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2/21/2010

Thank you to all the attendees who joined us in Chicago for ENA Leadership Conference 2010. We were thrilled to have you in ENA’s hometown during our 40^th Anniversary year. We hope you loaded up on enough education, inspiring presentations, networking opportunities and fun—not to mention Chicago-style pizza—to last you until our next conference.

Make plans now to join us for EMBRACE Present Opportunities & Future Possibilities at the 2010 ENA Annual Conference in San Antonio, Texas, September 22 – 25.

We hope to see you next year in Portland, Oregon, for Learn, Lead & Inspire at Leadership Conference 2011, February 16 – 20.

As one attendee said here in Chicago, “I love coming to this conference, because there is always so much to learn, the networking is great, and people are willing to share. It is like coming home to my other family.”

Safe travels to all of our ENA family.

- Amy

Posted at 1:21 PM by Amy Carpenter-Aquino | Category: Sunday, February 21 | Permalink | Email this Post | Comments (0)

From Safe to Shots Fired: When the Mental Health Crisis Ends in the ED

Wolff

“Big numbers of ugly things are happening to emergency nurses,” said Aaron Wolff, RN, BSN, CEN, pointing to results from a 2007 ENA study on violence in the ED. More than 70 percent of emergency nurses in the survey reported being hit while working in the ED, while 95 percent were victims of verbal attacks. “That is a very, very high risk for us,” he said.

Wolff reviewed several recent events involving persons who brought weapons into the ED with the intent of harming either others or themselves. In one instance, security staff confiscated two loaded guns from a patient, but when the patient later pulled out a third loaded gun in a treatment room.

“How many of us feel that initial sense of relief when we find a weapon?” Wolff asked “This illustrates why that should not be the case.”

In what Wolff termed a “suicide by cop” event, a man walked into a triage area and stated he was there to donate his organs. He showed that he had a gun but did not threaten the staff. A quick-thinking triage nurse said, “I’ll go get the form for that,” and called 911. The event revealed several needs in the ED, such as better communication with security and reinforced walls.

Risks for violence from mental health patients are increasing across the country due to the decrease in outpatient resources for psychiatric care, the lack of inpatient beds for mental health patients and the closing of several EDs.

“The reality is that working in the ED can be dangerous,” said Wolff. “We need to own the problem and build the skills we need to fix it.”

- Amy

Posted at 1:13 PM by Amy Carpenter-Aquino | Category: Sunday, February 21 | Permalink | Email this Post | Comments (0)

Leading at Every Level

Sanborn

Closing Session Speaker Mark Sanborn, CSP, CPAE, gave emergency nurses an important concluding message about true leadership this morning when he advised them to say every day, “I am a leader, I have faith and I can take it.”

That phrase ended a motivational General Session—“You Don’t Need a Title to Be a Leader: Leading at Every Level”—defining leadership, which he characterizes as positive influence, people who want to make a positive difference.

Leadership comes from internal resources, Sanborn instructed. It is about who you are and what you do. “You joined the Emergency Nurses Association to get better at what you do, to learn leadership skills that power up your career.”

Leadership is an invitation to greatness, he said. It is visible competence: Do you have the energy, values, emotional intelligence and character of leadership? He suggests those elements include:

Relationships: The connection you have with other people. It is a performance. Patients watch every little thing you do. You are influencers. How was your infuencer performance today?
Focused attention: Leaders focus on the important work that has to be done now.

Power: You get things done by the power of relationships. You have to be interactive and fully engaged in people. Make them feel special.

Passion: Passion sells. “This is really important!” “This really matters!”

Greatness: Leaders choose to engage in the extraordinary every day. It is not about thinking; it is about doing. It is about implementation. Aspire to greatness.

Nurses need someone to remind them that they do important work, Sanborn added. “It is important for leaders to mentor others, to give back, to contribute. Give back so they can give back to the people who come after them.”

- Jill

Posted at 11:37 AM by Amy Carpenter-Aquino | Category: Sunday, February 21 | Permalink | Email this Post | Comments (1)

2/20/2010

Workplace Bullying: Don’t Be a Victim of Emotional Violence

The key to dealing with difficult people is changing your response to them and the situations they create, said Denise Ramponi, RN, MSN, CEN, CRNP, DNP-S, FAEN. While you cannot control the event created by the difficult person, you are in complete control of your response.

Most difficult people are insecure and lack confidence; they see themselves as victims, and they are motivated by fear. Negativity is a reflection of a difficult person’s inner state.

“Anger feeds on anger, and negativity can snowball,” said Ramponi. “If you don’t address it, it will spread throughout the unit.”

