Biomedical subjects
Publications and source records attributed to M Schoessler.
Managing during restructuring is a little like managing during a tidal wave or an earthquake. The environment is turbulent, unpredictable, often personally threatening, and laden with long term consequences. As in a natural disaster, you must plan ahead, keep the short term in focus, and the long term in perspective.
While research has shown preoperative teaching to be an essential nursing activity, it has become increasing difficult to accomplish. Increased outpatient surgery and morning admission on the day of surgery have reduced time available for assessment and preparation activities including teaching. In this study, 116 postsurgical patients and 159 hospital-employed nurses completed an investigator-developed questionnaire. The statements were written to operationalize the five dimensions of preoperative teaching: psychosocial support, situational information, patient role, sensation--discomfort, and skills training. For each of the questionnaire statements, subjects were asked to: (1) rate the importance of a 5-point Likert-type scale ranging from "not important" to "very important" and (2) indicate the preferred timing for teaching to occur: before admission to the hospital, between admission and surgery, or at the time of the event. Patients also indicated whether they received the teaching from a nurse. Mean ratings of importance for both groups ranged from moderately important to important with the nurses reporting the wider range of importance. Analysis showed a discrepancy between nurse and patient rank orderings as determined by mean ratings of importance. Patients rated the order of importance as listed above, which is parallel to the reported frequency of receiving instruction. The two groups differ in the ordering only in the placement of skills training. Nurses placed skills training second; patients placed it last. Both groups preferred delivering and receiving teaching between admission to the hospital and surgery. Independent t test results indicated nurses assigned more importance to psychosocial support and skills training than did patients; patients assigned more importance to sensation--discomfort than did nurses.
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Hospice nursing is unique because of the philosophy and issues surrounding hospice care. Program planning for hospice staff follows basic principles. The real challenge in developing programs for orientation, continuing, and inservice education is using a format that will truly enable staff to meet the objectives. A lecture, programmed instruction, or video/slide format works well for the "nuts and bolts," but more creativity is needed for the other issues facing the hospice nurse--death, grief, symptom control, stress, team roles, and helping patients with options. Incorporating into the program some of the methods suggested will offer staff the opportunity to become involved in learning and make that learning more meaningful.
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This article describes a documentation format for Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) standard 6. A system for maintaining ongoing documentation is presented. Once in place, only a few "last minute" items need preparation prior to a JCAHO visit. In the weeks preceding the visit, department members can review the materials for accuracy and completeness and ensure that the document adequately reflects the extent and quality of the department's activities. The system is easily adapted to changes in JCAHO standards.
Myers-Briggs concepts are useful for understanding and managing individual and group strengths, preferences, and "blind spots." Requirements of the work to be accomplished can be matched to the strengths and preferences of the individual or group. Work groups can be selected to enhance individual strengths and to counterbalance blind spots. This article describes the experience of one hospital-based continuing education department that uses the Myers-Briggs Personality Trait Inventory to explore department members' strengths and preferences. Understanding individual preferences has helped group members to understand, anticipate, and work with one another. The ideal mix of profiles challenges and stimulates both the individual and the department. Maximizing diversity increases the potential for conflict between individuals with opposite preferences; recognizing strengths and blind spots, willingness to talk about work style differences, and a little humor all make peaceful coexistence possible.