Category: Uncategorized (Page 1 of 3)

I liked my theme that I had before. I definitely needed to clear off some of the pages so that it was easier to navigate. I feel like it looks better now!

Through this interview with a nurse that I know who I feel encompasses all the characteristics of a leader, I learned that there are multiple different types of leadership. I would consider this individual a “silent” leader, who leads more by example. A leader does not have to be loudest or most controversial person in the room. Her characteristics line up pretty similarly with mine, so it was interesting to hear how she sees herself as a leader. This individual has been working at the same hospital on the same floor for around 20 years. Over that time, she created strong bonds with her coworkers, creating a close-knit unit. She expresses to me that this has both positive and negative effects on her role as an informal leader on the floor. In times of conflict, she explains that it can sometimes be difficult to confront such a great friend. In that case, she communicates her concerns with a formal leader on the floor including the nurse manager or nurse educator and they can address the situation. On a positive note, having colleagues that double as friends make work more fun and allow for easier collaboration.

This nurse has adequate social and self-awareness both in and outside of the workplace. She is always considering the feelings of other individuals which I expect carries over to practice with both coworkers and patients. Although she is self-aware in the fact that she is aware of how her actions will affect others, I do not believe she understands how positive her impact in on others. She does not give herself enough credit when it comes to being a leader. I was surprised when I had to elaborate on questions that were specific to being a leader. However, I believe that the best leaders are the ones who don’t even know that they are leader. She portrays herself in a way where others want to follow in her footsteps and be like her.

Her timid responses about considering herself a leader resonated with me and is something that I will remember once I enter clinical practice. It showed me that these informal leaders who leader more by example need to be told about their impact on their peers because they may not even know that they are seen as a leader. I am going to make a point to acknowledge individuals like her. It is important that these individuals understand how they are portrayed and valued in the workplace. Following this interview, it strengthened my respect for this individual even more than it already was. Her humbleness about being a leader in the workplace is something that I admire. I hope to work more closely with her as I approach clinical practice to leader even more from her. Leaders come in all different forms. It is important that we recognize this and do not discredit the “silent” leaders like this extraordinary individual that I interviewed.

The subject that I have chosen is a family friend who has been a labor and delivery nurse for over 20 years. I chose her because of her charismatic and compassionate manner. I have never seen her in her element as a nurse, but I know that she is definitely a leader in her unit. The way that she presents herself in an approachable, kind manner is something that I strive to have both as a person and as a nurse. I do not believe that she has an official leadership position in her role, however, I feel that the informal leadership roles are just as important. Formal leadership comes from structure, authority, power, and can come in the form of orders or commands, while informal leadership is created from relationships and influence that the individual has on others. Informal leaders are unique individuals who have the ability to make an impact on others and their actions tend to be more focused on connections with others. My goal is to be an informal leader in the workplace. Whether, I eventually have a formal leadership role or not, having an informal leadership role is something that is invaluable and can change the whole dynamic of the workplace. I am interested in learning how this individual has gotten where she is. I am eager to hear any tips she has as an experienced nurse on how to become an informal leader, even as a new graduate nurse. I have never had this type of conversation with this individual, so I am excited to hear what she says about this topic. I would like to know how she applies her natural characteristics including authenticity, humbleness, and wholeheartedness, into her clinical practice and how she spreads these exceptional traits to her coworkers. I am glad that this is an assignment because it gives me a reason to learn from an exceptional informal leader both in and outside of the workplace.

COURSE DESCRIPTION

This course is designed to facilitate the transition from student nurse to professional registered nurse. Emphasis is
placed on the knowledge, skills, and behaviors required for licensure, development of professional identity and social
conscience, and career advancement.

