While they must be patient and able to write education plans, nurse educators must enjoy teaching and, above all, have a passion for their profession. Their work is evidence-based and outcome-focused. By studying patient populations, they analyze systems to determine how to correct problems and improve quality of care. In short, they strive to prevent future problems by studying past mistakes.
Employers commonly look for a bachelor's degree in a healthcare field and possibly a master's. Employers that do know about certification consider it "the gold standard," says Boldrey, senior market medical expense management specialist for UnitedHealthcare in Urbandale, Iowa, and a board member of the Healthcare Quality Certification Board , which oversees CPHQ testing. Closely tied to quality improvement, risk managers also search for the root causes of mistakes to help improve systems and processes. With the upsurge in medical malpractice suits, opportunities for risk managers are increasing at hospitals, insurance companies, ambulatory-care surgical centers, long-term-care facilities and home-care companies.
Working with top medical and administrative staff members, risk-management nurses review patient records before and after lawsuits are filed. These pressure-cooker jobs require immense patience, tact and political savvy plus excellent communication and writing skills.
Most risk-management nurses hold at least a bachelor's degree and risk-management certification, which is available from the American Hospital Association Certification Center , the American Board of Quality Assurance and Utilization Review Physicians and colleges, such as the University of South Florida.
This proved to be quite successful as a strategy to encourage participation to create attitudinal and behavioral change. Eventually, there was more acceptance and collaboration on the part of the team to implement the change. In keeping with Skinner's theory [ 13 ], positive reinforcement, was used to praise and encourage staff. The ward manager helped in the reinforcement process by complimenting the whole team for their excellent effort to bring the change during the weekly meeting of staff.
The strategy of facilitation also involved providing training in the new skill demanded by the change. Mocked handover exercises were demonstrated with the different steps of bedside handover to different groups of nurses. This was done by adopting a democratic leadership style engendering a participative approach, which in turn generated a degree of enthusiasm for the change. Following a pilot handover session involving senior staff in a participant and an observer capacity over 2 morning and 2 evening handover sessions, which did not require any major changes, implementation of the bedside handover was started on 8 th of March For the first week, six senior staff who had experience in this area volunteered and took turn to continue to be present in as many handovers as observers and participants, to monitor and reinforce the established protocol step by step.
They also provided clarification and support to staff in cases of difficulty, and helped evaluate the extent of change that had taken place in an effective manner. The nurses present during the handover had no difficulty in adapting to this new situation, using a care plan incorporating a more psychosocial and patient-centered approach to bedside handover with the patients' participation. The evaluation of the implementation of bedside handover was carried out in two distinct phases.
Im ready for something less strenuous than bedside nursing. Any suggestions?
A protocol, as shown in table 2 , was developed which included 6 criteria was duly filled after every shift handover. As a benchmark, a good handover was one where at least five of the criteria were strictly followed. The data collection consisted of ten non-participant observation handovers. Semi-structured interviews, using a questionnaire derived from a focus group of staff and patients as shown in table 3 , with 40 patients were carried out to get their perceptions of the new handover.
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This was done randomly, consisting of both morning and evening handovers over a period of a week by a staff specifically chosen for this job from another ward to prevent bias from the hawthorn effects and ensure validity. We had to be cautious about the result for it could be either most of the staff had accepted the change or just doing it in this euphoric phase. The result was evaluated at a full staff meeting and the ward manager and colleagues recognized the change.
Despite unlearning of the old practice had taken place two nurses still displayed some difficulties with the new handover as they were always eager to report everything themselves rather than allowing the patients to have a say. After a reassessment of the situation, accurate feedback was given to them. With the group support, they became used to the new system by observing their colleagues in action during the handover and doing it in turn.
After a couple of sessions they became fully conversant with the new system. By this time, this project was ready for the refreezing stage. One of the major difficulties encountered was to rally everybody behind this project. The normative re-education, in line Bernhard and Walsh [ 1 ], was used in order to help nurses value the new knowledge and create a readiness for learning. Various tasks identified for the future, for example on how to deal with issues of confidentiality, patients who would keep talking endlessly making the process drag on for a long time were allocated to members of the team according to their expertise to prepare so that they could be discussed in depth during the next meeting.
