CMSA Today - Issue 4, 2012 - (Page 28)

CMSA Mentoring Matters The Advantages of Reflective Practice in Mentoring the Growth and Development of Case Managers BY WENDY DEVREUGD, RN, BSN, PHN, FNP, CCDS, MBA M arch 2012 was the “Onboarding” four-week period with Kindred Healthcare for the new MSNs in case management from Samuel Merritt University in Oakland, Calif. (Susan Ly, RN, MSN, PHN and Elise Ruddell, RN, MSN, PHN). Kindred Hospital Division, a longterm acute care hospital system that cares for complex and catastrophic patients, is in its third year of a Mentorship Program for new nurses with graduate degrees in case management. The Onboarding time helps the new case manager to adjust to role clarity, learn about the organizational culture, and “plant their feet” in the rich soil of support to grow and develop in confidence under a guided-learning experience model. Planting the seeds of growth involve nourishing, stretching, and direction throughout their first year and beyond, to cultivate the very best skills and competencies from the new case managers. Onboarding, also known as organizational socialization, refers to the mechanism through which new employees acquire the necessary knowledge, skills, and behaviors to become effective organizational members and insiders (Bauer, T.N., & Erdogan, B., 2011). Deeply embedded in this first fourweek period is the concept of “Reflective Practice” theory (Kofoed, N., 2011), which coaches the new case managers to be Benefits: EXAMPLE OF SWOTT (Strength, Weaknesses, Opportunities, Threats, Trends) Identifying strengths helps one to focus in building of skills. Identifying weaknesses helps to focus one on keeping overplay of strengths “in check” and continuous growth through experience Networking, develop relationships New CM tools and methods for assessing, planning, d/c etc. Hospital committee memberships Local/State/National CM organizations Kindred’s Matrix organizational structure > > > > STRENGTHS: Communication Style-Thinker: effective communication, weighs alternatives, analytical Strong initiative and drive to accoplish tasks Extroverted, “selling” personality Strong educational background, masters degree > > > > WEAKNESSES: Communication Style-Thinker: overplay of strengths may cause indecision and over-analysis Secondary Sensor can be too impulsive and quick to act Persuasion rather than follow up Less experience in nursing and CM field AREA OF OPPORTUNITY • • • Opportunity for involvement and interaction with people Opportunities to learn and advance High level of independence, autonomy and flexibility in activities AREA OF MISSED OPPORTUNITY • • • CM urgency may conflict with indecisiveness and over-analyzing Low interest in details not related to goals Follow-up is important in coordinating interdisciplinary care and developing relationships AREAS OF WORK • • • Strong thinker can weigh alternatives in determining level of care and funding Strong educational background can assist individual in “proving” oneself to others Extroverts can work with others to receive matrix organization buy in AREA OF CONCERN • • May express ideas without concern for traditional/established policies Can become inpatient and less effective if required to work with repetitive routines and under close supervision U.S. increasing cultural diversity Changes in health care legislation affect funding, health insurance, available resources Decrease in availability of narcotics • • • TRENDS: Proactive in learning customs • of predominate cultures within geographic location • Initiative to learn about implementing legislation changes to practice Strong advocacy for patients needing narcotics as well as mindful about resource utilization Impulsivity can lead to making assumptions about a culture Less experience in nursing and underdeveloped professional relationships may provide additional challenges to obtaining needed resources for patients aware of their thinking and responses to the vast array of challenges coming their way. The self-analysis and small adjustments allow flexibility, change, and growth, instead of becoming fixed in responses to new situations. According to Kofoed, “Reflection is the mindful (and prayerful) consideration of professional or personal actions in such a way as to transform present and future experience. Nurses will find ways to create transformation in patient care through reflection in practice, clinical supervision, leadership, education, and evidence-based practice.” I highly value this theory as a way to challenge and shift responsibility for self-analysis growth to the new case manager, not just the Preceptor who trains. Developing this daily habit has proven highly valuable in growing the new case manager’s insight into case management practice and people. One approach to Reflective Practice is identifying with the case manager what their motivation to grow and change is – through the analysis of Predictive Index Testing (The Oliver Group), which is viewed through the lens of Performance = Competence x Motivation. Each individual is unique in what motivates them to learn, grow, and sustain competence, and these factors are helpful for the Preceptors to know in advance – to tailor guided-learning experiences that will “stick.” A second approach to a Reflective Practice model takes the analysis several layers deeper in the Onboarding period. Testing the new case manager’s personality and communication style allows them to discover their primary (and secondary style under pressure) and also help them learn to identify how others may differ in approach and the way they “move through the world.” If your organization does not have these tools within Human Resources, many can be found on the Internet to use for this type of testing. The skill of knowing oneself is KEY to collaboration with others, and allows OPPORTUNITIES: Government restrictions to • SNF funding Low acute care census • Need “buy-in” from matrix employees Close scrutiny from experi- • enced CMs • • • • • • • THREATS: w 28 CMSA TODAY • • ISSUE 4 • 2012 • DIGITAL http://www.naylornetwork.com/cms-nxt/

Table of Contents for the Digital Edition of CMSA Today - Issue 4, 2012

CMSA CORPORATE PARTNERS
EMBRACING THE GOLDEN AGE OF CASE MANAGEMENT
INCOMING PRESIDENT’S MESSAGE
CAREER AND KNOWLEDGE PATHWAYS: THE JOURNEY BEGINS
SERVANT LEADERSHIP: INSPIRATIONAL VALUES
WORKFORCE STRATEGY SIMPLIFIED
DIGITAL, MOBILE, GLOBAL: EFFICIENCIES AND HINDRANCES IN THE MODERN CASE MANAGER'S ENVIRONMENT
ASSOCIATION NEWS
VIEW FROM CAPITOL HILL
CASE MANAGEMENT AND THE LAW
ETHICS CASEBOOK
MENTORING MATTERS
INDEX OF ADVERTISERS

CMSA Today - Issue 4, 2012

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