COURSE OBJECTIVES
Upon successful completion of this course, the student will be able to:
1. Demonstrate development of clinical judgment necessary for provision of safe, evidence-based nursing care that
improves health outcomes for individuals, families, and communities. (Clinical Judgment/Evidence-based Practice)
2. Demonstrate use of data to develop knowledge, skills, and behaviors necessary for successful licensure by
examination. (Informatics)
3. Demonstrate professional communication skills necessary for gaining entry into practice. (Leadership)
4. Demonstrate the knowledge, skills, and behaviors necessary for effective collaboration with
the interprofessional care team. (Interprofessionalism)
5. Demonstrate personal responsibility for professional growth through reflection and remediation.
(Professionalism/Self Care)

Westbrook College of Health Professions
NSG 447A Transition to Practice
Spring 2022

Nurses can hold such a wide range of responsibilities in the event of a disaster. Prior to a disaster even occurring, nurses play a huge role in the disaster response planning. They work to develop an understanding of the disaster preparedness and response plans. Additionally, they may educate patients and the community about the knowledge needed to make it through a disaster. This can help to reduce overall fear and anxiety during a disaster. In order to protect their families, nurses may implement personal preparation with an emergency plan and supplies within their homes so that they are prepared in the case of a disaster. During a disaster, nurses will be assigned a variety of responsibilities. They will implement the disaster plans at their workplace, triage, provide emergency treatment, and coordinate evacuations and transportations of patients. They could be tasked with delivering basic first aid and mediation and assessing the overall state of the victims. It is important that nurses understand what they are expected to do in a time of disaster and that preparation is in place.

In a time of disaster, the compassionate nature of nurses will come out, compelling us to help other that are in need. Provision 2 of the ANA code of ethics states that the nurse’s primary commitment is to the patient, while provision 5 talks about how nurses owe the same duties to self as to others. These two provisions are contraindicatory of each other leading to the potential of ethical situations. My thoughts on this topic are that nurses must take care of themselves in order to care for others. In the event of a disaster, nurses play a key role in the first aid and triaging of patients. If nurses are not protecting themselves then they will not be able to perform the tasks that they need which could inhibit the safety of multiple individuals. If the nurse is protecting themselves, then many more people will be saved, and the overall outcome of the disaster will be better. With all of this being said, nurses are essential in the event of a disaster so if their safety if taken away then it will take away the safety of many others.

Throughout my clinical experience, I have taken care of a variety of patients, all from many different backgrounds. The care that I provide to my patients is all the same, no matter what. However, not all health care workers are the same. During clinical, I took care of a patient who is homeless who had suffered from cardiac arrest at a pop-up clinic and was then admitted to the hospital. This patient is a “frequent flyer” on the floor that I am on and not all of the staff necessarily liked this patient. When going in to care for this patient, I tried to think of the hardships that he must have gone through and the obstacles that could interfere with him reaching optimal health.

Homelessness is a health hazard in society and individuals in this population may be predisposed to worsening health outcomes and challenges to access healthcare. Demographically, homelessness can affect men, women, and children of all races and ethnicities. According to American Family Physician, there are more than 610,000 people who are homeless in the United States on any given night (2014). Their situations are anything but simple. Health problems among homeless individuals can result from various factors such as barriers to care, lack of access to adequate nutrition, lack of proper resources, lack of transportation, unemployment, lack of education, and limited services. Unemployment can go hand-in-hand with homelessness and can be associated with food insecurity, inability to pay for healthcare, and poor social capital. These individuals are unable to buy nutritious foods or pay for the healthcare that they need. This could decrease the probability of this population seeking healthcare. Due to the social determinants of health that homeless individuals may go through, they are prone to both mental and physical illnesses. Homeless people are prone to many chronic conditions including arthritis, asthma, chronic obstructive pulmonary disease, diabetes, HIV/AIDS, hypertension, vascular disease, pneumonia, STIs, and tuberculosis. Mental health disorders that homeless individuals are prone to include bipolar disorder, dementia, depression, personality disorder, PTSD, and schizophrenia.  The homeless population is also susceptible to substance abuse disorder and increased risk of injuries and violence. It is essential that health care providers keep the hardships that this population may go through in mind when caring for a homeless patient.

