Nurse Leader
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Understanding New Graduates: Discovering Program Models That Aid in Transition and Retention
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Imagine graduate nurse Suzie, who has completed her 6-week orientation and is now caring for seven patients on a medical telemetry unit. Suzie is continually overwhelmed with the stressful working environment, and she has repeatedly left the hospital after 9 pm because it took her longer to complete tasks that should have been finished within a 12-hour period. When she seeks advice from her colleagues, many say that “This is just the way it is. It will never get better.” She has repeatedly spoken with her nurse manager, voicing her concerns, but it all falls on deaf ears. Suzie feels that her manager does not understan...
Source: Nurse Leader - September 30, 2009 Category: Nursing Authors: Marla Thomas Tags: Features Source Type: journals
The Great Divide: The Culture of Bedside Nurses and Nurse Managers
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As a career bedside nurse, I felt privileged to share my knowledge of moral distress at a nursing symposium. The feeling of achievement soon turned to disillusionment when I was informed that the content was inappropriate and biased. I began researching hospital work culture, which yielded knowledge that was validating and enlightening. I hope to extend this insight to others.
At the symposium, I presented Magnet™-oriented solutions to help alleviate moral distress. The areas that drew ire were physician–nurse collaboration and the image of nursing. Here is a contextual summation of what I shared with the nurse aud...
Source: Nurse Leader - September 30, 2009 Category: Nursing Authors: Ann Romano Tags: Features Source Type: journals
Shared Governance: Virginia's Empowering Nursing Leaders Speak
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Shared governance, a managerial structure that supports clinical decision-making by staff members, is a key empowerment mechanism in nursing organizations today. In many Magnet™ organizations, the shared governance model is the cornerstone of the forces of magnetism. Nursing literature is replete with shared governance successes and continued explorations of the model. This body of work suggests that healthcare organizations with shared governance models have stronger patient outcomes. This is supported in the business literature by Argyris, who states that the real measurement of empowerment's success is performance imp...
Source: Nurse Leader - September 30, 2009 Category: Nursing Authors: Nancy New Tags: Features Source Type: journals
Teaching Tech: The Challenges of Making IT Work Across Generations
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Start a discussion among nurses about adopting a new technology, and watch the generation gaps play out across the assembled faces.
Nurses fresh out of school are apt to look bored. Whatever device and whatever software you're putting in their hands, they've been there, done that. They likely did it this morning on their way to work—listening to iPods, watching “The Daily Show” on their cell phones, wirelessly accessing The New York Times on their laptops. Of course you need to get some more technology onto the floor. Why wouldn't you?
Some mid-career nurses, for their part, likely will roll their eyes and th...
Source: Nurse Leader - September 30, 2009 Category: Nursing Authors: Cathy Geisen Tags: Features Source Type: journals
The CNO's Role in Professional Transformation at the Point of Care
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The work of the chief nursing officer (CNO) is interpreted many different ways by the more than 5000 people in that role in the United States. Some describe their accomplishments as primarily financial or strategic or turn-around expertise. But what really matters is how the CNO has been able to influence (positively or negatively) what happens at the intersection where the nurse interacts with the patient. The system of care the CNO has been able to create influences what happens at the point of care every minute of the day. Every decision and innovation the CNO creates has the inevitable potential of facilitating or harm...
Source: Nurse Leader - September 30, 2009 Category: Nursing Authors: Karlene M. Kerfoot Tags: Features Source Type: journals
Data-Driven Systems for RN Autonomy
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In early 2005, as the nursing leadership team began to develop final action plans for our Magnet™ application, it became evident to us that we had concerns with our nursing staff's recognition of their professional role responsibilities. Staff appeared to be focused on tasks at hand and less focused on coordinating care based on patient needs. We also heard from our physician colleagues that staff nurses were not always able to articulate a concise report in terms of recognizing changes in a patient's medical condition. The nursing staff appeared to lack a true understanding of their professional responsibilities, first,...
