Tag Archives: nurse

Cultural Differences and Beliefs

Our beliefs in about different cultures and patient care should be respect. When I worked as a nurse in labor and delivery, I met parents from different socioeconomic stages and cultures.  During the time that a mother would be in labor, it was interesting to see how the woman from one culture perceived pain vs another culture, as well as the role that the father played in the whole birthing process.  As nurses, we may not understand everyone’s language or their culture, but we are required to use cultural competence to be able to take care of our patients.  If we are too quick to judge another culture because our beliefs are different, we may not be able to objectively take care of our patient.  For example, there are some religions that do not believe in blood transfusions, however, as an adult, they can sign for themselves stating that they are refusing medical treatment and they understand the medical consequences of refusing it.  As nurses, our treatment of the patient and their family after refusing a transfusion should not be different.  We should be respectful of their religious beliefs.

Our own beliefs as a nurse can impact a patient in many ways.  For instance, if you find yourself in a Christian hospital where praying is okay with a patient and encouraged, and you feel comfortable asking the patient if they would like to pray, then you would do that.  Now in the same situation, if you are a nurse that is not very religious but works in a Christian hospital and a patient asks you to pray with them, it can be very awkward for the nurse.  The nurse can let the patient know that she will stay there as they pray and a warm touch of the nurse’s hand on the patient’s hand can be all the comfort that the patient needed.

When assessing a plan of care for a patient, the work situation, their lifestyle, culture, and religious preference will all affect how the plan of care is initiated.  The plan of care involves the patient with his or her own patient-centered goals.  These goals should be measurable and attainable.  There should be an intervention as to how the patient will achieve his or her goals. In the care plan,  there should be an end date as to when the goal is perceived to be completed.  Lastly, at the end of the evaluation date, there will be a review to see if the client was able to fulfill his goal and how much progress they have made.  If they have not fulfilled their goal, what barriers prevented them from achieving their goal?  Then a new plan of care should be started so that the nurse can keep track of the goals and formulate time frames to complete the old ones that haven’t been done.

The medical model defines illness and disease as the absence of it. The World Health Organization (WHO) concentrates on social and medical wellness. In today’s world of medicine, people still run to the emergency room because they do not have a primary care doctor. Therefore, we as a culture have not adopted in full the ability to practice holistic medicine and prevention vs. treating the illness after it has happened. Holistic medicine is noted to have four components; physical, mental, social and spiritual (DeNisco & Barker, 2013).

 

References

DeNisco, S. M., & Barker, A. M. (Eds.). (2013). The slow march to professional practice. Advanced Practice Nursing (2nd  ed., pp. 6-17). [Vital Source Bookshelf].

Leadership Styles and Organizational Changes

The role of the professional nurse when implementing a change is to identify that there is a need for a change (Rubenfeld & Scheffer, 2014).  Once the need for a change is identified by the nurse, the next step is to implement a change in behaviors efficiently and with quality. When identifying the area specifically that needs the change, nurses need to be deliberate in stating the purpose for the change.  When speaking to the target group about making the change, it is important to keep their attention span with non-lecturing phrases.  As nurses we are not always in our comfort zone to explain why changes need to be implemented.  We should be prepared to explain why this change is needed and what improvements these changes will make.

managers

Generally, people will always be resistant to change.  But as professional nurses, our focus is to build trust and credibility.  The goal is to acknowledge that the change is coming and that you empathize with the feelings of the upcoming change (Rubenfeld & Scheffer, 2014).

Where I used to work, they were very involved with ACHA (Agency for Healthcare Administration), because we held a state contract.  Evidenced based nursing was in a sense required as far as the patient care when our case managers were managing a case.  However on the same note, although our case managers were not performing hands on care, they were required to know about all their diagnoses and treatments.  We had social workers and nurses alike seeing the same types of members.  The issue with nurses and social workers seeing the same types of patients is that the social worker is not able to use his/her critical thinking skills in their area of expertise.   They were required to assist members who had complex medical issues for instance, on a ventilator or more complex medical problems.   A suggestion was made when I arrived at my work place to utilize the social workers in conjunction to the nurses to manage the social aspects of the patients, however the decision was denied.  It was noted that ACHA is not paying the company to rethink how cases were managed and by whom because it was not hands on care, it was case management.

