NSG 517 Week 4 Discussion Board

NSG 517 Week 4 Discussion Board

Please answer the questions below in this weeks DB post. Please post your initial response by midnight Sunday. Please respond to 2 of your peers by Midnight the following Tuesday. Don’t forget to cite references. Through this discussion board interaction I hope to see how what you have learned so far in this course will impact you professionally in regards to your immediate clinical practice.

Your response should be 2-3 paragraphs. Here is a suggested model to follow. Be sure to refer to the rubric for this assignment.

1st Paragraph

  • Briefly describe a specific example of a work scenario, that upon reflection of this week and last weeks course content, you might have handled differently to reach a better outcome.
  • Reflect on and identify what biases, assumptions, behaviors might have led to the original outcome. Relate this to any of the content you reviewed THIS week. What would you do differently and why?

2nd Paragraph

  • What NONPFcore competency would this change exemplify?

3rd Paragraph

  • What attributes of a leader do you feel is a strength for you. What attribute do you feel you would like to strengthen?

Top nursing paper writers on hand to assist you with assignment : NSG 517 Week 4 Discussion Board

 according to NSG 517 Week 4 Discussion Board, recently while at work we had a patient check in to the ER with her chief complaint being bilateral, golf ball sized abscesses noted on the medial side of her elbows. The patient stated that she received these abscesses while admitted to another hospital in the area “because they missed while attempting IV access.” The patient has a history of IV drug use. The wounds were noted to be discolored in areas and necrotic in the center. The PA and myself were in to do our assessment, the patient was refusing to have labs taken and did not want to give a urine specimen.

I believe that in many cases patients come in to an emergency department several times a week for various concerns. As an ER provider, it can be very tiring caring for patients who chose not to care for themselves as stated by NSG 517 Week 4 Discussion Board.  Seeing a patient multiple times for the same complaint makes it difficult in some cases to care for the patient. The way I think I could do a better job is to treat each encounter as a fresh start. Spending more time coaching and educating our patients would allow for better outcomes. A better utilization of resources and more timeliness in dealing with situations we encounter.

The basis, assumptions and behaviors also play a large role in care. We learn to triage patients based on acuity in the ER and some patients end up waiting longer. This does not always end well for staff. Patients and families can become agitated and aggressive towards staff if they feel they have been waiting too long. I think that as far as assumptions go, it can be assumed that if a provider is not in your room for an extended period of time, it is not because we “forgot about you”, it may be that we are caring for a more critical patient. In the ER it is a good thing that you are not requiring multiple resources, it means that you have been assessed and deemed “stable.”

NSG 517 Week 4 Discussion Board states that utilizing the content we read this week about leadership I think that it is important to note that we as providers are put in some very difficult situations. We have to learn to take the emotional part out of everyday scenarios and work on actively listening to our patients. Educating them in making better lifetime decisions for a better quality of life. We need to lead by example.  By focusing on the needs of the patients we can come up with a plan of action that is agreed upon by both patient and provider.

The competency this exemplifies most would be the quality competency. I think that the fact this competency focuses on utilizing the best evidence and most up to date, to care and educate our patients. We evaluate our patients on multiple levels to gage which pathway is appropriate for care and understand that situations and evidence changes. We learn to adapt to increasing evidence and change in a patient’s condition.

I think that as a leader, some of the good qualities I possess are that I am easily approachable, I (despite being in a disorganized environment) am very organized in my patient care to ensure I do not miss important steps. I treat my peers with respect and can handle constructive criticism. The areas I think I could improve in are I need to be more confident in my interactions with MD, PA and DO.

Resources

Tracy, M., O’Grady, E. (2019). Hamric and Hanson’s advanced practice nursing: An integrative approach. St. Louis, MS: Elsevier.

