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 A Modern Chautauqua From The AORN Journal, Vol. 48, No. 4 The annual week-long continuing education conference sponsored by the Colorado Nurses' Association (CAN) has become a tradition. It is nationally and internationally recognized. For the last 12 summers, the CAN has conducted Chautauqua, a term used to describe an educational conference (often conducted outdoors) combined with entertainment. This 13th annual Chautauqua, held in Vail, Colorado, August 5 to 11, was attended by nurses from throughout the United States and abroad. The following is a summary of some of the educational sessions held at this year's meeting. Decision-Making "The quality of patient care is directly attributable to the decisions made by the nurse manager." Such was the philosophy stated by Dr. Corcoran in her presentation entitled "Decision-Making for Nurse Managers." Dr. Corcoran said she was first introduced to the subject of decision-making in 1980 when she did her doctoral dissertation. She searched the nursing journals and found only two articles on the process of how nurses make decisions. And, she said, those articles addressed the problem of how poorly nurses make decisions. When she delved into the management literature, however, she found a great deal on how nurses should go about making sound decisions. According to Dr. Corcoran, nurses make clinical decisions based on the nursing process, but they do not follow a specific system or process to make management decisions. Her question to the audience was, "How can nurses translate their clinical decision-making skills to management decision-making?" Often, the first step is to recognize that there is a problem that has resulted from poor decisions. "If there is a great deal of conflict in a unit, there is usually something wrong with the manager's decision-making behavior," Dr. Corcoran said. "Decision-making is choosing between real alternatives in the face of real uncertainties," Dr. Corcoran explained. The process involves collecting information, making judgments, generating alternatives, choosing among those alternatives, and then living with the consequences of that decision. Collecting information about a situation is important to reduce uncertainty in the mind of the manager and to increase the number of alternatives. Nurse managers generally do not do enough to collect information; they tend to get the information from the same sources, use selective perception, and do not take notes, she said. In creating alternatives, it is important to use people close to the problem and not eliminate alternatives simply because of tradition (i.e., "we've never done it that way before"). Managers should encourage new ideas and reward creativity even if they do not initially believe the new solution will work, Dr. Corcoran said. The timing of the next step — choosing alternatives —- is entirely up to the manger making the decision, according to Dr. Corcoran. When making a choice among various alternatives, the manager should consider who it affects, the risks involved, the payoff, and any policies and resources already in place. Then, the manager makes a decision and lives with the consequences. The consequences may affect the staff morale, retention and recruitment, credibility of the manager, and some degree of risk management. There may be positive or negative consequences in each of these areas. "You won't always win," cautioned Dr. Corcoran. Remember, the decision is the final stage of the problem-solving process, she said. The best way to improve decision-making skills is to develop strategies that can be followed each time a decision is necessary. Those strategies should include criteria important for making a final decision, a summary statement (e.g., data, graphs, and charts) for information and a problem-solving fact sheet. The best way to build decision-making skills, according to Dr. Corcoran, is to build confidence, do different things, be flexible, and attend continuing education sessions on decision-making. Preparing for Professional Excellence This breakfast address was delivered by Brigadier General Clara L. Adams-Ender, RN, MSN, Chief, US Army Nurse Corp. In her address, BG Adams-Ender reminded nurses that they have real opportunities to achieve excellence, and those who do it consistently are considered leaders. "Being a leader doesn't mean having all the answers, but you must explore the option," she said. BG Adams-Ender offered the following four steps to take in the pursuit of excellence. Plan purposefully. Planning is the most important step. You must know where you are going, or you will wind up somewhere else, she said. Prepare prayfully. Leaders possess vision, and this vision is enhanced by meditation and prayer. Addressing God in prayer changes our mental attitude first so that we can have a vision of the way things should be, she said. Reading and study are also essential for preparation. Finally, she said you must have a significant person in your life to assist you in your relationship with the world — to help you through your successes and your failures. Proceed positively. "Practice being positive," BG Adams-Ender advised. Remember, she said, each individual chooses success or failure. No one makes that decision for you. "Start each day by telling yourself something good — that you will have a good day. Make yourself a 60 second commercial, and repeat that commercial whenever someone is about to change your good day," she said. She also told the audience "learn to laugh at yourself; don't be so serious." Pursue persistently. Leaders have the art of never giving up. We used to think that working hard was the key to success, she said. "Not so." We also used to think that education was the key to success, she said. "Not so — there are a lot of educated people who are derelicts." The key to success, according to BG Adams-Ender, is to "press on and tire the others out." Those who persist will eventually succeed, she said. In their pursuit of excellence, nurses should develop the qualities identified in these eight P's, advised BG Adams-Ender.Sustaining a Peak Performance Have you ever had a day in which everything goes just right? Are those days just accidents or is there some secret as to why you perform so well on those days? Those were the questions posed by Walter Kowalski, BS, president, BreakThroughs, Inc., in his session entitled, "Sustaining a Peak Performance." According to Kowalski, peak performers share common skills, attitudes, and beliefs. They are committed to their work; they have a love, a passion, for what they are doing. To emphasize this point, Kowalski said to ask yourself the following questions:
The second most important characteristic of a peak performer is that of confidence. People are confident in what they do because they expect themselves to succeed, and when they slip, they tell themselves that they will do better next time. Peak performers are willing to take risks, and they are willing to make mistakes, Kowalski said. The third characteristic of peak performers is that of maintaining control over those things that can be controlled. For example, a person can control the quality of his or her product; the person cannot, however, control the current market conditions for his or her product. You can control your response to change, but you cannot control chance itself, Kowalski said. The fourth characteristic is dealing with change successfully, according to Kowalski. Peak performers are challenged by change and consider it to be natural and useful, whereas others may be threatened by change and see it as disrupting their comfort and security. Peak performers realize they can either react to change or initiate it; often they choose to initiate it. Kowalski warned the audience that fear often makes people hold on to a job that they dislike — fear of a lack of security. He said one can overcome exaggerated fear by doing a "reality check." First, you should identify the fear, and then "you should analyze it to death." Kowalski advocated the use of deep-breathing exercises, guided imagery, and mental rehearsal (i.e., creating images in your mind of steps to take to reach your goals). When you are happy with your career paths and develop the characteristics of a peak performer, you will be able to have more of those days in which everything goes just right, according to Kowalski. Copyright © BreakThroughs, Inc. 2003 | Terms of use |
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