We have competency fairs and we hear a lot about continued competence in
nursing, but do you want to remain merely competent or do you want to be
extraordinary.  Think about the difference between these two terms.  If a friend
recommended a plumber to you and said, "He is a really competent plumber."  That
might sound like a good recommendation.  On the other hand, what if the friend
said, "He is an extraordinary plumber."  Which of the two recommendations would
you be more excited about?

The ideas of maintaining or continuing competence bother me.  When you look
around at the knowledge and skill of the nurses that you work with we find that
some are better than others.  Even though all may be considered competent only a
few are extraordinary.  If one of your patients wrote a letter to the hospital
administrator complementing your nursing care, wouldn't you rather the letter
said "she is an extraordinary nurse" rather than "she was a competent nurse"?

To me competence indicates a basic level of preparation, knowledge, and skill,
but to me extraordinary is something else entirely which begs to question what
does it take to become an extraordinary nurse.  That is what mastery is all
about; developing your expertise so that you can master nursing.

In order to develop mastery you must first understand where you are and develop
a plan for where you want to get.  Most importantly action must immediately
follow.  It is daily action or baby steps taken toward the direction of your
plan for mastery that will make your care extraordinary.

Extraordinary nurses all have something in common; they work harder on
themselves than they work on other people.  In other words, it is more important
to them to develop their knowledge, skills, and inner resources than it is to
criticize other people or the system in which they work.  Blaming must be
eliminated.  One of the reasons why our healthcare system is the way it is is
because no one is taking responsibility for the system.  But you can take
responsibility for how you think, for how you provide care, and for developing
your knowledge and skill so that you can provide extraordinary care wherever you
are.

Mastering nursing so that your care becomes extraordinary does not happen by
accident.  It is planned and worked at in a daily fashion until a superior level
of care is achieved.  To determine if mastery is important to you go back to the
original question.  If a patient were to write a letter to the hospital
administration how would you want it to read?

At the end of your career how would you like your coworkers to think about you? 
What would you like your family to say about you and, closer to home, what would
you like your performance evaluations to read?  Competence will ensure a certain
level of comfort.  It is comforting knowing that you can get through your day
and get your work done on time and cause no harm, but excellence has so many
more benefits.  Excellence provides the ease and intuition to provide care that
is extraordinary.  When you make excellence your goal you will find that you
take more responsibility for your own knowledge and skill acquisition, for your
own professional development, and for the outcomes of your patients.

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

Re-imagine what nursing education will be like if every educational
activity was designed to be maximally effective; every piece of every
educational activity was designed so that every different type of
learner would have equal access to the information.

Imagine if every educational activity had the kind of leadership that
was necessary for every student to have an equal chance of being able
to succeed, and to have the support, the guidance, and the
inspiration to want to succeed.

Imagine looking at our nurse educators as talent, and not as the
first persons to be cut within an organization when the budget's
tight; but as being talented individuals who are saving our hospital
money and who are contributing in a positive way to the development
of our overall mission by empowering our nurses to become
extraordinary.

Imagine nursing education being on the cutting edge of trends that
are happening in healthcare, rather than on the trailing edge, trying
to catch up after few policies and new procedures have been
implemented; but instead on the cutting edge, defining those trends
for their current generations of nurses, using evidence based
practice.

What would your ideal be for your job, for your nurses, and for your
future? Re-imagine the possibilities!

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com
www.100k-Certified-Nurses.com

One of the marks of a professional is their willingness to take
personal responsibility for their competence. On occasion, nurses
have told me that they have not learned a new skill or concept
because their hospital has not given them an in-service about that
topic. Does this sound familiar?

As nurses we are responsible for our professional competence and the
competence of the organization that we work for. If, for example, a
policy is outdated it is the nurse's responsibility to obtain the
data and resources in order to change the policy to comply with
current standards. If these levels of personal, professional and
organizational accountability are not being demonstrated in your
institution you need to ask why. What are you doing to encourage
these traits in your nurses? Simply telling people to be more
responsible is rarely productive. Have you shown them how to develop
accountability for their practice? It comes to mind that nowhere in
the nursing curriculum do we teach nurses processes for acquiring
these skills.

Those who have chosen the path to mastery take responsibility for
their own learning and have chosen accountability instead of looking
to other people to provide the resources that they need. You can
encourage your nurses to take the journey to mastery by providing
resources that help them develop personal, professional and
organizational accountability. Do you have ideas for how to empower
your nurses to take professional accountability? Please share them
with us.

Best wishes,

David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com
www.dwoodruff.com

I agree with your assertion that educators serve those they strive to teach.  I
am currently finishing my study of Management in Nursing for my BSN.  One of the
contemporary theories of leadership is that of the Servant Leader (R.K.
Greenleaf, 1991.).  I found this concept intriguing.  As nurses, it is natural
to serve our patients, or at least, it should feel natural.  Nursing has always
been about serving, caring, and change, as in healing and growing.  It makes
natural sense to consider this in education.