Source: Nurse Leader - September 30, 2009 Category: Nursing Authors: Beverly Jones, Cindy T. White, Andrea Segura Smith Tags: Features Source Type: journals
Economic Turmoil: The Opportunity for Nursing
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Every once in awhile, there is a convergence of circumstances that puts so much pressure on a system that change, managed or not, occurs. To ignore, deny, or resist change in this kind of environment can put the whole system at risk. On the other hand, these can be moments of great opportunity. As pressure grows, the need to find new solutions grows, which can decrease resistance and increase openness. Openness is fertile ground for creativity, innovation, or finally implementing well-understood solutions that have not been embraced or made a priority and, importantly, presents a great opportunity to lead effective change....
Source: Nurse Leader - September 30, 2009 Category: Nursing Authors: Kathy Douglas Tags: Features Source Type: journals
Improving Hospital Performance—Case Study: Progress West Healthcare Center
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The following is one of the numerous case studies available through the American Hospital Association's Hospitals in Pursuit of Excellence (HPOE) initiative. HPOE provides an ever-expanding portfolio of resources to help hospital leaders, clinicians, and staff accelerate the transformation of care. (Source: Nurse Leader)
Source: Nurse Leader - September 30, 2009 Category: Nursing Authors: Jennifer Towne Tags: The American Organization of Nurse Executives Source Type: journals
AHA Introduces Hospitals In Pursuit Of Excellence
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AONE would like to share a valuable new resource to assist hospitals in their dedication to performance excellence—Hospitals in Pursuit of Excellence (HPOE). Through AONE's Transforming Care at the Bedside (TCAB) initiatives, AONE is providing tools and resources which empower frontline nurses to impact quality and safety of care. The success and achievements of the TCAB work are featured as part of the resources available through HPOE. (Source: Nurse Leader)
Source: Nurse Leader - September 30, 2009 Category: Nursing Authors: David A. Strickland Tags: The American Organization of Nurse Executives Source Type: journals
Elizabeth Nelkin McCormick, MSN, RN
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Diligent, industrious, attentive, tireless, and hardworking characterize this dynamic and results-oriented nurse leader. Her interesting history, personal philosophy, and career path are reflected in her journey, one that is full of accomplishments that have advanced nursing as a profession through demonstrated leadership and shaped by her personal passion for sailing. Her ability to achieve balance in her life is a testimony to the depth and breadth of her leadership. Her ability to gain insight from her experiences and learn from them serves as a constant source of renewal and energy as she leads her team toward providin...
Source: Nurse Leader - September 30, 2009 Category: Nursing Authors: Maria W. O'Rourke Tags: Leader to Watch Source Type: journals
Influence by Choice, Not Chance
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At the 2009 annual meeting of the American Organization of Nurse Executives, an attendee submitted an important question to this column: “How can nurse leaders make a difference in transforming the nursing profession to meet the needs of the future?” As I consider this question, I am struck by the intense focus that educators, policymakers, and many other national nursing leaders have on the future and how to meet its demands. (Source: Nurse Leader)
Source: Nurse Leader - September 30, 2009 Category: Nursing Authors: Catherine Robinson-Walker Tags: The Coaching Forum Source Type: journals
Control Is a Good Thing
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The word control seems to get both positive and negative reactions in the workplace. Control is often viewed as punitive and unnecessary and sets the stage for conflict if staff do not adhere to the mandates. On the other hand, control is a well-known process in management that supports accountability for results by ensuring that the policies and procedures of the organization are met. Is the act of control the issue that generates conflict, or is it the way the control is exercised that tends to cause staff reactions? (Source: Nurse Leader)
Source: Nurse Leader - September 30, 2009 Category: Nursing Authors: Katherine Vestal Tags: Lessons Learned Source Type: journals
The Many Faces and Facets of Leadership
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Leadership is apparent when one sees it in action. Effective leaders are measured by the results attained on behalf of the unit, team, department, and organization. We know that leadership can be formal or informal; that is, without necessarily having formalized power. Most often, leadership has been considered the art of persuasion; however, more emphasis has been placed on the multiple internal characteristics desired and those external actions that lead to success. Leadership and leaders have been subject to scrutiny and analysis. The essence of successful leaders is often defined through establishment of educational ob...