HiMeghan, Your post this week is very insightful. Undertaking healthcare activities encompass involvement in different practices that may be difficult to handle. Emergency room nurses often encounter different patients who may be difficult to handle (QuickRead, 2020). These patients may have different options in their treatment processes. They may also have different ethical practices that may inhibit effective delivery of healthcare processes. In most cases, ER nurses are involved in the treatment of patients suffering from traumatic conditions, injuries, as well as severe medical conditions that may impact their overall health and wellbeing (Tracy, 2019). Emergency room nurses should therefore be able to quickly make decisions to save lives of patients. ER nurses ought to apply their leadership skills to ensure that patients receive the quality of care they require (Davis, 2019). From this week’s reading, it is easier to determine different approaches that can be applied to ensure effective management of patient; this may encompass adherence to specific leadership skills and effective sources of knowledge.

References

Tracy, M., O’Grady, E. (2019). Hamric and Hanson’s advanced practice nursing: An integrative approach. St. Louis, MS: Elsevier.

QuickRead. (2020, March 27). Summary of Difficult Conversations by Douglas Stone, Bruce Patton, and Sheila Heen [Video file]. Retrieved from https://www.youtube.com/watch?v=OWpP46NIMQg (Links to an external site.) (Links to an external site.) 

Davis, W. D. (2019). Moving the Emergency Nurse Practitioner Specialty from Resistance to Acceptance: The Wyoming Experience. Advanced emergency nursing journal, 41(4), 279-281.

Briefly describe a specific example of a work scenario, that upon reflection of this week and last weeks course content, you might have handled differently to reach a better outcome. Reflect on and identify what biases, assumptions, behaviors might have led to the original outcome. Relate this to any of the content you reviewed THIS week. What would you do differently and why?

I work as a charge nurse on a medical/surgical inpatient unit. Early in my career I could never imagine myself taking on such a role, but I have grown into the position over time and now feel I generally do a pretty good job overseeing the care of our almost 40 patients. However, one area where I still have some difficulty is handling confrontational coworkers. The specific example that I thought of for this discussion post involves a scenario with a particularly well liked and hard-working, but also very argumentative, nurse. On this particular day, the nurse had a busy assignment and was due to get an admission. The day had been very busy and we had a very acute population. There had already been a couple of calls to the medical emergency team for patients decompensating and multiple nurses felt behind. According to the to NCG 517 Week 4 Discussion Board, every other nurse working that day had already taken an admission and the majority of nurses had an additional patient over her current assignment. However, the patient coming to her was also quite acute. She looked up the information on the patient and told me she couldn’t take the admission. She said her assignment was too heavy and there was no way she could manage it. I told her that I could help her and we could ask other nurses to help as well, but she was adamant that she would not be able to take the admission. Pressed for time, and if I’m being honest, unwilling to get into a full blown discussion with her, I took the admission myself in addition to my charge duties. The patient was time consuming and taking the admission myself cut into my time to make the assignment for the next shift, be a resource to other nurses, and finish the audits and safety checks that I normally finish before the end of my shift. I ended up rushing through the next shift’s assignment and getting out over an hour late finishing up what I hadn’t been able to complete while doing the admission.

After reviewing this week’s content, I certainly can see many issues with how I handled this conflict. According to Tracy and O’Grady (2018), the three characteristics of the leadership competency are mentoring, empowering, and innovation. I think that if I had handled this situation as a true leader, I would have done a better job in focusing on these points. As a mentor, I should be practicing self-reflection. Self-reflection would have helped me realize that being liked and not upsetting others are definite personal predispositions of mine. In realizing this, I would have been able to consider the meaning and importance behind these predispositions and consider the implications they had on my decision making. In this situation, I assumed the nurse would get upset and confrontational. Because of that assumption, I chose to take on more work for myself in order to not feel the discomfort of upsetting another individual. In making that choice, I made an assignment with less care and was less available to other nurses, which likely upset other, less confrontational individuals. Additionally, as a mentor, I should not only share power with others, but also empower others to do their best work (Tracy & O’Grady, 2018). I should have worked with this nurse to determine how she could manage this incoming admission. Giving her advice, like prioritizing, asking for help, and managing her time would have been helpful in empowering her to handle this situation and also preparing her for when it inevitably happened again. The characteristic of innovation includes being flexible, taking risks, having credibility, and being an expert communicator, among others (Tracy & O’Grady, 2018). In this situation, I certainly could have done better with communicating. As we all know, in healthcare, finding any extra time can be nothing short of a miracle. In this situation, I should have found the time to have an effective conversation about the situation at hand and what was expected. It is not uncommon to avoid conversations in order to preserve relationships (Quickread, 2020). In the book Difficult Conversations, the authors discuss the importance of having conversations that address learning, feelings, and identity. This allows both parties to look at the situation from a different perspective, discuss the potential impact on others’ feelings, and consider how the situation affected each person’s sense of identity (Quickread, 2020). If we had made the time to have a conversation where we both acknowledged these important things, I think we could have come to a better sharing of the responsibility and more lessons could have been learned. Instead, she walked away feeling misunderstood and frustrated, and I felt taken advantage of. Furthermore, my actions set an impractical precedent that won’t always be able to be repeated.