A flexible and humanistic in approach was adopted in dealing with conflict, and resistance was not underestimated. Suggestions were treated with respect and dignity. Considerable effort was made to maintain good interpersonal relationship and to highlight motivating factors and safety needs. Constructive feedback was provided on their level of performance. Positive behaviors were rewarded equally in terms of recognition and praise and often with a simple and genuine "thank you". Application of this knowledge was reinforced from day one when this new handover became operational into the practice area through continuous coaching, supervision and mentorship.
Nursing Careers Beyond the Bedside
Managing change in a hospital set up is a daunting task as it involves a change in the attitude and behavior of staff in a complex environment in order to gain their collaboration. The concept of no pain no gain was very evident throughout the process. Lewin's 3 — stage model was useful in implementing the change in a planned and structured way.
Resistance was overcome by creating a climate which encouraged open communication. The support of the ward manager and key stakeholders were significant. Evaluation has shown that the new system of handover is working well but monitoring will be ongoing with evaluation of a larger sample of patients. This change has been an enriching experience for the staff, and has generated enthusiasm and given them confidence to question some of the practices on the ward.
This new approach to handover can therefore be implemented in other areas of practice and evaluated to ensure that they are meeting patients' satisfaction. Further studies can be undertaken to explore how the multidisciplinary team could further consolidate this process. Bowman C, Asch D: Strategic management. Deputed power of medical control: the hidden message in the ritual of oral shift report. JAdv Nurs. Driscol T: Case management nursing: In Managing change in the handover. Nurs Stand. Greaves C: Patients' perceptions of bedside handover.
Hussay D: Creativity, innovation and strategy. The innovative challenge. Edited by: Hussay D. Managing change.
Edited by: Broome A. McKenna LG: Improving the nursing handover report. Prof Nurse. Sherlock C: The patient handover: a study of its form, function and efficiency. Skinner BF: Theories in practice, operant conditioning.
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The principle and practice of nurse education. How to do it: Research nursing may require a long-term commitment and can be heavily dependent on experience. Experience as a med-surge or ICU nurse is valuable, but at the very least you will need your BSN and often some type of regular work experience. It would also be valuable to get a second degree in Clinical Research. Diabetes Management Nurses advise and educate patients with diabetes. Often, they monitor patients on an outpatient basis, educate on maintaining glycemic blood sugar levels, how to self-administer medications, and other need-to-knows.
There are a lot of them, probably more than you can imagine. Most of them have similarities with Emergency Nursing, and experience in that field would be invaluable in landing these obscure jobs. Here are a few:. Cruise ships have physicians, nurse practitioners, and nurses on board to handle both emergencies and minor upsets. Cruise ships often have quite a functional medical facility, with X-ray machines, a small pharmacy, and a small medical team.
How to Be One: Cruise ship nursing can be very competitive and selective. Most recruiters look for nurses with emergency or ambulatory experience. ACLS certification is always a big plus. Salary: Cruise ship nurses usually measure their pay by the month. Summer camps, wilderness camps, and others have nurses on-site to deal with emergencies. They handle sick campers, minor injuries, and of course provide basic triage to determine if an injury needs to be taken to a higher level of care.
How to Be One: Just apply. Search camp nurse jobs [your area] into google and start applying. Salary: Camp nurses get paid, on overall, less than a steady full-time job. Many nurses who want to accompany their children to camps work at the same time. Camp nurse salaries are paid by week rather than hourly. Parish Nurses faith community nurses work in churches, and usually perform preventative care for the attendees and other members of the overall community.
Health promotion, education, and health advising are common duties for Parish nurses. How to Be One: ParishNurses. Most paid positions are associated with local hospitals, and can be found by searching for local programs. Other than that, being involved in your community and having a willing spirit are the best ways to become parish nurse. Can you think of more unique non-bedside fields in nursing?
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I liked the article. I found it very informative. I graduated as an RN about a year ago and cannot find a job since…. Any suggestions for new grads? I agree with the author, Kevin much of your infor, except, case manager still requires bedside nursing. Infused though, why your add us even on the north west college website. This school is a trade school for lvns so we all know they can nit assess a pt and yet your info alwYs talks about assessing, being an RN, having your ASN.
They will have none of these. Oh well. I wish you the best in your search! Good list, I also think nurse educator would be a good one. Lack of educators are part of the reason why nursing school is so competitive. Also it gives hospital nurses a chance to stay in the bustling hospital setting without crazy shifts and patient case load. The information is interesting and informative however, the information for a RN to become a diabetes educator is not that simple, at least where I reside.
Wishing all you wonderful nurses the best in your service career-the most honorable of jobs.