Reflective Journal - Week 12

This week as we talked about change I tried to look at my life, my personality, and my environment and consider what changes I could make to "mix things up".  In doing so I was slightly disappointed in myself at how much my life is mundane and without much change from day to day.  I don't dislike change, but I find it takes effort to make regular changes in routine and daily life.  So--I tried to make changes to see what happened.  I drove home from work in a different way, which took a lot of effort since I had been awake for 24 hours.  I went with my husband to a new restaurant we have never tried, I was pleasantly surprised.  I tried a new recipe for dinner, I enjoyed it as did my husband, but my kids were not as pleased.  Recalling these little changes in my life brings a smile to my face.  I like mixing things up, especially because it makes people (my kids) question me, wondering why I am doing something.  I think I need to try this more in the future to keep everyone on their toes.  If nothing else it is very entertaining!

Reflective Journal - Week 10

I really enjoyed this week assignments, especially the discussion with my teammates regarding our future in nursing and our ultimate career goal.  It was a good reminder for me of how different we all are.  I am glad that some of my teammates have the goal of becoming a unit nurse manager--since that is a job I never want.  Mostly because it seems difficult, and filled with a lot of meetings.    But every unit needs a good manager and I think some of those who expressed this as their goal have qualities that would help them be successful in this field.  

Last night I attended staff meeting for the unit I work in.   In this meeting we were told that IHC will require all new nurse hires as of July 1, 2017 to sign an agreement stating that they will complete their BSN within 5 years of their hire date.  This made me think back to last weeks discussion of the "future of nursing".  Many of us thought that the BSN requirement was coming, and this confirms that.  We were also informed that for now no requirement has been discussed for current working RNs within the corporation.  But I think that it is only a matter of time before that requirement is made for all nurses.  I was so thankful that I am almost done with my BSN when this thought came to my mind!  

A charge nurse position is going to be opening up in my unit.  I have been approached many times about my intentions.  Although in the past I have never really considered this type of position...this class has changed my thought process a little.  Thinking about my resume, with the plans of eventually attending grad school.  Having charge nurse as one of the highlights of my resume has intrigued me as I think about this position.  I still have not decided one way or another, but this class has definitely helped me view opportunities like this in a different light.  I guess a new adventure might lie ahead....maybe.   

Budget Interview

1.      What do you like most about budgeting?

I find it interesting to see where money goes, and trying to figure out how all the puzzle pieces fit together. 

2.      What is the hardest part of budgeting?

The hardest part of budgeting is keeping employees happy when budget cuts are being made.  Sometimes employees don’t understand that the budget cuts being made are done to avoid staff cuts and other significant changes in the work structure. 

3.      What kind of system do you use to keep track of the budget, is it electronic?

I use an excel worksheet that has been created and adjusted over time.  This makes it easy to quickly see what’s going on in the budget quickly. 

4.      What are some ways you try to keep within budget and where are the most budget cuts usually made?

From month to month there are not usually many changes so staying in budget is usually not very difficult.  The largest budget cuts I have had to make are in wages.  This usually results in having to lay-off 1 or 2 employees and then reassigning their workload. 

5.      Do you have a specific approval process you have to go through to get new items added to the budget?

In order to have new items added to the budget I have to explain why this is needed, and justify the increase in the budget according to increased profit.  This process is done with my manager.

6.      What consequences are there if you go over budget?

I have never had a month where I have been way over budget to know what would happen.  But I understand why this could be a serious problem. 

7.      Were you able to create your budget from scratch, or did the administration of your company hand it to you?

Prior to taking this job the budget was already made.  However, I have made adjustments since I started. 

8.      What is the most difficult aspect of budgeting?

Trying to find money that doesn’t seem to exist.

9.      What area/category of budgeting is the hardest to maintain?

The extras (lunches, flowers, drinks, etc) add up quickly, and people don’t understand that at times. 

10.  What is one tip you would give to a new leader on budgeting?

Frequently look at your budget and try to find ways it can be improved upon. 

11.  What area of the budget would people be most surprised by the amount spent?

The extra stuff in the department.  That stuff adds up quickly. 

12.  Is it difficult meeting budget from month to month?

Not usually since most things are fairly consistent.  

When I think about budgeting....actually lets be honest.  I don't like to think about doing budgets, or living by budgets, or talking about budgets.  But that is not reality.  We live every day within a budget, and the jobs we work at have to do the same.  As I was conducting this interview the one thing I was surprised by was expense of extra things.  I see this in may own life but I don't think I have ever applied it to workplace situations.  Every month when I look at the spending of my family I am slightly disappointed in how much money we spent of things of little to no importance.  In a workplace this can also be an area where the expense of little things can add up without even realizing.  

The person I interviewed was my brother.  He has always been a pretty financially savvy person, but by doing this interview I saw a new side of him.  It's funny how when we are wearing the "hat" of our job we can at times become a what seems like a new person.  I know that I see this in myself when I'm at work, but it is interesting seeing a new side of a person who you know well.  

