Not too long ago I wrote about a nurse, Cliff Willmeng, R.N., who was terminated from his emergency room position for refusing to wear his own personal scrubs while working.
Instead, he insisted on wearing hospital issued scrubs which he could leave at the facility to disinfect and clean rather than risking his family’s health by bringing home possibly COVID contaminated scrubs. He was terminated from his job. Mr. Willmeng filed a grievance with his union saying the hospital system’s uniform code policy violated standard nursing practices.
In the claim against Allina, the hospital system that fired him for not wearing his own scrubs and, instead, donning scrubs from the hospital.
The Arbitrator in the matter noted that Mr. Willmeng believed in good faith that laundering his possibly contaminated personal scrubs at home could jeopardize his health as well as that of his family.
Also, the Arbitrator noted that Allina lacked the grounds to terminate Mr. Willmeng, adding that some remedy short of discharge would be more appropriate in this matter.
Mr. Willmeng, according to the Arbitrator, should be reinstated in his job but that Allina does not owe him back pay. Allina has 90 days to appeal the Arbitrator’s decision on this particular issue.
Meanwhile, the Minnesota Board of Nursing closed the matter without charges but noted that it is a nurse’s responsibility to come dressed in a professional manner. However, his actions did not rise to the level of discipline.
The Board is referring to the fact that Mr. Willmeng was ordered on several occasions to not wear hospital scrubs but to wear his own, yet he insisted on donning the hospital garb to ensure safety for himself, his family, and his patients.
Mr. Willmeng is thrilled to be back at work and continuing to treat his patients.
There is little wonder why nurses are leaving the profession when faced with inconsistent and questionable policies developed during the pandemic such as that of Allina.
Reflecting on Mr. Willmeng’s conflict, it is worth noting that when you advocate for change, especially for yourself, be sure to do so in the appropriate manner so you can avoid ramifications such as those Mr. Willmeng came to face.
For Nurses Week, Kaiser Permanente Antioch Medical Center in California gave its nurses a ROCK!
Can you imagine what the heck may be going on if you received from your employer the gift of a rock for this special occasion?
The rock was blank but came with a message saying, “Encouragement Stone … please take one. Take a moment to paint an image, a word or a phrase of encouragement or wisdom. Keep the rock or give it to a friend as a reminder that the work you do ROCKS! Happy Nurses Week.”
This was beyond insulting that nurses were given a rock for Nurses Week and asked to put their own words of encouragement on it.
It may have been different if the rock came from their manager with a special message noting just why they are so amazing, making it truly a reminder of how outstanding they are which they could keep and cherish. But to have nurses writing their own congratulations on the rock as part of Nurses Week is just appalling.
After this past year of challenge and sacrifice that nurses have experienced while caring for patients in this pandemic, many times in short-staffed facilities, Kaiser Permanente’s intentions may have been honest and sincere but, in my opinion, gifting a rock is an insult.
I found reports that Kaiser Permanente’s Antioch facility has been cited for not reporting COVID cases. Additionally, Kaiser announced this past week that they will be terminating 200 healthcare workers in their northern California facilities. I don’t believe any of those being dismissed are nurses but, obviously, Kaiser Permanente is having a financial problem.
If the above noted is true, being open and honest with their nursing staffs on the situation could go a long way to creating goodwill with staff.
For what it may be worth, for the nurses at Kaiser Permanente in Antioch, as well as for nurses EVERYWHERE, I honor and appreciate you for all that you do for your patients and for the community.
What has your employer done for you this Nurses Week in honor of your service?
A recent Ohio University study revealed a correlation between stress and medical errors. Even before the pandemic, in a study of critical care nurses nationwide, 40% reported depressive symptoms, more than 50% experienced anxiety and over 60% rated their physical health as low.
This is so sad that we have such a number of depressed, anxious, and unhealthy nurses in our workforce. And in my opinion, it’s only going to get worse.
Nurses are stretched beyond belief in working against this pandemic and eventually somethings got to give. Nurses should not have to work in MASH units for such a prolonged period of time.
If you are feeling depressed, anxious, or not as healthy as you would like to be, please get the help you need.