Source: Nurse Leader - September 30, 2009 Category: Nursing Authors: Roxane Spitzer Tags: Editorial Source Type: journals
Table of Contents
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(Source: Nurse Leader)
Source: Nurse Leader - September 30, 2009 Category: Nursing Source Type: journals
To a New Nurse
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I look at you, and I remember being you.
You are so thrilled you have attained your goal of becoming a nurse.
I'm trying to remember what drove me to ever do this in the first place. (Source: Nurse Leader)
Source: Nurse Leader - July 31, 2009 Category: Nursing Tags: Features Source Type: journals
To an Experienced Nurse
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I have earned my RN, but when I look at you,
I feel so inadequate, so new.
You are so good at seeing the whole patient.
You can take information from everywhere, and it makes sense to you.
How do you do that? (Source: Nurse Leader)
Source: Nurse Leader - July 31, 2009 Category: Nursing Authors: Dora Sue Redford Tags: Features Source Type: journals
Keeping the Focus on Shortening the Nursing Shortage
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As I begin to write this assignment, the mixed emotions and thoughts are flooding my brain, and I am trying to focus on the task at hand. I am about to finish my first semester toward my master of science in nursing (MSN) in administration and leadership. As I reflect back over many of the reading assignments, while at times overwhelming and discouraging from a leadership and management perspective, I am eager and excited to forge ahead in hopes of being a positive member of the nursing leadership ranks some day. I hope I will be bold and fearless when charged with the task of battling key issues affecting nursing and heal...
Source: Nurse Leader - July 31, 2009 Category: Nursing Authors: Anita M. Rivera Tags: Features Source Type: journals
Cultivating Nurse Leaders from the Bedside to the Boardroom
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Nursing is a noble profession, demanding intelligence, strength, flexibility, and compassion. In the past, nurse graduates expected and accepted that they would work off-shifts and weekends and, until they gained seniority, would have last choice for preferred schedules, vacation, and holiday time. Today, we have a new generation of nurses who highly value personal time. They are upbeat, independent, and self-assured. Like most members of the Y-Generation, today's nurse graduates work to live. They know what they like and refuse to accept anything less. Another cohort of nurses, baby boomers, is nearing retirement age, cre...
Source: Nurse Leader - July 31, 2009 Category: Nursing Authors: Paula B. Hoeger, Jeaneane C. Wilson, Joan H. Evans Tags: Features Source Type: journals
Nursing Executive Practice: A Specialty for Long-Term Care
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This article addresses nursing leadership in the LTC setting. (Source: Nurse Leader)
Source: Nurse Leader - July 31, 2009 Category: Nursing Authors: Sue Heitkamp Tags: Features Source Type: journals
What's So Special About Home Care?
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Since 1965, when the Medicare benefit was passed into law, home care has evolved from a public health paradigm to an acute care model. With healthcare reform targeting the need to contain hospitalization and emergency costs, the home is catapulting to the forefront of discussion as a preferred site of care. Multiple articles have been published about models of care that center in the home. In programs with labels such as “hospital at home,” the “patient-centered home,” the “medical home,” or “telehealth chronic disease management,” outcomes are confirming success in providing cost-effective, excellent care ...
