...AN INDEPENDENT VOICE FOR NURSING Work Engagement, Moral Distress, Education Level, and Critical Reflective Practice in Intensive Care Nurses nuf_237 256..268 Lisa A. Lawrence, PhD, RN Lisa A. Lawrence, PhD, RN, Instructional Faculty, Nursing Department, Pima Community College, Tucson, AZ Keywords Critical reflective practice, education level, moral distress, registered nurse, work engagement Correspondence Lisa A. Lawrence, PhD, RN, Nursing Department, Pima Community College, Tucson, AZ E-mail: llawrence@pima.edu AIM. The purpose of this study was to examine how nurses’ moral distress, education level, and critical reflective practice (CRP) related to their work engagement. The study is relevant to nursing, given registered nurse (RN) documented experiences of job-related distress and work dissatisfaction, and the nursing shortage crisis. A better understanding of factors that may enhance RN work engagement is needed. METHODS. A non-experimental, descriptive, correlational design was used to examine the relationships among four variables: moral distress, education level, CRP, and work engagement. The sample included 28 intensive care unit RNs from three separate ICUs in a 355-bed Southwest magnet-designated hospital. RESULTS. There was a positive direct relationship between CRP and work engagement, a negative direct relationship between moral distress and work engagement, and CRP and moral distress, together, explained 47% of the variance in work engagement. Additionally...
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...CHCPN(C), and Frances Flint, RN, MN Current nursing literature recognizes the need to honor the concept of ambiguity. Nurses experience uncertainty with handling or honoring complexity and ambiguity when confronted with times of struggle. Traditional models of care fall short as patients and families define their expectations of the healthcare system. Nurses bear witness to the discomfort caused by the unknown in their daily practice. They are challenged to address their feelings, unsure of what to anticipate, what to say, or how to respond to their patients. Uncertainty diminishes the opportunity for meaningful dialogue between nurses and other people. Nurses attempting to ease the discomfort of ambiguity by providing patients or families with reassurance, offering advice on how to fix problems, or avoiding talking about situations often express dissatisfaction. Nurses should be invited to explore ambiguity and seek understanding through dialogue and nursing knowledge. Encouraging nurses to define the meaningfulness in nursing practice that embraces human science theory will help relieve some of the ambiguity that exists in current practice. This article will explore the concept of ambiguity, highlight how nursing theory based on human science can support practice, and propose recommendations for practice. urrent trends in the healthcare system call for nurses to build the capacity to practice in situations that require complex decision making on the part of practitioners, patients...
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...of the role of a mentor have evolved over the years, for a variety of professions (Gopee, 2011) as too have the requirements for mentors within the health profession. The current definition from the Nursing and Midwifery Council (NMC, 2008a) states that “A mentor is a registrant who has met the outcomes (of a mentor preparation course) and who facilitates learning, supervises and assesses students in a practice setting” (NMC, 2008a). The role of a clinical nurse mentor is described as someone who supervises, teaches and assesses student nurses in a practice setting (Jokelainen et al, 2011, Ousey, 2009), although the role is more complex in that a clinical nurse mentor needs to process the ability to select and support learning opportunities, they have a responsibility to manage diversity and equality, be accountable and ensure standards are maintained (NMC, 2008a). This is supported by Jokelainen et al (2011) who describes mentoring as being complex due to contextual, collegial, pedagogical and clinical teaching. Student nurses are supernumerary in the practice placement, meaning they are there as learners even though they must make an active contribution to the work of the practice area (RCN, 2007). Their active contribution is additionally supported by Morgan (2002) who emphasises that students may feel surplus to requirements through their supernumerary status. Standards relating to mentoring nursing students are set by the Nursing and Midwifery Council (2008a). They include;...
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...PNR400 Role Development for the Practical Nurse Leadership Reflective Essay Assignment Grade: 10% of final grade Length: 4 pages maximum, Due Date: October 19, 2015 at 7:00 pm (see below) * 12 font, New Times Roman, double spaced, excluding reference list and title page. * Hard copy and electronic copy due at beginning of class as assigned by professor * Include a copy of the rubric with the hardcopy of your essay * Submit an electronic copy to Safe Assign on your assigned due date. Topic: Reflections: Leadership Development as you transition from learner to practitioner This essay is a critical analysis of your personal journey reflecting on your leadership skills development as you transition from being a student to a practice RPN. It may be helpful to focus on one significant experience and/or challenge: Examine how it made you feel made and how you have grown and developed leadership skills as a result. The primary focus is on your development of leadership skills as you transition from learner to practitioner. It should be honest and include examples, details, and relevant literature to support your opinions and thoughts. A good reflective essay should help you to understand yourself better. It must be written in the first person. Though this is a reflective paper, you need to clearly support your thoughts and ideas with references from the literature. Theoretical references may come from the literature related to leadership theory...