There is no shame.
In fact, getting the help you need actually could reduce the incidents of preventable medical errors, thereby saving someone’s life.
As nurses, we go into nursing to help others. But, if we are not taking care of ourselves first, we cannot take care of others.
Knowing that the higher level of stress, anxiety and/or depression could negatively affect a patient, I strongly encourage you to get whatever help you need.
You’ll feel better and perform better while being able to do the good that you set out to do for your patients.
The study showed that nurses who perceive having wellness support from their organization are more likely to enjoy better health than those nurses who do not work in supportive work facilities.
A study by the American Hospital Association indicated that 90% of hospitals do have employee wellness programs. Therefore, help is available. The question is, are nurses taking advantage of it?
We want our patients to get the help they need; we get to do the same.
I took a mindfulness-based stress reduction class at Scripps Medical Center. Many hospitals do offer these types of programs. Mindfulness-based stress reduction was created by Jon Kabat-Zinn. Maybe there’s a medical center near you that provides these. These courses are also available online for free. This program has made a huge impact on me personally and has substantially decreased my stress level. I am hoping it will do the same for you.
Even after being an attorney for 30 years and having my own business for the past 21 years, sometimes I still feel like an imposter.
Imposter Syndrome is “a psychological pattern in which an individual doubts their skills, talents or accomplishments and have a persistent internalized fear of being exposed as a fraud.”
In our society, people look at professionals as those who have the “answers” and know immediately the solution for all problems. I felt that imposter syndrome was worse for me in the beginning of my career as an attorney and then as a legal nurse consultant … and even when I was a nurse.
When I began in nursing, I would all the time run into situations where I had no idea what was happening and had to ask for help or turn to my policies and procedures or even do some research.
One cannot be expected to know everything. That is an impossibility. That is why practicing law and practicing nursing, with the operative word being practicing is so important is because you can’t know everything. We are always practicing, learning, and growing.
What’s good is that if we have a situation about which we are not sure, we know how to find the answers. Having put expectations on yourself that you must have the answers to everything is completely unrealistic.
Now when this happens, I take a breath, analyze the question, and research information to figure out the best answer or course of action.
On the television series “House,” the main character always has a diagnosis for some obscure case within the approximate 45 minutes. On “Law and Order,” the average broadcast gets to a case verdict in about the same time frame.
Real life doesn’t work this way. And our job is not to come up with the quick fix or answer but to serve as a consultant or coach to construct the best course of action to serve our clients.
No matter which business you’re in, it is normal to feel like an imposter. But that is okay. It is an unrealistic expectation for you to know everything. Your value is not that you’re an imposter because you don’t know everything. Your value is that you know how to get the answers and the results for your clients.
According to a recent new article spotlighting a Washington Post-Kaiser Family Foundation poll, about one-third of health care workers are considering quitting because of burn-out from the demands on them during this pandemic. Actually, the statistic was 3 in 10.
Can you imagine what would happen if 3 in 10 nurses leave the profession? The nursing field is already short-staffed!
Eight years ago, long before COVID-19 changed our lives, I composed a “Nurse’s Bill of Rights.” Interestingly, the things that were addressed at that time still apply today.
Nurses have the right to:
Speak their mind.
Have a reasonable and fair assignment.
Complete work assigned.
Paid more for higher acuity patients.
Go home feeling like they did a good job.
Feel part of the team.
Not be pushed to work overtime because there is no one else.
Not to be made to feel that they can’t call in sick when they are really ill.
Adequate staffing so everyone has time to do everything each patient requires including psycho-social support.
Be respected by patients, their families, co-workers, management, administration, physicians, and other health care providers.
Be acknowledged for doing a good job.
A fair schedule with an equal number of holidays and weekends compared to coworkers.
Not be hurt by a patient.
Be supported after a difficult shift.
Have time to document care provided.
Refuse to be floated to an unfamiliar unit.
As you can see from the Nurse’s Bill of Rights, getting more money is not one of major concerns of nurses. Nurses just want to be respected and appreciated. They want to have fair assignments and feel that they’ve done a good job for their patients.
