Conflict Resolution Journal

Before class, I was expecting more of a discussion on conflict resolution directly in the workplace amongst coworkers or with management.  We spent the day talking about labor unions and how they are annoying and a little bit about how they are beneficial. It was interesting that they are so like a mafia in that they will turn your coworkers against you in order to strong-arm you into approving the union.  If a union is approved within your workplace, then you have to pay the dues, which can be hundreds of dollars each month.  The vote for a union can pass with just one vote over 50% approval.  They can be beneficial in order to protect the rights of the employees and they can work in order to gain pay raises, for example.  Any management above a charge nurse cannot be a part of a union.  All of these are things to consider in the future if i am faced with a decision to join a union.

Quality Reflective Journal

Before class, I was expecting to discuss the way quality is measured and achieved in a healthcare setting.  We discussed how to attain quality in healthcare.  This means communicating and inquiring about the expectations we have as employees and the expectations our patients have.  Some patients seem to have very high expectations about what treatment they get from their nurses while in the hospital while others don't expect the nurse to do very much for them.  We touched on patient surveys and how, when a hospital outsourced their patient satisfaction callers, they received lower scores than when the person was local or knew how to pronounce the name of the city, for example.  Also, scores were higher when they would say "excellent" more frequently with the patient.  We talked about how making changes upfront causes prices to be lower than when changes are implemented later on.  The costs could be time, money, or patient or employee satisfaction.  We addressed what Deming had to say about quality.  He had the view that the changes in a company should come from the bottom up, rather than having to go through management.  He has 14 key points to his theory about quality.  Finally, the toast video we watched brought up the fact that we need to make changes back at the point of the toaster rather than after the toast has been burned and then we try to make the burnt toast look nice.  That is referred to as acting to the special cause rather than reacting to common causes.
Our guest speaker was interesting because she was pretty different from our risk management guest speaker.  This speaker always wanted to be a bedside nurse and didn't have managerial aspirations.  With both of these ladies, however, it seemed as though they were almost handed their positions that got them to where they currently are.  They were hard workers, of course, and by being that way, they were impressive to superiors who offered them positions or suggested they go for a position they would have not applied for otherwise.  She mentioned that relationships are very important and to not burn bridges, because you need those connections.  Very interesting perspectives from the CNO.

Risk Management and Legal Responsibilities Blog Post

I expected to learn about what happens when legal action is taken against the hospital or any employee of a hospital.  Karie Minaga-Miya talked to us about the job of a risk manager and what kinds of decisions she needs to make.  There were a few scenarios that were no-brainers, but then others brought up in class that I'm not sure how I would make the judgement call.  From what we discussed, the risk manager is probably very concerned about proper documentation and facility protocol.  All the talk about legal issues makes me worry about documentation and getting sued.

Leaders as Educators/Future of Nursing reflective journal post

Before class, I was expecting to have class, but instead we had our combined class time and then no individual class time. Troy talked more about travel nursing and about teaching and why he chose to teach. We discussed tenure as well and how a teacher attains it. After discussing both of those topics at length, we ended our class time. I have never really considered teaching since the idea scares me, but it sounds like a better idea than doing bedside nursing for the rest of my life. With teaching, I would get the holidays and possibly summers off and the work wouldn't be as stressful physically.  Troy also mentioned that there is a lot of paperwork involved with a teaching position outside of grading papers. It seems that that is what happens when you have a position that requires a master's degree.

Strategic Planning Reflective Journal

Today, we had a guest speaker who works with Troy and she talked about how she became a nurse and how she did not like beside nursing, so advancing her degree to a BSN and then MSN has helped her go toward management positions.  She worked as a bedside nurse for 20+ years, but did not want to do it her whole life, which is something I will need to consider since the physical labor associated with bedside nursing is not always an option as a person ages.  Troy talked about his job in patient placement.  In our regular class, we discussed strategic planning.  That means that you plan with a goal in mind.  We did a project with the goal of getting more patients to our facility and then we did another group activity suggesting ways to get people to our BSN program.
I got motivated to pursue my MSN during the first part of class.  I currently don't like my job in psych nursing, but I hope that after a while, i will be able to determine which area of study I enjoy and then go into either an MSN or NP program. Right now, I would prefer to work while I figure all of that out since I haven't really enjoyed my nursing experience yet.

Change Reflective Journal Entry

Before class, I expected to cover different ways staff adapts or doesn't adapt to change, much like the "Who Moved My Cheese?" discussion. In class, we discussed issues we face when there is a change. We also talked about how CEOs are hired to fix problems, usually budget issues. CEOs generally change the administration soon after they are hired so that they can put in their own people that they already know they work well with and that already know them and their vision. It seemed that budget is the biggest issue to be resolved in a for-profit hospital and it can cause a manager to get fired if they do not stick to their budget. We then discussed "Who Moved My Cheese?" and ways that staff can either go with the change or drag their feet and even go out of their way to hinder the process. At work, it's important to look at the positive aspects of change, but if it really is not working, I think we need to vocalize our opinions instead of just dragging our feet without saying anything.

Budget Interview

1. How often do you review your budget? Monthly, weekly, or yearly basis?

They do weekly profit and loss budget reviews via email with each department manager and then monthly meetings with each department manager in person.

2. If you are over budget, where are adjustments made first?

Cutting costs.

3. How do you determine how much of your budget will be allotted to employee pay, products, or other expenses?

Analyzing prior year budgets, sales forecasts and trends, etc.

4. If you have no problem areas of your budget, what would you say contributes most to being able to stay within your budget?

Continual review, accurate and realistic projections 

5. Are changes in the budget communicated to your employees and staff?

Yes 

6. Who is involved in the process of reviewing the company budget?

Mainly their Financial Controller.

After doing this interview, I don't think I would be very good at determining a budget. It's great that each department manager is involved in the budget and that the other employees and staff and notified of the changes. I have no idea of our budget where I work, but I would be interested to see it.

(I interviewed Jenny from Thrive Life.)