Lisala

--- In mpoweryournurses@yahoogroups.com, "David Woodruff" <dwoodruff@...> wrote:
>
> Great educators know one thing. The purpose in life is not to win.
> The purpose in life is to grow and to share. "When you come to look
> back on all that you have done in life, you will get more
> satisfaction from the pleasure you have brought into other people's
> lives than you will from the times that you outdid and defeated
> them." – Harold Kuschner.
>
> As an educator, you have many responsibilities. Those include making
> sure everybody gets through their competencies, and orientation, and
> developing new continuing education programs. But the greatest
> responsibility we have as educators is to serve. John Maxwell says
> that "servanthood is the missing link in most chain of commands."
> Serving your nurses means more than just putting on another
> educational program. It means being a part of their daily lives so
> that you can learn the basis of their understanding in order to
> develop programs that meet their needs.
>
> You may develop a program that you think would be valuable to nurses
> without truly understanding their point of view and the needs that
> your nurses have. For example, a program on managing an emergency
> situation may be helpful if your nurses have a good foundation and
> understanding of principles such as hemodynamics. If not, the
> program will be just more useless information that they have no way
> of applying.
>
> As educators, we need to get out into the trenches to find out what
> our nurses really need. How solid is the foundation of their
> practice and how can this program be best developed so that they can
> increase their understanding of what can be used at a patient's
> bedside? By envisioning yourself as a servant of those whom you are
> charged to educate, you will get a different perspective on what kind
> of education is most important to them and how best to deliver it.
>
> As was said by Martin Luther King, Jr., "Anyone can be great because
> anybody can serve. You do not have to have a college degree to
> serve. You do not have to make your subject and your verb agree to
> serve. You only need a heart full of grace and a soul generated by
> love."
>
> Best wishes,
> David W. Woodruff, MSN, RN-BC, CNS, CEN
> President, Ed4Nurses, Inc.
> www.Ed4Nurses.com
>

Great educators know one thing. The purpose in life is not to win.
The purpose in life is to grow and to share. "When you come to look
back on all that you have done in life, you will get more
satisfaction from the pleasure you have brought into other people's
lives than you will from the times that you outdid and defeated
them." – Harold Kuschner.

As an educator, you have many responsibilities. Those include making
sure everybody gets through their competencies, and orientation, and
developing new continuing education programs. But the greatest
responsibility we have as educators is to serve. John Maxwell says
that "servanthood is the missing link in most chain of commands."
Serving your nurses means more than just putting on another
educational program. It means being a part of their daily lives so
that you can learn the basis of their understanding in order to
develop programs that meet their needs.

You may develop a program that you think would be valuable to nurses
without truly understanding their point of view and the needs that
your nurses have. For example, a program on managing an emergency
situation may be helpful if your nurses have a good foundation and
understanding of principles such as hemodynamics. If not, the
program will be just more useless information that they have no way
of applying.

As educators, we need to get out into the trenches to find out what
our nurses really need. How solid is the foundation of their
practice and how can this program be best developed so that they can
increase their understanding of what can be used at a patient's
bedside? By envisioning yourself as a servant of those whom you are
charged to educate, you will get a different perspective on what kind
of education is most important to them and how best to deliver it.

As was said by Martin Luther King, Jr., "Anyone can be great because
anybody can serve. You do not have to have a college degree to
serve. You do not have to make your subject and your verb agree to
serve. You only need a heart full of grace and a soul generated by
love."

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

Did you ever know one of those people who were always smiling? When
you met that person with the smile on her face, it was probably hard
not to smile back. Whatever we put out there into the world tends to
boomerang back to us. If we are positive and happy, we tend to find
ourselves surrounded by positive, happy people. On the other hand,
if we are constantly complaining we tend to find those people who
like to complain too. This is the idea of the boomerang.

In an article entitled "Perceptions of Empowerment and Intent to
Stay," Nicole Nedd described some of the variables that are involved
in the decision making processes that nurses use when deciding
whether to stay in their current employment. She identifies two
guiding principles that help nurses determine whether they will
continue their employment. The first is opportunity, and the second
is structure of power. Opportunity refers to growth, mobility, and
the ability to increase knowledge and skills. Access to power is
described as having access to resources, information and support.
Nurses who work in organizations that value these criteria tend to
regard their employment more highly. For the staff nurse, this
should mean that these qualities of growth, mobility, access to
increasing your knowledge and skills, and the access to resources,
information and support should be rated very highly when selecting an
institution to work for. Don't get drawn in by the benefit programs
and how beautiful the lobby is but pay close attention to those
things that are going to be more likely to make you want to stay at
that institution in the long run.

For those in management and education positions, these are the
criteria that nurses are looking for. When a hospital offers huge
sign on bonuses to recruit nurses the money may sound very
attractive, but in the long run they are sending out the message that
they can buy your devotion rather than supporting you in other ways.
Look carefully at the message that you are giving to your nurses or
prospective nurses. And instead of offering a sign on bonus, it
would be more effective to use that money to provide office days for
your current staff; and offer your nurses opportunities to serve,
opportunities for decision making, and rewards for jobs well done.

Best wishes,

David W. Woodruff, MSN, RN-BC, CNS, CEN
Alumnus CCRN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

Have you ever walked out on a movie that you absolutely loved? I've
done it a couple of times. It might have been to take care of a sick
kid or for some other dire and pressing need. But in general, people
don't walk out on a movie that they absolutely love.

The same is true for our presentations. If people get up and leave
during your presentation, it is not a reflection on their
professionalism but rather a reflection on how compelling your
presentation is. But simply making your presentation louder or
funnier is not going to captivate the audience and make them want to
stay.

I can get up and leave an action movie and not feel like I really
missed something. On the other hand, the movie that really connects
with my heart and my soul is the one that I hate to miss. When you
connect with your audience's heart and soul they'll want to stay with
you the entire time and they'll be asking for more. If you don't
connect, then you are relying entirely on how interesting your
presentation is; and keep in mind with the MTV generation our
presentations have to be very interesting in order not to lose them
in the first 20 minutes.

