Zoom salons are truly amazing. Last evening (11/17/2021) there were nine people on the screen from four different states, the other five were from Minnesota. The states represented are Michigan, Washington DC, Nevada, and Wisconsin. Each one of these is in some ways the same and in some ways different.

Before I go any further, I want to say that time and again I hear about the impact conversations and salons are having in people’s lives. Last night was no exception. One of the attendees is a nurse executive in a western state who commented that since she has been coming to salons over the last four to six months, her life has changed dramatically. She is still in the same role and the external reality she lives in is the same, but the way she experiences and responds to that reality has changed as a result of the conversations at the zoom salons.   It has made a big impact on her life experience.

The horrific external reality in hospital nursing was again thoroughly discussed. Staffing transactionalism is creating major unit culture problems. The anger of patients and relatives continues to impact nurse-patient relationships. I could go on about this, but I think we all know it. What happened last night that is so important is the sharing of strategies and initiatives that are popping up in hospitals all over the place. We need to study the impact of things like the ‘honor guard’ of nurses. At another place there is now a newly formed Patient/Relative Advisory Council that looks at examples of extraordinary care. Another hospital is expanding the Daisy concept to a much broader group. There were many other examples discussed.

The point I want to make is that in the midst of the chaos and confusion and high-risk realities of nursing care, the underlying values of nursing are being brought forth by frontline managers, executive leaders, and most importantly by staff nurses themselves. It was truly amazing to hear the originality, creativity power and innovation being incorporated into the hospital care of human beings right now. The values of Nightingale, Henderson, and the other Legacy Care Leaders are being brought forth at the grass roots level of practice!  To me, this is a very positive sign. Changes are coming and in the best way possible, from within the practice of nursing. HOPE is the order of the day!

I invite comments from readers about innovative ideas you are using to counteract the negative experiences many nurses feel.

The FOURTH WAVE IS HERE. 

At the virtual Salon last evening (8/18/2021), two nurse leaders from a large metropolitan hospital in a western state were in attendance. These nurse leaders were abundantly clear about the harsh reality they are experiencing as the fourth wave of COVID surges through their state. We have all heard or experiencing some of their situation:  

40% turnover rate for nurses.

Fewer and fewer travel nurses available

Recruitment is disappointing, esp. when nurses just hired decide to go elsewhere before they even start orientation

Lack of support and understanding from Hospital Administration

Patients who are dying, yet refuse to accept the diagnosis of covid

Nurses who refuse vaccination.

After careful and compassionate listening, the conversation veered over to the idea of self-care and personal well-being.   Support from everyone was inspiring and life-giving. Specific strategies with practical application were exchanged amongst the group. In particular, the notion that we are responsible for managing ourselves, came forward and provoked much deep thought.   

In a future post I will put forth some thoughts about a quality of character I refer to as responsibleness.

Each one is different, and last night’s conversation (7/21/2021) was somewhat unusual, very deeply felt and as always, a unique experience.   Four of the seven attendees were either former or current CNO’s.  The major theme had to do with the impact of covid, not only on Staff nurse, but also ….and most especially in this conversation on the role of the CNO as a leader of nurses.

One of the attendees is in a hospital with a 40% turnover rate, and other spoke of equal or higher turnover rates.   It is a perfect storm with very low or no success in recruitment, a dearth of travel nurses, an increasing covid census, plus staff that is angry and exhausted and demoralized.   These are the factors that cause nearly unbearable stress on all caring leaders, none more so that top level CNO’s.   There was a felt need to bring this raw truth to the surface last night, and emotions were high. 

Eventually we moved on to asking the question: What does self-care mean in circumstances like these?   Clearly it doesn’t mean a simple trip to a spa (if one had the time!) And certainly not an increase in salary (as it is very high in some places, with bonuses, etc.)  We began toward the end of the session, talk about self-care at a deeper level.   Recognizing that we are spiritual beings in a human body and that concept leads to a commitment to care for not only the self, but also the Self.

 Although our time by now was short, we did talk about some positive actions and the importance of prioritizing Self Care no matter what.   The impact of the absolute loss of resiliency was the underlying theme of the conversation.  

MM Note:  Elsewhere on this blog the issue of Nurse Suicides, referencing an outstanding research report on the increasing incidents of nurse suicides. please see musing note for more detail on this research.

Last nights salon (6/16/2021)was an amazing experience. Once again, the power of conversations to create moving and really unforgettable experiences happened last evening. Attendees were from around the US, Washington State, Las Vegas, Wisconsin, San Diego, Maryland, and Minnesota. Roles ranged from a a couple of retirees to a pre-licensure masters student, to a new RN working on her unit for 15 days, to a nurse executive of a major hospital, to a health insurance advisor (RN) to two nurse researchers and two staff nurses. Ages from mid-twenties to my own mid-eighties. Part of the beauty of this experience is that none of those differences in role or age made a difference to value of their presence and contributions.

While it is hard to try and summarize such a free-flowing value-laden, provocative and healing conversation, I will just point to one issue that was captured a lot of attention. It is the age-old issue of the time pressure that drives nursing care…..and also the related issue of burnout and turnover. While tough stuff was always ‘on the table’ the conversation often turned to ways of being in nursing…..i.e., strategies for real change, skills for leaders to create healing cultures, etc.’ that generate hope and the shared positive experience that energized all of us and made the conversation is wonderful and generative experience.

These conversations are held on zoom the third Wednesday of the month. The link is always the one on this page.

I do usually send out a reminder a few days before, but the link is always the same and on this blog