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...expertise team. The risk of long term complications needs full support from various professionals to conduct diabetes care. Acute complications can be prevented via ongoing patient self-management education and awareness of illness. Patient self-management education and problem solving skills development are necessary to be provided in diabetic clinic plan through a variety of strategies and techniques. Creation of a primary care diabetes clinic with trained paramedics who provide individual or group education, life-styles counseling, and diabetic complications screening will help to improve diabetic control and insulin acceptance. Many evidence-based studies have found that diabetic self-management education had significantly improved the clinical outcomes,...
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... although it is recognised that the fundamental theories explored may be applied to any setting where the teaching, training and mentoring of adults occur. The essay will explore the writer’s understanding regarding the role of a mentor within the workplace and the theoretical ties surrounding mentorship and how these are linked into the writer’s role of a mentor. Any names or areas of work mentioned in the essay have been changed in order to maintain confidentiality, clause five of the Nursing and Midwifery Council (NMC) Code of Professional Conduct: Standards for Conduct, Performance and Ethics (NMC 2004). The term ‘mentor’ is defined by the English National Board (ENB) and the Department of Health (DOH) to “denote the role of the nurse, midwife or health visitor who facilitates learning and supervises and assesses students in their practice setting” (ENB & DOH 2001a P6). Nicklin and Kenworthy (2000) define a mentor as someone who by example and facilitation guides, assists, and supports the student in learning new skills, adopting new behaviour and acquiring new skills. Quinn (2000 P.427) furthers this definition by pointing out the fact that a mentor is someone who “enters into a formal arrangement to provide education and personal support to a student throughout the period of the placement.” This denotes the level of responsibility and commitment required by the mentor, as an agreement is established. Within that agreement a contract of...
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...Professor Varnell Hudson August 28, 2013 How the IOM Report will Impact Nursing Education and Nursing Practice. The focus of the report is to show a need for more education for the graduate level nurse and a continued education plan for nurses already in the field. The IOM cited many reports that touched on the need for diversity amongst nursing graduates to meet the need to function as leaders and the dimensions of health professionals to deliver safe and excellent patient care (Johnson, 2010). The transformation of clinical practice key message was changing a nurse’s role (Johnson, 2010). This would require changing the old nurse roll to a more involved role using critical thinking, clinical judgment and nursing process (Creasia, 2011). The focus on other topics beyond the provision the NCLEX-RN would need to alter the test to encompass a more diverse multitude of questions that would be considered critical thinking (Johnson, 2010). The impact of the IOM report on transforming education is to incorporate more consistent competencies among nursing schools (Johnson, 2010). By providing nursing facilities with strategies to integrate quality and safety content into their curricula, with an interactive course work focused on a six core Quality and Safety Education for Nurses (QSEN), competencies. Using a Train the Trainer approach that helps to lead the institutions faculty to incorporate, to teach and mentor students, to train faculty to accomplish these goals (Barnsteiner...
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...CURRICULUM REVISION A CONCEPTUAL MODEL to Support Curriculum Review, Revision, and Design in an Associate Degree Nursing Program B E T T Y W. D AV I S P A R T I C I PAT I O N IN CURRICULUM DESIGN of program outcomes has been identified as a core competency for nurse educators A N D E VA L UAT I O N (Billings & Halstead, 2009; Southern Regional Education Board, 2002). Facing declining NCLEX-RN® pass rates, faculty at an associate degree nursing program at a public community college in Mississippi responded to the National League for Nursing ([NLN] 2005b) call to transform nursing education by undertaking an intensive critique of its curriculum and program outcomes. Based on this analysis, a conceptual framework was created to guide curriculum revision, development, and implementation. The framework provides structure for ongoing and systematic curriculum review and revision. A review of the literature revealed the need to move from a teaching-centered to a learning-centered approach to teaching. Learning-centered institutional design is reflective of a number of principles: the need to bring about substantive change in participants; the full engagement of learners and the mindset that students bear primary responsibility for personal choices; multiple learning options to appeal to students’ preferred learning styles; the enhancement of collaboration; educators as learning facilitators; and measurement of success through the documented improvement...