But even the most thrilling action movie rarely leaves people wanting
more. It's the heart and soul connection that makes people want to
come back and that makes them want to know about you. Without the
connection you are doing nothing more than relating facts and they
can get that same information from a book, or from reading an article
on the Internet.

The purpose of a presentation is to connect with your audience at a
heart and soul level. What do you use to connect with your nurses?

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

Flowers brighten up any room… that is already bright.

A local flower shop promises that flowers will brighten up any room,
but I doubt that they will do very much for my basement. I agree
that flowers would add a nice touch of color to a room that is
already neat and attractive, but flowers are not going to change a
room from drab to beautiful.

The same can be said for your PowerPoint presentation. It is a nice
way to illustrate a point, but PowerPoint won't save your
presentation. Content must come first, and once your content is
extraordinary, then PowerPoint can help you illustrate it. A bad
PowerPoint presentation will have the same impact as a bouquet of
dead flowers. It will be distracting at best and offensive at the
worst.

When you begin developing your next presentation, spend at least 90%
of your time developing the content. Decide what you need to teach
and figure out what would be the best way to teach it that involves
the most number of senses. We retain more of what we see, hear, and
feel.

Once the content is developed, then start thinking about how you can
illustrate it with your PowerPoint presentation. Here are some tips
to help you make your next PowerPoint presentation better:
1. Less is better: only one idea per slide, clearly
illustrated, and with as few words as possible.
2. The rule of sevens: only seven words per line, and only seven
lines per slide.
3. Pull important words out of the handout material to use on
your slides. Don't use PowerPoint as your outline and read from it
(a good cure for insomnia).
4. Animation can help illustrate a point, but is otherwise
distracting. Remember that the focus should be on you, not the wild
slides flying in and out.
5. Complex charts and graphs are better in a handout. They will
be too small to see on the screen, and are boring.
6. Like a bouquet of flowers, complementary colors are nice.
Avoid florescent or clashing colors. The idea is to make your slides
interesting, not obnoxious.
7. Trim it, prune it, and shape it for maximum impact.
Eliminate anything that doesn't help you teach the primary principles
of this lesson.
8. Avoid clip art! Use pictures instead. If you have a complex
concept to explain, use a picture and describe it with your
presentation.

PowerPoint can be an attractive way to illustrate your ideas when you
teach, but if it is not used correctly it will be distracting, and
eventually boring. The point of your teaching is the content. Spend
your time on the content and use PowerPoint to illustrate your most
important points and you will transform your next presentation from
ordinary to extraordinary.

Get more help with your PowerPoint presentations:
http://www.sethgodin.com/freeprize/reallybad-1.pdf

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

I mostly agree with your ideas on the value of specialty nursing
certification; in fact, I have obtained a nursing certification by
exam and belong to the associated nursing organization, which is a
great resource for continuing education, conferences, and nursing
research.

However, one part of your thesis is dicey when you say:

    "This goal does not require having to hire experienced nurses.
     Junior nurses could be hired in, trained, and get their experience
     on the floor while being mentored by a more experienced nurse".

In my view, nursing is a praxis of didactic and direct bedside
experience.  There really is no good substitute for such experience.
We need to value the bedside experience of older nurses who have
"walked the walk" for many years.

I agree that experienced nurses can mentor less experienced nurses,
but these arrangements need to be made judiciously since not all
nurses are equipped to be effective mentors, and all parties need to
actively engage in this type of teaching-learning relationship.

Your comment as excerpted above has a bottom line undertone that does
not value the richness of bedside experience that many of our
experienced nurses can offer.

patty

Many nurses are pursuing certification due to pressure from their
employer who is striving for magnet status, or for financial
incentives that come as a result of having certification in their
specialty field. An unintended but positive consequence of nurses
seeking certification is that we are developing a reliable standard
for excellence in care.

For centuries, nurses and physicians have pursued their profession as
craftsmen. Some nurses are better at clinical skills while others
are better at assessment and still others better at dealing with
patients and patients' families. Encouraging different levels of
satisfactory care actually decreases the level of safety we have in
our institution. Those systems that are very safe have a
standardized level of care that is not dependent upon individual
preferences.

For example, the airline industry has a very safe level of service
and is highly standardized. Very few people know, or care, who the
pilot is that is flying their plane. However, most people choose a
physician based on their personality or anticipated skill set and
believe that the outcome of their care will be dependent upon that
physician's personal skill. When we encourage different levels of
skill in nursing, we are encouraging mistakes and errors to occur.
By standardizing the knowledge skill and basic levels of care
required of nurses, safety will be improved.

An argument could be made that nursing is an art and certain nursing
behaviors cannot be standardized. On the other hand, landing a plane
is an art that requires hours and hours of practice and is done a
little bit differently from one pilot to the next. However, certain
standards were developed and maintained in order to assure safety in
the airline industry.

Professional certification helps to validate the knowledge and skills
of the practitioner. Recent efforts to increase the number of
certified nurses in our hospitals will also help improve safety by
standardizing the basic knowledge and skills required in a specialty
area. Imagine the level of care that would be delivered by a team of
certified nurses if every nurse on a particular floor was required to
achieve specialty certification. This goal does not require having
to hire experienced nurses. Junior nurses could be hired in,
trained, and get their experience on the floor while being mentored
by a more experienced nurse.

