox printables to put in my kiddos’ lunchboxes…because, you know, I am never creative at 6:30 AM as I’m spreading PB&J over wheat bread while simultaneously thinking about my to-do list for the day and dreaming up how I am going to squeeze in a minimum of 30 minutes of exercise before I crash into my sumptuous pillow later that evening. I need all the lunchbox-note help I can get! Turns out my kiddos adored the notes. Yay! In addition, the Kind Over Matter Breathe poster is now on my office wall, and I have given it away to numerous nurse manager and leader colleagues; I also plan to share it with my team members in a meeting this Friday. It is an excellent reminder and a beautiful piece of medical art.

Amanda, Kind Over Matter author, has this most excellent freebie for a Free Compliments Poster – Break Room Edition. After subscribing to her blog and reading more about her, I learned she has quite a bit of healthcare background working as a nurse aid in hospice and home health. Rock on! In all of five days, her blog has brought me much inspiration. I hope the same for you. I took Amanda’s Free Compliments Poster – Break Room Edition and ran with it to create a nursing-specific compliments poster. Print it, download it, hang it in your nursing break room, share it with others. Work is hard enough; share the love.

The “Keep Calm” posters always make me smile. There are a few nursing-related “Keep Calm” items. I thought I’d add a few of my own versions to the mix. You can download them yourself, as well.

Download Keep Calm and Bevel Up.

Download Keep Calm and Charge.

Download Keep Calm and Lead.

Download Keep Calm and Look It Up.

Download Keep Calm and Nursing Process.

Download Keep Calm and PPE.*

Any other “Keep Calm” suggestions?

*PPE = Personal Protective Equipment

Alex’s Lemonade Stand Foundation (ALSF) recently awarded a refreshing $100,000 to three nurse researchers. Pam Hinds, RN, PhD, Celeste Phillips-Salimi, PhD, and Gloanna Peek, RN, MSN, received varying amounts over the next two years to study childhood and adolescent and young adult cancer. ALSF added the Nurse Researcher Grant Program to its funding portfolio in 2007, making it the first national childhood charity to fund nursing research.

Alex’s Lemonade Stand Foundation (ALSF) emerged from the front yard lemonade stand of cancer patient Alexandra “Alex” Scott (1996-2004). With the vision of finding a cure for all childhood cancers, Alex set out to hold lemonade stands to raise funds to do just that. A decade later, the Foundation bearing her name funds both medical and nursing research which aims to not only find better treatments and cures for all childhood cancers, but to improve the quality of care and life for children and their families fighting the disease now. To date, Alex’s Lemonade Stand Foundation, a registered 501(c)3 charity, has raised more than $50 million toward fulfilling Alex’s dream of finding a cure, funding over 200 research projects nationally including those examining leukemia, brain tumors, neuroblastoma, Wilm’s tumor, lymphoma, and osteosarcoma, among others.

Bravo, ALF; cheers to our nurse colleagues!

The Associated Press recently ran a story of Gail Stotler, BSN, RN, which was picked up by newspapers across the U.S. Gail developed a vein dilation technique in direct contrast to what most all of us learned – a tight tourniquet, rubbing, slapping, and flicking – to identify a ripe vein for the sticking. Stotler’s advocacy for gentle touch to dilate veins may seem like a stretch, but it has been recognized by the National Phlebotomy Association, American Society for Clinical Pathology, and the World Association of Societies of Pathology and Laboratory Medicine. Sounds vetted to me. Stotler practiced the technique for years and published a seven-book series in 2006.

Gail is one in three million U.S. registered nurses (American Nurses Association, 2011) choosing to make a difference one less-painful needle-stick at a time.

The 1 in 3 Million series highlights individual nurses – diverse, frail, powerful, artistic, opinionated, daring – those changing their own lives and the lives of those surrounding them.

Friday’s Article of the Week made me think about family presence during resuscitation a lot.

Take Our Poll

What are your thoughts on the topic?

The Article: Davidson, J., Buenavista, R., Hobbs, K., & Kracht, K. (2011). Factors inhibiting or enhancing family presence during resuscitation in the emergency department. Advanced Emergency Nursing Journal, 33(4): 336-343.

Big Idea: This grounded theory qualitative study was conducted in a Level I trauma center to identify themes or “drivers” of family presence during ER resuscitation. The results of the study helped with the revision of an organizational policy surrounding family presence during resuscitation.

Survey Says!: Twelve healthcare professionals participated in this study. Professionals with both positive and negative views of family presence during resuscitation in the ER were purposely included in the interviews. The authors identified enhancing and deterring drivers, with some drivers simultaneously in both categories. For example, authors categorized “personalizing the patient” as both an enhancer and a deterrent to family presence during resuscitation.

Quotable: “Furthermore, Roberts, de Wit, Epstein, Didomenico, and Devlin (2010) have reported that nurses will block translation into practice by willful nonadherence to protocols when they do not agree with the protocol” (p. 337).

“The central phenomena of allowing family presence at the bedside during resuscitation is affected by staff knowledge, ability to cope with raw family emotion, personal values regarding family presence, the environment, and resources available within the code response” (p. 342).

So What?: I intentionally diverged from my typical articles this week. I may not necessarily use this article in my every day nursing practice, but I do find it valuable. Family presence during resuscitation has always intrigued me as I have been involved in both kinds of codes – those with and without the family present. This article gives a thorough overview of the grounded theory approach in addition to the study concept, and the authors explain grounded theory is an excellent way to drill down to root causes of professionals who choose not to implement practice changes.

The Tournament of Roses Parade is a U.S. New Year’s Day tradition. For the first time, a nurse – Sally Bixby, RN, MS, CNOR, Director of Surgical Services at City of Hope in California, will preside over the 124th Tournament of Roses Parade and 99th Rose Bowl on January 1, 2013. In honor of Sally and nurses everywhere, a float celebrating our profession will grace the world-famous Rose Parade course.

You can like the Nurses Float on Facebook, follow it on Twitter, volunteer with the float, donate to the float in honor of a colleague, and more. Your organization can sponsor a nurse to ride the float, or you can reserve a seat on the float yourself for a mere $30,0o0.

Yeah, don’t look for me on the Nurses Float unless someone wants to sponsor a nurse blogger to cover the momentous occasion. I will likely be watching, though, from a TV away. Wave to me!

Seriously, though…Honor a colleague with any size monetary donation to this special event. Hopefully this won’t be an every-124-years event.

I am joining millions of other individuals and thousands of websites worldwide, such as Wikipedia and Google, to speak out against American censorship, which is currently proposed by two Federal bills – the House’s Stop Online Piracy Act (SOPA) and the Senate’s Protect IP Act (PIPA). The bill names sound great, and I am all for protecting privacy and curbing piracy but not in the name of censorship. Here’s a quick video of what’s happening. Thanks, Fight for the Future, for this video.

And if you want more info, check out the corresponding infographic. You know by now I love a good infographic. I wouldn’t want SOPA or PIPA preventing me from sharing my favorite finds in the future. If you want to join the voices, write Congress now. If you live outside the U.S. and still want to help, petition the State Department. Tweet about it today and until the bills are voted on within the next few weeks using #SOPASTRIKE. If you blog or have a website, consider joining the movement today, as well.

However you do it, rock the day.