...scenario will demonstrate passive communication that leads to a passive aggressive outcome. The charge nurse in intensive care unit delegates out assignments to the other nurses, and at times the intensive care unit nurses refused to take more than two patients. Instead of the intensive care unit charge nurse delegating assertively the assignments she chooses to take the third patient. This causes her to become greatly behind in her own care, in turn providing a lower level of care to her patients. In a code or emergency situations because the charge nurse becomes burdened down with three patients, she cannot assist in these emergency situations and poorly manages direction and flow of the unit. This has led to the charge nurse holding resentment to some of the other nurses because they refuse an extra workload. When it came time for the other nurses to take vacation the charge nurse who does the scheduling tried to be fair and took three days less of her own vacation days to facilitate the fellow nurses vacation. The charge nurse did bring it to the attention of the manager; both nurses cannot take vacation at the same time. The manager did not listen to the charge nurse and granted both the vacations. This led to multiple nights putting the intensive care unit short with their staffing matrix. Thus, causing the charge nurse to take three to four patients. The charge nurse became so...
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...Nursing-sensitive indicators consist out of three categories that include the following: Structure, process and outcome. Structure refers to the organizational aspect of nursing that is made up of staffing levels; experience vs inexperience; educational levels or the make-up staffing at any point on the unit or facility. The Process is aspect of policies and procedures at the facility and Outcomes are determined when greater levels of nursing care and quantity are involved with better patient outcomes (ANA, 2015). Nursing-Sensitive Indicators The scenario paints a picture of multiple areas that should be approved on and addressed by management. The use of restraints, as described by the scenario, indicates a clear lack of knowledge in regards to nursing-sensitive indicators, the use of restraints and subsequent pressure ulcer formation is directly related and reflects on all 3 aspects of the indicators. The American Nurses Association, ANA, recommends that restraints only be used when no other viable options are available and this is also the case with the organization that I am involved with as a RN, Seton Health. While reading the scenario, it did not mention patient behavior that would justify the use of restraints; there is no mention of medical or behavioral interference that could possibly require the need to use restraints. The patient is elderly, has a history of mild dementia and a fractured hip, none of these should require the use of restraints but they all create conditions...
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...Macy Walker HRM 424 Interview #1 Interview of Clinic Supervisor For my first interview I decided to interview Lacey Wilson, a nurse turned clinic supervisor of OMC Primary Care Clinic located in Port Angeles. I chose to interview her because my mother is a PA (Physician’s Assistant) there and I have also worked at the clinic since 2013 in the call center, so I am familiar with a lot of the staff including Lacey. I have always found it interesting that as a nurse she chose to take the turn towards management and I was very curious to find out why. During the interview we discussed many things including her current and past roles, what training she has had to help her do her job more effectively, and how experiences outside her job have helped her progress as well. Lacey graduated from UW nursing school in 2000 with a BSN (Bachelors of Science in Nursing) and has basically been with the clinic ever since. She started working with Primary Care in 2001 as a float nurse but was soon assigned to a team (at Primary Care there are four “teams”: Central, East, Cherry, and Sequim, each with their own doctors and one nurse). Not long after Lacey was assigned to a team she became the lead nurse, who is essentially responsible for all the other nurses working at the clinic. Lacey said working as a team nurse gave her experience with managing a small team of employees, including conflict management, time management, and customer service. Over the years Lacey has also been involved...
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...yyThe new nurse supervisor should spend time educating all of the clinicians in the clinic on how to incorporate teamwork through collaboration, effective communication, and by implementing the interdisciplinary care approach in order to improve quality and continuity of care for clients. It is important for healthcare providers to realize that they cannot single handedly meet all the healthcare needs of their patients through an independent practice approach. In order to be successful as a team, time needs to be spent in establishing goals for the patients, delegating tasks appropriately, explaining each member’s role, designating a team leader for decision-making, communicating effectively and resolving any conflicts that arise. In simple terms, the team should know which direction it is going, what is expected of each team member, what needs to be accomplished, who is responsible for what, and how it all will be done. Research has shown that there are multiple benefits to utilizing the interdisciplinary care team approach including improved patient care by increasing collaboration of multiple disciplines, encouraging patients to actively participate in their care and thus increasing patient empowerment. For the healthcare professionals it provides an opportunity to learn new skills and the ability to utilize expertise, allows the providers to focus on preventive care rather than on acute care only, and assists in professional satisfaction. The NCSBN and the ANA define delegation...
