Are you a nurse manager? Even if you're not, you might want to learn more about nursing management issues. This can be accomplished by joining the discussion on RN Manager, an Internet list for nurse managers at all levels and in all specialties. I've been monitoring this list for a while, and although many members do not affix signature tags to identify their institution, listmembers seem to represent primarily hospital settings. To subscribe to RN Manager, write via e-mail to: mailto:[email protected] with the message subscribe. This list also has a Web page (http://www.med-employ.com/rnmgr/), sponsored by a commercial medical employment agency, and is accessible to nonmembers. Web page resources include RNMGR Journal, (a compilation of subjects discussed on the list throughout the course of 1 month, not searchable), a collection of management policies submitted by list members, and a limited number of commercial Internet links. New members receive a standard sign-on welcome message outlining "netiquette" rules (keep discussion professional, edit previous message when replying, no attachments, no commercial messages).
Nurse managers on this list want to share policies (anesthesia consent, visitor hours, disaster communication), and often request or offer advice on important institutional events such as preparation for accreditation visits, converting from paper to computer documentation, using new biomedical equipment, or merging patient units. Listmembers have also discussed topics such as service animals in the hospital and cash bonus incentives for management personnel. This column will discuss several threads with wide application.
Hot Topics for Managers
Recent list threads include many current "hot topics" familiar to maternal-child nurses. Providing adequate and competent staff is a priority for all nurses; thus, it's no surprise that managers raise questions about factors that contribute to competency, including absenteeism, preceptor programs, and patient assessment. A question recently addressed on the list was: "How can managers reduce absenteeism without the use of discipline?" Members offered several suggestions, including having discussions with staff during which actual data on sick-calls are shared in an atmosphere of problem solving, and replacing "sick time" benefits with "earned benefit time (EBT)" that can be used either for illness or as planned vacation time.
Preceptor programs are an important topic for nurses, and list members have shared descriptions of their preceptor programs, including recognition and rewards for their valued preceptors. If you're interested in this topic, visit the Vermont Nurse Internship Project's Web site for documents, references, a slide-show presentation, and numerous links on preceptor programs (Boyer, 2001).
Another hot topic is the role of licensed practical nurses (LPNs) and exactly what assessments they are permitted to perform. List members have discussed various strategies for using LPNs and unlicensed assistive personal (UAPs) in assessing patients, including assessment "training" programs for non-RNs, identifying what the RN should delegate and cosign, and how to distinguish "collecting data" from professional assessment. Several managers have reminded the list members to check the description of professional assessment in their state nurse practice act before developing policies.
One of the hottest topics in infection risk today is the wearing of artificial fingernails by caregivers, a topic of discussion among many nurse managers. List members report that their institutions are revising dress code policies to ban artificial nails because of growing evidence linking the cosmetic nails with high microbe counts and patient infections. At several care facilities, work policy prohibits the wearing of artificial nails by staff who provide direct patient care. Although nurse managers may not administer direct patient care, some members state they, too, are complying with the ban on artificial nails to provide a role model for staff. Several institutions are encouraging physicians to follow nursing's lead in eliminating artificial nails. It is wise for all of us to remember that The Guidelines for Perinatal Care now recommend "no false fingernails or nail polish should be permitted" for personnel in the obstetric or nursery areas (American Academy of Pediatrics & American College of Obstetrics and Gynecology, 1997).
Whether you are a novice or expert manager, consider sharing your challenges and strategies with colleagues on this list!
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