Partnering Together to Strengthen Your Professional Organization

Happy New Year and welcome to 2015! I’m thrilled to begin my tenure as your 2015 president. As we embark on our 45^th anniversary, let us first and foremost celebrate our organization and the leaders who have brought us this far. We must recognize everyone who has dedicated themselves to our organization, from co-founders Anita Dorr, RN, FAEN, and Judith C. Kelleher, MSN, RN, CEN, FAEN, to our chapter, state, and national leaders over the past 45 years. I would like to express my congratulations and sincere gratitude for your work and accomplishments.

For 2015, our focus must be on value and stabilization. First, what do you value about your Emergency Nurses Association membership? Is it the discount for courses or the opportunity to receive the Journal of Emergency Nursing and ENA Connection? The fundamental question is, what can ENA do to keep our nurses, other emergency department personnel, patients and their families safe while helping our members provide exceptional, skilled emergency care?

We also must identify our members’ needs. Your ENA Board of Directors looks at the 40,000+ membership as a whole. Your Board works alongside the talented ENA staff to identify the future of emergency nursing and plan our future to protect our nurses and those we serve. We want to hear from you. Let us know what is working and what needs improvement. As your president, I will focus on identifying the needs of our members. This will give your Board the assessment information it needs to make decisions that will strengthen our organization and benefit all members. As you see our surveys this year, please take the time to complete them to have your voice heard.

Stabilization is another important topic for 2015. In recent months, Ebola and workplace violence have been recognized internationally as issues affecting emergency nurses. ENA continually brings the concerns of emergency nurses to the public, legislators, and other professional healthcare organizations. When these crises arise we are able to partner and build relationships with other associations and public entities, making our association stronger.

We have also identified the areas needing improvement. For example, we are working rigorously to improve the structure of our work teams, committees, and advisory councils and increasing our partnerships with affiliated boards. We remain focused on our fiduciary responsibility to ensure ENA’s current and future success. This is our year to make a difference by partnering with members, committees, affiliated ENA boards, staff, and outside organizations to look at improving emergency medical care at home and globally. I invite all of you to participate in innovative, exciting events, such as Day on the Hill, April 28-29, in Washington, D.C., and our first combined conference, Emergency Nursing 2015 in Orlando, Fla., Sept. 28 – Oct. 3.

We have always solicited member input and will continue to do so. As mentioned in my president-elect statement, please wear your angel wings of hope and passion to drive us forward in a collective and professional voice of emergency nursing practice. Please always communicate not just what ENA can do for you or what you can do for ENA, but most important, what we can accomplish together.

Welcome to 2015 – this is our year!

Transitions and changes

Happy Holidays! I can’t believe it’s December 29^th, and I am writing my last blog as ENA President. It’s hard to put into words what this year has been like. I continue to be humbled that I had this opportunity to serve and represent all of you as president of our professional association. Absolutely the best part of my journey was working with our members to ensure they had the tools, knowledge, resources and skills they need to stay safe and practice safely in an emergency care environment.

As I reflect on my blog posts, JEN editorials and ENA Connection articles in 2014, I can’t help but believe that a focus on patient safety and safe practice is essential to our everyday work. We need to speak up when things aren’t right. We need to learn to respectfully hold our peers and each other accountable. When we bypass procedures and processes meant to keep us and our patients safe, we need to speak up and call each other out. We need to be each other’s wingman, support each other, lean on each other, and continue our journey towards zero errors in the ED.

Standing up for our right to practice in a safe environment is also key. Stop accepting that violence is part of our job in the ED. Start asking what you can do to help stop the epidemic of violence we experience. For those of you who have implemented solutions and changed culture…get out there and share the great work you have done. We all have something to learn, and we need to commit to lifelong learning as emergency nurses.

Changes and transitions are part of our daily practice now. Embrace those changes as they mean we have an opportunity to do things better and strive for better outcomes. It’s perfectly okay to question, however when the change is rolled out, dive right in and don’t sabotage. Give new things, processes and procedures a try. You might find they actually work. And if they don’t, work to find better processes and solutions.

I am ending this year with a big transition of my own, I am taking a big step in my journey by taking a new job in a new role and moving to Ohio. At the end of three crazy whirlwind weeks of packing, moving, traveling to Chicago twice and one 9 hour road trip to Cincinnati, I am confident I am headed to where my heart will sing. I want you all to find your passion, and run towards it with wild abandon.