Therefore, when it comes to gifts, I am not just saying “pay them more,” or, “give them a bonus,” or, “buy something for them.” I am saying to gift them with something in addition to the things in the Nurses’ Bill of Rights.
Look to see which of these areas you can improve at the workplace so that nurses feel that they are acknowledged, appreciated, and heard.
With Nurses Week and Nurses Month coming up, what in the world do we get our nurse friends, colleagues and family members to commemorate the occasion?
According to Gary Chapman in his book 5 Love Languages, there are 5 love languages: words of affirmation, acts of service, quality time, gifts and physical touch. Nurses can be any of these love languages but usually one is dominant.
To determine what your nurses’ love language is and what to get the nurse in your life as a gift, here are a few suggestions.
Words of affirmation: words that makes the nurse feel loved and appreciated. It is important to give nurses positive encouraging words, share how much they mean to you and how valued they are. Nurses are constantly encouraging patients now you get to encourage the nurse.
Acts of service: nurses are so busy taking care of everybody else and always being of service to other people. Nurses are always providing care, going above and beyond for their patients. Gifts for this love language include hiring a housekeeper for the nurse, grocery shopping or helping the nurse organize, schedule or plan.
Quality time: many nurses have outside interests and hobbies that they love. They also love to spend quality time together with their loved ones. If the nurse’s love language is quality time, give them time to read, meditate, relax or time to do their favorite hobby. A day off with focus on doing what they love would be a perfect day for them.
Gifts: nurses are great at giving gifts for others but are not necessarily great at receiving gifts. If receiving gifts is their love language, they are the ones always giving gifts to everyone else. What is something meaningful and thought provoking that you could give them?
The last love language is physical touch. If your nurse’s language is physical touch, nurses are always touching their patients, examining them, holding their hand and making them feel better. Back when I was a nurse, we gave all our patients HS back rubs. If a nurse’s love language is physical touch, they would love a massage, a spa day, skin care, a long bath with a bath bomb or bubble bath would be a great gift.
Depending on your nurse’s love language will help you decide on what gifts your nurse would love.
Usually, a person’s love language is the language that they express most. So, for example, if they are expressing words of affirmation to you or their patients, then that’s probably their love language.
If their love language is touch, they’re always touching their patients (in a good way!), that’s an indication that touch is their love language. You get the picture.
Nurses Week this year is May 6th-May 12 and after a year in the pandemic, it’s going to be especially important.
Nurses are leaving the profession in droves and anything special, unique, and meaningful you could do for them would be greatly appreciated.
There is a plethora of articles throughout the country discussing the fact that nurses are leaving the profession due to the pandemic.
Many nurses are frustrated due to the stress and the lack of support. Many are being forced to reuse PPE, to cancel PTO and to work mandatory overtime. Overall, most are flat out exhausted if not completely burned out.
According to National Nurses United, “We can’t afford to lose even one more nurse!”
However, the pandemic is not the only reason so many nurses are abandoning their careers. Workplace violence remains a large factor in why some nurses are calling it quits.
The U.S. House of Representatives is considering a bill (H.R. 1195) to address that problem. It would mandate several OSHA home health care and social service employers responsible for developing and implementing a plan to prevent workplace violence. Though the bill is expected to come up for a floor vote in the near future, the bill currently is before the House Committee on Oversight and Reform.
However, on the flip side of this situation, more nurses are applying to nursing school. So many that there are not enough clinical facilities to train them. [Story]
What are your thoughts on this crisis? Let me know by commenting below.
Escape from Alcatraz, you know the movie, but now you created a prison that is holding you captive in your business and it’s time to escape. I don’t mean sell your business. If you are like me, you built your business so you could have freedom but what you did was build yourself another J-O-B. You are putting way too many hours in, your to-do list is a mile long and you can’t seem to get everything you want done. That was me in 2012. The good news is it doesn’t have to be that way. I know, I am a recovering workaholic, and you can recover and escape the prison too.