What NONPFcore competency would this change exemplify?

according to NSG 517 Week 4 Discussion Board, the change I discussed would be to communicate and collaborate more effectively so as to construct a plan where the nurse could successfully manage her current assignment and the admission. I think this change exemplifies the competency of health delivery systems. According to Thomas et al. (2012), the health delivery systems competency includes using advanced nursing knowledge to “[minimize] risk to patients and providers at the individual and systems level” (p. 4), “[analyze] organizational structure, functions, and resources to improve the delivery of care” (p. 4) and “[collaborate] in planning for transitions across the continuum of care” (p. 4). My understanding of the current state of the unit and my decision to have her take the admission would reflect my understanding and utilization of the resources available to minimize any patient harm. as stated in NSG 517 Week 4 Discussion Board communicating with her and helping her to manage her assignment reflect collaboration in planning for patient movement within the organization.

What attributes of a leader do you feel is a strength for you. What attribute do you feel you would like to strengthen?

According to Tracy and O’Grady (2018), five attributes of APRN leaders are expert communication skills, commitment, developing one’s own style, risk taking, and willingness to collaborate (p. 272). I feel as though I am a very committed leader and also good at collaborating, and usually with communicating. I work very hard to ensure safety, a positive experience, and quality care. I make every effort to be fair to all of my coworkers, and collaborate with them to determine the best actions to take in order to provide the best care to our patients. I also act as a resource and frequently mentor my peers. I have been commended for my ability to speak up and get my point across when speaking with coworkers, leadership, and patients and their families. I generally feel confident in my communication, but as described in the situation above, I do tend to be more insecure when dealing with aggressive or confrontational parties. I would like to strengthen the particular attribute of risk taking. According to Tracy and O’Grady (2018), risk taking involves self confidence, assertiveness, acceptance of failure and willingness to try again, and coping with change effectively. Generally speaking, I tend to play it safe because I feel like there is so much to lose if mistakes are made as in NSG 517 Week 4 Discussion Board. It is easy to use that as an excuse for stagnation, however. I think my unwillingness to change has sometimes hampered my own growth and thus also has the potential to hamper growth within my unit or organization. I have grown tremendously in my assertiveness since my youth, but I still am not always the most self-confident either. I definitely feel as though my self-confidence and fear of change have held me back as a leader thus far, and would be very interested in improving in these areas.

References

QuickRead. (2020, March 27). Summary of Difficult Conversations by Douglas Stone, Bruce Patton, and Sheila Heen [Video file]. Retrieved from https://www.youtube.com/watch?v=OWpP46NIMQg (Links to an external site.) 

Thomas, A. C., Crabtree, M. K., Delaney, K. R., Dumas, M. A., Kleinpell, R. Logsdon, M. C. … Nativio, D. G. (2012). Nurse practitioner core competencies. The National Organization of Nurse Practitioner Faculties. Retrieved from Rivier University Canvas course page.

Tracy, M. F., & O’Grady, E. T. (2018). Hamric & Hanson’s Advanced Practice Nursing – E-Book (6th Edition). Elsevier Health Sciences (US). https://bookshelf.vitalsource.com/books/9780323447706 (Links to n external site.)

Also read: