nurse – Page 4 – JRM Nurse Consultants

February 02 2017

Why is Leadership Important to Nursing

Nurses are not often recognized for their professional expertise. I know that when Florence Nightingale started the very first school of nursing her goal was to change how people viewed nurses by educating the nurses (DeNisco & Barker, 2013).

Leadership is important to nursing because without it, there is not going to be anyone to educate new nurses. The baby boomers are retiring and we will need new teachers that are prepared to teach new nursing students as well as students at the graduate level. Recent studies show that nurses that are prepared with their bachelor’s in nursing experienced less pressure ulcers, deep vein thrombosis and hospital acquired infections in their patients. It was noted that although an associate’s degree is less costly and provides the care needed to a patient; by the year 2020 the goals are 80% of nurses will have their BSN and doubling for nurses with their doctorate.

There are organizations that provide nurses of higher education grants to conduct research and be able to make difference. In order for these research projects to be done, it is required that the nurse be able to write a solid proposal request for the grant. This may require the skill of a grant writer, but the nurse must be knowledgeable in the project and what it entails in order to help the grant writer correctly write the grant to fund the project that the nurse wants to do (Laden, 2013).

In Orlando, we have the Florida Nurses Association. It is an organization that will support nurses from the student level through the advanced level. The organization is involved in many things especially any that are legislative where a nurse wants to make a difference. The Florida Nurse’s Association has subgroups called Special Interest Groups ( Sigs), these groups will benefit the members because they are formed to specialize in something that a particular group wants to see changed. For example there is a group called Nurse Entrepreneur Special Interest Group, this groups supports nurses that have an entrepreneur business that they want to start or have started. If there is a group that you want to start for a particular interest that you have and it is not a group already listed here, then after speaking with leadership in the group, if they approve it, then you could start it. The group is responsible for having ten members in it in order for the group to work. A master’s and beyond prepared nurse would be able to conduct research needed for any new programs that need to be implemented.

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].

Ladden, M. D. (2013). The Case for Academic Progression: Why Nurses Should Advance Their Education and the Strategies that Make this Feasible. Retrieved from http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2013/rwjf407597

February 02 2017

Quality and Safety at Well Baby Clinics

Recently, I was speaking with a health nurse at a clinic about the increase in babies being sick due to a lack of well baby check ups and vaccinations. In speaking with the health nurse and in review of her concerns about her well-baby clinic, one of the critical dimensions that came to mind was inquisitiveness to determine whether offering immunizations at her clinic was working or not working to get the parents to come to the clinic. If it is a well baby care clinic, are the parents bringing in the babies for any other check ups? For instance are they coming in when a shot is not needed?

After our conversation, the health nurse decided to seek information about the mothers that were not coming and noticed that there was a drop in the amount of people who came because they did not have public transportation available for them, due to the distance that they lived from the clinic (she is in a rural area). I suggested that there should be some creativity on the clinic’s part to establish a new way for the immunizations to get to the parents.

Creativity and inquisitiveness were two critical thinking dimensions that I identified in this well baby clinic scenario as I was speaking to the health nurse. The structure is the routine immunizations that they provide to the parents at the clinic. The process is based on the age of the infant and that will determine when they come in for their routine immunizations. The outcomes are the hopes of reducing childhood illness, for instance measles (Rubenfeld & Scheffer, 2005).

In thinking, there are a few alternative ways that I think would help the well baby clinic and also help these families. First of all, finding out where the majority of the families that were affected by the lack of transportation live. Once that is determined, locate a school, church or shopping center that will allow once per week or once per month depending on the amount of babies that need immunization, to set up an immunization clinic for those families affected by the bus system. The schools, church and shopping centers are places that parents will need to go to if they have school age children or if they have to buy groceries or attend a church. Even if they don’t attend the church, if it is in the community they have easy access to bring the baby for the immunizations.

