As a nursing student, asking for accommodations can help level the playing field by giving you a different environment or approach so you can adapt to any kind of physical or cognitive disability. As mentioned in a previous blog, extra time on tests, a quiet environment , or possibly even a note taker in class are all accommodations that can help nursing students perform their best.
Once you graduate and enter the workforce, how can you make sure you have accommodations you might need?
Many laws in the Americans with Disabilities Act prevent discrimination or retaliation based on accommodations, but the workplace isn’t always as adaptive to requested accommodations. If you know what you need, can request what has worked for you, and the accommodation will fit into the required job description, then your chances of successfully blending the two are much greater.
Keep in mind realistic expectations. If you can’t lift more than 30 pounds due to a previous injury, that will restrict you from doing some specific hands-on roles. But you might be able to with assistive devices. And if you have a hard time writing discharge information or charts in any kind of excessive noise, knowing that will help you prepare for what you need—possibly just a quiet space. If hearing loss makes listening difficult, amplified equipment can help. But not being able to lift heavy things, needing a quiet place to do administrative work, and progressive hearing loss never mean you can’t be an excellent nurse.
In fact, asking for an accommodation when you know it helps you do your job better keeps nursing standards high and ensures patient safety. Asking for an accommodation at work is often done through the human resources department where they can help guide you and determine what will best suit your needs and those of your unit or department. You might be asked to provide medical verification or some kind of official documentation of your disability.
From that point on, you are not obligated to share the reasons of your accommodation with anyone else at work. Accommodations are often a personal matter and many nurses fear a pushback or a stigma if others realize a change has been made for their benefit.
Is that fear realistic? Possibly. Revealing too much personal information in the workplace always has the potential to return to you in unexpected ways, so it is better if you keep the details to yourself. As long as your workplace helps you and assists you in working out a new approach or by offering different equipment, you can continue to do your job with the exacting precision expected of nurses.
Deciding when and how to talk about accommodations depends on how big of an impact it has on your work and then you should consider the impact it might have on your career. You don’t want to mislead a potential employer and you also don’t want to do substandard work because you are afraid to disclose your need for an accommodation in your current role. For example, if you have progressive hearing loss, but it is not impairing your job now, you might choose to wait a while to disclose. But if you are having trouble haring through a stethoscope, you cannot wait to bring that to the attention of your employer so you can get assistive equipment.
The decision is personal and weighing when and how to tell an employer is crucial to making sure you can do your job while also ensuring you are meeting the high standards expected in the nursing profession.
As the United States becomes more of a melting pot, encouraging and nurturing a workplace that welcomes the different cultures, ethnicities, and lifestyles of staff are paramount to optimal collaboration, productivity, and success. In health care, where diversity increasingly is exemplified among patients as well as employees, such an embrace is critical to achieving best outcomes.
Health care institutions across the country are heeding the call for inclusion. Many have implemented initiatives to not only attract diverse staff, but also to keep and engage them.
The Mayo Clinic in Rochester, Minnesota, for instance, launched the Multicultural Nurses Mayo Employee Resource Group (MNMERG) in July 2014 to recruit and retain nurses from diverse cultures and offer them professional support and networking opportunities. The MNMERG also mentors and educates Mayo’s diverse nurses and involves them in community programs.
With some 25 members, the MNMERG welcomes all Mayo staff. It meets monthly at the hospital, but this year will add quarterly dinners off site and is evaluating online technologies such as Skype and Sharepoint to “engage a 24/7 workforce,” says MNMERG cochair Deborah A. Delgado, MS, RN-BC, a nursing education specialist in psychiatry.
Mayo Employee Resource Groups (MERGs) have been an important component of Mayo’s overall diversity initiative; the goal is to have the following five core MERGs—African American, LGBTI, Hispanic, Disability, and Veterans—at Mayo’s three major clinical sites. Each MERG has an executive sponsor who is a leader at Mayo, but not a member of the group. For example, the MNMERG’s sponsor is a male cardiologist with experience in developing family/patient advisory groups. All of Mayo’s MERGs have formally chartered to align with at least one of the organization’s strategic diversity goals.
“These range from culturally competent care to inclusion and addressing health disparities,” says Sharonne N. Hayes, MD, FACC, FAHA, director of diversity and inclusion and professor of medicine at the Women’s Heart Clinic at Mayo. She notes that the groups share innovations and hold cross activities. “By that collaboration,” she says, “you get more hands to do the work obviously, but you also get a wonderful side product of some cross-cultural mentoring and some cross-cultural experience.”
While the MNMERG is in its infancy, feedback has been positive. “By being visible, by engaging, and by contributing, it just leads to retainment,” Delgado offers. “People want to stay because they’re able to use all of their gifts and talents to affect the organization’s purpose and goals.”
The Clinical Leadership Collaborative for Diversity in Nursing (CLCDN) at Massachusetts General Hospital in Boston has realized recruitment and retention success with diverse students of nursing. A scholarship and mentoring program established in 2007 by Partners HealthCare (PHC), an integrated system of which Mass General is a member, the CLCDN draws applicants from the nursing program at University of Massachusetts Boston.
