Rosie Moore – Page 6 – JRM Nurse Consultants

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

Implementing Changes

Many nurses ask themselves, how can we as nurses implement changes in our units and departments? One way to implement change is by communicating in a narrative format; doing a synopsis of what has been happening on our unit or department. For example, how many patients have had complications as a result of coming in with an ulcer to the unit vs. the ones that may develop them in the hospital? Without laying blame on anyone, if this study is brought as a statistic and narrative then it may help the nurses see the importance of proper documentation on initial admission.

Everyone is always afraid of change but if presented in such a format where they are given the time to learn it, for example paid education to come to the training on an off day with different options given for the training based on the two or three shifts that a hospital or facility has. Once the plan is implemented for training, being able to have the educators follow up with how each nurse is doing, will show the staff that the management genuinely cares. It is important to know if the new transition towards the change is working and if not why, so that the training can be revamped. Once the nurses see that the change is going to make their jobs easier and the patient’s quality of care will be raised to a new level, they will be more receptive.

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

January 01 2017

Best Practices for Informatics

The informatics that is available to nurses is amazing. Although there is always going to be something that someone thinks of that will improve the quality and speed of how we do our jobs, we as nurses have to be willing to have intellectual integrity that moves us beyond our own needs (Rubenfeld & Schaeffer, 2014). I used to work remotely from home as a manager for field case managers. Our case managers would go out in the field and see the members on our health plan. They carried a laptop so that they could document anywhere and pull up their member’s information. Of course the security to get into the laptop was only via an ever-changing token so that they could access it. With protected health information, the nurses had to be extremely aware of technology.

Years ago, many nurses had to document on paper when they would visit a patient in their home and they carried a paper chart in their car. Informatics has improved in leaps and bounds.

When the case manager is at the member’s home, they are able to do their assessments right in the member’s home and share the outcome from the assessments with the member. Meetings were held via WebEx when we had them because everyone worked from home. This made training on a new process easier giving everyone the ability to receive new information at the same time.

We also had a patient interface after the member was enrolled in our program. The member would get in the patient status screen and would be able to add goals to their plan of care that they wanted to work on. When the member filled this out, the nurse on the file would receive an alert that someone updated their file.

Close-up of happy female doctor talking with senior patient at clinic.

I see many opportunities for transforming knowledge from the use of informatics. For instance if we were able to send doctors an email right from the member’s file, and get the reply from them instantly, it would cut back on the time and phone calls to doctors to get certain forms filled out for the teams throughout. Some nurses that did not grow up with computers may have a challenge adapting, but with some education that can be done right from WebEx, they can learn. Computers and their programs are not going anywhere; they are the wave of the future.

References

Rubenfeld, M. G., & Scheffer, B. (2014). Critical Thinking Tactics for Nursing Achieving the IOM Competencies (3rd ed.). [P2BS-11]. Retrieved from http://online.vitalsource.com/books/9781284059571

January 01 2017

Culturally Competent

In today’s world, there needs to be more education of staff on diversity of cultures. In healthcare it is very important to have all staff, not just nurses, be aware of the different cultures that come in to the hospital, nursing home, rehab centers and doctor’s offices. Health and illness are looked at in many different ways by different cultures. Take for instance the Hispanic population; it is one of the fastest growing ethnic groups in the United States.

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There are many health risk factors in the Hispanic population. Some examples of health risk factors are smoking, uninsured under the age of 65, diabetes, diet, hypertension, obesity and low birth infants. There are also many causes of death seen in the Hispanic population for instance, heart disease, cancer, unintentional injuries, stroke, diabetes complications, chronic liver disease, homicide, influenza, pneumonia and disorders originating during pregnancy.

Hispanics are challenged on a daily basis because they have environmental and community risk factors as well. This group has limited access to healthcare, problems with immigration status, language barriers, cultural barriers, lack of preventative care, and lack of insurance and dangerous work conditions at times.

As nurses we need to be able to provide culturally competent care to our patients. At times rather than just going through the motions of medicating patients, we need to process the information that we are receiving. There are several strategies that we as healthcare workers can use. The first strategy in assuring culturally competent care should be evaluating the healthcare professional’s individual approach to the culture that is being worked with by asking yourself questions. Am I aware of my own biases and prejudices towards the group I am treating? Do I have the knowledge and skill to conduct the assessments that are needed in a sensitive manner? Do I seek out to interact with other cultures other than the ones I am comfortable with? Do I really want to be culturally competent? (Jeffreys, 2008) Another way that nurses can become more culturally diverse is by gaining the patient and family’s trust.

References

Jeffreys, M. (2008, November/December). Dynamics of Diversity Becoming Better Nurses through Diversity Awareness. NSNA Imprint, 36-41. Retrieved from http://www.nsna.org/Portals/0/Skins/NSNA/pdf/Imprint_NovDec08_Feat_Jeffreys.pdf

January 01 2017

Critical Consciousness

My awareness of critical perspective has expanded beyond the arena of where I work, it has involved my charity The Gift of Life and my wedding business 27 Miracles. I started out my nursing career working in a high risk labor and delivery unit. In labor and delivery you meet all kinds of people from different walks of life, different religions, different ethnicities and socioeconomic status. During a critical time such as labor when there is pain, this is when you learn about other people’s cultures and how pain is perceived by them. As a nurse we learn about those different cultures through experience so that when we do encounter them, we can understand what level of privacy and respect they need.

My husband and I own a wedding and event planning business called 27 Miracles. Through the years we have become well known in our town for working with ethnic weddings from different countries as well as interracial. It has allowed me as an individual to learn many cultures and be able to show respect for other cultures and their ways of communicating. It is a beautiful thing to see love spoken and expressed in so many different languages and cultures through music, food and traditions.

I have learned through my nursing experiences and my wedding experiences how to appreciate people more and take interest in who they are as a person. As nurses we get busy when we work on the floor or in an office and talk about our patients as just another number because we are in a hurry. Even on our busy days, we need to stop along the road and take a moment to say hello to our patients, provide a gentle touch to their hand or shoulder, and a listening ear. These are all part of critical perspectives or as I like to call it cultural awareness.

Many say that the parents of premature babies experience preterm birth because the parent did something wrong, they smoked, drank, did drugs or a teen age pregnancy caused the premature birth. Although some of those reasons may be true, there is another side to prematurity that people do not think about. The mother that develops maternal illnesses like Diabetes and Hypertension, or the baby that for some reason starts developing intrauterine growth retardation and it is unsafe for him or her to be inside the womb. It is very easy to judge when you don’t know the situation or have never experienced it, but as nurses we need to develop ways of thinking that allows us to be aware about ourselves and those around us (Gotzlaf & Osborne, 2010).

Working with a population of parents that have premature babies, has shown me that premature birth happens all over the world. Premature birth limits no race, religion or economical status. Our job as a nurse is to be aware of the different cultures and take the time to learn about their culture and how you can work with that person.

References

Gotzlaf, B. A., & Osborne, M. (2010). A Journey of Critical Consciousness: An Educational Strategy for Health Care. International Journal of NursingEducation Scholarship, 7(1), 1-15. http://dx.doi.org/ 10.2202/1548-923X.2094

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

Tag Archives: Rosie Moore

Rapid Changing Healthcare System

Implementing Changes

Best Practices for Informatics

Culturally Competent

Critical Consciousness