postaday2011

Looking Forward: 2012’s One Word

by Nursetopia on December 31, 2011

So my “one word” for 2012? It’s completion.

I have at least three ideas that have been just that – ideas – for two years or greater. One idea, a goal really, has been bubbling and building within me for five years. I have several other goals I want to complete this year, and completion has a deeper meaning to me, which I know will keep me going even when I want to quit. I have no doubt in my mind this time next year I’ll proudly share a list of goals while reveling in the thought of completion.

Here’s to a fabulous 2012! See ya next year.

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Looking Back: 2011’s One Word

by Nursetopia on December 30, 2011

I adopted the “one word” resolution as opposed to a set list of goals or resolutions in 2011. I thought long and hard about my one word and finally decided “words” fit nicely.

The “words” theme wove throughout all aspects of my life in 2011. I focused more on what I said (and didn’t say). I wrote thank you notes galore. I read more books and journal articles than I have since grad school. I submitted an article for publication in a peer-reviewed journal (which was accepted for publication in 2012). I posted on Nursetopia almost every day in 2011. I focused on additional writing projects with other organizations – some small, some very large. I spoke sweeter to my husband and children, while “words” echoed in my head.

Words, words, words. 2011 may be barreling to an end, but “words” with remain with me in 2012, for sure.

You may want to try the “one word” resolution version, as well. I already have my one word for 2012. I’ll share it tomorrow.

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The Top Five 2011 Nursetopia Posts You Haven’t Read

by Nursetopia on December 29, 2011

These are not the most read Nursetopia posts by far. However, they meant a lot to me in one way or another – either helping me stretch my writing style or serving as a cathartic moment. Here are my top five favorite Nursetopia posts of 2011.

1. The Art of Nursing: The Canvas of Me

2. Bevel Up

3. I See You

4. Quiche, Crosswords, Revolution, & Homelessness

5. Into that Good Night

What about you? Any favorite Nursetopia posts this year?

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The Top Five 2011 Nursetopia Posts by the Numbers

by Nursetopia on December 28, 2011

With the WordPress PostADay2011 Challenge, 2011 was full of Nursetopia posts. Here are the top five posts of the year based on the WordPress stats.

1. Resourced: Free, Full-Text Nursing Articles

2. ‘Star Wars’ Flavor to Dr. Patricia Benner’s ‘Novice to Expert’

3. Lean Tools and Concepts Reduce Waste, Improve Efficiency

4. Nike, You Should Make Scrubs

5. Patient Navigation: An Update on the State of the Science

I love that four of the five posts relate to nursing research. The other one…well, I just hope Nike is listening.

Tomorrow I’ll share my personal five favorite Nursetopia posts of 2011 – those that were especially meaningful to me.

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Happy Holidays!

by Nursetopia on December 23, 2011

You may have noticed the Nursetopia posts have slowed down a bit and become more sporadic than usual. I’m enjoying the holidays with my family and friends. Don’t fret; it’ll be no time before we – including Nursetopia – are all back in the routine. Until then, Friends, soak up life with those you love.

Happy holidays!

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Check-Box Committees

by Nursetopia on December 21, 2011

Committee.

The word gives me shivers. Mainly because I have been a part of too many time-wasting committees. In my mind there are three types of committees:

1. The Effective Committee. This kind of committee has a clear focus and dedicated leadership and team members who work, work, work until change occurs. Either this committee disbands once the vision is achieved, or it is continuously evolving, developing, and effecting change.

2. The Perpetual Committee. This type of committee lasts forever. There is no end in sight, which may be because there is still a lot of work to do to effect change, or it is all talk and no action (e.g. brainstorming without implementation), or no one steps up to re-evaluate the committee’s work to see if the committee has fulfilled its purpose.

3. The Check-Box Committee. This committee is a by-product of a “strategic plan” or an administrator thinking “Let’s form a committee to discuss this more!” The committee has no resources or direction or power to do anything. It is quite simply a completed task someone can say, “Oh, yes. Check! We did that.” No real outcomes are expected from the committee and none are delivered.

Committees themselves do not worry me. I have been (and continue to be) a part of many committees making actual changes. However, it is the check-box committees that scare me. You can spot a check-box committee because no one can clearly explain the purpose of the committee or tell the members what it is exactly they need or want them to do. The committees meet for meetings sake, and you may find yourself thinking, “What are we doing here,” or thinking about what a time-waster the meeting/committee is until you are able to escape and decline all future meeting invites. Check-box committees are typically perpetual committees, too, since no one has any direction, it is hard to know when the committee has completed its purpose so it continues to meet indefinitely. It’s a nightmare especially if you are “required” by your employer to be a part of the committee.

