Keeping clinicians up to date on clinical knowledge is one of the main goals of the Wild On Wounds (WOW) conference,held each September in Las Vegas. Each year, I present the opening session of this conference, called “The Buzz Report,”which focuses on the latest-breaking wound care news—what’s new, what’s now, and what’s coming up. I discuss innovative new products, practice guidelines, resources, and tools from the last 12 months in skin, wound, and ostomy management. (more…)
In 2014, more than 8,000 new articles related to wound healing were added to the PubMed online database and hundreds of new patents for topical wound formulations were filed. Staying up-to-date with the latest and greatest findings and products can be challenging. We all lead busy lives, and our demanding work schedules and home responsibilities can thwart our best intentions. Although we know it’s our responsibility to stay abreast of changes in our field, we may feel overwhelmed trying to make that happen. (more…)
By Laura L. Barry, MBA, MMsc, and Maureen Sirois, MSN, RN, CEN, ANP
Why is it that some things don’t bother us, while other things catapult us from an emotional 0 to 60 mph in a heartbeat? We all know what it feels like when someone says or does something that gets our juices flowing. We feel it in our bodies, emotions, and mood. We have an overwhelming urge to react. We may express it in words at the time or take our frustrations out later on someone else. It just doesn’t feel good. We want to explode, set the record straight. (more…)
As a wound care nurse, do you feel the weight of the world on your shoulders when trying to implement a pressure ulcer prevention program? Many staff members think it’s up to the wound care nurse alone to implement the program. However, a successful program requires involvement from all staff and is a 24/7 endeavor. Here’s how to do it. (more…)
Like cling wrap, new biomaterial can coat tricky burn wounds and block out infection.
Wrapping wound dressings around fingers and toes can be tricky, but for burn victims, guarding them against infection is critical. Today, scientists are reporting the development of novel, ultrathin coatings called nanosheets that can cling to the body’s most difficult-to-protect contours and keep bacteria at bay.
The researchers are speaking about their materials, which they’ve tested on mice, at the 248th National Meeting & Exposition of the American Chemical Society (ACS), the world’s largest scientific society.
The meeting features nearly 12,000 presentations on a wide range of science topics and is being held here through Thursday. (more…)
It’s time again for annual staff education, and you, the certified wound clinician, need to teach the staff at your organization. You dream of staff entering a state-of-the-art classroom with computers at each station, mannequins, wound anatomy models, and enough products for each student to do hands-on demonstrations. But when you open your eyes, you’re sitting in a room with ordinary tables and chairs, your laptop, a screen, a brain full of knowledge, and a very tight budget. (more…)
By Carrie Carls, BSN, RN, CWOCN, CHRN, and Sherry Clayton, RHIA
In an atmosphere of changing reimbursement, it’s important to understand indications and utilization guidelines for healthcare services. Otherwise, facilities won’t receive appropriate reimbursement for provided services. This article focuses on Medicare reimbursement for hyperbaric oxygen therapy (HBOT). (See What is hyperbaric oxygen therapy?)
At some point, most of us have encountered a bully—most commonly when we were kids. You might think that as we get older, bullying wouldn’t be a problem we have to deal with. Unfortunately, that’s not the case. In the healthcare field, bullying can be even worse than it was when we were children.
Bullying in health care takes many different forms, including fighting among different types of clinicians, managers bullying subordinates, peer-to-peer bullying and, most commonly, specialists bullying other specialists. Years ago when I realized my dream of becoming a wound care specialist, I thought other specialists would be relieved I was on board to help with the overwhelming task of spreading wound care knowledge and healing wounds. But I found out quickly that I was pretty much alone with those thoughts, and my first encounter with wound care bullies occurred.
I began to ask myself: What did I do wrong? Why are they slamming me? What did I do to them? They don’t even know me; they’ve never even talked to me. This may sound familiar to many of you, whether you’re a wound care specialist, an ostomy specialist, or a diabetes or lymphedema specialist.
Workplace bullying is defined as repeated, unreasonable actions by individuals (or a group) directed toward an employee (or group of employees) that are intended to intimidate, degrade, humiliate, or undermine. Bullying occurs for many reasons; these reasons almost always include insecurity, competition, and the desire to feel more powerful and be in control.
So how do we deal with the bullies?
• Follow the Golden Rule: Treat others as you’d like others to treat you. Don’t stoop to the bully’s level.
• Stay calm and rational. Don’t get emotional. Bullies take pleasure in manipulating people emotionally.
• Don’t lose your confidence or blame yourself. Recognize that this isn’t about you; it’s about the bully. Be proud and confident in your certification credential.
• Focus on your purpose—to provide safe, competent, high-quality care to every patient.
• Document the bullying incident. Start a diary detailing the nature of the bullying, including dates, times, places, what was said or done, and who was present. Start a file with copies of anything in print that shows harassment and bullying; hold onto copies of documents that contradict the bully’s accusations against you.
• If the bullying behavior compromises patient safety and care, report the bully.
