 Sheppard Pratt Gives Nurses a Voice
in Decision Making
When Sheppard & Enoch Pratt Hospital clinical director
Kay Sienkilewski heard her nurses complaining about communication issues, she
decided to step up and reorganize. In February, the 322-bed psychiatric
hospital, applied for magnet status--a nationally recognized gold standard
awarded to hospitals with the best nursing management, philosophy, and
practices.
“When you’re applying for magnet status, you
assess all of your processes,” said Sienkilewski. “When I assessed
nurse input at our hospital, so much was dependent on nursing managers.”
A 16-year veteran of the Baltimore hospital, Sienkilewski
decided that all Sheppard Pratt nurses needed access to information and needed
to be able to have more direct input in decision making. Sienkilewski created
four nursing councils: Practice, Education, Leadership, and Research. She
placed 8-10 nurses and nurse managers on each council who assumed
responsibility for changing different aspects of the clinical environment.
The Practice Council participants oversee models of nursing,
participate in research on nursing practice, and evaluate the credentials that
nurses should have. Along with the Education Council, the Practice Council is
implementing a new staff development model where the hospital will sponsor
nurses to get continuing education units through the American Nurses
Credentialing Center (ANCC). The council also had five open forums in May 2005
to learn more about the recognition and benefits of further professional
competency.
The Practice Council also started a specific nursing
newsletter called Notes, Quotes & Antidotes—a publication to
keep nurses up-to-date on council activities and an open forum for nurses to
publish their own articles.
The Education Council is currently looking at developing a
career ladder for promoting nursing staff using the Registered Nurse Certified
(RNC) credentialing as a factor. “Questions being asked are:
- Do we need to require charge nurses to have RNC
credentialing?
- Do we need to change the qualifications?
- Should all preceptors have to attend formal programs?
“We’re looking at all of this,” said
Sienkilewski. In order to develop the career ladder, the general focus of the
Education Council is to review and evaluate all of the position descriptions
and assess the requirements of nurses for certain positions.
The Education Council is also involved in making educational
courses readily available to the nursing staff. The Council recently bought new
software with 500 nursing courses online. Using the software, nurses can get
their ANCC credit for continuing education courses.
The primary goal of the Leadership Council is recruitment
and retention. The group just finished a survey of all nurses at the hospital
and got an outstanding 60 percent response rate. One of the nurses’ main
responses was that they wanted improved doctor/nurse relationships. As a
result, Sienkilewski created a joint committee of doctors and nurses with a
goal of communicating and improving relationships.
The Research Council’s main task is oversight of eight
newly created Evidence-Based Practice Teams which would research individual
nursing practices that need improvement. The teams include mental health
workers, nurses, doctors, occupational therapists, and drug counselors. They
are currently researching non-pharmacologic interventions for patients with
chronic pain and developing a patient education group where patients will be
taught to use guided imagery and relaxation in order to control their chronic
pain.
The Evidence-Based Practice Teams are also researching best
practices for dealing with male adolescents who come in depressed and suicidal
from the criminal justice system and are admitted to the hospital. In addition,
the groups are looking at behavioral interventions for geriatric patients with
cognitive deficits and ways for children to maintain control in their lives.
In December, all eight teams will present research to the
Research Council and the Practice Council will then make recommendations. If
these councils approve the recommendations, Sienkilewski will take the final
recommendation to the hospital board.
“Magnet Status is a big deal and a huge honor for our
nurses,” said Sienkilewski. “With our new structure, nurses have a
voice in the decision-making process for their own practice in the most
effective and most efficient ways.”
Ultimately, Sienkilewski’s goal is to get the councils
to a point where they can function independently without being overseen by a
manager.
“Instead of top-down communication, we’ve moved to
bottom-up,” said Sienkilewski, who adds that the nurses seem to be
responding extremely well. “There’s a real positive response and
morale has been boosted. They’re excited.”
Contact:
Kay Sienkilewski
Clinical Director
Sheppard and Enoch Pratt
(410) 938-3505 (Back to the top)
|