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...RTT1- Organization Systems and Quality Leadership Task 1 Nursing sensitive indicators developed by the American Nurses Association “reflect the structure, process, and outcomes of nursing care.” (American Nurses Association). To further understand the American Nurses Association definition a breakdown of each section is appropriate. To address the structure of nursing care it is important to access the skill level of the nursing staff, the availability of nursing staff, and the education level/certification level of the nursing staff. The process portion of nursing sensitive indicators measures assessments performed by nurses, appropriate nursing interventions and job satisfaction of nurses. (American Nurses Association). Finally, outcomes of nursing care according to the American Nurses Association, measures the quantity and quality of nursing care, for example, prevention of pressure ulcers, prevention of patient falls, and IV infiltration to name a few. Given the scenario in this case, there were several nursing sensitive indicators present that could have been prevented provided that the staff involved received proper training and had a strong foundational understanding of nursing-sensitive indicators. To begin the case of Mr. J, there was no definite explanation of why the restraints were applied. This is an appropriate opportunity for education related to restraint use. Although Mr. J was given pain medication, he obviously knew where he was...
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...Plans Christine Grandfield This study is about an impending blizzard is set to hit the area with accumulations forecasted to bring 2-3 feet of snow and damaging winds during the next 12-18 hours. Nurses on the floor are looking to Gillian Scott for direction on how to proceed if and when staff begin calling out and creating staffing shortages due to the weather situation. Gillian continues to monitor the weather closely and stays in close contact with her nursing supervisor. It is better for everyone, staff and patients included, that a plan be put in place sooner rather than later. Since this is second shift, most executives have gone home. The hospital has an Emergency Operation Plan (EOP) in place that Gillian reviews, paying special attention to the weather emergency section. Gillian knows that if the weather predictions are correct, they will have to keep the staff that is currently working until other workers can arrive at the hospital safely. With this in mind, the challenges she will be facing are tired co-workers as well as a floor that is short staffed. Gillian’s supervisor decides it is best to come into the hospital while roads are still passible. It will be easier to implement a plan while onsite as well as be able to help as needed. As the supervisor travels into the hospital, she notices that the roads are getting harder to pass and the snow predictions are proving to be correct. When she gets to the hospital, she calls a meeting with Gillian to...
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...people who deliver healthcare to patients every day. It is important to examine the concept because unhealthy stress can cause multiple effects on the caregiver and patient. Positive forms of stress can be beneficial to practice, and negative forms of stress can put practice in danger. A conceptual analysis of stress will strategically define the concept, explore antecedents, and pinpoint consequences associated with stress. The mental and physical effects of stress will be examined, and the link between effects and antecedents will be established. The antecedents of stress are essential to identifying the underlying problem, and prevention methods can be implored once those problems have been identified. In addition, cases will be presented reflecting the use of stress to educate the reader with knowledge and recognition of the concept. A model case, related case, contrary case, and borderline case are given in the text as examples to illustrate the concept of stress. A Conceptual Analysis of Stress Stress is a concept that derives from strain placed on a human being. Dictionary.com (2012) defines stress as “mental, emotional, or physical strain or tension”. Positive and negative aspects of stress exist depending on the particular incident or situation. Stress can be activated when a student is nervous about presenting a speech, or a supervisor is worried about his first day on the job. There is no real danger present, but the person experiences feelings of anxiety and...
