Key to The Future: MNHHS Nursing & Midwifery Conference

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                Simulation Education Workshop: Technique, Not Technology: Nursing CPD 2.0

This post is to curate a selection of materials linked to the the Simulation Education Workshop I delivered on May 12th (International Nurses Day) at the inaugural Metro North Hospital and Health Service Nursing and Midwifery Conference.

The central theme of this workshop was scenario based simulation through the progress of a nursing career. There is increasing adoption of simulation as a teaching technique for many technical and team based skills in the health professions. The aim of this workshop was to outline practical tools that can facilitate the utility of simulation at pivotal points in the progress from undergraduate nurse, to new graduate, to team leader, educator, executive and beyond. Nursing has many divergent career pathways, but using the correct framework, I believe scenario based simulation can facilitate a smooth transition, expanding scope of practice, leadership and communication skills and understanding the risks our environments hold.

 

Australian Healthcare Simulation Community

This Health Workforce Australia (HWA) project aims to connect simulation educators and provide standardised resources that can smooth out the bumps and workload involved in introducing a simulation program into your institution.

SimNET

 

Simulation Glossary of Terms

A very useful glossary of the vocabulary of health simulation. Development of a common language is important to take simulation from being an ad hoc event such as the “Mock Arrest” to a more educationally sound and crucially integrated teaching technique. Terminology sets expectation.

HWA Data Dictionary

 

Templates

These documents are pro-formas that may assist with planning and evaluating scenarios.

Scenario template (pdf)

Scenario Template (doc)

Post Scenario Report (pdf)

Post Scenario Report (doc)

 

Podcasts & Blogs

There are some posts in the back catalogue of Injectable Orange that can be found here SIMULATION Posts

Top ten tips for In Situ Sim at St.Emlyns – A great blog and podcast post giving ten solid tips about integrating simulation into your workplace education program.

Injectable Orange Simulation Basics: Back to the Future – A casual walkthrough of the phases of simulation.

Simulating Healthcare Blog  – A brilliant blog by Dr Paul E. Phrampus, a guru in the world of healthcare simulation.

Mobile Medical Simulation – A brilliant website curating a whole host of resources from scenarios, templates and debrief guide.

 

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Thanks again to my awesome co-conspirators Sean Lannan and Thea-Grace Collier.

 

Why “Soft Skills” Matter

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Follow Jennifer on Twitter @JJackson_RN

Injectable Orange Editorial: So the call went out on Twitter for eager bloggers to share there words via injectableorange.com and Jennifer replied… big time. This post is the second in what we are hoping to be a series of regular guest posts focussing on professional communication and the so-called “soft skills” of nursing. Enjoy.Slide1

In this blog, I examine professional development, and other non-clinical aspects of nursing. It is important to illustrate why these skills matter for nursing, and why you should care about these issues. To understand this effectively, it is helpful to talk about the pillars of the nursing profession; this gives us a framework. In this post, I talk about how nursing is structured, and how soft skills fit into this structure, and why it is important for you.

We all love some excitement. Many nurses love the adrenalin rush of participating in a Code Blue or other high-intensity scenario. There are a multitude of psychomotor skills required in these events, and it gets your blood pumping to be in the middle of a critical situation. Today, I am here to advocate for a different type of essential nursing skill: soft skills. I believe that these skills are integral to nursing, and are among the most important abilities that a nurse can have at the bedside.

Soft skills, or non-clinical skills, or non-technical skills, refer to skills that are above and beyond the psychomotor tasks that nurses complete. They have been loosely defined as skills that enhance interpersonal interaction. Examples of soft skills are communication, advocacy, critical thinking, and interpersonal skills. It is important to see these skills as a distinct, and learnable part of nursing. All nurses can work to improve their soft skills, and in turn their nursing practice. In this post, I will cover 3 distinct reasons why soft skills matter: they connect domains of nursing practice, they express different kinds of nursing knowledge, and they make a difference for patients (and employers!). We’ll also explore what do to next.

Connecting Domains of Nursing Practice

It is important to consider how the nursing profession is structured. Nurses have 4 distinct domains of practice: clinical, administrative, educational, and research. Each of these areas is united by the fact that we all use the nursing process. While the bulk of nursing takes place in the clinical domain, each of these domains is essential. They reflect how nurses create professional knowledge (research), learn professional knowledge (educational), apply professional knowledge (clinical), and foster the creation/learning/application of professional knowledge (administrative). Side note: this is why we should refer to nurses by their domain of the profession, such as “clinical nurse” instead of staff nurse, frontline nurse, bedside nurse etc. It ties the role directly back to its pillar of the profession. Each domain is a leg of our table, and is essential to having a robust nursing profession. It is important to know how the profession is structured, so you can map where your role lies, and how you relate to other roles within the profession. This is not a hierarchy- it is an understanding that we are different but that we are all on the same team.

However, each domain is also different. You can discuss backwards regression analyses in research and progression of mobilization in clinical practice. So how do we talk to each other? Soft skills. We use interpersonal and communication skills to connect between domains of practice, and share our insights and our challenges. This is important because clinical nurses may have a great suggestion for new nursing research initiatives. Nurse educators may inform nurse administrators about a need for advocacy around educational funding. Our soft skills can break down barriers and strengthen the integration of our domains of practice, making nursing practice easier for all of us.

Expressing Different Kinds of Nursing Knowledge

In addition to having different domains of nursing practice, we also have different kinds of nursing knowledge. These kinds of knowledge cross all 4 domains of practice, and represent how nurses understand their profession. Carper’s landmark article outlined that nursing knowledge is categorized as art, science, ethics, and experiential knowledge. Chinn and Kramer later added social justice or emancipatory knowing as a fifth type of nursing knowledge.

Domains of Practice Types of Nursing Knowledge
Clinical Art
Administrative Science
Research Ethics
Education Experience
Social Justice

Everything we do is multidimensional, or it would not be nursing. Our unique types of knowing are expressed through soft skills, in everything that we do. Let’s take an IV insertion, which is a bread-and-butter psychomotor skill. While you get your supplies to put in the IV, you grab a hot pack- your experiential knowledge tells you your patient might be a hard poke, and your science knowledge tells you that heat will help this situation. While you prepare your supplies, you comfort the patient and explain the procedure. That’s the art of nursing. This patient may need a PICC line, but could be high risk for IV drug use- the ethics and social justice of nursing. One commonplace procedure; 5 types of nursing knowledge.

So how do we express our different types of nursing knowledge? You guessed it, soft skills. Nursing runs on this complex integration of knowledge; however, a lot of it can happen internally and it is not seen or recognized by others. When we can articulate what we are doing, using our nursing knowledge as a framework, we demonstrate the full range of nursing. This will increase the appreciation and respect for our profession.

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Soft Skills Make a Difference for Patients (and Employers!

No matter where we work, nurses make a difference for patients. When you ask patients what makes the biggest impact to them during a hospital stay, nursing communication ranks consistently as one of the most important factors. In my experience as a clinical nurse, I found that many people placed emphasis on psychomotor skills. I remember the days of being a student and saying, I need an IM and an IV start! However, if we really want to make a difference for patients, we need to have good soft skills too. Research has demonstrated that communication makes a huge impact for patients, and is the most important aspect of being a health care leader. In light of this, we need to consider soft skills as seriously as any other type of nursing skill.

Increasingly, employers care about soft skills. Now that patient experience is a common measuring point in hospitals (whether it should be or not- this is reality), administrative nurses are hiring clinical nurses for personality instead of experience or background. I have heard this stated by many nurse managers- “We will teach them everything they need to know during orientation. What I need is someone to be part of our team.” If you are looking to score your nursing dream job, you need to demonstrate that you have strong soft skills. To see how to write a resume that does this, see this post.

So Now What?

Soft skills are an essential part of nursing, across all domains of practice and types of nursing knowledge. So what does a nurse do about this? Treat soft skills the same way as you would any other skill. Practice, seek out resources, ask for advice, and participate in continuing education. It is reasonable to ask your colleague, how can I improve at IV insertion? It is also completely reasonable to ask, what are some ways to communicate with a family that is grieving? You wouldn’t put in an IV without learning about it first, and the same logic applies to soft skills too. Consider soft skills an integral part of how you nurse and how you talk about the nursing profession. You will see great benefits for yourself, and also for your patients.

I will continue to explore soft skills and nursing in this blog, so stay tuned! In the meantime, how have soft skills impacted your nursing practice?

 

Podcast Ep. 5 – Simulation Basics: Back to the Future

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In this episode we revisit a conversation I had with my good friend and fellow of the nursing brotherhood, Brian Ericsson. Brian, a clinical lead emergency nurse, invited me to have a chat and brainstorm about some of the risks, benefits and logistics of getting a program of in situ simulation started in his work place. We got quite carried away and ended up with two podcast episodes. One year on and in the lead up to SMACC Chicago, where I will be working on two workshops, including ‘Leave the Sim Lab Behind: In Situ Simulation for Clinician Educators’, I asked Brian if I could remaster and re-release a trimmed down single episode version of our conversation. I am really keen to deliver a number of episodes dancing through some of the more nuanced topics in sim and wanted to start with a solid foundation of looking at the phases of a simulation teaching event and some of the benefits for the learner and the educator in using sim in the workplace. Quite frankly, I had used all my best material and it would have been a poor surrogate if I’d tried to record it myself, so hence we have the first erNURSEpro/Injectable Orange crossover effort.

