The Strange Voyage
1. I think that the patient misunderstood the nurse’s intentions when he was moved from the ICU to the other places in the hospital because there was limited communication letting the know what will be happening. It seems that the patient was not familiar with the hospital, procedures and the people and because of that, the patient felt that all the interventions were to harm him. Even before the surgery, the surgeon visited the patient very quickly and told the patient this was a routine surgery. Although it may be routine, I think that it would be good to educate the patient about what will be occurring in each of the processes. In addition, when the patient was going for exams, the patient had to wonder what exam and why he was getting this procedure. Moreover, I think that he was not oriented to the time or place, and it does not seem like he was reoriented based on his responses.
2. As a nurse leader, I think that it would have been helpful to educate my team of nurses to effectively care for the patient. Communication is the key to interaction between individuals. I feel that if nurses in the ICU, OR, PACU were providing good communication between one another and with the patient, the patient would have had a better understanding of the situation. This was the first triple bypass surgery that the patient had, and it is a major event in the patient’s life. After the surgery, they are often placed in the ICU to recover so that their heart, lungs are oxygenating and pumping effectively. I think that it was an essential to communicate everything with the patient before and after the surgery.
The type of leadership management that I would use would be transformational leadership style. Transformationa...
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... building a team of staff to provide care for the patient, one must understand that every individual is different and be willing to come together to achieve a common goal to provide safe care to the patient. In looking at the team building principles, the nurse manager should set guidelines for meetings such as by setting a time frame, reviewing the progress of the unit, establishing standards, and talking to each member of the team. It is important to make sure that groupthink does not occur and that everyone gets the opportunity to express his or her concerns.
Reference
Harkness, G. & DeMarco, R. (2012). Community and Public Health Nursing: Evidence
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Merriam-Webster (n.d.). Despair - Definition and More from the Free
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Within the scenario, there was a lack of communication between the resident and nurse. There were no established principles for communication on the unit. Nurses could write on a bulletin board if they had a non-urgent matter to discuss with the doctors. The other method for communicating with doctors was to directly page them. Interprofessional rounds occur only once a week which does not account for the communication required between the doctor and nurse on a daily basis. There were no other formal communication methods for when doctors can speak to nurses. Nurses hear from doctors if they happened by chance to have seen the doctor, by word of mouth from other members, or from orders. The resident in the scenario did not seek out the nurse for second opinions and did not let her know about discharge plans. Thus, there was a lack of communication about care
1.Casida, J., & Parker, J. (2011). Staff nurse perceptions of nurse manager leadership styles and outcomes. Journal Of Nursing Management, 19(4), 478-486. doi:10.1111/j.1365-2834.2011.01252.x
The ability to promote structure, safety, and positive environments for both patients and colleagues alike are unique characteristics to quality leadership. Those same traits are essential to possess to have a cohesive interdisciplinary team of healthcare providers. There are various strategies that a nurse can employ to foster the collaboration of a particular team. The most influential strategy is the use of active communication, more specifically assertive communication. This type of communication is considered the healthiest because it is free from any bias. The nurse who is an assertive communicator values the whole picture as opposed to only one small piece of the equation. This approach takes into account all individuals involved, and validates the thoughts and feelings of others.
It appears as if the doctors performing the surgery have emotionally removed themselves from the situation at hand. By removing themselves from the emotional aspects of the surgery, the doctors can complete the task much easier than they would have been able to do if they had become emotionally attached to the patient. Had the doctors been emotionally involved in the surgery, they would have become more prone to making errors while operating on the patient because they would be thinking more of their feelings than they would about the surgery in progress. Although emotions are great and necessary things, sometimes trying to remove them is for the best.
The ever changing health care field call for leaders that are dynamic, and innovative and incorporate critical thinking to match the demands of the health care industry. A successful nurse leader would be the one that is open to new ideas from others by way of research findings to simple ways to execute a task in the clinical arena. The doctorally prepared nurses are the future leaders of nursing and as such their education (DNP curriculum) should gear towards preparing these future leaders to be transformational leaders. Transformational Leadership was originally developed by Burns who describes it as “... a process whereby leaders and followers raise one another to higher levels of morality and motivation” (Karen Drenkard, 2012). These leaders
A transformational leader is one who encourages intrinsic reward amongst individuals (Nielsen, 2013, p.128). Grossman and Valiga (2013) comment on the power of transformational leadership and state: “this motivation energizes people to perform beyond expectations by creating a sense of ownership in reaching the vision” (p. 73). In order to move forward and to minimize horizontal violence, nursing leaders must work towards creating a safe and fair work environment (Nielsen, 2013, p. 133). However, it is not only nurse managers who are required to take action, but every nurse must hold themselves responsible to assume leadership at work (Grossman & Valiga, 2013, p. 71).
Why now? Why are we focusing on transformational leadership? Healthcare costs are continuing to rise. Some of the critical problems and active debates prevalent in many hospital organizations include the rapidly intensifying healthcare costs, funding and reimbursement cutbacks, and concern regarding the overall quality and safety of health care. “Healthcare systems have come under pressure to improve performance and manage productivity” (Botting, 2011). To be successful in the 21st century, there is a demand on healthcare systems to have a vision and executive and clinical leadership to inspire the change process and make the difference between success and failure in change.
Leadership at times can be a complex topic to delve into and may appear to be a simple and graspable concept for a certain few. Leadership skills are not simply acquired through position, seniority, pay scale, or the amount of titles an individual holds but is a characteristic acquired or is an innate trait for the fortunate few who possess it. Leadership can be misconstrued with management; a manager “manages” the daily operations of a company’s work while a leader envisions, influences, and empowers the individuals around them.