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...people who deliver healthcare to patients every day. It is important to examine the concept because unhealthy stress can cause multiple effects on the caregiver and patient. Positive forms of stress can be beneficial to practice, and negative forms of stress can put practice in danger. A conceptual analysis of stress will strategically define the concept, explore antecedents, and pinpoint consequences associated with stress. The mental and physical effects of stress will be examined, and the link between effects and antecedents will be established. The antecedents of stress are essential to identifying the underlying problem, and prevention methods can be implored once those problems have been identified. In addition, cases will be presented reflecting the use of stress to educate the reader with knowledge and recognition of the concept. A model case, related case, contrary case, and borderline case are given in the text as examples to illustrate the concept of stress. A Conceptual Analysis of Stress Stress is a concept that derives from strain placed on a human being. Dictionary.com (2012) defines stress as “mental, emotional, or physical strain or tension”. Positive and negative aspects of stress exist depending on the particular incident or situation. Stress can be activated when a student is nervous about presenting a speech, or a supervisor is worried about his first day on the job. There is no real danger present, but the person experiences feelings of anxiety and...
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...University of Phoenix Material Appendix A: Matrix of Theoretical Models |Theoretical Model |Description of Theoretical Model |Health care changes situation where model | | | |best applies | |McClelland 3-Need Theory |David McClelland, a psychologist, developed|Managing a group of people is always | | |an Achievement Motivational Theory built on|challenging. They all have different | | |his belief that all human beings have needs|personalities and like to receive | | |and innately search for ways to meet those |recognition in different ways. However as a| | |unsatisfied needs. These needs vary from |leader, it is our responsibility to | | |person to person. He acknowledged three |recognize what motivates team members. | | |types of motivational needs: Achievement, |David McClelland’s Motivational Theory | | |Power and Affiliation. He alleged that all|provides a way to identify peoples | | |three needs can be present in...
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...Leadership and Management IOM Competencies Case Study Nurses who work night shift at hospitals are often faced with the dilemma of whether or not to call a physician for advice during the night. Fear of having to deal with an unpleasant doctor can be intimidating, as the physician is frequently asleep when being called. Failure to communicate has been linked to poor quality and patient errors, therefore nurses and doctors must communicate and work collaboratively in order to provide high quality and safe care to their patients. The Institute of Medicine (IOM) recommends educating health professionals in five different areas: providing patient centered care, working in interdisciplinary teams, employing evidence based practice, applying quality improvement, and utilizing informatics (Yoder-Wise, 2011). Learning and applying these competencies will help nurses and physicians to deliver the best healthcare possible and lead to positive patient outcomes. The following will describe how IOM competencies can be used in healthcare. A decline in patient status can require needing further recommendations by the physician. Nurses should assess patient situations early, as this could help to avoid waking a doctor. It is best to try and prevent calling doctors unless it is an emergency and cannot wait until morning. Other avenues should be pursued prior to reaching out for guidance to the doctor. Asking a senior nurse or a supervisor for assistance, support and guidance should be one...
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...Nursing shortage has been a hot topic in the nursing filed for more than decade. Multiple components are the catalyst to this disaster. The reason why I identify our nursing shortage as a disaster is because human lives are in our hands. Another concern is the potential of not been able to meeting the health care needs of our communities. This national growing problem makes it crucial to attract students to the profession (Vioral, 2011). Even after students enter nursing programs, 13% of newly license register nurse change their bedside job after one year and 37% of nurses report a desire to change jobs after one year (Vioral, 2011). These are alarming rates most shift our focus to ensuring we keep our nurses engage and satisfied with their job. What I was able to gather from my research was not a bit surprising as to why nurses are not satisfied with their jobs. These reasons consist of stress related to understaffing and the high acuity, lack of support from the leaders, salary, scheduling problems, an unfriendly or negative environment and the lack of professional growth. I do not about you all but these are not new words to my ears. I have been listening to the same tune for more than 25 years. As a leader it is very frustrating working with HR recruiting department and the engagement crew to keep our nurses engage and at bedside. Fostering a culture of genuine support by nursing administration and educators is one the first step an organization has to take in...