 

erNURSEpro  http://www.ernursepro.com

INJECTABLE ORANGE PODCAST-2

Episode 5 – Simulation Basics: Back to the Future (35.22)

 

For more on Injectable Orange relating to Sim, follow this link – http://injectableorange.com/?s=simulation

Also be sure to check out these two brilliant offerings from the St. Emlyn’s team and one from Dr Tim Leeuwenburg at KI Doc:

1) Top Ten Tips for In Situ Sim at St. Emlyns (Blog and Podcast)

2) The SWEETest Sim – Real People, High Fidelity at #SWEETs15 (Blog)

3) Simulation Apps – Review (Blog)

 

If you are in the market for free awesome simulation resources, check out:

http://mobilesim.wordpress.com (Great site with loads of resources and scenarios from Dr Jon Gatward)

http://intensiveblog.com/resources/icu-sim/ (New and very slick offering of fully templated scenarios for ICU In Situ Sim from Dr Chris Nickson)

Podcast Ep. 4 – The Power of Social Change

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In this episode I’m joined by two change makers, thought leaders, and all round inspiring people. British Paediatrician, educationalist and philosopher, Dr Damian Roland (@Damian_Roland) and experienced health and social care leader, radical, and champion of Change Day Australia, Mary Freer (@FreerMary). With both the NHS and Australian Change Days coming up on the 11th March 2015, we got together to talk about the power of social change. When you finished listening, please spread the word about change day and jump on line to take action and make a pledge.

NHS Change Day http://changeday.nhs.uk

Change Day Australia http://changeday.com.au

INJECTABLE ORANGE PODCAST-2

 

Episode 4 – The Power of Social Change (40.17)

Podcast Ep. 3 – Intern’s Guide to the Galaxy   Recently updated !

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Episode three of Injectable Orange Podcast sees me talking to, well, um, me. I know, only episode three and doing solo shows already. It’s not exactly like that.

Last week I delivered a 25 minute talk to the new Intern group at my hospital. The talk was well received with some of the eager new docs coming and asking if they could share it with their colleagues or have my slide set. While they were most definitely welcome to the slides, as you can see from above, they were purely intended as a visual support to the talk (they are not my presentation). Mixed with a little egging on via Twitter, I thought I would record a condensed, made-for-podcast version and float it out into the ether.

So, for the new doctor, nurse or healthcare worker in your life, please share if you find it helpful.

A couple of links I mentioned in some length in the face-to-face talk are included here:

‘THE COAT & REVIEW APPROACH: HOW TO RECOGNISE AND MANAGE UNWELL PATIENTS’

BY NICHOLAS CHRIMES & JULIA HARRISON

‘GRADED ASSERTIVENESS’

BY EMERGENCYPEDIA

 

INJECTABLE ORANGE PODCAST-2

Injectable Orange Episode 3 – Intern’s Guide to the Galaxy (10:17)

Podcast Ep. 2 – Ross Fisher on Presentation Cubed   Recently updated !

Tears in rainFollow Ross on Twitter @ffolliet

Episode two of the podcast delves into the amazing mind of Ross Fisher. Ross is a Consultant Paediatric Surgeon in Sheffield in the UK. Ross is a self described presentation geek. In what is definitely the greatest moment for me with my Injectable Orange hat on, I speak to Ross about his passion, inspiration and philosophies on why we, as clinicians, must become better at presenting. I hope this episode serves as a gateway to Ross’ brilliant blog:

P Cubed Presentations – http://prezentationskills.blogspot.com.au

The post discussed in the podcast relating to the P Cubed concept is ‘The Maths of a Better Presentation’.

In addition to P Cubed, the talk at Queen’s College referred to in the podcast is linked below. This is truly a presentation that anyone can learn from, no matter how good you think you are at presenting.

 

 

The other great achievement that Ross wears on his sleeve with pride is his inspiring talk ‘Inspiration: Is This What You Are Looking For?’ from TEDx Stuttgart.

On to the Podcast

INJECTABLE ORANGE PODCAST-2

Injectable Orange Episode 2 – Ross Fisher on Presentation Cubed (34:00)

 

Other Links:

Garr Reynolds – Presentation Zen

Nancy Duarte – Blog