Another alternative, is working with the resources available in the community. Perhaps the clinic can find out if the transportation available to take people to doctor’s appointments would be available to bring the parents on a specified appointment day. If the bus can pick up the parents where they used to take the city bus and bring them in to the clinic to get the shots, then go back to the bus stop once the group was done.

When the clinic presents these alternatives to the stakeholders making the decisions on what they will pay to make the clinic a success, it is important to share the benefits for doing the immunizations. If presented in a narrative format, explaining first, the subpopulation that uses the clinic, then the treatment and frequency that they come as well as the consequences of the parents not coming. Presenting the stakeholders with realistic facts if the babies are not immunized and that they can get a childhood illness like the measles, and how an epidemic can spread in the community, is an eye opener. If there are complications from the illness without having proper care to the child or even an adult who was never immunized as a child, there can be an inpatient hospital stay. The inpatient hospital stay would cost the tax payers and stake holders more money when simpler solutions could have been implemented.

In conclusion, education and preventative care is the basis of the well-baby clinic, but when the parent does not have the means to get to the one and only clinic, then an alternative to provide the same service has to be sought to keep the community healthy and avoid unnecessary inpatient hospital stays.

References

Rubenfeld, M. G., & Scheffer, B. K. (2015). Critical Thinking TACTICS for Nurses:Achieving the IOM Competencies (3rd ed.). [Vital Source BookShelf]. Retrieved from http://online.vitalsource.com/books/9781284059571

February 02 2017

Communication Resources

As a nurse leader, one has to be able to communicate with the staff and the patients as well. Nurses are influential in informing people about changes that will affect their health (http://www.health.gov/communication/resources/Default.asp). Patients do not like change, much like we do not like change. In order for you to make an impact on someone to change, the person has to be able to feel that remaining the same will be more painful physically or emotionally than making the change itself. For example, the patient that is a diabetic but insists on eating the wrong foods because they like cookies, cake, ice cream and soda, has to be willing to want to make a change. The obvious change that we want to see is that the patient follows a diet and exercise routine to maintain his diabetes so that he can avoid elevated blood sugars and all the other complications to the body that come from elevated blood sugars.

Sometimes the assistance of oral agents to control the blood sugar is necessary. The painful alternative to not stopping the inappropriate diet would be, monitoring blood sugar four times a day and administering insulin on a sliding scale. The pain of needle sticks and frequent trips to the doctor to manage the diabetes may be an incentive to the patient to follow his diet.

Now on the management side of things, just as communication is going to be the key to our patient accepting change, this is also true for employees. In a previous position, change was always happening. We were dictated and told that the change was here and it was happening effective yesterday as the expression goes. As managers we were to accept it, implement it and move on to the next thing (Stevens & Caldwell, 2012). The employees were kept in the dark and not given much information except to say that the change was here and it had to be done to perfection. An example was a company department goal that was added to the staff evaluation was to have zero mistakes on any reports based on the staff doing their work one hundred percent perfect with no margin of error. It was an unattainable goal as no one in this planet is perfect. The staff was never made aware of this goal and how it would be tied to the financial aspect of the company. If the employee had one mistake this would affect whether they obtained a bonus or a raise.

When I was in a leadership position, my leadership with my team has to be such that I could be and influence to them in a positive way and be able to help them grow and embrace new changes. This was not an easy process for me as I always try to be there for my staff, but there is no one there for me. I opted not to be a transactional leader to my team. I opted to be a transformational leader that will help their team grow in the long run.

References

Stevens, K. R., & Caldwell, E. (2012, August 29, 2012). Nurse Leader Resistance Perceived as a Barrier to High-Quality, Evidence-Based Patient Care. The Ohio State University Research and Innovation Communications. Retrieved from http://www.health.gov/communication/resources/Default.asp

February 02 2017

Rapid Changing Healthcare System

In our rapid changing healthcare system, it is very important to be able to have information at the tip of our fingers so that we can best help our patients. How great it is to have the patient’s medical records available after entering their information in the system when the patient asks a question. My favorite thing about having the patient’s information at your fingertips, is when a patient calls me, to help me remember them I always jot down some personal information about them; for example, one patient loved to watch her Spanish soap operas, another had a pet bird named Sam. Knowing these trivial things helps me build a relationship telephonically with the patient, this allows me to ask about it so that when it comes time to discussing their healthcare and goals, I have established a trust to build a stronger effective care plan.