She suggested the BOP approach as one way to address a difficult person:

Become Compliant—If the situation is not that important, such as getting cut off in line at the grocery store.

Operate from the Opposite—Laugh it off if someone yells at you, because that person is expecting you to yell right back.

Practice Care-frontation, not Confrontation—Use “I” statements and explain how the negativity makes you feel. Helpful “I” phrases include, “I see…,” “I feel…” and “I would appreciate it if…”

Ramponi recommended a more assertive communication method called the CUS/S method for handling situations with angry people:

I am concerned;

I am uncomfortable;

I need you to stop this behavior—it is a safety issue.

Ramponi also addressed the issue of patient complaints in the ED and advised leaders that since complaints are inevitable, it is best to address them as quickly as possible, ideally within five days.

“It has been shown that a patient who complains is actually more loyal if you address the complaint; that patient is more likely to come back,” she said.

- Amy

Posted at 7:59 PM by Amy Carpenter-Aquino | Category: Saturday, February 20 | Permalink | Email this Post | Comments (0)

Assess the Risk for Violence in Your ED

“I want to make sure everybody has the tools they need to protect themselves,” said Patricia Allen, RN, BS, MBA, in this session Saturday. “You are all at risk for violence, whether you are a 10-bed ED or a 100-bed ED,” she added.

Allen called several volunteers up to the podium to work through different role-playing scenarios that presented different levels of risk of violence, from subtle to obvious.

In one situation, a staff nurse turned her back on a patient to close the room curtain, and the patient pulled a knife on her.

“The only way to protect yourself in that situation is to screen for weapons. You cannot protect yourself if there is no barrier to weapons,” Allen said. “You must also be aware of the patient immediately.”

Another scenario involved a nurse who noticed that a female patient who had come in the day before for a facial wound from falling on the ice was returning the next day by ambulance and was unconscious.

“I consider your risk very high, because that patient should be considered at risk for interpersonal violence,” she said. “That person could then try to come to your ED and be enraged that she came in for treatment.”

Allen had attendees take a 12-question violence risk self-assessment which asked questions about their facility, such as whether a weapon had ever been found on an emergency patient or if their facility had controlled access to the ED. Some attendees from the same facilities found that their risk assessment scores differed based on which shift they worked.

- Amy

Posted at 7:22 PM by Amy Carpenter-Aquino | Category: Saturday, February 20 | Permalink | Email this Post | Comments (0)

Candidates Address Issues at Election Forum

More than 200 ENA members attended a candidates’ election forum at the Hyatt Regency Chicago Saturday. 2010 election candidates for the positions of president-elect, secretary/treasurer and director on the national ENA board of directors delivered statements and answered random questions on issues ranging from health care reform to using social media for membership recruitment. The 90-minute session provided members with the opportunity to hear directly from their national board candidates on a wide range of topics.

Questions included:

· What are the key points in the ENA bylaws that make this a member-driven organization?

· Providing definitive care for patients with psychiatric issues is a major crisis for emergency departments. What role can ENA play in finding solutions to this issue?

· If you could have input into health care reform, what would be your top three priorities as it relates to ED care?

· Two major sources of revenue include the Leadership and Annual Conferences. How will you assure that these remain a valuable cost effective activity for all members to attend?

· If you were in an ENA leadership role, how could you mentor newer or less involved members into more active roles at the national level?

· How should ENA assist members with the increasing level of violence in our emergency departments?

Complete information for all candidates for the ENA board of directors and the Nominations Committee will appear in the May issue of ENA Connection.

- Amy

Posted at 6:01 PM by Amy Carpenter-Aquino | Category: Saturday, February 20 | Permalink | Email this Post | Comments (0)

Power Hour Sessions

How does a nurse go from being a good nurse to a great nurse? It may be due to emotional intelligence, explained Denise King, RN, MSN, CEN, as she began her Saturday Power Hour presentation, “Emotional Intelligence.” Technical and cognitive skills add up to 20 percent of what it takes to be a great nurse; 80 percent is emotional intelligence, she said.

Emotional intelligence is: the intelligent use of emotions, not allowing your emotions to rule your intelligence, intentionally making your emotions work for you by using them to help guide your behavior and thinking in ways that enhance your results, and the dimension of intelligence responsible for our ability to manage ourselves and our relationships with others.

“It is critical to be aware of these skills and, more important, to master them as you work your way up the career ladder,” King advised. Improving these areas takes persistence, proactive, sincere desire and concerted effort, she added.

The second half of the Power Hour focused on “Professional Work/Personal Life Balance: Is it Utopia?” presented by Denise Ramponi, RN, MSN, CEN, CRNP, DNP-S, FAEN. Most of us would say, “There is no utopia,” she said, “but there are ways to create more balance in our lives.”