Students must demonstrate leadership qualities, have cumulative general and nursing GPAs of 3.0 or higher, and must be entering their junior year of study since the CLCDN will carry them through their senior year. They link with racially and ethnically diverse nurse mentors, attend unit meetings and social and educational events, and observe nurses and nursing leaders in action. Additionally, they receive a stipend and financial support for tuition and fees with the expectation they will pursue employment at a PHC institution after graduating.
“When you’re a minority and you’re going into an environment where you might be the only diverse person on your clinical unit, as an example, it can be really challenging; it can be very lonely,“ says Gaurdia E. Banister, PhD, RN, FAAN, the PHC CLCDN liaison to UMass Boston and executive director of the hospital’s Institute for Patient Care. “We wanted to put mechanisms in place to ensure the success of our students and, certainly once they graduated, the best possible [career] alternatives,” she says.
Mass General diverse nurse leaders who have successfully navigated such waters can “provide these wonderful, wonderful pearls of wisdom and support and encouragement and listening skills,” explains Banister, and they serve as mentors, as do CLCDN graduates. Of the 54 mentors to date (32 from Mass General), some are repeats. Other statistics are just as impressive—such as PHC’s 82.6% hiring rate among the 69 graduates thus far (47.8% of whom have been employed by Mass General) and the almost 80% retention rate for these graduates.
“They love being a nurse. It’s exactly what they anticipated their career to be,” says Banister. “They are constantly promoting how positive it has been for them and that they feel like our organizations are becoming much more of a welcoming and diverse place to work.”
At the Cleveland Clinic, location-specific Diversity Councils at each of the enterprise’s community hospitals and family health centers are effectively supporting and sustaining an inclusive work environment. These employee-led councils implement action plans and sponsor activities based on strategies and goals defined by an Executive Diversity Council, all aimed to enhance employee engagement and cultural competence.
While the Executive Diversity Council works “to set the tone and the agenda,” the location-specific councils “serve as the tactical team,” explains Diana Gueits, director of diversity and inclusion. The main-campus council, for one, formed the Nursing Cultural Competence Committee and the Disability Task Force; the task force, in turn, developed the Disability Etiquette Lunch ’n Learn, a program to assist caregivers in their interaction and communication with disabled individuals that has since been taken enterprise-wide. Gueits notes the councils share and cross-pollinate ideas.
Cleveland Clinic’s chief nursing officer sits on the Executive Diversity Council, and many nurses participate in the location-specific councils with several diverse nurses serving in leadership roles (the councils overall represent a cross-section of the clinic’s workforce). Two cochairs and a cochair-elect lead each council, act as local ambassadors for diversity, engage with executive leadership, and provide feedback to the Office of Diversity and Inclusion, which facilitates the business-like, SMART-goals approach of the councils.
“This is a passion for them,” says Gueits of the cochairs, who are selected based on their experience in leading transformative teams and their commitment to diversity and inclusion. “I think that what the councils provide them is an opportunity to see, to actually be part of an initiative and be part of that process from A to Z.”
Cleveland Clinic has 21 location-specific councils, a number that is sure to increase as the enterprise expands. “That is the intention,” Gueits says, “to make sure that we embed diversity and inclusion in our commitment to all our locations and give an opportunity or platform for all our caregivers to be engaged.”
Julie Jacobs is an award-winning writer with special interest and expertise in health care, wellness, and lifestyle. Visit her at www.wynnecommunications.com.
How do you measure the impact of diverse leadership in the workplace?
Part of the answer may be in dollars and cents. A recent study found that large companies with more diverse leaders reported better financial results.
A study of 366 public companies in the U.S., U.K., Canada, Mexico, Chile and Brazil by McKinsey & Co., a major management consultancy, found “a statistically significant relationship between a more diverse leadership and better financial performance.”
Companies with gender diversity that ranked in the top quartile were 15 percent more likely to have financial results above their national industry median. The returns were even better for companies in the top quartile of racial/ethnic diversity. These businesses were 30 percent more likely to have financial returns that outpaced their industry.
On the other hand, companies that ranked in the bottom quartile for ethnicity/race and gender were less likely to achieve above average financial results.
The link between diversity at the highest levels and increased profitability should not be a head scratcher. Highly diverse companies appear to excel financially due to their recruitment efforts and talent pipelines, improved decision-making, strong customer orientation and increased employee satisfaction, the report said.
How does your workplace fare in the diversity arena? Are the decision-makers reflective of an increasingly changing nation, not just in in terms of gender and ethnicity/race, but also sexual orientation and age?
Is there a systematic approach to achieve a diverse talent pool where you work?
Investing in diversity not only increases creativity and encourages personal growth, it can improve your workplace’s competitive edge. Learn more at http://www.mckinsey.com/insights/organization/why_diversity_matters.
Does your workplace have coworkers who complain constantly, fail to pull their weight or behave as drama mamas? You are not alone. Dysfunctional employees are everywhere and they can make the workday extra stressful.
