week 12 PN – Flashcards

The service provided is vital to humanity and welfare of society There is a special body of knowledge expanded through research The service involves intellectual activities; individual responsibility is a strong feature Practitioners are educated in institutions of higher learning 5. Practitioners are relatively independent and autonomous 6. Practitioners are motivated by service and consider their work an important component of their lives 7. There is a code of ethics to guide decisions and conduct 8. There is an organization/ association that encourages and supports high standards of practice

Nursing has an active and enduring leadership role in public and political determinations about the following six key areas of health care: 1. Organization, delivery, and financing of quality health care 2. Provision for the public's health 3. Expansion of nursing and healthcare knowledge and appropriate application of technology 4. Expansion of healthcare resources and health policy 5. Definitive planning for health policy and regulation 6. Duties under extreme conditions

A narrative about you, your values, and why you are interested in pursuing a particular career path Why nursing, why now? Important for career changers to develop a compelling story about why you are moving into a new field Your story should be heartfelt, reflect your personality, and have some 'drama' to it. Practice telling your story so it becomes natural and you start seeing yourself in your new nursing career

Nurses create value and make important contributions to the profession and health care It is important to actively manage your career to move up the hierarchy or gain new opportunities at work Women and minorities face obstacles in gaining power and access to work opportunities Today's class takes a sociological view on power, gender, and social dynamics in the context of work and the nursing profession Some of the content in today's class may challenge your beliefs.

Male registered nurses (RNs) make more than $5,000 per year than their female counterparts across most settings The salary gap occurs in most specialty areas and positions and has not improved since 1988 Specifically, the gap was $7,678 for ambulatory care $3,873 for hospital settings $3,792 for chronic care $6,034 for cardiology Orthopedics is the only specialty without a pay gap between men and women Salary differences exist by position, ranging from $3,956 for middle managers to $17,290 for nurse anesthetists Over the course of a 30-year career, female RNs will have earned about $155,000 less than male RNs based on adjusted earnings gap data For more information see: Muench, U., Sindelar, J., Busch, S.H., & Buerhaus, P.I. (2015). "Research Letter" in the March 24/31 issue of the Journal of the American Medical Association. http://jama.jamanetwork.com/article.aspx?articleid=2208795&resultClick=3

Demands of Family Life Women are more likely to take a career break, work part-time, take more days off Women are responsible for the bulk of domestic work, despite more participation from men than in previous generations Underinvestment in Social Capital Home responsibilities leave women with less time to socialize with colleagues and build their professional networks It is difficult for women to break into men's networks particularly if they focus on masculine activities ( e.g.: football, golf, paintball)

Determine your "market value" Your starting salary is important because is forms the foundation for your lifetime earning potential Determine the average nursing salary and cost of living in the local labor market. Shoot for a salary at the top of the range. Learn more about the target organization's salary and benefits package Be prepared to negotiate for your salary, work schedule, benefits, etc. Know when to walk away from a job offer.

political organizational individual

What you are (personal capital) Power derived from your ability and expertise Power in your self confidence and other's perceptions of your abilities Where you sit (positional capital) Power derived from the role you play in the organization Who you know (relational/social capital) Power derived from your networks

Does it work? - Knowing the landscape How does it work? Social capital Network types What can you do? Evaluating your social capital Personal strategies

Your knowledge, skills, capabilities and experience The resources you can access through your network of contacts

Individual contributors: Use your own knowledge and expertise Managers and leaders: Coordinate other people's knowledge and expertise

The set of relationships critical to your ability to get things done, get ahead, and develop professionally

Networks facilitate access to important information and resources controlled by other persons Networks facilitate cooperation between people that need to work together to promote the general interest but whose goals are not totally aligned in the formal structure

How adequate is your current network given your goals? What are the areas in which you think you might need to strengthen your network? Breadth, depth, leverage? What are the main obstacles you find to do so? What do you think you can do to overcome those obstacles?

BREADTH Does the network allow access to diverse groups? Seniority Insiders/Outsiders Places of work DEPTH Does the network allow for effective use of your time and energy? Duration of the relationship Frequency of interaction Strength of the relationships LEVERAGE Does the network allow you to influence key individuals and to maintain autonomy? Number of contacts Density of ties among contacts Centralization

Sociability All encounters are opportunities for expanding and diversifying your network: explore Think long-term Build ties before you "need" them Recognize the rule of reciprocity Understand the natural tendency (to stick to our own kind) and break out of it More networks not always better Too many relational demands consumes time and slow things down Understand what you want to achieve Based on skill sets and networks Be prepared to adjust over time as network needs change

Power the ability to get people to do things they wouldn't otherwise do Politics is the use of power either to Gain more power Exert influence (other than formal, legitimate authority)

Politics -the practice of trying to win the acceptance and votes of a particular point of view Policy - what elected politicians, analysts, and administrators are supposed to accomplish

Theory of Structural Empowerment: Social structures within the work environment that provide employees with access to: Information Support Resources Strong interpersonal relationships Opportunities to learn and grow Empowering social structures are a reflection of the management team and the value they place on nurses and nurses' contributions.