Stopping all bullying in health care may seem like an insurmountable goal, but I believe that together we can try to stop the bullying cycle in our specialty. By setting the example and supporting each other, we can turn the focus back to healing and caring for our patients as a team, not as one practitioner against the world.
Actions speak louder than words. As Ralph Waldo Emerson said, “What you do speaks so loudly that I cannot hear what you say.”
Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS
Editor-in-Chief Wound Care Advisor
Cofounder, Wound Care Education Institute
Plainfield, Illinois
Renee asks her mentor, Susan, a question. Susan puts her hand near Renee’s face, gesturing for her to “Stop,” and says in a loud voice, “I told you the answer to that this morning. Why are you bothering me again?”
You’re working your shift with Amy, who’s in charge of the unit. She refuses to have a meaningful conversation with you, and ignores you or sighs impatiently when you try to share patient information with her.
These examples reflect lateral (horizontal) violence or abuse in the workplace, defined as violence or abuse occurring between workers. It includes both overt and covert acts of verbal and nonverbal aggression.
Chances are you’ve experienced or witnessed disruptive or inappropriate behavior by a peer or colleague. Intimidation, bullying, insults, humiliation, gossip, constant criticism, and angry outbursts are a few examples. More subtle examples include favoritism, unfair work assignments, inappropriate or unfair evaluations, sarcasm, snide comments, withholding information, holding a grudge, and belittling gestures.
Lateral violence in any form feels bad. It creates fear—and fear causes you to shrink and hold back from being your best. You can’t be productive in a fearful environment. Instead, you may feel violated, anxious, stressed, disrespected, and angry. A response of silence or ignoring the offender is common, but not ideal. Here are some better strategies.
Acknowledge your feelings
Admit to yourself that you’re hurting and something is wrong. Many victims dismiss or minimize the event, or even blame themselves. Resist that temptation. If it feels bad, it is bad. And if you allow the behavior, that person is sure to repeat it—not because she’s a bad person, but because she doesn’t realize her behavior is wrong. If you respond by acting surprised and assuming she doesn’t know what she’s doing and has no idea how her actions affect you, it will be easier to respond professionally and quickly.
If abuse or violence of any form is tolerated, it will continue. And the negative workplace culture will significantly affect the health and well-being of both staff and patients.
Respond appropriately
Here are the four keys to responding appropriately to lateral violence in the workplace—or anywhere else, for that matter.
Manage your emotions
Take a deep breath and pause. Don’t react right away. Self-awareness is crucial to managing your emotions and your responses. Take a time-out if you’ve become emotional. Use calming techniques, such as deep breathing, guided imagery, humor, or prayer. If you try to deal with the perpetrator while upset, you’re more likely to behave unprofessionally. Restrain yourself until you feel able to assert yourself in a professional manner.
Use empathy
Try to find out where the person’s coming from to help understand what’s going on with her that might have triggered her behavior. For example, a person may engage in negative behavior because she’s going through a divorce. (See It’s not about you by clicking the PDF icon above.)
Keep in mind that bad behavior reflects poor self-esteem and serves as a wall to keep people out. It’s also learned behavior. Someone who behaves badly has learned this behavior brings some kind of reward; otherwise, she wouldn’t do it. Perhaps the reward is attention or power. Whatever it is, she gains something from the behavior at others’ expense. Most likely, she’s unaware of this dynamic.
By using empathy, you not only learn more about the offender; that person learns more about herself. Show an interest in why she behaved that way by asking questions; for instance: “I’ve noticed you’ve been more impatient lately. Are you okay? Is there something going on I should know about?” When you’ve gained a clearer understanding of the person, you can set clear expectations and boundaries.
Assert your boundaries
Asserting your boundaries tells others what behaviors are unacceptable. When you assert your boundaries, you honor yourself. When something doesn’t feel right, tell the person directly that her behavior is inappropriate and ask her to stop it. If you say nothing, your silence implies the behavior is acceptable.
Tell the person directly that her behavior is inappropriate. Keep it simple and clear. Use such language as “This doesn’t work for me.” That way, you’re accepting responsibility for your feelings and you’re not making her wrong.
Asserting a boundary might sound like this: “Please lower your voice.” But be careful of the tone you use when making the request. You might ask, “Did you realize you were yelling?” She might not be aware of how angry or loud she is at that moment.
Make direct requests
Tell the person directly how you’d like to be treated or how you want the two of you to work together. Identify what you want instead of what you’re getting—and then ask for it. Don’t assume she knows how to treat you. Determine what your goals are and what you need from her to accomplish what’s expected. If you can, try to establish a mutual goal for you both to work on, such as a more productive relationship so there’s less tension. Clearly communicating your requests informs others of the behavior you expect.
A case of respect
You might not want to befriend people at work, and you don’t have to like them. But each of us deserves to be treated with respect. To get respect, you must give it. If it’s not reciprocated, ask for it. Treat everyone with respect.
If you experience lateral hostility or violence on the job, deal with it directly and immediately. If it happens again, deal with it directly again and report it to your supervisor.