There are traditional time-management strategies, such as desk organization and controlling paperwork; learning to say “no” to all of those requests; rethinking your cleaning standards; organizing e-mails, to-do lists and calendar listings; and making a time log to see where your time is going.

To create balance, Ramponi said, it is critical to make time to nurture ourselves: protect your day off; get enough sleep; and manage your energy physically, emotionally, mentally and spiritually.

There is a new term gaining ground, she said: Weisure = Work + Play (Leisure). Utopia? Could be.

- Jill

Posted at 2:27 PM by Amy Carpenter-Aquino | Category: Saturday, February 20 | Permalink | Email this Post | Comments (0)

Ignite Your Life

John O’Leary took attendees on an emotional ride Saturday morning as he inspired attendees to overcome challenges. The survivor of a childhood fire that burned 100 percent of his body, he opened the General Session with a famous quote:

The most powerful weapon on earth is the human spirit on fire.” (M.F. Foch)

Through his personal story, graphically depicted on screen in photos taken from when he entered the emergency department at 9-years-old to recent times, O’Leary presented his beliefs that overcoming life’s challenges involves five key areas he calls:

Courage: Ask, “Today, what am I courageously fighting for?

Vision: “There is nothing like a dream to create a future.” (Victor Hugo) Roy, a hospital worker would pick him up and carry him across the floor, saying “Someday you are going to walk,” until O’Leary started to believe it himself.

Selflessness: “You can do anything in life if you just help enough other people to get what they want.” (Zig Ziglar) O”Leary told the story of Jack Buch, former St. Louis baseball announcer who visited him in the ED when he wasn’t expected to live. Buch gave him the pep talk of his life, saying “Kid, you are going to live. Keep fighting. See you soon.” Thereafter, Buck had players send signed baseballs to O’Leary (60 that summer).

Intentional: What we often call accidents, really are choices we intentionally make, said O’Leary; such as remembering to buckle our seat belts, wash our hands between patients. When he was in the ED and his mother told him he could choose between life and death, O’Leary said he chose life, and that is when he learned to fight.

Perfect: “Growth is the only evidence of life.” (John Henry Newman)

In summation, O’Leary said, “You can’t choose the path you walk in life, but you can always choose the manner in which you walk it.”

- Jill

Posted at 2:26 PM by Amy Carpenter-Aquino | Category: Saturday, February 20 | Permalink | Email this Post | Comments (10)

Recruiting Overseas Nurses to Meet Staffing Needs

Hospitals are finding that it is more and more difficult to maintain adequate staffing levels because of the increasing nursing shortage in the U.S. To remedy the problem and to fill the void, Joanne E. Navarroli, RN, BS, CEN, said that organizations throughout the country are recruiting nurses internationally.

Turning to nurses in foreign countries is not a panacea, however, as this practice comes with its own problems and challenges. Navarroli, a staff nurse/preceptor in Arizona’s Chandler Regional Medical Center, explained from her first-hand experience that both new employee and employer faced orientation issues, communication barriers and cultural adjustments.

Migration itself was not easy for many of the overseas nurses who lived without friends and family ties. And while the overseas could speak English, they had to deal with idioms, slang and jargon that often made little sense to them. This was encountered not only from living in a new country, but especially in the nursing profession or hospital environment. As examples, Navarroli related how a nurse from the Philippines was asked to bring a Christmas tree to a treatment room and was quickly frustrated with a request for a "hat" and a physician’s instruction for a "3H" enema.

Navarroli said that the preceptor and the overseas nurse can work together to meet the unique challenges and will end up with a successful emergency department team committed to a common purpose with exceptional results.

- Ginger

Posted at 1:04 PM by Amy Carpenter-Aquino | Category: Saturday, February 20 | Permalink | Email this Post | Comments (0)

Poster Award Recipients Announced

The ENA Research and Evidence-Based Practice Poster Award recipients were announced at Leadership Conference 2010. The recipients were:

Research Award Recipient
408-O
Evaluation of the Pediatric Emergency Department Left Without Treatment Experience
Janet E. Abbott Eckhart, RN, EdD, MSN; Erin Anne Eckhart, RN, BSN, CCRN, BPMI

Evidenced-Based Practice Award Recipient
436-O
Retrieving a Reputation: A Story of an ED Turnaround
Becky Montesino, RN, BSN, MS

Interviews with the award recipients will appear in the May issue of ENA Connection. Click here for photos from the poster sessions.

- Amy

Posted at 12:53 PM by Amy Carpenter-Aquino | Category: Saturday, February 20 | Permalink | Email this Post | Comments (0)

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