In the airline industry, they have a pilot and a co pilot. The pilot
is typically the captain. The captain has achieved a higher ranking
than the co pilot due to more years of experience and additional
certifications. They fly and work together in order to make the
flight a successful one. The co pilot is being mentored by the
captain until she reaches the point where she could become captain.
A similar system could be set up on your floor. Junior nurses would
always be assigned a senior nurse who would be working along with
them; giving them guidance and direction when necessary.

The airline example is much different than our system where we teach
junior nurses to call if they have any problems; this would be
similar to sending the co pilot up in the plane alone with a radio so
he could call if he had any problems. Having an assigned mentor
assumes a relationship where both the mentor and mentee are working
together on a consistent basis and learning from each other.

I propose using the system of certification as a basis for improving
care and healthcare safety. The content areas on the exam have been
researched by nursing experts and determined that those are the most
important things that nurses in a particular area should know. This
is a great framework for building excellence in your nurses. The
exam blueprint consists of the concepts that nurses need to be
taught. A certification exam is designed to be able to validate
whether the nurse actually knows the information or not, and if they
are able to use it. Certification is a great validation tool for
determining your nurses' knowledge and skills.

Lastly, your nurses who have achieved certification should be
mentoring those who have not; with the expected goal that those
nurses will pursue and achieve certification to validate their
knowledge and experience as well. Anticipate that you will meet some
resistance initially. Nurses have been trained that they do not need
specialty certification in order to work. However, if we make
certification an expectation and pursue that expectation with every
staff member, we will find that eventually it will become well-
accepted. In fact, your peers will take pride in the fact that you
have an all-certified nurse unit.

Specialty certification has been known to improve confidence, to
decrease errors and improve patient satisfaction with nursing care.
It is also a marvelous design for building more educated and
competent nurses and standardizing the level of care that is
delivered in your unit or on your floor.

Help us to empower 100K nurses to become certified in their specialty
area by the year 2010. Visit www.100k-Certified-Nurses.com

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

According to Dr. Ernest of Ohio State University, leadership is not
an innate characteristic. It can be developed through training. All
nurses are leaders; so the choice is not whether to be a leader, but
rather, whether to be a good leader or not.

We lead our patients, their families, and each other. It is
important to recognize our leadership potential and to develop it.
Daniel Goldman in his book "Primal Leadership Realizing The Power Of
Emotional Intelligence" states that the individual's ability to
recognize and regulate his emotions and emotions of others accounts
for 80 percent of leadership success in organizations. As nurses we
need to recognize the leadership potential in ourselves and in each
other.

Dan Amos, the CEO of the insurance company Aflac, states if you treat
your employees well, they will take care of your customers and your
business. As a leader, it is important to develop an interest with
those people you work with, whether they are your employees or
whether they are your co workers. If you have a sincere interest in
the people you work with, you express that interest by finding out
more about them and by listening to their concerns. Developing a
genuine and non-judgmental interest in other people will help you
strengthen one of the most important leadership skills, the skill of
relationship.

The people you lead know whether you are genuinely interested in
their well-being or not based on your relationship. Developing
relationships is one of the most important things you can do as a
leader. You need to know what makes your co workers, your employees,
and other people tick. For example, if you have a competency that
you need for your employees to understand and implement, you will be
in a better position to gain their cooperation if you understand what
their needs are and you shape the development of the program around
their needs.

The first step in developing leadership that works is developing the
relationship; and if you are genuinely interested, you can find out
what makes them tick. Then you have the opportunity to show them how
what you are teaching can make their job easier and make their life
better. Leadership takes time and it takes effort, but good leaders
can change the entire culture of their organization leading to more
cooperation and better patient care.

Best wishes,

David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

"Nobody gives you power, you just take it." -Tom Peters, business
author.

What Tom Peters is referring to in this quote is the fact that power
cannot be obtained by position or education but in fact must be
earned by creating opportunities through education and reflections on
experience.

As a nurse educator, you must recognize that power is important for
you to be able to do your job. You need to have power to be able to
create change in the healthcare system that leads to better patient
care. You may talk of empowering your nurses; but really what you do
is you provide opportunities and preparation so that when the nurse
becomes prepared and meets the opportunity that they will have a
successful outcome for their patient.

Preparation + Opportunity = Successful Outcome

To learn more about how you can increase your ability to empower
yourself and others to higher levels of professional achievement
please check out this month's mPower4Nurses PodCast at
http://ed4nurses.typepad.com/mpower4nurses/.

Best wishes,

David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

Leaders are visionaries. The most important job of any leader is to
share a vision for a powerful and glorious future that keeps hope
alive. As a nurse educator, your job is more than just testing
competencies and performing in-services. You are a leader. You can
choose to be a good one or a bad one. Regardless of what you think
your leadership skills are, having a clear, powerful, and positive
vision for the future is the most empowering leadership quality that
you can possess.

Throughout the history of nursing, there has never been a more
important time for our leaders to have, to share, and to embrace a
powerful vision for the future. Your nurses feel overwhelmed with
the problems of understaffing, exponential increases in knowledge,
and the sheer physical labor of the jobs. Many nurses are
desperately trying to find hope in the form of a powerful vision for
the future from their leaders.