No matter how professional and respectful you are or how assertively you express your boundaries and needs, if your work environment remains abusive and leadership doesn’t address it or do enough to change it, you may need to leave your job. Stop wasting time and energy trying to fix a problem no one else wants to fix. Life is too short, and you deserve better.
Julie Donley is nurse manager for Devereux Children’s Behavioral Health Services in Pennsylvania. She has published hundreds of articles and just released her new book, Does Change Have to Be So H.A.R.D.? Visit www.JulieDonley.com to learn more.
Do you experience chronic stress? Is your body stiff and inflexible? Does your mind seem dull and sluggish, your spirit exhausted?
Restorative yoga may help “open” your joints, ease your mind, and revive your spirit. It’s based on the concept that we’re overstimulated and don’t get enough rest. Constant stimulation activates the sympathetic nervous system, overtaxing the fight-or-flight response. The body responds by increasing cortisol and glucose production, which (along with additional unhealthy responses) raises the risk of metabolic syndrome.
Restorative yoga promotes active relaxation, helping to halt the overstimulation cycle. It promotes balance by alternately stimulating and relaxing the body, which is supported in yoga poses with such props as blankets, pillows, yoga mat, and eye covers. Research suggests restorative yoga may ease hot flashes in postmenopausal women and may promote a calm, positive mood in women with ovarian or breast cancer.
Five facets of restorative yoga
Restorative yoga takes a five-faceted approach to relieve the effects of stress. Over time, you’re likely to notice a new awareness of and appreciation for your body, mind, and spirit.
Simply put, networking is an information exchange, a forum for communicating your needs or agenda and, in return, listening and responding to others’ needs or agendas. Good networking requires emotional reciprocity, which means caring about the needs and agendas of the people you network with. Caring about others’ needs is what nurses do, so networking really shouldn’t be that difficult for a nurse.
1. Using props, restorative yoga supports the body in yoga poses, helping muscles and joints release tension and achieve muscular balance.
2. The restorative poses move the spine in all directions—flexion, extension, rotation, and lateral flexion. This enhances spinal flex-ibility, lubricates vertebrae, and strengthens the deep muscles that stabilize the spine.
3. Inverted poses, in which the feet and legs are elevated, counter the effects of gravity and promote lymph and fluid drainage to the heart.
4. The poses compress and release internal organs, cleansing them while aiding removal of cellular waste and renewing oxygen and nutrients.
5. Finally, the poses balance the body’s male (prana) and female (apana) energies.
Learning the poses
To learn the poses, consider taking a restorative yoga class. (See Finding an instructor.) Beforehand, make sure to tell the instructor about any special health concerns you have, so the instructor can modify the poses for you. Expect to bring your own blankets, pillows, eye covers, and yoga mat. The class will last from 60 to 90 minutes.
Restorative yoga typically doesn’t involve active (hatha) yoga poses, although it may include stretching poses to warm muscles and joints before the restorative poses begin. The instructor will help you use your props to make the poses right for you, and will direct you into a pose using them. Expect to stay in the pose for 5 to 10 minutes. The instructor will guide you by helping you focus on your breath and turn your attention inward. If your mind wanders and your body stays active, accept this reaction and don’t judge yourself. Over time, you’ll learn to use your breath to release tension and to focus and calm your mind.
After you hold the pose for the required duration, the instructor will help you into the next one. Generally, the class is near-silent, with minimal talking; the lights are low and music may play.
When the class ends, you may feel more relaxed and in touch with yourself. If you feel restless and jittery instead, accept your reaction. Don’t judge yourself. Try again. Give yourself the opportunity to experience something different.
Restorative yoga is just one method to renew and reconnect with your inner being. Only you can know if it’s right for you. n
Selected references
Cohen B, Kanaya A, Macer J, Shen H, Chang A, Grady D. Feasibility and acceptability of restorative yoga for treatment of hot flushes: a pilot trial. Maturitas. 2007;56(2):198-204.
Danhauer SC, Tooze JA, Farmer DF, Campbell CR, McQuellon RP, Barrett R, Miller BE. Restorative yoga for women with ovarian or breast cancer: findings from a pilot study. J Soc Integr Oncol. 2008;6(2):47-58.
Lisa Marie Bernardo is the managing member of The PIlates Centre, LLC, in Hampton Township, Pennsylvania, and adjunct faculty at Carlow University School of Nursing in Pittsburgh, Pennsylvania.
To find a certified yoga instructor in your area, check the Yoga Alliance website at www.yogaalliance.com. Restorative Yoga Teachers (www.restorativeyogateachers.com) focuses exclusively on restorative yoga. This site is operated by Judith Hansen Lasater, PhD, the leader in restorative yoga practice.
In the current healthcare environment, wound care practitioners need to capitalize on all available reimbursement avenues for care delivery and wound care supplies and dressings. And when it comes to reimbursement, there’s one constant: The rules change constantly. Whether these changes always benefit the patient is questionable. Nowhere is this more evident than in acute-care settings. Clinicians constantly are challenged to make sure their patient-care decisions comply with current Medicare reimbursement guidelines. (And if you’re not sure about today’s guidelines, be prepared for the guidelines to change tomorrow.) (more…)
