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Toxic Nursing, 2nd Ed. Cheryl DellasegaЧитать онлайн книгу.

Toxic Nursing, 2nd Ed - Cheryl Dellasega


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12.9 A Different Kind of Viral

       summary

       part 3 navigating toxic systems

       13 politics and CYA

       clearing toxicity: scenarios, insights, and reflections

       13.1 Mergers/Demergers

       13.2 Easy Change

       summary

       14 patients as victims

       clearing toxicity: scenarios, insights, and reflections

       14.1 Painful Practice

       14.2 Family Friction

       14.3 Power Trip

       14.4 Nurses as Victims

       14.5 Challenging Patients

       14.6 Stereotypes/Biases Against Patients

       summary

       15 on the battlefield: nurses under attack

       #MeToo and nursing

       preventing workplace violence

       clearing toxicity: scenarios, insights, and reflections

       15.1 Physical Attack

       15.2 Too Touchy

       15.3 All the Wrong Attention

       summary

       16 toxic culture/environment

       clearing toxicity: scenarios, insights, and reflections

       16.1 Burned Out

       16.2 Ambitious Attributes

       16.3 Organizationally Cynical Energy Vampires

       16.4 Special

       16.5 Unsupportive Support

       16.6 Replaceable

       summary

       17 conclusion

       embodying transformational leadership

       nursing ethics

       de-tox nursing

       reflections on authentic leadership

       appendixes

       a is your management style causing conflict?

       b conflict case scenario

       c organizational cynicism self-assessment

       d when it’s time to seek outside counsel

       e compassion fatigue

       references

       index

      introduction

      Today’s nurse managers face unprecedented demands in their role as leaders of the largest healthcare workforce in the industry: They must be clinically competent, relationally savvy, and administratively gifted. The lopsided aging of the population has had a double impact: More nurses are retiring from the profession at the same time as elderly baby boomers require increasingly complex and costly care.

      Implementation of the Affordable Care Act came with a renewed effort to contain healthcare costs and promote accessible, high-quality care, partially through the use of the electronic health record, which currently consumes half of the work nurses and physicians perform (Brown, 2020). An emphasis on value-based care rather than a fee-for-service model makes a reduction in hospital readmissions vital, even as length of stays dwindle. As healthcare legislation continues to change and evolve, new challenges are sure to be introduced.

      Nurse managers are tasked with a wide array of responsibilities, from staffing and budgeting to promoting safe and effective patient care. Ideally, they also work to create and sustain a healthy work environment:

      A healthy work environment is one that is safe, empowering, and satisfying, not merely the absence of real and perceived physical or emotional threats to health, but a place of physical, mental, and social well-being, supporting optimal health and safety. A culture of safety is paramount, in which all leaders, managers, healthcare workers, and ancillary staff have a responsibility as part of the interprofessional team to perform with a sense of professionalism, accountability, transparency, involvement, efficiency, and effectiveness. (American Nurses Association [ANA], 2015, p. 21)

      Due to a need for filling positions and a lack of succession planning, new nurse managers may not have the training or qualifications to manage effectively, nor the education and support needed to gain traction. Many nurse managers tend to fall into management positions because they have clinical experience or seniority, or perhaps because they are the ones willing to step into such a daunting role. If managers find it difficult to keep their unit staffed, remain within a budget, and maintain low rates of nosocomial infections, then providing support to staff and promoting a healthy work environment are going to feel mightily out of reach. The learning curve for a new nurse manager is steep, and the extended time it may take to train while on the job has the potential to impact negatively on a unit’s culture and morale (Roche, Duffield, Dimitrelis, & Frew, 2015). In a survey of 1,600 nurses, intent to leave their current workplace was closely related to the nurse manager’s leadership characteristics. The nurse manager’s people skills were identified as the most desired characteristic (Roche et al., 2015).

      transformational leadership

      Transformational leadership is based on five practices that promote “open communication, inspiration, enthusiasm,


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