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...having a well educated nursing workforce in the interest of improving patient safety and providing enhanced nursing care. Research has shown that lower mortality rates, fewer medication errors, and positive outcomes are all linked to nurses prepared at the baccalaureate and graduate degree levels. Education enhances both clinical competency and care delivery. The overall outlook of healthcare professions has dramatically changed in the past few decades. In nursing, competencies define the duties and skills required for nursing positions and establish the educational requirements needed to qualify for each nursing title. In its October 2010 report on The Future of Nursing, the institute of Medicine states” an increase in the percentage of nurses with BSN is imperative as the scope of what the public needs from nurses grows, expectations surrounding quality heightens, and the settings where nurses are needed proliferate and become more complex.”In a study released in May 2008 issue of the Journal of Nursing Administration, Dr Linda Aiken and her colleagues confirmed the findings from their landmark 2003 study which shows a strong link between RN education level and patient outcomes, The researchers found that every 10% increase in the proportion of BSN nurses on the hospital staff was associated with a 4 % decrease in the risk of death and failure to rescue by 5%. The Bachelor of Science degree in Nursing requires a four-year university degree in which the first two years focus on general...
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...Justo Abstract The leaders of nursing throughout history have shaped not only the practice of the nursing, but also entrance to the profession via, Diploma, Associates Degree and Bachelors Degree programs. While multiple avenues exist to gain entry into the nursing profession as a Registered Nurse (RN), not all nurses are equally prepared for a professional career in nursing. An aging Baby Boomer generation entering into retirement relying more heavily on the healthcare system, will create a greater demand not only for Registered Nurses with Bachelors Degrees, but furthermore for those RNs with advanced post-graduate degree education to be able to manage an ever changing and challenged healthcare landscape. Educational Preparation The purpose of this paper is to examine the differences between Diploma, Associates Degree, and Bachelors Degree prepared nurses who take the National Council of State Boards of Nursing’s (NCSBN’s) Nursing Licensure Exam for Registered Nurses (NCLEX-RN) exam. While all three types of nurses are authorized to take and pass the NCLEX board exams for licensure, not all RNs are equally prepared to handle and manage the complex and ever changing healthcare landscape and in particular regards to preparedness of practice of the professional nurse. Differences in Competencies Diminishing Diploma Programs Established in 1873, Massachusetts General Hospital initiated the very first formal nursing educational program in the United States (Friberg and Creasia...
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...stay in 2006. They go on to say, there are approximately 16,000 nursing homes and about 1.7 million nursing home beds in the United States. While only twelve percent of nursing home residents are between the ages of 64-74, 45% are over 85 years of age. It is estimated that anyone over 65 years of age will have a 43% chance of spending some time in a nursing home (Kemper and Murtaugh, 1991) and about 24 % of these individuals will spend less than a year in residence at a nursing home (CDC, 2012). The key employees of the nursing home that have the most interaction and greatest impact with the residents of nursing homes are the registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants (CNAs). For several years the shortage and turnover rate of nursing home staff has long been a serious problem for multiple nursing homes nationwide (Pillemer, et al., 2008). Providing effective and safe quality care in nursing homes requires clinically and interpersonally competent staff. Research findings suggest that inadequate supervisory, managerial, and human resource practices within nursing homes contribute to poor outcomes, including high nursing staff turnover, lower employee satisfaction, and poor clinical outcomes (Anderson, et al 2003). When a staff member leaves an organization, the knowledge, skill and experience that the person has brought to, and gained at, the organization is lost. Although high rates of nursing home staffing shortages...
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...RETENTION RESEARCH PAPER Nurse Retention Herbert Albert Health Sciences Center School of Nursing 07/28/08 Contents Introduction Literature review Plan of action Discussion Conclusion Introduction The priority goal of every hospital leadership team is to develop and retain a stable workforce that provides high quality patient care (Missouri Hospital Association [MHA], 2005). Nurse retention and recruitment are the top issues that all health organizations are facing in nowadays. They most effectively develop strategies not only to recruit nurses, but to retain experienced and knowledgeable bedside nurses who will deliver an excellent care. Practical retention plans and strategies are crucial to the financial and quality outcomes of an organization (Golden, 2008) Factors that are contributing and affecting nurse retention and consequently causing workforce disruption are related to high turnover, aging workforce, and job dissatisfaction. Literature Review Turnover is costly to an organization, creating significant financial burdens and affecting morale and clinical quality (Golden, 2008). Although the full impact of staff nurse turnover on hospital costs has not been assessed, costs associated with recruitment and hiring, personnel processing and training of new nurses are known to significantly increase as result of high turnover (Weisman, Alexander&Chase, 1981). There are several...
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