Source: Nurse Leader - July 31, 2009 Category: Nursing Authors: Erin Denholm Tags: Features Source Type: journals
Springboard to Research: A Service and Academic Partnership
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Nurses are attracted to practice settings that encourage and support clinical inquiry and evidence-based nursing practice. Service and academic research partnerships can create a culture and the systems to support nursing excellence and nurse recruitment. This case history describes the evolution of a collaborative service and academic partnership to establish a nursing research program in a multistate community hospital and healthcare system. (Source: Nurse Leader)
Source: Nurse Leader - July 31, 2009 Category: Nursing Authors: Barbara Caspers, Frances R. Vlasses Tags: Features Source Type: journals
CNO Succession Planning: A Case Study
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Understanding that turnover among chief nursing officers (CNOs) is a concern because of the impact on both the organization and the individuals involved, it is important to share stories of successful transitions when one CNO leaves a position and another CNO assumes that role. Competent succession planning can avoid the major disruption in staff morale and patient care programs that are producing desired outcomes during the usual leadership gap when CNO turnover occurs. (Source: Nurse Leader)
Source: Nurse Leader - July 31, 2009 Category: Nursing Authors: Carol A. Watson, Beth Houlahan Tags: Features Source Type: journals
Across Borders: Leading Nursing Internationally
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Traditionally, the international aspect of nursing implied the immigration of foreign-trained nurses to the United States to fill nursing vacancies, or it meant caring for culturally and ethnically diverse populations. We are now on the cusp of true international healthcare. Just as manufacturers have become multinational in their productions, US healthcare is also expanding internationally and brings exciting challenges for nurse leaders. (Source: Nurse Leader)
Source: Nurse Leader - July 31, 2009 Category: Nursing Authors: Jean Dols Tags: Features Source Type: journals
AONE Guiding Principles for the Nurse Executive to Enhance Clinical Outcomes by Leveraging Technology
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(Source: Nurse Leader)
Source: Nurse Leader - July 31, 2009 Category: Nursing Tags: American Organization of Nurese Executives Source Type: journals
AONE's Transforming Care at the Bedside Dissemination Initiative Update
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The American Organization of Nurse Executive's (AONE) second phase of dissemination of the Transforming Care at the Bedside (TCAB) initiative has been adopted as part of our long-term goals to design patient care delivery models of the future and transform the culture of how nurses care for patients. TCAB is a program designed to share a set of practical, easy-to-use tools to help hospitals improve the quality and safety of patient care on medical and surgical units. (Source: Nurse Leader)
Source: Nurse Leader - July 31, 2009 Category: Nursing Authors: Veronika Riley Tags: American Organization of Nurese Executives Source Type: journals
Karen Ripper, BSN, MBA
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Most nurse executives' résumés list a number of experiences in different hospitals or healthcare institutions. This innovative leader has been able to pursue her education, accept new challenges, and advance in her career within one system. All of her nursing profession has been practiced in her hometown and the community where she grew up. Her long-term attachments to the organization and community have enhanced her experiences as a nurse leader. (Source: Nurse Leader)
Source: Nurse Leader - July 31, 2009 Category: Nursing Authors: Kathleen D. Sanford Tags: Leader To Watch Source Type: journals
The 70% Team
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Recently, I was invited to work with a team of directors of clinical services in a successful, medium-sized health system. When I met with these nine leaders for the first time, I was impressed by each member's apparent competence and commitment. Despite their individual strengths, however, their results as a team were seriously lacking. (Source: Nurse Leader)
Source: Nurse Leader - July 31, 2009 Category: Nursing Authors: Catherine Robinson-Walker Tags: The Coaching Forum Source Type: journals
Managing Challenges: Employee Engagement
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No one could have predicted that the nursing shortage would be temporarily mitigated by the sudden downturn in the global economy. The nursing vacancy rates were reduced dramatically in many markets as nurses who might have retired stayed in the workforce, and many who had left the profession returned to work. This reversal of the workforce has given healthcare short-term relief that could be an opportunity to recruit the number of nurses needed and to hopefully retain them after the economy begins to improve. (Source: Nurse Leader)
Source: Nurse Leader - July 31, 2009 Category: Nursing Authors: Katherine Vestal Tags: Lessons Learned Source Type: journals
We Get It
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It is exciting to see the current wisdom focusing on the importance of being actively involved in healthcare policy as a strategy for nursing leadership. This focus is particularly critical at this time in history, since we have a unique opportunity to make inroads at a time when our administration needs and desires nurses' input and expertise. (Source: Nurse Leader)
Source: Nurse Leader - July 31, 2009 Category: Nursing Authors: Roxane Spitzer Tags: Editorial Source Type: journals
Table of Contents
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(Source: Nurse Leader)
Source: Nurse Leader - July 31, 2009 Category: Nursing Source Type: journals
Meet the Professional Persuader
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This article explains which unions are active in today's healthcare arena and the fierce competition to represent healthcare employees. The author speaks from personal experience as a union organizer of RNs. Three techniques used to organize RNs are discussed in detail: (Source: Nurse Leader)
Source: Nurse Leader - June 1, 2009 Category: Nursing Authors: Keith Peraino Tags: Special Section: Labor Relations Source Type: journals
The Nursing Leader's Perspective on the Current Labor Environment
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If the Employee Free Choice Act (EFCA) had been in effect in February, a large healthcare system would be unionized in spite of the fact the health system's secret ballot election was won by 75%. The EFCA was introduced in the House and the Senate, and RNs visited legislators the next day urging passage of the EFCA. (Source: Nurse Leader)
Source: Nurse Leader - June 1, 2009 Category: Nursing Authors: Carolyn Roe Tags: Special Section: Labor Relations Source Type: journals
The Healthcare Union Battle
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This article reviews the history of organizing activities for healthcare professionals, including the initiation of the Organizers Institute in 1996. Today's hospitals need to be ahead of the game by educating team members about the reality of union deceit and distortion. What is the Change to Win Coalition? What are the important aspects of the Employee Fair Choice Act (EFCA)? What has motivated Big Labor to fight for passage of this legislation? This article addresses these matters. (Source: Nurse Leader)
Source: Nurse Leader - June 1, 2009 Category: Nursing Authors: Ricardo Torres Tags: Special Section: Labor Relations Source Type: journals
Are Patients Becoming a Wedge in the Overcrowding Turf War?
