Nursing must stop "eating its young"

As a nurse, staff educator, and mentor, I found the article "Combating Workplace Violence with Peer Mentoring" by Christine L. Latham, DNS, RN; Karen Ringl, MS, RN; and Mikel Hogan, PhD, in the September issue to be informative. The article brought a necessary awareness to the topic of workplace violence. Nursing has adopted a culture of "eating its young." As nurses, we accept that this is the way things are. This type of bullying and horizontal violence often goes unreported because our culture accepts it. It's important to educate nurses on the impact and prevention of these types of actions.

My facility has adopted a mentor certification program to encourage nurse leaders to support and develop new nurses. This is an evolving program, but we've documented success with the results of our staff satisfaction surveys. If we create a culture of awareness and zero tolerance for horizontal violence, maybe we can create a culture that no longer "eats its young."

Hiring the right way

I read with great interest the article "Hiring Right, Every Time" by James Higgins, EdD; James E. Kuthy, PhD; Felicia Sadler, BSN, RN, CPHQ; Ron Gonzalez, MS, BSN; and Dan A. Biddle, PhD, in the September issue. Although I've been a nurse for more than 20 years, I haven't had formal training or instruction for employee selection. However, a recent promotion has required me to hire four nurses in the past year. A multidimensional assessment tool eliminates the guesswork in the hiring process. Despite the inclusion of peer interviewing as part of our hiring process, it's difficult to assess in such a brief time whether a candidate is compatible with the team. High-performing, collaborative teams are essential to facilitate the healthcare system transformation necessary to attain the goals of quality care, cost efficiency, and patient satisfaction.

Clinical, situational judgment, and personality/behavior assessments all provide statistically significant correlations to performance on the job. Perhaps the most useful to creating cohesive, high-performing teams is the personality assessment. Candidates can be coached to respond to interview questions appropriately when evaluating clinical and situational judgment, yet identifying and measuring key behaviors, such as conscientiousness, tough-mindedness, stability, and teamwork, are difficult. Utilizing an assessment tool translates subjective information in an objective context for hiring purposes.

According to the authors, honest and conscientious work practices and accountability correlated strongly with work performance. There was a time when clinical expertise was sufficient. Now, positive outcomes, cost efficiency, and technologic advances require a new skill set, which this assessment tool identifies and evaluates. In addition to the financial benefit of hiring the right person, there's a clear benefit to honing in on the significant, pertinent components that make a potential employee the right "fit" for the team, as well as the organization. Managers-novice or expert-can benefit from utilization of this evidence-based hiring tool so they may hire right, every time.

Does education matter? Yes!

As a new clinical coordinator in an ED and a current MSN student, the article "Does Nurse Manager Education Really Matter?" by Jared A. Thompson, MEd, MSN, RN, and Roseanne Fairchild, PhD, RN, CNE, NE-BC, in the September issue was extremely relevant to my current role and the ongoing staff reorganization at my hospital. Higher education and the role of a transformational leader are necessary in today's complex healthcare environment with its rapid changes, increased technology, and healthcare reform.

At my agency, the nursing directors and charge nurses were all forced to reapply for the newly developed patient care leader and clinical coordinator positions. Although these management positions had preferred educational requirements, applicants were allowed to obtain their BSN and MSN degrees within a set timeframe and with tuition reimbursement offers from the agency. In the year since the development of the clinical coordinator position, many of the managers originally hired into this position have since requested position reassignments; some asking to return to clinical nurse positions.

Some of these disenchanted managers had BSN degrees, but most didn't have leadership training or previous management experience to provide the confidence and skills necessary to feel comfortable in their new roles. This article supported my belief that higher education and immediate leadership training are critical for a nurse manager to be successful in today's healthcare environment.

Although five studies were researched to develop this article, I was disappointed to learn that only literature older than 5 years focused on the benefits of higher education, especially considering the position statements of national healthcare organizations establishing a BSN as the minimum education for nurse leaders. Today's nurse managers must perform new evidence-based research to encourage their agencies to set a BSN as the minimum requirement for new managers. In today's complex and rapidly changing healthcare environment, managers must be transformational leaders and role models for higher nursing education.

Thumbs up for mandatory flu shots

I'm writing in response to "Mandatory Influenza Vaccination: Is It Part of The Answer?" by Kristin K. Vondrak, DNP, ARNP-BC, NE, CPHQ; Patricia Starling, BSN, RN, CIC; and Jessica de Guzman, RN MAN, NE-BC, in the August issue. Recently, the clinic I work for has converted to this policy. They're requiring influenza vaccinations just as they do other vaccinations required for employment.

It's important for the appropriate leader to initiate this approach. Whenever the issue of something being mandatory evolves, there will be a certain amount of resistance from employees. A good leader will take the role of an advocate and ensure that each employee is protected against preventable hazards related to vaccinations.

I believe that making influenza vaccination mandatory among healthcare workers should be approved just as any another vaccination that's required for employment. Influenza is more common than some of the other diseases we're required to be vaccinated against, so why wouldn't influenza vaccination be mandatory? This will assist in increasing healthcare work productivity because there will be less time missed from work as a result of influenza, in addition to decreasing morbidity related to influenza.

Kathy Lee, BSN, RN

Dawn de la Vega, BSN, CGRN

Laura Hayes, BSN, RN, CEN

Tonya Burks Ballard, BSN, RN