4550 Critical Thinking Week 10

·         Does the use of EMR guarantee error-free patient care? If yes, why? If no, why?

I do not think that the use of an EMR guarantees error-free patient care.  I think that it can help achieve this goal but it depends on how accurately the EMR is filled out.  Since this is usually information provided by the patient there is room for human error.  Because of this I do not think that it guarantees anything.  But, if done correctly it can be a great tool that can help provide care for a patient that is safe. 

·         What types of nursing behavior regarding the use of EMRs might contribute to jeopardizing patient safety?

·         

      -Rushing the patient while filing out the EMR form

·         -Not looking closely at the names, dose amount, and dose schedule and transferring this information incorrectly to the electronic version

·         -Not clarifying with the patient information that is difficult to read, or doesn’t make sense

·         -Not including OTC medications on the list

·         What are the dangers of excessive system alerts in computer charting systems?

When there is an excessive number of system alerts in a system I think that users become desensitized and stop taking them seriously.  Also, users might stop looking at each individual alert and make assumptions of what alerts has been triggered, and assume incorrectly. 

·         How can the nurse guard against the potential effect? 

To guard against this effect nurses need to take the time to look at the alerts being triggered and see if there is common theme.  Maybe the nurse is doing something wrong that is resulting in a large number of alerts.  Changing their process could help decrease alerts and therefore allow the nurse to focus on potential problems.  

This past year I was involved in the launch of a computer charting system in our hospital.  In the beginning there were many problems, and charting took a long time compared to our old ways.  I kind of got used to alerts being triggered, and when I would read them or find a specialist they would tell me not to worry about it.  This behavior eventually became normal.  Luckily, most of those alerts were fixed.  Now when one is triggered I try and pay attention and read the information provided to fix the problem.  

In my unit we do not complete EMR since I work with newborn babies.  In fact, I have joked in the past that not having to do med recs is one of my favorite things about my job.  Prior to working in the NICU I worked in Behavioral Medicine, and medication reconciliations were very difficult, and very often incomplete...I am so glad I don't have to do them anymore :)

Reflective Journal - Week 9

This week I realized how disorganized I am :)  Trying to find all of the items I needed for my Professional Portfolio was quite the project.  I guess when the semester is over I have one more thing to add to my list....organizing all of my important documents!!

As I work on my Professional Portfolio and think of the future of nursing I had many thoughts go through my mind.  What do I want my future of nursing to be???  This is a question I have asked myself many times throughout my professional life.  When I first started as a nurse I sure I had a timeline in mind for completing things such as my BSN.  Well, I think I'm completing it a little later than I had expected.  But I don't regret it.  In the last 9 years I have accomplished a lot in my nursing career, as well as my personal life.  When people have asked me why now...why not 5 years ago?  My answer is...I wasn't ready 5 years ago.  I had a 2 year old, and had just suffered a miscarriage.  I was not focused on growing my resume, I was focused on my personal life...which was and still is more important to me.  I love being a nurse, but one of the things I love most about being a nurse is the flexibility it gives me to also be a mom and wife.  A mom who has time to help in the classroom, a mom who can read books in the afternoon, a mom who feels like she is able to be primarily at home, and a mom who can raise her own children.  I know that this life isn't for everyone, but I love that nursing gives me that flexibility.  I love my job, and my job fills a different need for me.  When I am at work I thrive on the mental stimulation I can experience, I have so many friends I work with and in many ways these are the people that understand me the most.  So, I guess I have found a balance between work and school, and this balance shifts on a regular basis depending on my needs at the time.  Finishing my BSN fits in my life right now, and I am so glad that I took on this adventure.

Reflective Journal - Week 8

We all love money...but we don't all love to budget!  This week working on budgeting was a new thing for me.  I live my life on somewhat of a budget, but definitely not a strict budget.  Maybe that is why this week assignment was not super easy for me.  Another reason I think that it was difficult was because I felt that cutting nursing budget was the most obvious answer to the problem, but this was so personal to me at the same time.  As an RN, I almost felt bad for thinking that I should cut budget from fellow RNs.  But, as a manager I'm sure feelings like this would not be foreign since each manager started out as a nurse.  I also think feelings like this are a good thing, and help us realize that each budget cut we make is not just a number, but can also be a person and their well being.  Although it wasn't super fun to cut the budget, I tried to find a way to cut budget from the RN wages, but increase budget for the support staff.  This I felt would help the RN feel valued, and supported while on the floor.  As a leader on the unit, I feel that a nurse manager needs to make the staff feel valued and supported.  I hope that if I was actually working with a real budget, and the cuts I made were affecting real people, that they would feel that with the arrangements I made I was keeping their best interest in mind and not just making cuts without understanding who each cut would affect.

From now on my thought process will be a little different when hearing things about budget...more than me just rolling my eyes ;)