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Sick patients now are being used as a wedge in the turf war over hospital overcrowding. Some emergency department (ED) physicians are transferring admitted patients to unit hallways as a way to relieve ED overcrowding. They reason that “in-unit boarding” will force nurses to find beds more quickly. This means that patients, often in physical pain and under emotional stress, are being forced to suffer in public thruways and use portable toilets behind linen screens while family remembers stand around them. (Source: Nurse Leader)
Source: Nurse Leader - June 1, 2009 Category: Nursing Authors: Anthony Sanzo, Lisa Romano Tags: Features Source Type: journals
Catastrophic Conditions, Tough Decisions: The Roles and Responsibilities of Nurse Leaders in Disaster Settings
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There are disasters—a crane collapse, a tornado touchdown or a 40-car pileup—and there are catastrophic disasters, the sort of events that shake our society to its foundation. Nursing is a profession born of catastrophe, and nurses have a long and storied history of providing care during some of the darkest times in human history. (Source: Nurse Leader)
Source: Nurse Leader - June 1, 2009 Category: Nursing Authors: Chad Priest Tags: Features Source Type: journals
Undertaking the Quality Journey
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Many hospitals across the country are embarking on the “quality journey,” pursuing significant and lasting improvements in the processes of care delivery. For some organizations, this endeavor may be related to the pursuit of major recognition for improvements in quality and efficiency such as: (Source: Nurse Leader)
Source: Nurse Leader - June 1, 2009 Category: Nursing Authors: Joan Bowman, Maureen Boshier Tags: Features Source Type: journals
Getting Ready for Your Next Patient: Embedding Quality into Nursing Practice
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One of the roles of a chief nurse executive is to create context for complex problems and to position issues in a solutions-based manner that can be easily adopted by large workforces often spread across many sectors of an organization or system. (Source: Nurse Leader)
Source: Nurse Leader - June 1, 2009 Category: Nursing Authors: Nancy M. Valentine, Mary McKay, Beth Glassford Tags: Features Source Type: journals
Nursing Leadership's Responsibility for Patient Quality, Safety, and Satisfaction: Current Review and Analysis
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The increase in the occurrence of adverse events leading to longer lengths of stay, higher rates of infection, injury, and death is well known to healthcare executives, practitioners, and the general public. In fact, it is not uncommon to hear or read that skydiving is safer than a hospital admission. Emerging in response has been the steady development of methods to measure and evaluate hospital care and, inevitably, more stringent regulatory involvement. Moreover, healthcare professionals have been inundated with new information produced by randomized controlled trials about what does and does not produce good patient ou...