Critical thinking needs to be incorporated in to the informatics process. Through critical thinking and informatics, we are encouraged to consider our own needs, have positive feedback and think logically to assist us to make good decisions that are based on evidence rather than on emotional feelings (Rubenfeld & Schaeffer, 2014).

References

Rubenfeld, M. G., & Scheffer, B. (2014). Critical Thinking Tactics for Nursing Achieving the IOM Competencies (3rd ed.). Retrieved from http://online.vitalsource.com/books/9781284059571

January 01 2017

Updating Training in the NICU

Most recently a nurse working in the neonatal intensive care unit (NICU) approached me to ask about changing policies at her hospital regarding the updated training that they offer the new nurses on the unit. In discussing the policy that she wanted changed in her unit, I would have to agree with her after reading about the training that they are giving the new staff. If the new staff is watching old videos and training with different staff that have a different approach on how to do things, this will create stress in the learner. There should be two trainers dedicated to teaching the new staff the preliminary things with several nurses trained as preceptors. During the preceptor time, additional staff should be brought in so that the preceptor can properly train the new nurse without ignoring the learner and their needs or neglecting the patients.

The new parents coming in to the nicu to spend time with their babies are already highly stressed, this is why it is imperative that they have a nurse who is confident in the care of their infant. The only way that this can be carried out is through the staff being properly trained. Using a program with a check off system is good as far as having the information taught, but there needs to be a return demonstration on it. Once the new nurse has been taught the things that are required about the unit and has completed the checklist, then the roles should be reversed. Meaning the preceptor becomes the nurse and the nurse becomes the preceptor going through the day with what the job entails and the preceptor documenting how well the nurse mastered the information. This will allow the preceptor to know if the new staff needs further instruction.

In thinking about what the nurse stated that the hospital has to spend money to send staff to conferences, purchase new training videos and new computers, this is a necessity. There is not any amount of money or value that can be placed on the life of a premature baby that a large hospital can’t do to properly train staff. There are online courses and expert teachers that may come and do continuing education monthly at the hospital so that they can save some money on sending staff to conferences. Also sending someone to the conference is a good idea, because they can come back with a wealth of knowledge to update the staff that did not go. Hospitals can also check if there is an option to purchase the conference material after the conference for those that could not attend. Implementation is considered the fourth step in the evidence based practice process. The problem is identified and the solution is noted, however implementing it is what is left to do (Fineout-Overhult & Johnston, 2006).

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The preceptor NICU nurse, should make every effort to make the environment for the new nurse, conducive to learning, the focus should be on the new nurse. The environment should be very comfortable and peaceful, allowing the new nurse to ask the necessary questions that they may have (Pilcher, 2012). In the end, if the investment to properly train new nurses is taken and continued throughout their employment, imagine the efficiency that the unit would have decreasing the stress level of this unit and increasing the patient satisfaction.

References

Fineout-Overhult, E., & Johnston, L. (2006). Teaching EBP Implementation of Evidence: Moving from Evidence to Action. Worldviews on Evidence Based Nursing, 194-200.

Pilcher, J. (2012, January/February). Toolkit for NICU Nurse Preceptors. Neonatal Network, 31(1), 39-44.

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Years of experience in Work Comp, Case Management, Disease Management, Utilization Review and Prior Authorization.

Tag Archives: nurse

Why is Leadership Important to Nursing

Quality and Safety at Well Baby Clinics

Communication Resources

Rapid Changing Healthcare System

Updating Training in the NICU