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...Jean Watson’s Theory of Human Caring NRS/403 Theories and Models of Nursing Practice 27 November 2011 Candace Cane Abstract Due to the ever changing health care system nationally and the increase need for qualified nurses worldwide, nursing responsibilities and patient load have intensified. Nurses are expected to care for higher acuity patients in more complex health care situations. Despite increased hardships in the work place, nurses must continually try to find ways to preserve their caring approach. Jean Watson’s caring theory can be seen as indispensable to this goal. This paper will explain the background behind the theory and take a personal approach in showing how it can be applied to every day nursing care. Jean Watson Nursing theorist Jean Watson of West Virginia, graduated with a Bachelor of Science in Nursing from the University of Colorado in 1964. She continued her nursing education at her alma mater and received a Masters of Nursing with a focus in psychiatric-mental health in 1966 and PhD of educational psychology and counseling in 1973. Dr. Watson holds the title of Distinguished Professor of Nursing; the highest honor accorded its faculty for scholarly work. In 1999 she assumed the Murchinson-Scoville Chair in Caring Science, the nation’s first endowed chair in Caring Science, based at the University of Colorado Denver & Health Sciences Center (Dr. Jean Watson, 2011). She has previously served as the Dean of Nursing at the University Health...
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...Authentic Leadership Leaders of the future should be obliged to embark on their own journey of personal development to earn the title leader (Whitmore 2012). The need for governance has mainly increased the pressures on organisations to have aspiring leaders with the skills needed for their fields of interest. This is supported by The Open University (on-line 2012) when it is suggested that clinical leadership is essential for service redesign, quality, innovation, productivity and prevention. It is recognised that in order to facilitate whole system approach in today’s National Health Service (NHS), leaders need to understand not only the people and culture they are trying to change, but also their own personality traits and how these may affect the process (Judge and Bono 2000, 754). In this regard a personal based analysis will be conducted, realising how far I have already gone concerning the developmental processes. I shall conduct a critical reflection (Gibbs 1988) of a personal leadership archaeology found in Appendix One. To facilitate the learning demonstrated two tools have been used; a full Myers-Briggs Type Indicator (MBTI) assessment has been completed, which allows a level of understanding by analysing individuals’ preferences as they make up a personality. Secondly the Belbin team role self perception inventory (BTRSPI) has been completed by both self and observer assessments used to consider my role within the team. The completion of these tools...
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...Abstract Due to the ever changing health care system nationally and the increase need for qualified nurses worldwide, nursing responsibilities and patient load have intensified. Nurses are expected to care for higher acuity patients in more complex health care situations. Despite increased hardships in the work place, nurses must continually try to find ways to preserve their caring approach. Jean Watson’s caring theory can be seen as indispensable to this goal. This paper will explain the background behind the theory and take a personal approach in showing how it can be applied to every day nursing care. Jean Watson Nursing theorist Jean Watson of West Virginia, graduated with a Bachelor of Science in Nursing from the University of Colorado in 1964. She continued her nursing education at her alma mater and received a Masters of Nursing with a focus in psychiatric-mental health in 1966 and PhD of educational psychology and counseling in 1973. Dr. Watson holds the title of Distinguished Professor of Nursing; the highest honor accorded its faculty for scholarly work. In 1999 she assumed the Murchinson-Scoville Chair in Caring Science, the nation’s first endowed chair in Caring Science, based at the University of Colorado Denver & Health Sciences Center (Dr. Jean Watson, 2011). She has previously served as the Dean of Nursing at the University Health Sciences Center and has acted as the President of the National League for Nursing. Dr. Watson has authored numerous...