In 2012, I heard those awful words, “I’m giving my 2 weeks notice.” I had gone through 6 part-time assistants, most lasting only about a year to a year-and-half. I have been on this merry-go-round before and it seems like every time I had someone trained to where they were working effectively, they would leave, and it would be time to replace them. Now I would get to spend more time, which I did not have, training someone new.
Dejected, I went to my favorite breakfast restaurant and sat in the section with my favorite server, Amanda. She said, “You look sad. What’s wrong?”
“My secretary just gave notice,” I confessed.
I asked if she knew of anyone looking for a part time position as a legal secretary. She promptly told me that she would be interested but would need to work full time.
There I was, looking at this 18-year-old girl who had just graduated high school and was starting her work experience by waitressing in a coffee shop. All the while thinking, “Does she have any of the skills I need for my law firm?”
I watched how she was able to serve all of her tables, each with customers who seemed happy with her and her service … drinks filled, and their breakfast orders correct. Certainly, she had qualities that I really admired like organization, prioritization and keeping her customers happy. However, I wondered did she have the skills to work in my law firm? I realized that one can hire for skill or hire for qualities. I realized I can teach the skills but not the qualities.
The first decision to be made was whether I could teach her the skills she would need to succeed in my business. I then was faced with the second decision; would I be able to pay an assistant full time rather than the part time salary I had budgeted? It would mean I would have to generate more revenue to cover her salary and she would be paid before me. In my mind, thinking I would have to work even harder to generate more revenue.
My choice was either to stick with business as usual, just barely scraping by, working harder, and doing things that did not generate income. Or I can take the plunge, invest in myself and focus on money generating activities and hire Amanda full time.
I chose to hire Amanda full time!
It’s 9 years since that time and that decision remains one of the best I’ve ever made. Amanda was one of the keys to unlocking my prison cell. Amanda has grown with me and the practice. She was a quick learner and her skills have developed. She is now my office manager taking care of everything! The best part is that I get to do what I love every day and do not have to deal with the non-money generating parts of my practice. I am free and no longer a workaholic.
The day I hired Amanda was the day that I went from business owner to CEO of my company. Everything I do now, I run through the scope of the question would a CEO do this?
If the answer is, “No,” I deleted it or delegated it.
One of the problems I had initially was I felt I was the only one who could do the work. I built my own prison. If I did it, I knew it would be done right. It also was a place to hide, solitary confinement, so that if it did not get done, it also was on me.
I felt like I was the best kept secret because I knew I had a great service to offer but no one knew who I was. I was locked away. It was not until I invested in myself, that I was able to have time and freedom to take massive action and therefore, I was able to grow my business and start several other successful businesses.
As a business owner, time is your biggest asset, and it is the only non-renewable asset. You can always make more money, but you can’t make more time.
If you spent time like money, what would you do differently? Would you spend all those hours on your business or do something you enjoy?
Getting back my time from doing non-money generating activities was the biggest gift. I was able to spend more time with my family and even take 2-week vacations, true freedom, without worry while still generating income.
One of the reasons that many of us feel that we have to work harder to make more money is because we are tied to the dollar-per-hour model. Many of us have come from jobs where we were paid by the hour and the only way to make more money was to work more or work harder to get a promotion with a raise.
However, there are several other business models that do not rely on the dollar-per-hour model such as creating packages or a membership program which allows you to maintain consistent cash flow without spending more time or working harder.
The second thing that is important to know about time is you get to choose how to spend your time. I find that putting everything in my calendar instead of having a to-do list helps me avoid being overwhelmed.
It seems counter intuitive that putting everything in your calendar actually gives you freedom. By putting everything in your calendar, it allows you the flexibility to reschedule if you can’t get something done. I suggest putting your self-care in first. Making yourself a priority allows you to take care of yourself. Once you are fulfilled, you have more to give to others.
In addition, when you put everything in the calendar, not just self-care activities, it should include vacations, time with your family and if you have children, time with your children. By putting all the things in your calendar that are important to you first, gives you the energy and the stamina to fill in the other parts of your business and makes working on the business parts much more enjoyable.
There are different stages to every business. There is the infant stage where your business is a baby, and you have to feed and nurture your business. This is the stage where prison begins. We feel like we can’t get a break and need to do everything. Try some of the suggestions mentioned above to avoid your lockdown.