The surgeon came in and they ended up taking her back to surgery immediately but this incident happened over the course of three hours. I manually held pressure on her groin to try to stop the bleeding with the intensive care nurses at the bedside to help if I needed. Eventually, after the two-hour mark, things started to slow down and I ended up getting pulled from the room to take a phone call. It was my supervisor asking me to take another patient onto my team of five that I already had and was not even able to check on during this incident. Needless to say, I told her no and she ended up sending the patient anyways. Thankfully one of the other nurses got the patient settled and as a team, they all took care of this new patient despite having five others of their own. This is a very good example of how dangerous it is to be short staffed. Acting in the spheres of influence is one way to try and prevent future problems like this one from ever happening again. Unfortunately, short staffing is a constant problem for nurses everywhere and doing the best we can do takes a toll on our health. Great job on your post and thanks
They arrived at the ER and were seen immediately, first by a nurse. The nurse brought patient C into a room and started by introducing herself followed by asking the patient to explain what happened (Personal communication, Sep. 25, 2016.). The nurse also name checked the patient by asking for her full name and date of birth (Personal communication, Sep. 25, 2016.). The nurse kept patient C calm while waiting for the doctor to come to her room. The nurse respectfully addressed the questions asked by the patient’s parents with full attentiveness (Personal communication, Sep. 25, 2016.). Patient C had questions of her own like if she would feel any pain during the stitches and what it is like to get stiches. The nurse assured Patient C that she was going to be okay (Personal communication, Sep. 25, 2016.). The nurse’s attention was always on the patient and her family. Throughout the time the nurse spoke to the patient she remained calm and did not act frantic, as that would have made the patient anxious or scared. According to Vertino (2014), nurses who use interpersonal communication techniques can help reduce stress in their patients (2014). This technique was used by the patients nurse and was effective in calming her nerves and making her feel safe. Patient C also noticed that the nurse never broke eye contact with her (Personal communication, Sep. 25,
I was then introduced to a patient who was in isolation. Her legs were immovable and were crossed in a very uncomfortable position. I wish I could’ve done something so that her legs could be in a more comfortable position, but all I could do was observe and get her a cup of ice cold water to drink. During this clinical observation, I didn’t get to see much but overall, it was a good experience. It made me realize what it was like to be in a hospital setting and what it meant to be a nurse. Seeing how the patients were still able to smile through all the pain they went through, it made me want to become a nurse even more because I would also like to make my patients happy. If I could do one thing differently during this clinical observation, I wish I didn’t ask my senior nurse about what externships she took and instead, I wished I asked her more questions about the patients in order to gain more information about
Aside from what the other nurses and I believed was best for this patient, it will always be up to the patient and family to decide the most appropriate decision for the patient situation. Therefore, no matter what the patient and family decides they want to do for this patient, whether it be to continue invasive life sustaining measures or have the patient begin palliative care, we have a duty to provide respect and compassion for our patients. I think this experience helped me to realize that no matter where I decide to work, there will always be ethical situations or dilemmas that I am faced with and the best thing I can do when faced with these issues is to support my patient and advocate for their wishes. This event will help shape my practice because it made me realize that we have to continue to have empathy for our patients because we never truly know the amount of pain or discomfort they are in. This patient had a long list of serious disorders and I am thankful I was able to be by her side throughout some of the weakest points of her life. She continued to thank me for providing oral cares and moisturizing her lips, or repositioning the pillow where it felt right and minimized the pressure on her sore. I also realized that we may be the patients only form of support throughout a certain point in their life and so it’s best to stay as supportive as possible. I
An organization’s mission, vision, and philosophy determine the goals the company seeks to achieve and describes the structures used to reach objectives. The mission statement speaks to the relationship the organization has with the community by linking its actions to the people it serves. The vision statement gives details of the organization’s purpose and values to employees and customers. The philosophy defines principles and overall beliefs that guide the organization in reaching its goals (Current Nursing, n.d.). For this paper, I will describe the mission and vision statements of my organization, discuss how my role supports the mission, discuss pros and cons of the nursing department’s structure, and give examples of how nursing could
Time out was done by the anesthesiologist, the circulating nurse, the surgeon, and the scrub tech all pausing before the surgery and verifying the patient’s name and date of birth, the procedure being done, the site and location on the body in which the procedure was being done, and documented the count of all the equipment the scrub nurse had before surgery to compare to after surgery. 5. The patient’s privacy was protected and respected throughout the whole surgical procedure. The staff was very professional and I felt I learned a lot from them during my OR experience. 6. A sponge count is when the scrub nurse counts the sponges that are unused before the surgery she relays this to the circulating nurse and it is documented. After the surgery the count is redone to make sure that there are no sponges left in the patient. 7. The circulating nurse documents the information and signs the chart in the operating room. From pre-op to the operating room the nurses in pre-op gave off report to the circulating nurse by SBAR. From the operating room to PACU the anesthesiologist went with the patient and handed off the patient’s condition and information to the nurse in there. 8. There were no ethical or legal issues that were raised during my observation in the whole surgical process. 9. I learned how the whole operating procedure works from start to finish, all the legal paperwork involved, and how the team interacts and helps each other out to give the patient a safe and
Sam was only assigned one patient, D.H., a 41-year-old male admitted on 11/7/16 for end-stage renal failure. The patient’s code status was not determined and there were no discharge plans. D.H. was an admission, therefore Sam was able to experience the admission process and how a patient might adjust to their first few hours in the hospital. She reported that he seemed to be slightly anxious and afraid of the whole process. Sam was administering medications on Tuesday and was able to push an IV med for the first time. Additionally, the patient was a dialysis patient, so she was able to accompany him to his peritoneal dialysis treatment that