Serving as the ENA President has been a life changing experience for me. It has changed the way I think about my practice, how I care for my patients, and how I support and mentor those around me.

Thank you to the 2014 ENA Board of Directors and the amazing ENA staff for the tremendous work we accomplished in 2014. As I transition the role of president to Matt Powers, I look forward to his leadership in 2015. Thanks to all of you for your comments, thoughts, ideas, success stories, support, questions and feedback this year. You helped shape our journey now and into the future of ENA. Emergency nurses rock!

Have a wonderful holiday season, and a safe and happy New Year!

How long are we going to tolerate violence?

This week yet another story about violence in the ED made the national news. Three ED nurses in Oklahoma were stabbed by a patient. I have read many member comments on ENA’s social media (such as Facebook and Twitter). While virtually everyone agreed this shouldn’t happen, there were many differing thoughts about what we can do to make it stop. The lack of metal detectors, security officers, staff shortages, and not enough training were mentioned as causative factors. The attitude of “it happens all the time and it’s never going to change” was pervasive throughout what I read. There seemed to be a general acceptance that this is our reality in our EDs.

What was lacking in these comments was the “what we can do”. We know from evidence that when you report all episodes of violence in your department, you start to see less violence. We know that in order to get buy-in and support from the C-suite of the hospital, there needs to be data about the scope of the issue in your department. We need the reports to be able to make the case.

Yes, I know, this is more work for us. It would be so much easier if we walked into work and said “fix this” and there was no more violence in the ED. That’s the tactic many of us have been employing for years. Clearly, it isn’t working.

Imagine if all 41,000 ENA members walked into work tomorrow with a different plan. Instead of accepting the violence we see on a daily basis, start reporting it. ALL of it. The verbal abuse from patients, families, and each other. The physical assaults. Take the time and report each and every episode. Encourage your peers to do the same. At daily huddles and staff meetings, ask how many episodes of violence your department sees in a day, a week, a month. Offer to create a team to review the incidents and look for patterns. Use ENA’s Workplace Violence Toolkit to help you. Recommend changes to help reduce the incidents of violence. In other words, become part of the solution.

Imagine how different our EDs would be if we had 41,000 emergency nurses believing that violence in the ED is unacceptable. We all need to be committed to creating a culture of zero violence in our departments. Imagine what that would be like. It’s not only possible, it’s imperative. Take the first step and commit to reporting everything, all the time. We will walk this journey together to eliminate violence in our EDs.

Yes we can!

Right now, I am in Tampa at the Nursing Organizational Alliance meeting. Essentially, it’s a meeting where nursing leaders from over 30 different nursing organizations get together and discuss issues that touch our profession. It’s a fantastic opportunity to network, grow, and learn. In my travels this year, I have been very fortunate to meet all kinds of incredible nursing leaders. I want to share with you an experience I had today.

I was sitting with a small group, discussing the challenges we face justifying nursing in a business model. Sitting next to me is Kelly. Full of passion, conviction, and excitement, she made a suggestion. Across the table is a 30-year veteran nurse who is also full of passion, conviction, and enthusiasm. I watched the conversation play out, with the experienced nurse focusing on why we can’t or won’t be successful. She focused on how hard it’s going to be. Honestly, there was nothing she said that was not true. And next to me, I watched the wind fall from Kelly’s sails.

How often do we do that? How often do we focus on the “why we can’t” or the “it’s going to be really, really hard?” When you are having a conversation and you hear that, what goes through your mind? Do you want to take on the challenge, or do you start thinking about how hard it might be, and think about moving on to something else? How many great ideas have been squashed, abandoned, or disregarded because we spend so much time talking about how hard it is going to be to achieve.

Let’s try something different. Instead of “it’s so hard”, focus on how much better it will be when we are successful. When you hear “we can’t”, ask “what can we do?” Focus on the positive, and commit to turning the negative responses into positive ones.

Why? Why does it matter? Imagine if we all channeled our passion and enthusiasm into a positive spin, instead of a negative one. How much happier would we be? How much better will we feel about ourselves and what we are accomplishing? What a better work environment we will have!

