Monday 14 September 2015

Supporting the future

'Un pour tous,
tous pou un!'
The three Musketeers (1844)

Well, what a week I've just had at work!  There were 3 main highlights from last week that can be put into 3 categories - Mentoring, RCN and Revalidation.

Mentoring:  As with a lot of Trusts and NHS professional areas we are struggling with staffing levels - Retirement and retention are proving to be a problem.  Due to this we have had a huge intake of international and newly qualified nurses, as well as a large number of agency nurses.  Although this appears to be a bad thing I have found it to be quite a good thing for me on a professional level as it means that as an AP I have been put to good use.  Over the last week I've been working with one of our newly qualified nurses to help her find her feet.  I've found it challenging in some ways as I start to go into auto-mode and just start to work automatously (big word for me!) before realising that I'm there as a support role and have to put the breaks on.  She has found it had over the past 4 weeks as our clinical leaders have been up to their eyeballs in mentoring and supporting the large number of new staff we have and so struggle to get round everyone... step in yours truly :)  I had a long chat with her while on shift and told her, in my opinion, the best way to run her bay.  This involved a number of thing.

1. Use your support worker - As an ex-support worker myself I know how useful these lovely people are and how they form the foundation of the work place.  Use them to the best of their ability, but never... EVER... abuse them.  They are hard workers but if you abuse them they will become disgruntled and not want to help you, thus causing a long and uncomfortable shift.  Always offer to help them and thank them for supporting you... you will be amazed at how nice it is to be thanked and how much more they are likely to want to work with you in the future.

2. Time management - You need to prioritise your workload.  Some jobs are more important than other and you do not have to do EVERY job yourself, if you try to work like this you will never leave the Ward on time.  By prioritising your workload you can ensure an efficient and safe shift.  As above, use your support worker to help by giving them some items from your list of jobs.  This will make them feel valued and show that you have trust in their abilities within the work place.  This then leads to the next item...

3. Delegation - I find this to be one of the hardest things for new staff to do as they don't want to look like they are abusing the staff they are working with.  This takes both items 1 and 2 above into account and will have a huge knock-on effect.  Delegating to your support worker will mean that your time management stays on track.  One thing to remember though, if you delegate a task to someone then you are saying that you feel they are competent in that job - If they make a mistake... you have made that mistake also.  I find the best way to get a newly qualified nurse to delegate is to tell them that I will not do anything unless they tell me.

4. The 'Huddle' - For me this is a vital part of working as a team, and incorporates items 1, 2 and 3 from above.  Every few hours you should have a 'huddle', this can be in the corner of the bay, the back room or by the nurses station.  The 'huddle' is where you and your support worker can get together, pass on things that have been said on Ward rounds, inform each other of situations with patients, and formulate a plan of action.  The action plan involves you deciding how to use your support worker to the best of their ability, managing your time and then delegating jobs.  Here is a conversation from one of my 'huddles' last week and an example of how I try and teach newly qualified nurses how to run a bay. 

'What needs to be done?'
'I need to change 3 wound dressings, I need to do a CHC & STRATA, I have 2 DN referrals to do, I have a dietitian referral to do, and 2 discharges.'
'Ok, While you do all of them I am going to go and have a brew in the back.'
'Err, umm, ok.'
*walk out of the room and then come back in again* 
'Would you like me to do any of these jobs for you?  If you don't tell me, then I wont do them.'
'Err...Yes please...'
'Ok, you know what I can and can't do.  What do you want me to do?'
'Do you want to change that wound dressing...?'
'No, what I actually want to do is go and have a brew in the back.'
*Grins*
'Oh... Ok then.'
'Would, you like me to change that wound dressing?'
'Err... only if you want to.'
'As I said, what I really want to do is go and sit down with a brew.'
'Err... Ok then.'
'I will say it again.  Would, you like me to change that wound dressing?'
'Only if you want to...'
'What did I just say I want to do...?  Delegate.  If you don't tell me... I won't do it.'
'While I discharge one of the patients, can you please change the wound on bed X'
'Yes.  And after that?'
'After that can you do the 2 dietitian referrals.'
'Yes I can.  Now that wasn't to hard was it?'
'No.'
'There you go then.  If you want to get out on time you need to delegate.  If you ask a support worker to do a job and they say 'No', ask them again and ask why they won't do it.  If they still say no and don't have a legitimate reason then tell them to do it - 'I have asked you to do job.  As your senior, I am now telling you to do the job I have delegated to you.'  If they still say no then inform the clinical leader.  You may feel bad about this but that is part of the role for both you and them.'

RCN:  I received an email during the week from my NW RCN Learning & Development Facilitator informing me that she was happy to sign off my 2nd module learning grid.  What does this mean?  It means that I've passed my RCN Learning Representative course... I'm a fully fledged  RCN Learning Rep!!! :D

Revalidation:  During the 2nd module of my RCN Learning Rep course, and following a Ward meeting I've been looking into NMC revalidation.  This doesn't affect me as I'm not a nurse but I feel that as a Learning Rep it is something I can sink my teeth into.  I brought this up a while ago in a Ward meeting asking if people knew what the provisional criteria was at that point in time.  The reaction I got wasn't great as the only people who had the vaguest idea of what I was talking about were the Ward manager and clinical leader in the room.  Following on from this I decided that the large intake of newly qualified and international nurses not knowing anything about the new revalidation criteria would be a great project for me t sink my teeth into.  I decided that the best thing I could do would be to make a simple guide that condensed the NMC's 30ish page document into a bite sized easy reader.  I ended up making a double sided A4 pamphlet that broke down the criteria into individual areas and explained what was needed for each bit.  Before I could start handing this out though I had to get the all clear from my Trust's senior management team to make sure it contained the correct information and that they were happy with i's presentation.  Ward staff I had shown it to thought it was great and quite a few staff from other Wards have come and asked me about revalidation and if they could have a copy.  Well, mid week I got a few emails from our Listening into Action tem, chief of nursing and our Communications team all saying that they supported the pamphlet and that I could distribute it to staff!  One small step for the Trust, one giant leap for Learning Representative Shaniepoo! :D

Right, I've been procrastinating all morning and have jobs that need doing round the house so am going to stop talking and get a shifty on.  Remember guy... Respect your support workers, they are the foundation of your team :)

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