2018 Ncsbn Annual Institute Of Regulatory Excellence Ire-Books Pdf

2018 NCSBN Annual Institute of Regulatory Excellence IRE
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will talk with you Yeah okay Good Good All right, So here s my question So if the first PhD in Philosophy and Theology was in the 12th or 13th century. when was the first terminal academic degree in Nursing When was the first PhD in Nursing Go If it. follows that we have at least in the last 40 years been claimed in some writing as a semi profession. you could think it s not been all that long, So the very first PhD in Nursing for all intents and purposes was in 1970 Now there are people in this. room who have a memory of 1970 aren t there Yeah And for those of you who do not have a memory. of 1970 if you remember watching Apollo 13 and so there s that really poofy hair and those really short. dresses that was 1970, So it seems actually like a long time ago when we think about it that way but just for a moment think. how far we have come as a discipline We now have over 100 schools that are granting PhD degrees in. this country, We have 223 at last count that are doing the professional doctorate So we have come a very long way. in a very short period of time with our academic discipline So I ve put the objectives up there for us. and you ve got them in your handout But what I want to think about first is why would we be talking. about professional identity not just the term not just the language but why is it important that we look. Well the first objective I have listed is the importance of teamwork with professional identity And if. you have not read this there was a i Harvard Business Review i article It s in your reference list. down here i Harvard Business Review i article done in 2013 which sounds like a long time ago. by Porter and Lee, Lee is one of the leaders in the Partners Program in Boston This was a very clear picture of what these.
gentlemen who are visionaries in healthcare thought was going to be the way we re going to fix our. healthcare system, This is what value based care was going to look like And so I m just going to read through not all of. them but how is it that this could actually happen One we have to be organized into integrated practice. units Two we have to measure the outcomes and cost for every patient Three we have to move to. bundled payments for care cycles, Four integrate care delivery across separate facilities Five expand excellent services across geography. Six build an enabling information technology platform that is going to require a tremendous amount of. synchronicity isn t it That cannot be done with a medieval hierarchy It really can t be done that way or. any other kind of hierarchy, It s going to have to look really different In our world we talk a lot about patient outcomes There s. even some conversation in the health professions about finding ways for us to look at how we teach a. student and that carrying through to how they care for patients I think that s a pretty tall order myself. but maybe we ll be able to get to that, 2018 National Council of State Boards of Nursing Inc All rights reserved 2. But our language is filled our time is consumed with outcomes like we have measured them to this. point but I would argue we need to look at terms a little differently So let me define some terms for. The first one is professionalism and I have a story about that If you are thinking professionalism and. professional identity are fairly closely aligned I think you would be correct However what we have. found my colleague and I wrote this book called i The Making of Nurse Professionals A. Transformational Ethical Approach i and what it does it s the philosophic inquiry into the term. professionalism, Well if we lined up 100 people or 100 nurses around the room we would find that people had different.
definitions of what professionalism meant and that s the flaw because you can have a professional carpet. cleaner But to think about what professionalism is in a profession it s a very tough nut. So is there a way we can find another way to say that So I m going to be talking a fair amount. about from an interprofessional standpoint mostly about medicine because it is our colleagues in. medicine that have done an amazing amount of work in this area fairly recently. So to my colleagues from Canada I tell you the story of doctors Richard and Sylvia Cruess These are. faculty at McGill University in Montreal They both practiced as surgeons until age 65 when they retired. from being surgeons and they are now 85, And for the last 20 years they have been wrestling and working with this idea of what is. professionalism in medicine What does it look like How can we measure it How can we teach it. How can we get there And about the time they first started looking at this the standard in medicine was. this We know we need to teach, medical education We know we need to teach professionalism so let s test it Let s measure. professionalism So they would create surveys and measure professionalism they would teach. professionalism without a particular curriculum grounded in a theory base And a number of you are. doing research and you know about the necessity of including a theoretical framework before you start. all this but they just jumped right in and said We re just going to start assessing professionalism. And Cruess and Cruess about seven or eight years into that said Wait a minute this is not going to. yield us the results that we need We don t have enough of a foundation for this And I ll be talking a. little bit more about what that means and how other authors have come in and helped work with that but. they have come up with the idea about identity formation or professional identity. And then since most of what I have for medicine is from medical education its been in nursing that. we ve been talking about forming and fostering So if you re thinking about how we influence students. and how we influence practicing nurses forming is the front end and fostering is post that first. educational experience and going forward, So I would argue that we can define professional identity as this Professional identity and nursing is a. sense of oneself that is influenced by characteristics norms and values of the nursing discipline. resulting in an individual thinking acting and feeling like a nurse. 2018 National Council of State Boards of Nursing Inc All rights reserved 3. Now Dr Crigger my co author and I used the core of what doctors Cruess had come up with at McGill. because this is after their 20 years of thinking about this this is where they have landed So you would. see their definition of professional identity and medicine being thinking acting and feeling like a. So that person you talked to just while ago I d like to see if we could informally chew on this a little bit. and see whether this has any meaning to you as we re talking about professionalism and then the next. iteration professional identity I ll give you about 60 90 seconds to do that. Thank you And bring up a bit of a foil to this Some of you are involved in practice some of you are. involved in education and I m sure at one time or another you have been frustrated with inadequate. measurement tools I am sure that each of you could argue that perhaps patient satisfaction is not the. best indicator of what kind of care people receive in the hospital right. I mean it seems limp at best I m being kind in my language but can you imagine if that was your daily. or an age gaps too to have to get a 9 or a 10 to make it count I mean in some ways our measurement s. at least not there yet So put that against a definition that came largely from 2 surgeons who are 85 years. old who worked actively in surgery all those years this is pretty touchy feely isn t it. And what they have concluded is that this is a better description of what we re trying to get to And I ve. spoken with them on the phone and even more what they talked about is how the lines are much more. blurred than they ever understood and they are trying so hard to have a healthcare professional model. rather than This is what a physician does, This is what a nurse does really trying to look at this much more together So hopefully we will get to. that and medicine is helping us do that But can you imagine in the medical education world how. transformative they have been by using this kind of a definition and then creating curricula and. measurement instruments that came off of something like this. It s quite a move So in terms of identity formation what do we know from the literature We know that. it is an implicit or explicit part of all professional education And what we re seeing in the research. literature too is that we must intentionally address this. You know if you don t have something up front you don t end up doing it We all know about focus. Sometimes if you don t have things on the list they don t get done If you don t have a focus on this this. doesn t get done I have been in practice up until 10 years ago working med surg on floors on the. weekends on a part time basis, But the last 10 years I ve been at this academic health center and we had a major curriculum revision so.
I ll tell you our story We ve been around for 106 years at the University of Kansas and we were pretty. sure we re pretty hotshot nursing program you know how that goes And we started looking at how the. criteria for measuring our disciplines called the AACN baccalaureate essentials outcomes. So we started looking at that And when we saw that the analysis said that about 25 of what we needed. to spend our time on was professional identity and communication and those of you in practice would. 2018 National Council of State Boards of Nursing Inc All rights reserved 4. not disagree with that how important professional identity and communication is we found that out of. our 64 credit hours we had one credit hour on informatics. And we had made the promise to ourselves that we were going to proportional eyes our curriculum. based on the analysis and we have And we now have 7 credits out of 64 devoted to 3 courses in. professional identity formation We know it has made a substantial difference in the students being. grounded in what they re there for, They have some idea why they are there So we could talk more about that but we probably won t at this. point So let s use an example of forming and fostering and one of the reasons I bring this up is at our. school our nursing advisor for beginning nursing students says that still her biggest problem is. professionalism Nelda we still have problem with professionalism with our students. So what does that mean Well of course we have a wide generation span that we re working with. There are certainly cultural divides in how different groups communicate with each other We know. that But I thought maybe this would be an example of maybe one situation in practice where we have. some professional identity work to do, I ll read it Nurse K is the next professional nurse to care for Mr R Nurse K is taking courses for. graduate school and has a family of younger aged children for whom she is responsible She views work. as a necessary evil Without work I don t support my family Let s see here is my list of tasks may as. well start with Mr, R Hurry hurry here s the care plan If I work hard to do all the duties then I can be done by 9 30 I can. break then and call Michael s school I also need to get online and email the cable company Lunch I. may have some time to run to the store and back Laura can probably cover for me. So rather than me discussing this with you from the podium why don t you again talk to your. colleagues about professional identity formation deficits that might appear There are several might. appear in here So please talk We have wise wise people at these tables I think it would be a really. good thing this generated a lot of interest I can t tell. So let s think in a more positive vein with this By the way this is a real story I bet you knew that. didn t you I mean don t you know this This is how some stories go You are nurse leaders every one. So what would you do if you were going to coach this person What would you do Where would you. start What would be the thing you would talk about And so I actually would like for you to do that. again at your table Think through two or three approaches or steps you might take in coaching. someone like this I mean you have to assume that you re not just walking in off the street. I mean you have some legitimate reason for someone asking you maybe to talk to her or something. what would you do in terms of coaching And then I ll ask several of the tables to report out on your. ideas Okay All right I d like to ask for four of our tables to report out four maybe five So if you think. you re a candidate for that why don t you just go to a microphone and we ll let you tell us what your. plan was because I think we d like to hear what your approaches might be. 2018 National Council of State Boards of Nursing Inc All rights reserved 5. And we ll be listening for themes we ll be listening for facets but also for themes So okay Great. Thank you Ruby Hi I m Ruby from Oregon and this is my table over here. And I can tell you that I ve actually had these nurses I actually was one single parent responsible for. kids but what I used to tell my nurses once I adopted the professional identity was that If all you did. was tasks I could save our hospital a lot of money be a hero fire all of you and hire technicians. But for this particular person again having been in this position it star. you have not read this there was a lt i gt Harvard Business Review lt i gt article It s in your reference list down here lt i gt Harvard Business Review lt i gt article done in 2013 which sounds like a long time ago by Porter and Lee Lee is one of the leaders in the Partners Program in Boston This was a very clear picture of what these

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