So, today, I turned to Kelly and told her she had incredible gifts to offer the profession and not to let anyone ever make her think she didn’t. You see, Kelly is the current president of the National Student Nurses Association. Three semesters into her program she took on a leadership role. She is full of excitement, enthusiasm, passion, and knowledge. She represents the future of our profession. She has much to contribute, now and throughout her career. By focusing on the “why we can’t”, we are crippling our future. Everyone we work with has something to contribute. Some ideas are small, some are pie in the sky, and some may seem impossible to actualize. By creating a supportive environment that focuses on what is possible, we encourage creative problem solving. We create the opportunity for growth and success. And most of all, we smile more. So, stop knocking the wind out of the sails of your teammates. Start embracing the possibilities. Dream big. Be positive. Seek out the Kelly’s and embrace them. What a better world it will be!

Ebola, workplace violence prevention remain top priorities

While the arrival of Ebola in the U.S. certainly brought many challenges over the past month, it also started an important dialogue, strengthened important relationships with our colleagues, and allowed ENA an opportunity to have a voice at the table.

We’ve met with several leading national organizations about how we get nurses what they need to be prepared for patients with Ebola. These conversations, coupled with high-profile media interviews, have even grabbed the attention of the White House. ENA continues to be actively involved in conversations at a federal level about Ebola. We’re committed to advocating for emergency nursing needs for an issue that is not going away anytime soon.

The increased exposure of ENA over the last several weeks has also led to some great opportunities for ENA to speak out about another epidemic: workplace violence. While we emergency nurses know the very real nature of workplace violence in the emergency care setting, the recent assault of our colleagues in Minnesota put a national spotlight on this growing problem.

CNN turned to ENA last week looking for the emergency nurse’s perspective on workplace violence. Thanks to our colleagues such as Dr. Lisa Wolf and her team at ENA, we have hard data to prove that workplace violence is a problem due to things like the 24-hour accessibility of hospitals, lack of adequately trained, armed, or visible security guards, and the unusually high-stress environment.

While on a site visit for Emergency Nursing 2015 in Orlando, I also took the opportunity to speak with the FOX-TV affiliate in Orlando who invited me to speak about workplace violence on their morning show. My message was this: workplace violence is a problem across the U.S., we need to eliminate the culture of acceptance around this problem, and we need to know how to recognize and diffuse these dangerous situations. What happened in Minnesota is not an anomaly; this happens every day and we’re committed to putting an end to it.

I want to remind everyone that ENA has several resources to help you combat workplace violence. First, become familiar with the research on this topic. Thanks to an OSHA grant, earlier this year we launched an online course that covers ways to recognize and mitigate violence toward emergency healthcare providers.

You’ll also want to check out the workplace violence web-based toolkit which takes a practical, step-by-step approach to tackling the issue of workplace violence. The toolkit houses a library of resources, sample forms, policies, checklists, and staff educational materials to help emergency department leaders or designated staff easily initiate and conduct an ongoing quality improvement project aimed at violence prevention.

And finally, consider advocating to make violence against a healthcare worker a felony. ENA’s Government Relations team is ready and willing to help you cultivate relationships with legislators to convey ENA’s legislative and regulatory priorities in an effective manner.

Violence from patients and visitors is NOT part of your job. We hope these resources serve as solutions, or at the very least, conversation starters in your healthcare setting, to make the hospital a safer place for everyone.

Standing together as Ebola arrives

Ebola is here. Each of you has probably received an email from your leadership team stressing the importance of obtaining a travel history on every patient with concerning symptoms. It’s possible you have been trying to reassure your friends and family members that the chance they will contract Ebola is virtually nonexistent. While the media initially looked to assign fault regarding how a patient with Ebola was seen and discharged from a hospital, there is no surprise to me that a system failure was the root cause. In order for us to care for our patients safely, the entire healthcare team must have access to the same information. I am willing to guess each of us can provide examples about documentation that is not easily accessible by a teammate.

ENA is committed to ensuring you, our members, have the information and resources you need to safely care for patients with Ebola and other infectious diseases. Yesterday I had a great conversation with Alex Roseneau, the ACEP president. He and I agreed that now is a time we come together as emergency care providers. In order for us to learn from the situation in Dallas, we need to recognize it takes nurses and physicians working together as a team to identify high-risk patients and take appropriate action. Now more than ever we need to partner together and recognize we are the front line to prevent an epidemic here in the United States.