Take this opportunity to sit down and draft your vision for the
perfect future of your department, your hospital, and your nurses.
Keep it in front of you every day and strive to work a little bit
closer to that perfect future. Share your vision with your nurses.
I think you will be surprised at the positive response you will
receive. A leader with a positive, insightful, empowering vision is
a dealer in hope.

"Learn from yesterday, live for today, hope for tomorrow." –Albert
Einstein

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

Some people call it a mission statement; some call it a daily
affirmation – that sentence or two that clearly describes what it is
that you were placed on this earth to accomplish. This statement is
not merely a whimsical platitude about an ideal future; but rather a
reaffirmation of your higher purpose. I call it a statement of
purpose; and mine is to "Empower Nurses to Become Extraordinary."

This is different from your hospital's mission statement. These are
the documents that were developed through months of board meetings;
they are often framed and placed in the hospital lobby where the true
meaning is quickly forgotten.

I write mine out every day at the top of my daily planning calendar.
Many times I will include details about the specific task that I am
doing on that day. For example: "Empower Cleveland Nurses to Pass
the CCRN." Now my attention is really focused on what it is that I
have to do today. This is a powerful tool. It keeps me focused on
the most important things and acts as a filter for evaluating
priorities. As author Steven Covey says "the main thing is to keep
the main thing the main thing."

To find out what your purpose is just allow yourself to daydream for
a few moments and remember why it was that you chose the job you have
now. What were you hoping to be able to do? What kind of impact did
you want to achieve? Spend a few moments really thinking about these
questions; and don't be judgmental!

Most people tell me that they give up on their dreams because
they "got real" or in some other way "joined reality." Not true! If
you've given up on your dream, it's because you gave it up. The
dream, the vision, the movie in your mind; this is your highest
purpose. Don't let it frighten you; it's big. Don't let people take
it away; it seems absurd. Hold on to it, cherish it; treat it like
you would a newborn baby. This is your destiny.

OK, back to reality (right?) A week of short-staffing, loads of new
competencies, orientation and other responsibilities threaten to rob
you of your higher purpose; and that's why I write it down every
day. Life will distract me from my higher purpose, but not if I make
a habit of looking at it every day and spend some time embracing it
on occasion.

So how do you keep first things first? By using your higher purpose
as a filter for what things are most important to do. When you do
this on a regular basis, you will find that some of the things that
you've been doing are really not that important; and as the less
important things start to drop away, you will have more time and
energy for what leads you to your higher purpose.

"Many persons have a wrong idea of what constitutes true happiness.
It is not attained through self-gratification but through fidelity to
a worthy purpose." -Helen Keller

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

Get your nurses certified! Find out how at www.100K-Certified-
Nurses.com.

The French tried but couldn't build the Panama Canal. Rain hampered
progress, mudslides buried equipment, and workers got sick and quit
faster than they could be replaced. Then along came John Frank
Stevens. His first priority was to take care of his workers – to
provide them with housing, healthcare, and allow their families to
come to stay with them. His concept paid off. Happy workers = more
production and the completion of a seemingly impossible task.

The French efforts at building the Panama Canal sound like our
efforts in making healthcare work. Employers are demanding more from
their nurses while giving less. Is it no wonder that nurses are
leaving? When there is no clear benefit to working at one
institution, nurses will leave when more pay, better hours, or any
other perk is offered. But there is no end to this. I saw an offer
for up to $10,000 in bonuses and relocation reimbursements from a
hospital seeking nurses recently! Who is going to up the ante next?

Perks may get nurses, but they don't keep nurses. Respect,
professional support, and educational opportunities keep nurses.
Nurses can't get enough of hospitals who sincerely provide these
invaluable resources. The key word here is "sincerely." Lots of
hospitals give lip service to these values, but few provide them.
It's time for a change…

What can you do to show respect, and provide professional support and
education for your nurses? Let's start with respect. Do you
sincerely respect the dedication of your staff? How do you show them
your respect? Start with them as a person: ask for your nurses' help
with projects that require their expertise, inform them of
opportunities for professional growth; and make it easy for them to
pursue them. More importantly show them your passion for nursing.
Bored and burnt-out leaders foster bored and burnt-out followers.

Passion moves mountains. Passion generates enthusiasm. An
enthusiastic group of nurses can accomplish anything. The best
organizations have passionate leaders, but if your leaders are not
passionate, you still can be. Nobody can extinguish your enthusiasm
but yourself. Don't believe the naysayers, nursing is the most noble
and magnificent profession. The opportunities are endless. If you
can't see them, then you only have to open your eyes because they are
there.

What is your passion? How do you pursue it? These are questions
that you need to answer before you can lead from where you are. And
make no mistake about it; you must lead from where you are before you
can lead from anywhere else.

Passion, Energy, Enthusiasm: it's contagious! Your role is to create
an atmosphere where your nurses can be more than they every dreamed
of.

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

In 2005 the American Association of Critical Care Nurses (AACN)
released their standards for establishing and maintaining healthy
work environments. One of the recommendations they made was for the
development of authentic leaders. The qualities the AACN identified
as being essential to the authentic leader include: genuineness,
trustworthiness, reliability, compassion, and believability.

I totally agree that our leaders should exhibit these qualities, and
that authentic leaders could help to change the nursing environment
into a more nurturing atmosphere for nurses and patients alike. But,
managers can't do this alone; real change will only happen when
nurses become authentic leaders.