In my experience caring for a patient who was homeless, there were assumptions about him prior to me even meeting him. Health care workers would warn me before going into the room that he is frequently a patient and “doesn’t do anything to help himself”. I found this really difficult to hear, especially after meeting this patient. He was a great guy who was just in a tough place and was scared because he does not have the access to the resources he needs to take care of himself once he is discharged from the hospital. I am proud of how I handled this situation. Even though, I was told negative things about this patient prior to taking care of this patient, I did not let it affect how I cared for this patient. I think that the stigma behind the homeless population needs to be changed and the health care system needs to do something to help them. We, as a society, are failing the homeless population. Something needs to be done to help provide these individuals with adequate health care, regardless of the social determinants they may face.

When we were asked to create a project on vulnerable populations in health care, both of our minds automatically went to people suffering from a mental illness. Even though we are not even nurses yet, we have both been in situations in hospitals where we have seen mistreatment first hand. If we both have seen this mistreatment, then just think about how often this happens. We feel strongly that this is an issue that needs to be worked on and addressed throughout healthcare. We created an outline (which is linked below) which answers questions regarding this topic, and facts about it as well. Along with the outline, we prepared a 15 minute podcast briefly going over this topic and what we put in our outline. We tried to have a real conversation on the podcast, talking about information that was not even in our outline. We used examples from what we have seen as well as movies we have seen to give people a better insight on the effects of this issue. We talked about the ethics in health care and how this goes against it as well as hospital/ state policies and patient rights as well. We feel strongly that a change needs to be made regarding the treatment of this population in health care.

I have never really thought about death with dignity and my thoughts on it because I hope to never be in a position where that is an option that I am considering. However, when asked, my initial thoughts are that I have no idea my thoughts on it are, whether I believe it is right or wrong. I feel that it is impossible to really have a viewpoint on it unless you are in the patient’s shoes. I know that if I was in a position where my daily life function would slowly deteriorate, I would not want people to remember me that way. As I thought more of this idea, I began to support the idea that, when faced with a terminal illness with only a certain amount of time left to live, the patient should have the option to pass with dignity or live all the way until their last day. Once it gets to the point where no turnaround is possible, it should be an option for patients. This is a view on it as a free American citizen. On the other hand, my viewpoint on it as a health care provider, I would struggle with the fact of giving a patient something that would kill them. I know that there is so much more that goes into this process but putting it in simple terms of killing the patient is something that I would greatly struggle with.

The first ethical principle, non-maleficence, or do no harm is directly tied to the nurse’s duty to protect the patient’s safety. These principles dictate that nurses do not cause injury to our patients. The death with dignity does challenge these principles because as nurses we are supposed to promote health and wellness of our patients. Death with dignity goes against everything within our scope of practice. As nurses, we are supposed to take care of our patients with individualized care plans to keep them comfortable and alive. It my final year of nursing school, the death with dignity concept has never been talked about until now. We are always told to respond to end of life commentary with therapeutic responses and not actually collaborating with physicians to give patients medications that will grant their wishes. My take on death with dignity is conflicted by my beliefs as a human being and my beliefs as a nurse.

Electronic health records (EHRs) support that documentation with data can help to enhance patient safety, maximize efficiency, and evaluate care quality. It helps to provide accurate, up to date, and complete information about patients are the point of care. It allows for quick easy access of patient information and health status. Not only will EHRs help nurses on admission with help in seeing past medical history and other pertinent information, but it will help throughout their shift by giving medication administration reminders and potential drug interactions. EHRs allow more effective communication between those in the health care team. It will give everyone the same information on each patient to look at and allows the ability to write notes regarding the patient’s care that everyone looking at the chart would have access too. Basically, utilizing EHRs will keep everyone on the same page which would help promote adequate, wholesome care and positive patient outcomes.