The lessons here are strikingly similar to those I have shared all year. We need to be accountable and report when system flaws are present so they can be corrected. We need to speak up when something doesn’t feel quite right. We need to work to ensure we are communicating effectively to all members of the healthcare team. We need to constantly be seeking out opportunities to learn about new diseases, therapies, treatments, and medications. And when we are not sure, we need to seek out resources to answer our questions.

All of us should know how to properly screen a patient who might be at risk for Ebola. If you are unsure or have questions, here are some resources for you:

• Checklist for Patients Being Evaluated for Ebola Virus Disease in the United States
• CDC Webinar on Ebola Preparedness for the U.S. Healthcare System
• Detailed Hospital Checklist for Ebola Preparedness
• Ebola Virus Disease Screening Criteria

Thank you for all you do to ensure the safety of the patients in your care. Thank you for being the voice of reason when people want to panic. And thank you for working to protect our country from an epidemic. Emergency Nurses Week starts Sunday, October 5. I am looking forward to spending the week with nearly 3,000 of my awesome emergency nursing colleagues and friends at ENA Annual Conference in Indianapolis. For those of you who cannot join us, thanks for holding down the fort while we are gone. Without you we couldn’t be in Indy. Emergency nurses rock! Have a great week!

Countdown to Indy!

 

At the end of last week, I had the opportunity to speak at the Sigma Theta Tau International Leadership Connection conference in Indianapolis. I shared ENA’s research on workplace violence with two groups: a group of clinical bedside leaders and a group of hospital nursing leaders. It’s always fascinating for me to hear other nurses perceptions of violence in the workplace. Both of these groups acknowledged we have much work to do to create a culture of zero violence. I was able to share both the ENA Workplace Violence Toolkit and the ENA Workplace Violence Prevention online education program to get these nurses started changing the culture in their organizations.

I took some time while I was in Indianapolis to walk around the downtown area. The entire city is totally walkable with a great variety of restaurants, bars, shops, museums, and outside spaces. The canal walk is gorgeous, and as the leaves on the trees start to turn colors, I can only imagine how beautiful that will be next week.

Everyone I chatted with was very excited to have the Emergency Nurses Association descending upon Indy next week. No one was more excited than the Indiana State Council! I had dinner with Ron Kraus, Sherri Marley, and Teri Joy, and they shared the great work they have been doing to get ready for our arrival. Hoosier hospitality was everywhere!

I am very much looking forward to seeing my ENA family in just a little over a week. I am especially excited we will be celebrating Emergency Nurses Week together in Indy! The Resolutions Committee has done an outstanding job preparing for General Assembly. The Annual Conference Committee has put together a stellar educational program that is not to be missed. Safe travels to all, and I will see you soon!

ENJOY INDY!!!!

Inaugural global conference provides international perspective on safe practice, safe care

Greetings from the 1^st Global Conference on Emergency Nursing and Trauma Care! I have been afforded the opportunity to spend three days with almost 400 emergency nursing colleagues from 28 countries in Dublin, Ireland. And what an incredible opportunity it is been. Yesterday I was able to share my thoughts about how our bedside behavior can negatively impact patient safety, and how each of us needs to change our thoughts and attitudes about patient safety.

I also had an opportunity to share the findings of ENA’s research on workplace violence and what we need to do to change the culture of acceptance that is rampant in our profession. I have also been blessed with the chance to listen to emergency nursing researchers from around the globe share their insights and findings about our common practice.

I have said before, one of the most amazing things about emergency nursing is the opportunity we have to share our knowledge and experiences with our team members, and leverage that depth and breadth of knowledge to provide the safest, highest quality care possible. It’s the unique individual experiences and expertise that, when brought together, makes us stronger. At this meeting, I am reminded those strengths go way beyond the borders of the United States. The commonalities of issues and opportunities as they relate to the global profession of emergency nursing are staggering. Crowding, violence, throughput, patient satisfaction, patient safety, access to care, and care of vulnerable populations are just some of the topics discussed. The can-do attitude, passion, and desire for clinical excellence is evident in each speaker’s presentation. The conversations after and in between sessions provide a global snapshot of our profession: its successes, struggles, opportunities, and best practices.