As a staff nurse, you are a leader; you lead your peers, you lead
your patients, you lead your institution, and you lead society. So,
the question isn't whether or not you are going to be a leader, it is
simply whether you are going to be a good one!

A healthy work environment isn't just created by administration –
it's created by you. How often have you heard that "nurses eat their
young?" Managers can only do so much in discouraging the practice of
negative thinking and critical leadership by their staff. But, peer
pressure is a powerful tool. When you take on the qualities of an
authentic leader, other staff will be drawn to you and negative and
disruptive work habits will stop (at least in your little part of the
world).

Don't wait for some extraordinary leader to lead us out of the desert
of negativity and self-destruction – it's not going to happen! The
only way nursing is going to be the profession you want it to be is
by taking personal action to stand for what you believe in. I'm not
suggesting going on strike or picketing Washington; I am suggesting
that you start with you. Be the change you want to see happen.

If you want better care for your patients, then make that your
personal mission. Make "provide extraordinary care" your personal
mission statement. Every day when you wake up, write it down.
Remind yourself continuously that "extraordinary care" is what you
are about, and don't let anyone take it away.

There are 2.7 million nurses in the US, and we are the largest group
of employees at any hospital; nurses are a powerful force. Let's use
that power for the good of healthcare. Start with yourself and be a
power of example for your peers. Take on the qualities of
genuineness, trustworthiness, reliability, compassion, and
believability. Make them the basis of your character and you will
become an authentic leader capable of changing lives and the quality
of nursing care.

"Let others lead small lives, but not you. Let others argue over
small things, but not you. Let others cry over small hurts, but not
you. Let others leave their future in someone else's hands, but not
you!" –Jim Rohn

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

There are times when I just don't know how I'm going to get
everything done. Deadlines are looming, and the pressure is on.
That's when it hits me – the idea for the one project that could have
a major impact my career and the lives of countless others!

Have you ever said no to an idea or project that could send your
career soaring, or could benefit others because you couldn't possibly
see how you were going to be able to do that project on top of
everything else? Did it come back to haunt you later? If only…

Most people only look at the HOW of any project: how am I going to
find the time, how am I going to get the money, or how will I regain
my self-esteem if it doesn't work out? Focusing on the HOW becomes
paralyzing; we only see the negatives and talk ourselves out of the
big dream because we don't know HOW to make it work.

If your dream is important to you, don't worry about the HOW; when
the WHY is big enough, the how will take care of itself. It is my
goal to get 100,000 nurses certified in their specialty by the year
2010. I don't know how to do that; but I do know that it is
important. It is important to me and to the nursing profession:
certified nurses make fewer errors, collaborate better, and have
higher self-esteem than nurses who are not certified. The WHY is
important!

The how begins with what we already have in place: the best
certification programs available that guarantee success. In the next
four years, more "hows" will be revealed. We made the commitment and
we want to see it through to fruition. It is like magic – when you
make the commitment to a lofty goal and get started toward it's
completion, the methods find you. In other words, when the WHY is
big enough and important enough to you, the HOW takes care of itself!

Embrace your dream: see it, feel it, imagine the impact. Don't let
go of the WHY just because there are obstacles – nothing important is
easy to accomplish. It is just a matter of believing in your dream
and in yourself. You can do it, and you should do it! Stop
listening to any reasons why it can't be done. Have you heard the
story about the 90 pound grandmother who lifted the car off the
child? She wasn't thinking about how she was going to do it, she
just did it. When your why is strong enough, the how just doesn't
matter.

"Most people never run far enough on their first wind to find out if
they've got a second. Give your dreams all you've got and you'll be
amazed at the energy that comes out of you." – William James

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

Nursing specialty certification increases nurse's job satisfaction.
See www.100K-Certified-Nurses.com for more information.

From a recent interview with Quint Studer:

Better hand washing is one of the most effective ways to prevent the 2
million hospital-acquired infections that occur each year.  However,
research shows that caregivers only follow proper hand hygiene
protocols about 40% of the time.  If improved hand washing eliminated
just 10% of these infections we would save 10,000 lives and $3 billion
each year.

By hardwiring hourly rounding hospitals can prevent more than 250,000
falls and save more than $2 billion each year.   Hourly rounding can
also help prevent more than 350,000 pressure ulcers each year, which
result in thousands of needless deaths, increased costs and lawsuits.

Decreasing employee turnover below 12% will decrease length-of-stay in
hospitals by 1.2 days and lower mortality rates, resulting in lower
costs and lives saved.

See the rest of his interview on MSNBC's morning show:
http://www.studergroup.com/videos/quint_morning_joe.dot

What is your point of view on the nursing continuing education that
you provide? Many educators view their continuing education
offerings as a necessary part of their jobs – it's important to do,
but not important enough to obsess about. So we have an inservice
that is thrown together with the expectation that if people will just
pay attention they might get something out of it. The idea of
putting on an inservice that is exciting and compels your nurses to
change their practice is rarely considered. Your point of view about
your educational offerings can make the difference between a boring
presentation and an empowering experience.

In other words, what is the experience you want your nurses to have?
Starbucks changed the entire experience of drinking coffee. Gulping
down a cup of coffee from the local 7Eleven just doesn't cut it
anymore. Starbucks opened our eyes to variety, and brought us back
to a simpler time when people would slow down and chat over a cup of
java. This is all about design, Starbucks carefully planned the
experience that they want you to have when you enter their store. It
is no accident that there is a fire burning in the fireplace on cold
winter mornings.