Health information exchange (HIE) allows doctors, nurses, pharmacists, other health care providers and patients to appropriately access and securely share a patient’s vital medical information electronically. It improves the speed, quality, safety, and cost of patient care. Some common challenge that clinical work flows may present include updating patient care plans when multiple providers are caring for them, piecing together medical history, readmissions due to lack of communication and engagement, and gaps in patient information which increases the change of creating a care plan that can cause adverse effects. HIE can help to solve these solutions by creating a better, safer, and easier solution for the healthcare environment. It does this by improving communication and care planning among healthcare providers during transitions of care, providing assurance that care teams have accurate information at point of care, enabling improvement in both quality and cost outcomes through reduction in duplicate testing, medical complications, readmissions. HIE also will assist in targeting care for patients with chronic diseases, risk for future utilization, and quality measure gaps to put care plans in place more quickly. Overall, the evolution of where we are now with HIE has great improved communication within the healthcare system and therefore, patient outcome.

Learning about Electronic Health Records and HIE will help me to enhance the thoroughness and accuracy of my charting throughout clinical experiences. I did not know that what is charted within my facility can be seen by the other providers of my patients. This will improve the overall quality of my charting because gaps in the EHRs can negatively impact a patient’s plan of care. I will also utilize the EHRs during my nursing career to help make sure that I am efficient in caring for my patients. It will allow me to not forget to administer any medications and be sure that all medications given are compatible with each other. EHRs will also help me to know my patient before actually meeting them. It allows me to make a rough outline of my plan of care for the day for each patient. At the beginning of each shift, I will be sure to look at each my patient’s EHR to prioritize each patient’s needs and see which patient that I should check in with first. EHRs will be extremely beneficial to my future nursing career and I am excited to be able to learn even more about it.

Trauma is an emotional response to a terrible event that has happened in someone’s life. This can range from an accident, rape, or a natural disaster. Trauma can have lasting effects on your mental, physical, and emotional health. It can affect how your feel about yourself and others and cause increased risk of developing a mental health condition including depression, anxiety, or PTSD. Trauma can affect your physical health by triggering endocrine and immune problems leading to increased risk of chronic illness including chronic autoimmune illnesses, heart attacks, diabetes, strokes, or cancer. It can result in many physical reactions including fatigue or exhaustion, nausea, vomiting, dizziness, or insomnia. Spiritual well being can be affected because the individual could feel that they are being punished or abandoned by God, lose faith, decrease participation in religious activities, or feel a loss of meaning and purpose for living. Social well-being can be effected because it can cause an individual to withdraw from family and friends leading to isolation. The emotional distressed experienced can also make it difficult to relate to others.

Adverse childhood experiences (ACES) are potentially traumatic events that occur in a childhood and can include violence, abuse, and growing up in a family with mental health or substance use problems. ACES can have several long term impacts of adverse childhood experiences. It can change the brain development and affect how the body responds to stress. Additionally, ACES are linked to several chronic health problems, both physical illnesses and mental illnesses. It can cause chronic health conditions including depression, COPD, asthma, kidney disease, stroke, coronary heart disease, cancer, diabetes, and obesity. Health risk behaviors that can result from ACES include smoking, drinking, and other forms of substance abuse. Socioeconomic challenges that may be impacted include unemployment status, education level, and health insurance. Preventing ACES can help children to thrive and potentially prevent the chronic health conditions, risky behaviors, unemployment, low education levels and prevent ACES from being passed on from one generation to the next.

I will apply the Trauma- Informed Care (TIC) principles to my future nursing practice to help to prevent and identify ACES. I will anticipate and recognize current risks for ACES in patients who are children and understand the history of ACES in adults. I will establish rapport with my patients so that I am able to fully engage with the patient and get all of the information that I would need to properly care for the patient. I will respect the patient and their boundaries on what they are comfortable talking about. Additionally, I will treat my patients as actual people who I care about by taking my time with them and allowing them to feel heard and valued. Allowing the patient to be in control of these difficult conversations can also help. Overall, being aware of TIC in my practice will help to prevent and identify ACES in my patients.