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...DISCUSSION ON LEADERSHIP STYLE OF A LEADER 10-11 THAT IS APPARENT IN THE EFFECTIVE PROVISION OF HEALTHCARE DISCUSSION ON LEADERSHIP STYLE OF A LEADER 11-12 THAT FACILITATES POSITIVE STAFF DEVELOPMENT CONCLUSION 12-13 INTRODUCTION in today ever rapid changing and challenging healthcare environment, nurses are required to develop their leadership skills where effective leadership styles they choose to deliver high quality care with improved patient safety outcome (Treguno et al, 2009); healthy work environments (Shirey, 2009): job satisfaction (Heller et al, 2004; Sellgren et al, 2007); lower turnover rates (Gelinas and Bohen, 2000); and positive outcome for organization and patients (Wong and Cummings, 2007) and healthcare providers (Cummings et al, 2005). It must be emphasized that leadership should not be viewed as an optional role or function for nurses. Nurse leaders nowadays confronting challenges like new roles, new technology, financial constraints, greater participation, cultural diversity and education We must be aware and realized that leadership is a must in all healthcare facility where effecting change and achieving high standards of patient care are stipulated in job titles, such as Director of Nursing, Nurse Consultant, or Modern Matron (Sulivan and Garland, 2010). One of the most challenging nurses faced today in nursing profession is...
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...Change Project NUR 492 November 10, 2014 Dr. Christine Markut Change Project Today’s healthcare providers are struggling more than ever to provide high quality care while controlling the costs of healthcare. The demands of an aging population and shortage of medical personnel have brought challenges to the medical office and physicians somehow need to improve their access. Instead of limiting the time patients are able to spend with their physician discussing their medical concerns, why not increase the time and make it more effective for both the patient and the physician. Incorporating GMA’s may allow our physicians to see more patients, provide more care, and increase practice revenue. The patient benefits with increased access to the provider as well as receiving significant education with their peers that suffer from the same medical conditions (Rhee, 2013). This is a win – win situation for the organization and patients. Patients are typically allotted 15 to 30 minutes to discuss their concerns with the physician but with group medical appointments (GMA), patients are actually able to spend up to 90 minutes with their provider. GMA’s offer an alternative structure in the way effective and efficient care is delivered to chronically ill patients (Schmucker, 2006) and it allows greater interaction time with the provider. A GMA will typically involve approximately 8-12 patients while all of the components of individual appointments can be delivered to include: one-on-one...
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...The purpose of this assignment is to discuss how the module content and practice experience has contributed to my development as a nurse. It will involve reflecting on a particular episode of care delivery to a patient by me and my nursing mentor whilst on my 5 week placement and how I felt that the Foundation to nursing practice module helped equip me with both the knowledge and skills. In education for health-care professions it is recognised as an essential tool for helping students to make links between theory and practice and enables you to develop your knowledge and skills towards becoming a professional. Reflective practice is noted as being fundamental to development as a professional. To protect anonymity and maintain confidentiality the patient focused on this assignment will be known as patient A, furthermore consent was gained from patient A and they were provided with clear information on what would be included in this assignment and where informed that no recognisable information would be given, this is done in accordance with the Nursing & Midwifery Councils Code of Professional Conduct (2002) guidelines. Nursing assessment is considered to be the first step in the process of delivering individualised nursing care which is defined by A Dictionary of Nursing (2008) as care that is planned to meet the particular needs of one patient, as opposed to a routine applied to all patients suffering from the same disease. Every person...
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...Nursing 2312 Course Title: Dynamics of Professional Nursing Placement: Level II Credit Hours: 3 Semester Hours Pre-requisites: Completion of General Studies requirements and nursing support courses or special permission. Faculty: Course Description: This course is designed to introduce the registered nurse student to concepts inherent in baccalaureate nursing education. The philosophy, conceptual framework, program purpose and objectives will be discussed. Emphasis will be placed on the nursing process, as well as knowledge and skills that bridge prior learning experiences with current professional nursing practice. Course Objectives: 1. Describe the characteristics of professional nursing practice. 2. Interpret the relationship of the major concepts and theories threaded throughout the nursing curriculum to professional nursing practice. 3. Relate to professional nursing practice philosophical beliefs about man, environment and health. 4. Evaluate how nursing theory guides nursing practice. 5. Analyze how the professional nurse utilizes the nursing process to maximize quality care outcomes for individuals, families and communities. Teaching/Learning Activities: One or a combination of the following strategies/activities may be used during instruction in this course 1. Lecture 2. Group discussion 3. Reading Assignments 4. Student Presentation 5. Experiential...
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