Margaret Imbrock 29 Jan 07 5:51 PM MST Discussion: Forces of Magnetism: Consultation and resources The American Nurses Credentialing Center (2005) summarizes this force as having adequate consultation in the form of knowledgeable nurse experts and other resources available within the organization. There is to be peer support within the division or individual departments. Steinbinder, A. (2005) provides the example of nurses having access to CNSs, educators, pharmacists, chaplains, dietitians, therapists, and other clinicians to assist them in delivering patient care or answer questions related to patient care. Jordan Hospital interpreted this force to mean their advisory board roles, grant partnerships, and contractual agreements with area nursing programs (Taylor, 2005). Miami Valley Hospital used the example of their inpatient Lift Team development utilizing an interdisciplinary approach (Taylor, 2005). Strong Memorial Hospital used their medical library and intranet webpage resources to document this force (Taylor, 2005). Nursing’s Social Policy Statement (2003) identifies that nursing “specialists” have expert competence. The nursing profession measures this expertness through advanced practice degree licensure and certification examinations. Specialists in nursing practice must be graduates from an accredited graduate nursing program. The policy statement identifies expert competence as an abstraction and therefore relies on credentialing to keep the public safe. Specialists consult intraprofessionally and interprofessionally to plan and direct care for patients. Steinbinder, A. (2005) identifies advance practice nurses as clinical experts who teach unit based nurses specialized care and treatment information, develop new protocols, and demonstrate specialized skills. These staff nurses then serve as resources and consultants to their peers. This model allows staff to expand their own skill levels as well as to increase the advanced practice nurse’s network to identify issues needing further study. This force is evident in my organization. We have sufficient numbers of clinical experts available for consultation and collaboration when dealing with complex, difficult patients. We have interdepartmental consultation policies and procedures established. My organization has alliances with area colleges who use our facilities for student experiences in nursing, radiology, therapies, and medical residents. We utilize their instructors for some continuing education programs. Some staff members are clinical instructors for the colleges. We have access to library resources and if not available locally, our librarians have contacts to obtain the resources through a loan program. During our magnet application process, we identified the number of advanced practice nurses and nurses with their specialty certification. There has been a big push for staff nurses to achieve specialty certification. Our numbers grow each year. We are investigating making the requirement that our clinical, unit-based educators have their MSN; this part of the clinical ladder is under revision. Currently, they are BSN prepared and certified in their specialty. References: American Nurses Credentialing Center, (2005). Introduction to the magnet recognition program for students of nursing. Retrieved January 18, 2007 from http://www.nursingworld.org/ancc/magnet/forms/studentmanual.pdf. American Nurses Association, (2003). Nursing’s Social Policy Statement (2nd ed.). Washington, D.C.: ANA. Steinbinder, A. (2005). The magnet process: One appraiser’s perspective. Nursing Administrative Quarterly, 29, (3), 268-274. Taylor, N. (2005, September). Magnetic Pull. Nursing Management, 36, (9), 54-67. Date Modified: 30 Jan 07 8:01 PM MST Tara Narby 1 Feb 07 11:32 AM MST Margaret, I like the idea of keeping my hand in the clinical as well as academic side of nursing. I see that your organization promotes this and I sincerely hope this is the wave of the future. In addition, your organization seems actively involved in keeping the magnet spirit alive. Are there any projects you are working on or interested in? You have provided good information. Thanks, Tara Margaret Imbrock 2 Feb 07 11:06 PM MST Tara, My projects are primarily in the mandatory, have to know arena. I maintain our mandatory abuse reporter training curriculum. Iowa law requires 120 minutes of training in this area every 5 years and they established a panel about 6 years ago to oversee these requirements. My new assignment is to establish a simulation learning center for the Health System. We have recently acquired some computerized simulation dolls that need some planning and organization for use. My consultation work is in the area of EKG interpretation. I teach a single lead monitoring course and have been working the last few years to increase the skill level of staff nurses on medsurg areas. It is a slow process but fun hearing about their experiences and helping to boost their self confidence. Marge Tara Narby 31 Jan 07 5:34 PM MST Consultation and Resources Week 5: Dr. Karlene Kerfoot (2004) describes the Magnet Program as a staff driven program which organizes the framework for the future. Nurses in my Magnet facility continuously participate in staff driven projects and research using various resources and consultations to achieve best practices in our facility. There are several ongoing projects which characterize use of resources to validate and promote health in patients, community member, and staff. The Cleveland Clinic is a large urban 1,000 bed institution encompassing 8 outpatient family health and community surgery centers. Magnet is definitely prevalent in all facilities and below I will describe two examples that show ongoing consultation and resourcefulness abilities. Bumgarner and Beard (2003) describe Magnet as an ongoing process comprised of conceptual thinkers and doers. One example at our facility is comprised of a Magnet Council at a family health center. One of their goals is to explore the physical activity of nurses and how this impacts patient care. The group had no idea how to explore this issue and contacted me through the director of nursing because I am known for my research work at this particular site. I actually met with this group today and assisted them in performing a literature search and preparing them for research at their site. I gave them the information related to obtaining human subject research protection training and well as information regarding the submission of projects to the Institutional Review Board for review and approval. I am consulting with this group and providing the resources for them to prepare and implement their project. I have agreed to meet with them on a bimonthly basis to provide insight. My goal is to stimulate research excitement and influence in a way that doesn't feel overwhelming. The second example of resourcefulness and consultation also takes place in the same facility and is a part of their diversity council. The diversity council's mission is to provide healthy resources to staff, patients, and community members. The last two days we have had lunch and learn sessions which were provided for all women employees and focused on multiple health care topics presented by physicians, therapists, nurses, and dieticians to promote health. Topics included metabolic syndrome prevention, osteoporosis prevention, eye health, future implications of ob/gyn, and the prevention of female incontinence. In addition, various health screenings were offered for the employees as well. The same event is planned for this coming Saturday in which the surrounding community is invited to partake. The goal is to provide health awareness and explain what tests such as bone density, cholesterol, blood sugar, and blood pressure effect health. These events would be impossible to hold without the multidisciplinary team that has worked and implemented these projects. Bumgarner and Beard (2003) explain that Magnet must cross all organizational levels and departments to be successful and I believe that the above exemplifies the synergism of a multidisciplinary team to promote health practices. Resources: Bumgarner, S.D. & Beard, E.L., Jr. (2003). The magnet application: Pitfalls to avoid. The Journal of Nursing Administration, 33(11), 603-606. Canter & Associates. (Executive Producer). (2004). The nurse leader: New perspectives on the profession. Los Angeles: Dr. Karlene Kerfoot. Date Modified: 31 Jan 07 5:45 PM MST Margaret Imbrock 31 Jan 07 8:16 PM MST Tara, This is a great posting and provides terrific examples for the use of consultation and resources. You are exemplifying multidisciplinary collaboration. I like your diversity council's mission.