C'mon, be reasonable: Goals for the new year
Jacqueline Vance, RN
Well gang, it's a new year and the time where we set sparkly, brand spanking new goals. Oh, we get so excited because a new year gives us chance to do it better. Most of the world sets goals such as losing weight, getting in shape, setting their finances in order and things like that.
But no matter what the goal, the trick is to be reasonable. For example, if a person's goal is weight loss, most of us can't expect to look like a stick think model that genetically has a one-inch thigh gap. So why do people set that as a goal? Less than 1% of women will ever be able to achieve that and still live! (For me, my reasonable goal is to be able to wear corduroy slacks and not catch my thighs on fire when I walk!)
So what the heck has this got to do with nursing? Well, now is the time we can set some of those brand spankings new goals for our facilities. I know sometimes we are expected to hit lofty goals that are just not attainable.
We are expected to accomplish Herculean tasks from some top-to-bottom ideals. But, we can compromise and make major improvements. We just have to be reasonable so that we don't simply acquiesce to unreasonable requests and shoot ourselves in the foot by setting goals that can't be reached. My all-time pet peeve is a “resident will not fall in 30 days” care plan goal.
Let's say last year, during our QA meetings, we noticed we seem to be giving a lot of PRN pain medications and then, comparing that to our MDS reports, we see we haven't been super great at complying with F309 and pain control.
Well, we wouldn't make a goal of 100% pain control for all residents even if we are “requested” to do so. (That's actually impossible.) But what is possible? Can we say we will have a goal that if any resident receives PRN pain meds regularly for two days, we call the practitioner and discuss switching them to round-the-clock pain meds?
What about improving our behavior targeting? (Except mine, of course — that's way too much to take on!) I know this is a huge issue nationwide. So how about setting a goal to start by more appropriately defining target behaviors in order to be able to actually monitor them?
I call it the onion effect. If you peel the onion one layer at a time, before you know it, the onion is open (goal met). But if you cut the onion to open it, you wind up crying!
One of my educational goals, like many peoples' I presume, is around further reducing unnecessarily antipsychotics. It will require working with the full nursing staff to understand how to identify target behaviors so I can competently monitor those behaviors. That's my onion peel.
What are your goals this year? What do you really want to accomplish? You can do great things. If fact, you're already doing it, so brag a little! Let me hear from you.
Just don't ask me about the fate of my corduroy pants yet!
Just keeping it real!
Nurse JackieThe Real Nurse Jackie is written by Jacqueline Vance, RNC, CDONA/LTC, a 2012 APEX Award of Excellence winner for Blog Writing. Vance is a real life long-term care nurse. A nationally respected nurse educator and past national LTC Nurse Administrator of the Year, she also is an accomplished stand-up comedienne. She has not starred in her own national television series — yet. The opinions supplied here are her own and do not necessarily reflect those of her employer or her professional affiliates.