Design at the very basic level is about what you stand for. If you
stand for empowering your nurses to become extraordinary, then your
educational offerings should reflect that. Everything is important;
from the font you use on written materials to the tone of your voice
during a presentation. Like the fireplace at Starbucks, you will
send a message. Neglecting design will also send a message. Have
you ever walking into a store that is filthy? How did you feel about
it? Did you want to hang around and enjoy the atmosphere?

Design is your trademark, it is your expression of the experience you
want your nurses to have. Don't let it go unnoticed, unappreciated,
or dismissed entirely. Design tells your nurses whether you care
about them and to what extent you are willing to help them to become
extraordinary. Take some time this week to appreciate design. It is
all around you. Notice what design features you like and which ones
are distracting, uncomfortable, or distasteful. Think about your
design and consider what you could do differently; because if you pay
close attention to design you will be able to empower your nurses to
become extraordinary!

Best wishes,

David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com
www.dwoodruff.com

There are times when I just don't know how I'm going to get
everything done. Deadlines are looming, and the pressure is on.
That's when it hits me – the idea for the one project that could have
a major impact my career and the lives of countless others!

Have you ever said no to an idea or project that could send your
career soaring, or could benefit others because you couldn't possibly
see how you were going to be able to do that project on top of
everything else? Did it come back to haunt you later? If only…

Most people only look at the HOW of any project: how am I going to
find the time, how am I going to get the money, or how will I regain
my self-esteem if it doesn't work out? Focusing on the HOW becomes
paralyzing; we only see the negatives and talk ourselves out of the
big dream because we don't know HOW to make it work.

If your dream is important to you, don't worry about the HOW; when
the WHY is big enough, the how will take care of itself. It is my
goal to get 100,000 nurses certified in their specialty by the year
2010. I don't know how to do that; but I do know that it is
important. It is important to me and to the nursing profession:
certified nurses make fewer errors, collaborate better, and have
higher self-esteem than nurses who are not certified. The WHY is
important!

The how begins with what we already have in place: the best
certification programs available that guarantee success. In the next
four years, more "hows" will be revealed. We made the commitment and
we want to see it through to fruition. It is like magic – when you
make the commitment to a lofty goal and get started toward it's
completion, the methods find you. In other words, when the WHY is
big enough and important enough to you, the HOW takes care of itself!

Embrace your dream: see it, feel it, imagine the impact. Don't let
go of the WHY just because there are obstacles – nothing important is
easy to accomplish. It is just a matter of believing in your dream
and in yourself. You can do it, and you should do it! Stop
listening to any reasons why it can't be done. Have you heard the
story about the 90 pound grandmother who lifted the car off the
child? She wasn't thinking about how she was going to do it, she
just did it. When your why is strong enough, the how just doesn't
matter.

"Most people never run far enough on their first wind to find out if
they've got a second. Give your dreams all you've got and you'll be
amazed at the energy that comes out of you." – William James

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com
www.dwoodruff.com

Thank you! I will check the products and see if it is still available.

Denise G. Myricks, MSN, RN, NE-BC, CNS
Coordinator Staff Development
Akron General - Edwin Shaw Rehab
1621 Flickinger Road
Akron, Ohio 44312
dmyricks@...

phone: 330-784-1271  ext:5258
fax: 330-784-2524

>>> sstubbs@... 08/26/08 03:18PM >>>
There is a book out by Lippincott: Critical Thinking in Nursing

Authors are Saundra Lipe and Sharon Beasley. I found this at the NNSDO
national Convention last year and have been using it quite a bit. There are
practice sessions at the end of each chapter that are very helpful





   _____

From: mpoweryournurses@yahoogroups.com
[mailto:mpoweryournurses@yahoogroups.com] On Behalf Of Denise Myricks
Sent: Tuesday, August 26, 2008 1:18 PM
To: mpoweryournurses@yahoogroups.com
Subject: [mpoweryournurses] Critical Thinking Skills



I am the Staff Development Coorindator for the nursing staff at a
Rehabilitative Facility. I am discovering the need to keep my nurses up on
their critical thinking skills.I am wondering if anyone out there has a good
resource for this? Eager to hear from the group...

Denise G. Myricks, MSN, RN, NE-BC, CNS
Coordinator Staff Development
Akron General - Edwin Shaw Rehab
1621 Flickinger Road
Akron, Ohio 44312
dmyricks@edwinshaw. <mailto:dmyricks%40edwinshaw.com> com

phone: 330-784-1271 ext:5258
fax: 330-784-2524

I am the Staff Development Coorindator for the nursing staff at a Rehabilitative
Facility. I am discovering the need to keep my nurses up on their critical
thinking skills.I am wondering if anyone out there has a good resource for this?
Eager to hear from the group...

Denise G. Myricks, MSN, RN, NE-BC, CNS
Coordinator Staff Development
Akron General - Edwin Shaw Rehab
1621 Flickinger Road
Akron, Ohio 44312
dmyricks@...

phone: 330-784-1271  ext:5258
fax: 330-784-2524

I heard a startling statistic today: only three percent of the
population is interested in improving themselves. At first I thought
that can't possibly be right. But after more thought I'm not as sure
that it is wrong. I started to think about the number of people that
invest their time and money into self improvement and actually follow
through. I thought about how many people make written goals and
define the action steps to achieve their goals. I thought about
critical thinking…

More than any other topic, I'm asked by conference planners to speak
to nurses about critical thinking. I think that many people feel
that if nurses would just use critical thinking, then many clinical
problems could be solved and errors would be reduced. But what is
critical thinking? Isn't it just imaginative problem solving?