It is truly an honor to be here representing ENA in this international venue. It’s clear to me ENA has a global reach, and many of our international colleagues have shared with me how they have used the tools, resources, and ENA courses in their practice. We are all working towards providing the safest possible care in a safe environment every time, and for every patient. To have the chance to attend this meeting and network with emergency nursing professionals from across the globe is really humbling. The quality of work and passion for our shared profession is outstanding.  I am so proud to be an emergency nurse today!

No Matter Your Role, You’re Making a Difference

I am not usually one to share my feelings, but I have no doubt many of you will relate to what I am about to say.

I came into emergency nursing to make a difference for patients and their families. For me, specifically pediatric patients and their families. Working clinically at the bedside, I really believed I had the chance to do that everyday. As I gained more experience, I gained more nonclinical responsibilities. Still, every day at the bedside I felt like I was making a difference.

I earned my MSN and began a new role as a clinical nurse specialist. Instead of directly impacting patients and families, I now focus on helping nurses be the best nurses they can be. I help them identify strengths they perhaps didn’t see in themselves, and make sure nurses have the tools, skills, knowledge, and attitude to be exemplary bedside caregivers. I wanted to make a difference in their practice so they could make a difference in the lives of the patients and families they cared for.

With more experience came more nonclinical activities. More time away from the nurses I am supposed to be mentoring. More time improving systems and processes to impact the care all patients receive. More time at the computer, writing minutes, designing algorithms, and manipulating spreadsheets. All in the name of improving patient care.

A funny thing happened. The days of feeling like I made a difference became fewer and further between. Sure, there are days I would meet with nurses I was mentoring on projects and watched their faces light up when they shared their successes. But somehow, without me noticing…the days when I could feel I was making a difference were way outnumbered.

Don’t get me wrong, I absolutely love being a CNS. I love the amazing staff I have the honor of working with, and I actually do enjoy my leadership responsibilities very much. For someone who came into nursing to make a difference, it’s just a different set of realities now. 

Today, I had the extreme privilege of being with a family on the worst possible day of their lives. I had the opportunity to comfort, console, hold, support, and grieve with this family. And I remembered why I became a nurse in the first place. We do make a difference, each and every day. It may not be in some grandiose way, but we do. It may be a patient, family member, coworker, or friend whose life we touch. And most of the time, no one will tell us. So, I am telling you. Emergency nurses make a difference each and every day. Thank you for all you do, everyday.

Creating Partnerships to Keep Us Safe

It seems as if almost every day I am reading another news story about an episode of workplace violence. For every one I read, I know there are countless other events happening in our EDs each and every day that don’t make the news. At the end of last week, I had the opportunity to meet with a group of professionals who are just as passionate as we are about keeping nurses safe in the ED. Actually, they may even be a little more passionate.

ENA members Matt Powers, Kris Powell, and I headed to Chicago late last week for a meeting with the International Association of Healthcare Security and Safety (IAHSS) and members of the ENA staff. While Mother Nature tried to keep us apart, Tony, Tim, and Kevin from IAHSS arrived, and what transpired was a very productive conversation about how our two organizations can partner together to create safe environments in our departments. Topics discussed included crime prevention through environmental change, how to identify individuals at high risk for violence, the role of security, how should we view the security staff as a member of the healthcare team, among many others.

We spent quite a bit of time learning about each others perceptions of the role of security in the ED. We discussed the “Barney Fife” image of the security guard in the ED and how we need to move away from an “observe and report” mentality to one of action. We shared how at times emergency nurses can escalate a situation, or might not contact security until a high-risk situation is out of hand. And honestly, it comes down to communication, role clarity, and a shared mental model. Sound familiar? 

For those of you who have an excellent rapport and working relationship with your hospital security team, I can only guess you have clear expectations of each other, role clarity, and engage in frequent and meaningful dialogues about what’s going well and what could be done better. For those who are looking for a more meaningful relationship, we need to start with sitting down in the same room and understanding each other’s roles.

As a team, we were very excited about the opportunities for future partnership with IAHSS. What a great member of the ED team! These gentlemen were all very passionate about creating safe environments for us to work in, and they were just as passionate that security professionals should be part of the ED healthcare team. The question that we spent the most time answering was “What do ED nurses expect from security?” I am interested in your thoughts. We will share them with IAHSS as we work together to create safe practice environments in which we can provide safe care.