However, as you get busier and your business becomes a teenager and just like every teenager, the business can be rebellious and wants to go off on its own direction. Reigning yourself in and being diligent with your calendar will tame the teenager to get the most from your time with your business and give you the “get out of jail free card.”
The next stage is the adult stage where things function on autopilot. It means that you have the system, the finance, the operations, and the marketing all in place. Things run smoothly and you just do what you love because the rest is being handled automatically with the systems, operations, finance, and marketing.
When your business is an adult, you have the business functioning on autopilot except the things you love doing and are needed for you to do generate money. This is the ultimate freedom. Spending time the way you want and on your terms.
Therefore, by becoming the CEO of your business and following these simple steps of not trading hours for dollars, creating a new business model, delegating non money generating activities, being choosey of how you spend your time, and consciously know what stage your business is in such as baby, teen or adult will allow you to make more money, be more satisfied and actually love the time you spend in your business. No more working harder to make more money. No more stress that there is not enough time and your to do list is as tall as you are! You started your business to have freedom in your life over your time and how you spend it, so don’t just create another job for yourself. Congratulations! You have escaped from Alcatraz.
There are several different degrees in which one can become a registered nurse. They can have a diploma, associates or a bachelors. There also are several master’s degrees. When I attended nursing school, I became a MN, a Master of Nursing. But now, the prevailing degree is an MSN., Master of Science in Nursing.
With a doctor’s education, one can earn a EdD, PhD, DNS or DNP. EdD for education, PhD for research, DNS Doctor of Nursing Science or DNP Doctor of Nursing Practice to name a few. All of these terminal degrees can use the title Doctor. Now the State of New Hampshire is causing a stir about the use of the name of nurse anesthesiologist.
The CRNAs (Certified Registered Nurse Anesthetist) claim that “Nurse Anesthesiologist” is a clear term for patients to understand what the CRNA does. They believe the term anesthetist can be from a technical degree referring to anesthesiology assistants who have begun to refer to themselves as anesthetists.
Apparently, the CRNAs in New Hampshire were calling themselves nurse anesthesiologists until a lawsuit was filed by the New Hampshire Association of Nurse Anesthetists to use that term. The New Hampshire Board of Nursing recognized the term “nurse anesthesiologist.” In response, the New Hampshire Board of Medicine voted to prohibit individuals from calling themselves anesthesiologist unless they are a physician licensed by the Medical Board. The New Hampshire Association of Nurse Anesthetists filed suit against the New Hampshire Board of Medicine to remove their ruling to prohibit non physicians from using the term anesthesiologist.
The arguments were that (1) there is no trademark on the term anesthesiologist, (2) it makes it clearer to the patient that the term anesthesiology is a unique discipline in that multiple professionals are experts in anesthesiology, not just physicians.
CRNAs undergo rigorous education and professional training. The National Council of State Boards of Nursing promulgated the consensus model for Advanced Practice Registered Nurses of which CRNAs are a part of those model rules.
However, the New Hampshire Supreme Court ruled that the term anesthesiologist applies only to physicians. The American Society of Anesthesiologists was thrilled with the opinion and the American Medical Association also submitted a brief in support that nurses are not anesthesiologists in the same way that they are not physicians.
The American Society of Anesthesiologists claims that the use of anesthesiologist by nurses is misleading and confusing to patients. However, if you say you are a nurse anesthesiologist, I cannot see how that can be confusing or misleading, especially when nurse anesthesiologists perform similar functions as physician anesthesiologists.
This ruling applies only to parties in New Hampshire, but I would think it will be looked at by other states as well.
What do you think about CRNAs being called nurse anesthesiologists? Let me hear your thoughts below.
Lorie Brown, Nurse Attorney, of Brown Law Office, P.C., discusses the Exclusion List from the Office of the Inspector General (OIG). This list excludes nurses and other health care providers from treating Medicare or Medicaid patients. Lorie discusses how you get on the list, either mandatory or permissive, and possible jobs you can do if you are on the Exclusion List.