Just say no to check-box committees. Spend your time wisely.

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I Don’t Recommend Nursing to Everyone

by Nursetopia on December 20, 2011

I get a lot of questions about nursing. How do I become a nurse? How do I become an oncology nurse? What is nursing like…for real? Is it too late for me to switch careers and become a nurse? What kind of opportunities are there for me in nursing? What if I don’t make it through school or pass the NCLEX? Can you look at my resume cover letter?

I never tire of answering questions about nursing. I love my career, and I try to provide a balanced perspective of the good, the bad, and the ugly within nursing. However, as much as nursing needs interested individuals, I have actually told people nursing might not be the best choice for them.

In a nutshell, if you do not have a deep desire to help others, or you shy away from hard work (which may or may not include bodily fluids), or you get tired of problem solving, nursing is probably not the right career choice for you. You’ll quickly find that daily nursing work usually includes all these elements, and if you don’t love what you do, it shows. Nursing already has plenty of unhappy individuals that often make me wonder if they were always like that or if they are by-products of negative experiences and environments. There’s no need to add more unhappy folks to health care.

Do what you love. Love what you do. That may or may not be nursing.

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Tony Deifell refocuses vision and perspective in this brief TedxSF video, discussing teaching photography to the blind.

What will you see this week?

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“That” Aversion

by Nursetopia on December 17, 2011

My writing syntax changed forever during my freshman year of high school. My teacher taught numerous lessons remaining with me today as I write for personal and professional reasons. The largest of these lessons regards “that.” Yes, the word – “that.”

Friends who’ve asked me to proof their papers, resumes, and cover letters have heard the “that lesson,” I’ve questioned editors actually adding in “that” into draft works, and I’ve even offered the information, unsolicited, to at least one person. I cannot remember why exactly, but I’m guessing I had too much “that.”

For those inquiring, my teacher typically gave us word limit challenges to encourage succinct writing. Relay the information – still appealing and grammatically correct – in as few words as possible. One hint she gave was anytime we wrote “that,” re-read the sentence, removing the word. Often the sentence makes perfect sense without “that.” For example:

She told us that she was hungry.
The researchers think that the method will work.

Too many red circles and x’s helped the lesson stick. It just so happens one of my favorite writing blogs also recently discussed proper uses of “that,” as well.

Pay attention to “that.”

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The Article: Epstein, A.M., Jha, A.K., & Orav, E.J.  (2011). The relationship between hospital admission rates and rehospitalizations. New England Journal of Medicine, 365(24): 2287-2295.

The Big Idea: Preventing rehospitalizations is a big deal right now, especially as hospitals move towards an Accountable Care Organization (ACO) structure. Most rehospitalization efforts focus on enhancing transition care. However, these authors believe regional practice culture related to hospital admissions and access to healthcare professionals may have more impact on hospital readmissions than so-called lacking transitional care. This study utilized Medicare data to identify the 30-day, 60-day, and 90-day readmission rates for pneumonia and congestive heart failure patients ages 65 and older within 306 hospital referral regions (HRR).

Survey Says!: The authors found HRRs with hospitals with greater numbers of beds, greater numbers of specialists (cardiologists and pulmonologists), and generally higher numbers of admission rates had increased readmission rates, as well. In addition, this study did reinforce inadequate discharge planning as a factor for hospital readmission.

Quotable: “The severity of illness and the presence or absence of coexisting conditions affect the likelihood that an individual patient will be rehospitalized [references]” (p. 2288).

“Ideally, we would have focused our analyses on unplanned, preventable rehospitalizations. However, there is no consensus on how to identify preventable hospitalizations. As a second sensitivity analysis, we repeated our models but excluded readmissions with a primary diagnosis that indicated admission for chemotherapy or surgery performed on a nonurgent basis” (p.2289).

“The quality of transitional care is in need of substantial improvement (reference): many elderly patients fail to receive any ambulatory care before readmission (references), and only a minority of primary care physicians report receiving key discharge information about their recently hospitalized patients (reference). Such findings have prompted policymakers to focus on transitions in care between the hospital and the ambulatory setting as a way to reduce readmissions. Although these efforts probably prevent some readmissions, our findings underscore the importance of the general use of hospital care and suggest that policy initiatives such as creating a shared savings program with an accountable care organization might be effective in lowering rates of readmission as well” (p. 2293).

So What?: I’ve read a lot about preventing hospital readmissions via improved transitional care; this article stretched me. It is full of very complicated statistical methods and terms (at least for me!) and exposed me to some new national data sets I did not know existed. Hospital readmissions are obviously complex and multifactoral. There is no magic solution; still, moving towards an ACO payment structure will likely give organizations an incentive to change providers’ practices and promote proper service utilization among all.

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