Information Support Resources Career Opportunities Strong Work relationships ----> More professional behaviors Greater willingness to be in control of practice Higher job satisfaction/Less turnover Less burnout/emotional exhaustion Increased ability to speak up and challenge status quo Improved quality of nursing care More teamwork and capacity to change practice

How it works Economics and how unions promote power of nurses Nurses do not bring in revenue. They do save costs/money Nurses are employees and represent the largest salary cost for the hospital Money = Power Unions are organizations that represent workers -individuals and the group—to the managers of organizations

History of the Labor Movement Worker's rights and work conditions Equalizes power between workers and managers Focuses on promoting fairness in terms of wages, benefits, performance reviews, seniority systems; hiring and firing 1935- national Labor Relations Act—Gave workers the right to unionize 1947- Taft-Hartley Amendment - Equalized power between unions and management 1962/1974- Wagner Act- Allowed public employees and workers in non-profits to unionize 1989- NRLB ruled that nurses could form separate collective bargaining units from other healthcare workers

Collective Bargaining is the process that unions use to represent workers to negotiate terms and conditions of work Works on the principal of mutual aid and protection Approximately 16-22% of all nurses belong to a collective bargaining unit Collective bargaining is decreasing for 'blue collar workers' and increasing for 'white collar workers' such as university professors, teachers, physicians

To increase individual power To increase input into organizational decision making To eliminate discrimination and favoritism To be accepted Required to do so as part of the job (closed shop) Desire to improve patient outcomes and quality of care

Belief that unions promote the 'welfare state' rather than free enterprise Need to demonstrate individualism and promote social status Belief that professionals should not be unionized Identify with manager's viewpoint Fear retaliation by employer Fear lost income during strike or walk out

Nurses can only strike over issues related to patient safety or working conditions Eg: staffing, use of float nurses; use of unlicensed assistive personnel; Ebola preparedness; discharge policies; mandatory flu vaccines Managers need time to make arrangements to cover patient care needs during a strike Used as a last resort after negotiations/discussions have failed Negotiations for salaries/benefits occur when contracts are renewed

American Nurses Association represents nurses on both professional issues and working conditions Promoting safe and well-functioning work environments are a component of the Nurses' Code of Ethics Sometimes these purposes can be at odds with one another In some states (eg: California and New York) the collective bargaining (union) activities and professional (practice acts, lobbying, education reform) are handled by separate groups

"Right to work states"-Laws in place that secures the right of employees to decide for themselves whether or not to join or financially support a union "Closed shop" - Management is required to negotiate with the union and union membership is a condition of employment "Open shop" - Employees are not required to join the union, but an individual's contract will be based on what management and the union have negotiated

New York State Nurses Association -- largest union and professional association for registered nurses. 37,000 frontline nurses HHC, NYP-Columbia; Montefiore; Mt Sinai, NSLIJ 1199 -SEIU - Healthcare Workers Union New York Professional Nurses Union - smaller shop unions specific to one hospital

Policy involves principles that govern actions directed toward given ends, such as allocation of resources. Policies may result in laws, regulations, or guidelines that govern behavior in public or private arenas, such as health policy. Policy decisions reflect the values and beliefs of those making the decisions. As values and beliefs change, so do policy decisions. Example: American Nurses Association (ANA) focuses on policy issues of health promotion, illness prevention, and nursing practice.

Politics is a process that influences the allocation of scarce resources. Examples: money, people, time, supplies, equipment Policies are the decision; politics is the process. Stakeholders are individuals or groups who are affected by the decisions. They also have a vested interest in influencing the politicians, or others in power, who make the policy decisions. Stakeholders can include health care professionals, affected patients and families, administrators of nursing organizations, hospitals, etc. The greater an impact stakeholders make in influencing politicians, the greater will be the likelihood their preferred policies will be implemented.

Nurses must understand the connections between public policy and their professional practice and personal lives. Associations recognize that political action is a professional responsibility essential to nursing practice. Nurses are participating more effectively in politics than in the past as members of nursing organizations (especially ANA) that participate through: Nursing political action committees (PACs) Nurses' endorsement of candidates: local, state, and national Identifying health problems as policy programs Drafting legislation in collaboration with legislators Lobbying governmental officials Filing suits to implement health policy strategies for consumers Nurses strategic action teams (N-STAT) of ANA

Developing leadership skills Certification Continuing education Political activism Opportunities to define practice standards, take positions on practice issues, and develop ethical guidelines Opportunities to engage in research projects Opportunities for networking with peers Group-sponsored services for individual nurses Access to journals, jobs, newsletters; travel discounts; products; professional liability insurance programs; group health insurance programs

Three levels of political involvement: Nurse citizens Vote in every election Stay informed and speak out about health care issues Participate in public forums Join politically active nursing associations Participate in community organizations as health experts Other activities Nurse activists Join politically active nursing organizations and participate Contact public officials Contribute to a political campaign with money or work Lobby decision makers Form coalitions that support issues of personal concern Other activities Nurse politicians Run for elected office Seek appointment to a regulatory agency Obtain appointments to a governing board in either the public or private sector Use their nursing experience and expertise as a front-line policymaker to enhance the quality of health care and to enhance the nursing profession