10 Things (Part Two): Staff Role in Program Improvement

[Ed: Again, we welcome back Jen Pierce-Weeks with the 2nd part of her 10 Things guest post. If you didn’t get a chance to read Part One, you can find it here.]

Ten Things Clinical Forensic Nursing Staff Can Do To Improve Their Programs

Everything regarding program management interestingly enough does not lie with management.  Much of a program’s success or failure can be attributed to its staff.  With that in mind, the ten things listed below may be able to help staff in evaluating how they can improve their program.

 1. Check Your Commitment

So many nurses enter this field without understanding the commitment level required.  Most programs are on-call, requiring a minimum number of hours or shifts each month.  Don’t be so enamored with this new role that you forget to actually plug into a calendar your full time job, your expected call shifts and your family and personal obligations.  It is a guarantee that there will be more coverage necessary than the “minimum shifts required.”

2. Communicate Ethically with Your Team

Ethical communication requires direct conversation with the staff person you are having a problem with.  You remember the idea: go first to the person and only after no resolution, to your supervisor.  I know many nurses are uncomfortable with direct communication, but our own inability or unwillingness to do this is directly related to nursing’s reputation for eating its own.

3.  Remember the Learning Curve

If we are to believe Benner (PDF), and I personally do, all of us begin in this field as a novice and only through time and experience move to expert.  Give new forensic nurses the time, resources and experience they need to achieve competency.  After all, you did not understand the application of this practice in your first few months either.

4.  Take Charge of Your Own Competency

In most instances nurses can identify the areas of practice that they feel less than competent.  If you know you’re struggling with a certain area, ask for help.  There is no shame in saying I need more practice with something.  Of course there are nurses who cannot see the areas that need improvement in their own practice; however a solid quality assurance plan can usually tease out those challenges if used effectively.

5.  Understand that Martyrdom Doesn’t Becomes You

Are you the person who consistently covers the schedule? Do you carry half again as many shifts as your colleagues? Twice as many? Believe me, managers love you, as do staff, but the risk is that you begin to resent the team and you burnout.  Are you the only person in your program? Many of us started this way, particularly if you function in a rural setting.  Make it a goal to identify colleagues who can join you.  First, no one should be the only one of anything.  There are no checks and balances, and no relief in site.  Second, if anything happens at all, your program goes under.

6.  Self-Evaluate

Each of us grows and improves with our practice.  And yes, we get evaluated by our supervisors, so in that sense, we get feedback on our practice.  But, how do you feel about your practice?  What do you do well? What needs improvement? Create a concrete list of the qualities and behaviors you bring to the team.  Ask yourself if this accurately describes the strengths you bring to the team.  Then set your own personal goals for improvement.

7.  Assist in the Creation of Program Goals

Every team should have short and long term achievable goals.  Do you know where your team is headed? What you should be working toward?  Maybe it’s as simple as increasing patient volume through community awareness.  Maybe it’s a lofty in-house team seeing an expanded patient population.  Whatever it is, to be successful, the staff needs to embrace the goals.  Everyone is more likely to embrace a goal if they are active participants in its creation.

8.  Be Part of the Solution

Be willing to participate in activities that improve the whole, that make the program more sustainable.  Teach.  Nothing improves your knowledge of a subject like teaching it to others.  Cover.  All managers need a break. If you are one of the experienced on your team, take some back up call for your manager so she or he can shut their phone off from time to time.  Sit in and weigh in on staff interviews.  The interview is a unique opportunity to see if an individual fits well with the whole, answers questions in a way that suggests they would improve your team and is an excellent skill to improve upon if number 9 is of interest to you in the future. Embrace precepting.  Someone needs to clinically train the new staff. Be willing.

9.  Consider: Leadership, is it for You?

Change in leadership happens often.  When it does, you need to know if you are interested in the role, capable of the role and prepared for the role.  After all, it’s not all benefits and bonuses.  Another question you might ask yourself is “why do I want this role?”. If you determine leadership is for you, be prepared to show your leader self; after all, we have only seen you in your role with patients. Like anything new, you’ll be expected to prove yourself.

10.  Be Informed, Share Your Knowledge

One of the easiest ways to improve is through education.  Read the research, take a class, reach for a higher degree and then, share your knowledge.  If you keep what you have learned close to the vest (and there are many reasons people choose this approach), you only serve your ego.  If we want this specialty to survive, we must be willing to share all we have learned or there will be no future generation.

Jen Pierce-Weeks