Source: Nurse Leader - June 1, 2009 Category: Nursing Authors: Franklin A. Shaffer, Carol A. Tuttas Tags: Features Source Type: journals
The New Hospital Accreditation: Case in Point
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Ball Memorial Hospital (BMH), a Clarion Health Partner in central Indiana, is the only facility between Indianapolis and Fort Wayne. The hospital has 2,500 employees with a payroll exceeding $95 million. As the senior administrative director of quality and safety at BMH, I had the opportunity to speak to a local group comprising industry quality control and process engineers. My topic was about statistical control in healthcare. (Source: Nurse Leader)
Source: Nurse Leader - June 1, 2009 Category: Nursing Authors: Claire Lee Tags: Features Source Type: journals
Nursing Management: Confounding the Set-Up-to-Fail Syndrome
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The chief reasons employees fail to perform job functions adequately are that they do not know what to do or they do not know how to do what has been asked of them. It certainly isn't because they want to fail, and it rarely has anything to do with a bad attitude. We know this—or at least we ought to—because people have been writing about it for over 50 years! Yet, when asked why an employee performs poorly, the leaders typically blame the employee. (Source: Nurse Leader)
Source: Nurse Leader - June 1, 2009 Category: Nursing Authors: Leah Curtin Tags: Features Source Type: journals
The Evolving Study of Nursing Satisfaction with Support Services in the Clinical Setting
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Over the past 3 years, the American Organization of Nurse Executives (AONE) and ARAMARK Healthcare have conducted a multiphase study geared to improving nursing satisfaction with hospital support service areas, including food and nutritional services, environmental services, clinical technology services, facilities management, patient transport, laundry and linen, central supply/materials management, and security. (Source: Nurse Leader)
Source: Nurse Leader - June 1, 2009 Category: Nursing Authors: Jan Moellering Tags: AONE The American Organization of Nurse Executives Source Type: journals
AONE Guiding Principles for Building the Hospital for the Next Generation
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(Source: Nurse Leader)
Source: Nurse Leader - June 1, 2009 Category: Nursing Tags: AONE The American Organization of Nurse Executives Source Type: journals
Nancy Falchuk, RN
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, is the president of Hadassah, the largest volunteer organization and the largest women's organization in America. Founded in 1912, Hadassah sponsors progressive healthcare, education, youth institutions, volunteerism, and land reclamation in Israel. In the United States, Hadassah offers programs for education, youth, and health awareness, as well as advocates for issues of importance to women and the American Jewish community. She was a founding member of the Hadassah Medical Organization Board of Directors, serving from 1995 until 2004. The Hadassah Medical Organization (HMO) is one of the world's leading healthcare ins...
Source: Nurse Leader - June 1, 2009 Category: Nursing Authors: Leah Curtin Tags: Leader To Watch Source Type: journals
Turbulence Strikes: Whose Mask Goes on First?
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A hospital in which I have spent a lot of time is undergoing major funding cuts. This community resource is part of a small health system, and it has earned a great reputation, especially recent years. Today, its leaders are making every effort to maintain its quality of care while taking anything remotely “excessive” out of its budget. (Source: Nurse Leader)
Source: Nurse Leader - June 1, 2009 Category: Nursing Authors: Catherine Robinson-Walker Tags: The Coaching Forum Source Type: journals
Personal Initiative: Some Have It…Some Don't!
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As a leader, have you ever stopped wondering why some of your staff seem to do whatever is needed to move forward and others stay mired in problems and, at best, just meet you at the door to tell you about them? Do you wonder how you can have several children who seem so different in terms of personal initiative, yet you know they are genetically related? Does it frustrate you that, when you ask for volunteers to work on projects, it is always the same people who raise their hands, while other highly capable people never step up? (Source: Nurse Leader)
Source: Nurse Leader - June 1, 2009 Category: Nursing Authors: Katherine Vestal Tags: Lessons Learned Source Type: journals
Clinical Information and Sociotechnology
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Recent studies conducted in England and Australia developed a theoretical concept called sociotechnology. Think about it—how can an electronic system possibly be successful unless the people who use the technology are sufficiently involved with the planning and implementation? Technical expertise is indispensible in the design of both hardware and software, but as much as technology is shaping society, society is also shaping technology. (Source: Nurse Leader)
Source: Nurse Leader - June 1, 2009 Category: Nursing Authors: Roxane Spitzer Tags: Editorial Source Type: journals
Table of Contents
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(Source: Nurse Leader)
Source: Nurse Leader - June 1, 2009 Category: Nursing Source Type: journals
