NSG 517 Reflect on and identify what biases, assumptions, behaviors might have led to the original outcome

NSG 517 Reflect on and identify what biases, assumptions, behaviors might have led to the original outcome

NSG 517 Reflect on and identify what biases, assumptions, behaviors might have led to the original outcome

One day over the weekend at work I was charge nurse on my unit. We have a smaller sister unit who also has a charge nurse, but I am in charge of their overall admissions and staffing. We had a completely full census upstairs with admissions waiting; we were very short-staffed lna’s and downstairs had open beds and only short by 1 lna. The charge nurse on our smaller unit has 25 years of experience as opposed to my 3.5 years. She texted and called me multiple times during the day and complained about getting admissions, not having an lna, and how busy they were. I assured her many times I knew of the situation, I was sorry there was nothing I could do about it, that we were running even shorter upstairs with more patients, and we were all going to have to just make it work. Right before the end of my shift she called again requesting help to bring a patient to a test, I sent an lna from our floor to help them with that 1 task but that left us even shorter for a period of time and potentially compromised patient safety. Although not a critical situation, next time I would have once again reinforced that they were going to have to figure it out amongst themselves and do what was needed for that specific patient, as it was not urgent. I was so annoyed by the number of times she complained about things that I gave in and sent her help that was needed more upstairs.  This nurse most definitely has a combination personality of the volcano & the chronic complainer. She complains about things constantly and uses a domineering, arrogant approach to get her way. After working with her for years I have learned not to take it personally, set boundaries, acknowledge her feelings, use fewer words, and try empathy. I find it difficult when interacting with her to hold my ground, she uses her experience and knowledge to manipulate others into doing what she thinks is best. (Sherman, 2013)

The NONPF competency this change would exemplify is quality. This includes evaluating the organizational structure, care processes, and impact of quality along with variations in practice.  (Thomas et al., 2012) In order to maintain quality of care for the majority of the patients I should have not sent the lna down to help. Although that may sound terrible, the variation of being short-staffed puts all parties involves in a messy situation of weighing pros and cons. It is less harmful to risk reducing quality of care for the couple patients’ inconvenienced on the smaller unit versus the much larger number on the larger unit.

As a leader I feel my willingness to collaborate and commitment are two of my strengths. I am able to respect others, build teams, and mentor. I also feel I am able to balance my professional and private life well, listen to my inner voice, engage in self-reflection, and plan ahead. (Tracy & O’Grady, 2019, p.272) I would like to further strengthen my risk taking attributes. I am working on my self -confidence as a leader and willingness to fail and begin again. I feel as though I have a good balance of getting involved, using creative thinking, good sense of timing, and coping with change. (Tracy & O’Grady, 2019, p. 272)

 

References:

Sherman, EdD, RN, NEA-BC, FAAN, R. O. (2013). Dealing with difficult people. American Nurse Journal8(7).

Thomas, PhD, ANP-BC, GNP – chair, A. C., Crabtree, DNSc, FAAN, APRN-BC, M. K., Delaney, PhD, PMH-NP, K. R., Dumas, PhD, RN, FNP-BC, FAANP, M. A., Kleinpell, PhD, RN, FAAN, FCCM, R., Logsdon, PhD, WHNP-BC, FAAN, M. C., Marfell, DNP, FNP-BC, FAANP, J., & Nativio, PhD, CRNP, FAAN, D. G. (2012). Nurse practitioner core competencies. The National Organization of Nurse Practitioner Faculties.

Tracy, M. F., & O’Grady, E. T. (2019). Hamric and Hanson’s advanced practice nursing: An integrative approach (6th ed.). Saunders.

Upon reflection of this week’s readings, I chose to relate my personal work scenario to the Covey’s Eight Habits of Highly Successful People. This past week, I encountered a situation with a disgruntled family member who was upset at the lack of communication regarding their loved one and receiving updates throughout their surgery. As a PACU nurse, I often find that surgeons forget to update family members immediately after surgery as to how the procedure went. This along with the delay in timing that occurs due to patient prep, intubation, closure of the surgery, extubating and transport to the PACU often leads to a longer than anticipated time than families were originally told. Immediately upon arrival to the PACU the patient is cared for on a one-on-one basis and often requires a number of interventions that also take away from my time to call and update the family. So, when a surgeon tells a family member that surgery will take them an hour but the prep time, transport time and immediate care in the PACU add an additional hour or two families tend to assume something went wrong especially when they are not immediately updated by the surgeon at the completion of the surgery. This is the scenario that I encountered this past week. (Tracy, 2019).

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I receive a phone call from the surgery waiting room receptionist stating that my patient’s wife was pacing and crying

NSG 517 Reflect on and identify what biases, assumptions, behaviors might have led to the original outcome
NSG 517 Reflect on and identify what biases, assumptions, behaviors might have led to the original outcome

in the waiting room because she was not updated, and it had been over three hours since her husband had been wheeled off to surgery. The receptionist asked that I come out to the waiting room and speak directly to the family member. Meanwhile, I had been busy drawing labs, performing an EKG, bladder scanning, performing a straight catheterization followed by a foley catheter insertion and directly managing my patient’s airway. I was immediately frustrated by the lack of communication from the surgeon to the family and resolved the issued by going to the waiting room and speaking directly to the wife who was very understanding after we sat down and discussed how her husband was doing.

In the future I think I could draw upon Covey’s first habit which is to be proactive. Historically, particular surgeons neglect to update family members. In the future I will anticipate these situations with better understanding and reach out to the surgeon as a reminder to call the family and also give them an update more quickly upon their loved one’s arrival to the PACU. (Tracy, 2019)

I feel that this proactive change for the future reflects the NONPF core competency of quality. By proactively anticipating which surgeons often forget to call family members and sending them a reminder along with personally updating those family members earlier, I will be anticipating variations on practice and being proactive in implementing an intervention to promote quality in care. (Thomas et. al. 2011)

As a leader in healthcare, I feel that my biggest strength is my ability to be a mentor for both my patient’s and my coworkers. I easily encourage growth and push those around me to see their full potential. I feel my innovation could use some improvement as I am always growing and learning new skills and updated practices. This is an attribute I anticipate will always need focus and attention in my career. (Tracy, 2019)

References:

Thomas, A. C., PhD, ANP-BC, GNP. et. al., (April, 2011). NURSE PRACTITIONER CORE COMPETENCIES. Retrieved September 24, 2021.

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