Whether you are dealing with a self-promoter, gossip master or lazy lug, you still need to deal with them in a professional manner. Don’t respond to their pleas for help or dramatic antics. Chances are they will not change their behavior. But you can control how you react to toxic personalities.
Here are four common types of dysfunctional employees and ways to work with them without losing your cool:
The self-promoter. Everyone enjoys tooting their own horn. But sometimes a coworker will take credit for another person’s work. Your best bet is to say on top of your work and not get sucked into a game of one-upmanship.
The Lazy lug. This person is a drain on productivity and morale. And usually pretty disagreeable when caught not working. Enlist some allies and address the person directly. Or else continue picking up his or her slack.
The saboteur. This person enjoys seeing others struggle or fail. He or she may have been passed over for a promotion or bonus and feels justified in not being a team player. Always have proof of what you have done in case this person tries to blame you for mistakes.
The Drama Master. Everything that happens to this person is earth-shattering. If there is a major disagreement on the job, this person is in the middle. Your best bet? Do not engage.
The good news is that by controlling your behavior, you set an example to others on what to do to create a healthier work environment.
Robin Farmer is a freelance journalist with a focus on health, business and education. Visit her at www.robinfarmerwrites.com.
Most of us have heard the term “digital divide,” and many of us are familiar with the move towards electronic health records (EHRs) in the workplace. However, very few hospitals or medical offices are discussing the real-life implications of those two facts merging in hospitals and medical offices across the country where nurses who have limited computer experience are suddenly being asked to do electronic charting.
According to the US Census Bureau, only 56.9% of black and 58.3% of Hispanic households had internet access in their home, compared to 76.2% of all non-Hispanic white households, in 2011. This means minority households are currently falling on the wrong side of the digital divide. That being said, 26.8% of the nursing students in baccalaureate programs from 2010-2011 were minorities, according to the American Association of Colleges of Nursing, which means we have a significant percentage of nurses who will be entering the workplace with the potential of having limited computer experience. In the past, that wouldn’t have been a problem, considering most medical offices used paper charts and filing systems. However, with the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, medical offices and hospitals are being strongly encouraged to adopt EHRs as quickly as possible.
According to the HITECH Act, medical offices that do not use an EHR in a “meaningful way” by 2015 will start to incur penalties, beginning with a cut of 1% to Medicare funding in 2015 and increasing to 3% in 2017. After that point, medical offices may also be subject to additional financial penalties.
What does that mean for today’s nurses? Based on government reports, 72% of office-based physicians used electronic medical records (EMRs) or EHRs in 2012. In Massachusetts, that number goes as high as 89.2%. In order to qualify for funding and avoid penalties, offices must have met “meaningful use” objectives in 2012, including electronically tracking all orders, vital signs, medication allergies, medications taken, patient demographics, and smoking status.
Any of those items sound familiar? The same things nurses have been entering on paper charts for decades are now being entered electronically. In short, this means if you haven’t already begun using an EHR or EMR on the job, you will probably see one soon. And if you’re just starting out, the chance of finding a nursing position without needing to use one on a daily basis is dwindling incredibly fast. For some, that could mean using a piece of hardware or technology for the first time. But the transition doesn’t need to be scary. So, how exactly can you prepare for the change?
First of all, it’s important to understand that the EHR/EMR industry comes with support—and lots of it. If you’re currently at a job that’s implementing an EHR system like Cerner, Epic, or Allscripts, and you haven’t already done so, ask for training. Almost all EHR companies offer comprehensive training during the implementation process, and it’s expected that staff will attend those sessions. If for any reason you cannot attend a session the first time around, don’t hesitate to ask for additional training or inquire about what tutorials and materials might be available for you to review. There are entire support and training departments within each of the large EHR companies. Those departments are available to make your transition easier, so don’t be afraid to use the resources made available to you.
For the thousands of nursing students who will be entering a largely electronic workplace, what other preparations can be made? Many nursing instructors have decided to face the issue head on. By providing nursing students with access to an academic EHR in the classroom, instructors can help make the transition easier for students when entering the workforce. After all, nurses have enough to worry about during their first week in the field.
Computer programs like EHR Tutor, based in Parma, Ohio, can be purchased by nursing schools and used as a daily teaching tool in the classroom. For example, when discussing vitals or medications, students can look at charts done for electronic patients and analyze that data. Students can also chart information themselves, just as they would on paper, which can then be submitted to the instructor for grading. Schools with access to iPads or laptops are also allowing students to use programs like EHR Tutor during clinical rotations to chart real information under fake patient names. That way, by the time students are on their own, using EHRs will be just as comfortable as pen and paper.
EHRs and EMRs are here to stay. For some nurses, that may present a tremendous challenge. However, there are many tools available to nurses who may be feeling a bit overwhelmed. By using those resources (like using academic EHRs in the classroom and asking for additional training in your workplace), we can ensure that our nurses and future nurses make the transition to EHRs as painlessly as possible. That way, our nurses can spend more time focusing on the important things—the patients.
Nikki Yeager is a freelance writer and software trainer based in New York City.
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