There was very little nursing involved in my job role, it was primarily reports and meetings to talk about reports and how to fix these reports.  It was an ideal job for someone that had an interest in perfection of numbers and statistics.  Every other day, there was a new change that was being implemented. We often times questioned why there was a change, but what we were told was that the change was immediate and mandatory.  For the staff case managers, these changes were difficult because the staff was in the field.  They may receive an email about something that needed to be changed as soon as possible, however they may have just returned home at  5pm in the afternoon looking forward to the end of their day and they find  emails with deadlines on multiple items due.  These changes affect the staff because they have to work late hours to get the work completed timely. This kind of change caused many good nurses and social workers to resign.

As nurses or leaders we tend to fall in to the routine of lecturing due to the pressures that we are under.  However two of the six dimensions of dealing with complex dynamic changes are creativity and intuition.  As a leader we should not just teach our group something, we should implement a way to bring creativity in to the change and use intuition to know how to speak to your group.  The best way to implement a change is to get the group to commit to doing the new change and develop a smart goal with them that will allow them to measure their own goals.

The leadership theory that most resembles mine is the coaching leadership style.  The coaching leadership style allows me to work closely with the staff at different levels and  empower them to meet their goals and gain confidence of their strengths so that they can focus on them as they work on their weaknesses.  In my previous job, the leadership style could have been called a dictatorship, however for the purpose of the discussion here it will be stated as coercive.

My manager’s favorite phrase was, “I gave a directive and everyone needs to follow it, any questions (1 second wait) no, good.  It’s due by close of business.”  If questioned on how to juggle that with all the meetings and other directives, the reply was always as a manager makes it happen.  My manager always reminded me that she did not take lunch, breaks and basically had “no life” outside of work and she expected those under her to be like her. She was not a woman who read books as a matter of fact, she indicated that books were a waste of time, for fun she read the ACHA contract that was 350 plus pages because reading any other book was pointless (Barr & Dowding, 2012).

4

References

Barr, J., & Dowding, L. (2012). What makes a leader? In Leadership in healthcare (2nd ed., pp. 13-31). [Vital Source Bookshelf]. Retrieved from https://campus.capella.edu/web/library/home

 

Rubenfeld, M. G., & Scheffer, B. (2014). Critical thinking and patient-centered care. In Critical thinking tactics for nurses: achieving the IOM competencies (3rd ed., pp. 155-180). [Vital Source Bookshelf]. Retrieved from https://campus.capella.edu/web/library/home

Looking up to a Nurse

Have you ever thought about a nurse that you have worked with and looked up to?  What qualities do you admire?  The nurse that I would look up to would be someone who would be respected and trusted by her peers and her staff.

registered-nurse-large

In every organization there are communication barriers, but overcoming them is part of being professional and respectful of others’ opinion.  Another barrier that is seen in management is the inability to show respect to other team members and allow a learning environment. I agree that it is important for leaders to obtain feedback not only from their staff but from their peers.  The leader must be able to deal with the different personalities of the team that he/she is managing without letting personal feelings get in the way.

community

 

 

A True Leader

A true leader  places their staff before themselves and will work the job that their staff does so that they are familiar with it.  When I first moved to Florida, my first boss here was named Patty and she said to me when I started that she is the supervisor but she said to me that she will do the same job that I do.  She taught me that being a good manager means knowing what your staff’s job is and how to do it.  The reason being is because if you have someone who is out sick and there is not coverage, you will be able to jump in and help.  When thinking about Patty, she was a great leader because she encouraged me in the decision making process (Baer, 2012).

true-leader

As a nurse  I admire her because she followed Kouzes and Posner’s leadership model.  This model focuses on setting a vision, being a role model and enabling people to grow.

kouzners-practice-model

This is similar to John Kotter’s process for leading change in this day and age.

8steps

 

References

Baer, J. (2012). Theories of leadership. Leadership in health care (2nd ed., pp. 45-69). [Vital Source Bookshelf]. Retrieved from https://campus.capella.edu/web/library/home

Leadership Attributes

When a nurse leads by example and is not afraid to do the work that the  staff does, it makes for a strong leader. The people who follow that leader will know that although the nurse is in a position of higher authority, the nurse will still be humble enough to do the job the staff does and be able to explain it from their side and understand the position that they are in.  Knowing the staff’s job by example, allows the manager to know the timeliness of things that need to be accomplished and the ability of each worker’s caseload and what they can manage. A good leader will follow the  seven attributes to being a good leader vision, courage, integrity, humility, strategic planning, focus and cooperation (Baer, 2012).

nurse-managers

References

Baer, J. (2012). Theories of leadership. In Leadership in health care (2nd ed., pp. 45-69). [Vital Source Bookshelf]. Retrieved from https://campus.capella.edu/web/library/home