How often do we encourage nurses to use their imagination? In a
system that is governed by financial constraints, policies,
procedures, and a rigid authoritative structure is there any room for
imagination? And if a nurse comes up with a good idea, aren't we the
first ones to shoot it down? Oh sure, we've got good reasons for
resisting change; change is uncomfortable and most of us will do just
about anything to prevent it.

What would happen if we encouraged change; and when nurses came up
with an idea, we embraced it and supported them in every way possible
to see it to its conclusion? I think it would go a long way toward
encouraging imaginative thinking and problem solving.

Think about ways that you could encourage nurses to use their
imagination. How about starting a "Wild Idea" contest? The winner
could be given reimbursement for conference tuition and travel to a
nice resort location. The hospital would be the ultimate winner of
hundreds of good ideas and get a detailed report back from the
conference on other new ideas and updates.

Keep in mind that if you want to empower your nurses to use creative
problem solving, you must inspire them to want to contribute,
motivate them to do the extra work, and support them along the way.
Remember that many of your staff feels unappreciated and overworked
to begin with; but most of them would be happy to contribute if they
felt that their contributions would be valued and respected.

Critical thinking is necessary to the advancement of nursing as a
profession. Despite the lip service we give to critical thinking,
imaginative problem solving by nurses is not encouraged, nor is it
supported by the paternal hospital culture. If we truly want to
develop critical thinkers, we need more than just another seminar to
teach it, we need a culture change that encourages "wild ideas" and
embraces nurses with dignity and respect for their contributions.
Please share with us your ideas on how you inspire, motivate, and
support your nurses to become "wild idea" creators and encourage
critical thinking in your institution.

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com
www.dwoodruff.com

Nurse educators are in the unique position to be able to inspire
their nurses to become extraordinary, motivate them toward
excellence, and support them in their efforts to provide better
care. In doing so, educators will be in the position to transform
patient care to higher levels and act as a catalyst in the careers of
their nurses.

To become a transformational educator requires patient and persistent
self-development and constant attention to detail in your teaching
activities. Business author John C. Maxwell uses the acrostic
B*E*S*T to describe the essential components that will bring out the
best in your nurses.

B Believe in them. Regardless of what you think their real
motivation is, always believe that your nurses are there because they
want to provide extraordinary care. When you start treating people
as if they were motivated by higher standards, most will start to
live up to those standards. It is human nature that many nurses will
fall to the lowest level that you expect of them; so make that level
extraordinary, rather than satisfactory.

E Encourage them. Find more reasons why they can do it rather than
why they can't. Many people have been told their whole lives that
they can't do certain things, so they have come to believe it. I
can't tell you the number of nurses who tell me they are "bad test-
takers" during our certification review classes. Nobody is
intrinsically a "bad test-taker." It is a skill, just like starting
an IV. It takes practice, not intrinsic ability. In what ways can
you be more encouraging?

S Share with them. If people can see how you've overcome
limitations, they can see how they might be able to overcome their
own too! Look for similar experiences in your past that you can
share with students to encourage them to take the leap of faith into
resolving some of their own issues that may be keeping them from a
more successful and enjoyable career.

T Trust them. Although it is true that some people are motivated
only by their own self-interest, most nurses are interested in doing
what's right and helping other people. I try to always assume that
other person is sincere and give them my full trust. Will I be let
down? Sometimes; but I will always be disappointed if I don't trust
people at all. I've chosen a position that leaves me open to being
hurt or disappointed, and I know that. It isn't naïve, it was a
conscious choice. The benefit is that many times people will rise to
the occasion and surpass their own expectations, which results in
personal growth. Trusting gives the other person permission to be
responsible and to grow.

Try integrating these four concepts into your teaching style. You
may find, as I did, that a nurturing approach is very effective at
developing personal growth in your nurses and motivating them to
achieve higher levels of patient care.

Message from my mentors: "Whether you think you can or think you
can't - you are right." ~Henry Ford

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com
www.dwoodruff.com

Leadership does not require a position, title, or acknowledgement.
Leading can be done right where you are now. Have you ever heard
someone say "If I were in charge, it would be different around
here?" What they're really saying is that if they were given the
position of leadership, then they would act like a leader. But this
is not how leadership works. Nobody is going to give a leadership
position to someone who doesn't already display leadership qualities.

You can begin to become a leader by leading were you are right now,
even if you are at the bottom of the pile. To lead from any position
in the organization, you first need to do your job with excellence.
You can provide no additional value to your leaders if they have to
constantly clean up after you.

Once you can claim that you do your job with excellence persistently
and consistently, then you can start asking what you can do for your
leaders. Lighten their load by asking what you can do for them, and
they will lighten your load too.

The success of your organization is important to you. If your
institution does not thrive, then you will not thrive either. Before
you know it the organization will be in financial trouble, your
patients will be dissatisfied, and you will be overworked and burned
out! Do your job with excellence, and ask what you can do for your
leaders, and you will see your influence grow.

Everyone is a leader, so you might just as well be a good one!

"Men make history, and not the other way around. In periods where
there is no leadership, society stands still. Progress occurs when
courageous, skillful leaders seize the opportunity to change things
for the better." -Harry S Truman

Best wishes,

David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com
www.dwoodruff.com

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