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WAC PAPER PLAN 2

Ann Nonymous

N450

Plan for WAC Paper

Introduction

Briefly introduce topics of workplace violence and advanced directives. Discuss the ethical dilemmas that can arise on a daily basis when engaging in direct patient care within the healthcare setting.

Workplace Violence

Definitions and Explanation of Workplace Violence

· Discuss the difference between violence occurring between patient and nurse and violence occurring between a nurse and another member of the healthcare team

· Discuss different types of workplace violence: physical, emotional, bullying, intimidation

· “Current literature reports that 20–25% of nursing staff experience bullying behavior” (Wilson, 2016, p. 303).

Impact on Safe Patient Care and Nurse Retention

· Discuss the implications violence can have on nurse’s attitudes and beliefs associated with their job functions

· “those bullied felt isolated, insecure, fearful, and not valued. They also felt powerless, undermined and vulnerable” (Wilson, 2016, p. 304).

· Leads to burnout and nurses leaving due to the maltreatment received

· “Bullying can cause distress and depression, with up to 25% of those bullied leaving their jobs or the profession, and have an impact on patient care” (Wilson, 2016, p. 303).

Evaluation of Rapport between Nurse and Physician

· Within the case study videos, the Physician was annoyed and upset at the fact that the nurse was following proper protocols in regards to obtaining an informed consent. She was rude not only with the nurse but with the patient as well.

· It seemed like the physician was doing the surgery that day only because she would not be there the next day to perform the surgery, not solely because of the severity of the patient’s infection

· The nurse caring for Mary took the appropriate steps in getting her manager involved. Since she did not receive any changes in the physician’s stance on the issues, she involved her manager to advocate for her patient. The manager was then able to initiate conversation with the physician and explain her feelings regarding the legal protocol for informed consents.

Appropriate Leadership and Management Behaviors and Skills

· “People don’t report because they fear retribution, they accept it as part of the job, they don’t think management will do anything about it, or they don’t think that it is severe or serious enough” (2016, p. 44).

· “Good leadership has a profound effect upon organizational effectiveness” (Marquis, 2012, p. 4).

· Leaders are those who follow the proper rules and regulations set by an institution while also building upon good relationships with all staff and patients. They have a joy for the work they do and other staff can see their passion and are willing to follow their lead.

· Just because someone is in a management position does not make them a good leader.

· “Two of the most important responsibilities for a leader is providing vision and being a mentor to followers” (Marquis, 2012, p. 8).

· Reference tables 1.1 and 1.2 in textbook

Advanced Directives

Nurse Responsibility with Advanced Directives

· Provide the patient with all of the information necessary for them to make an informed decision and get help from other interdisciplinary team members like case managers and Chaplains if more information or assistance is needed.

· Facilitate discussions with the patient between family and other pertinent healthcare team members on their wants and wishes.

· “The living will is a document by which a person can register, in accordance with their wishes, which treatments to be submitted to in the case of an incurable disease, to ensure the patients right to die with dignity, in accordance with their personal views” (Cogo, 2015, p. 265).

· The Code of Ethics also supports nurse’s advocacy for patient’s decisions. For example, they recommend that “the choices and values of the competent patient should always be given highest priority, even when these wishes conflict with those of the health care team and family” (Nursing care, 2012, p. 2).

Evaluation of Nurse’s Advocacy for Patient

· The nurse did a great job of involving the physician in the discussion with Tom’s family member regarding the wishes he had verbalized prior to him becoming unresponsive. She took the time to explain to Tom’s son that Tom did not want any “heroic measures” taken to keep him alive. He expressed that he made peace with himself and God and was emotionally and physically ready for when he passes.

Observations Regarding Leadership and Management Skills Used

· The nurse really advocated for what Tom had expressed to her. She was professional, respectful, and compassionate in the way that she approached discussing this difficult time with Tom’s son. She stated Tom’s words and wishes directly so that his son would have a better understanding and acceptance with his father’s wishes. She also included Tom’s longtime physician in the conversation who was there to express not only her professional opinion but her personal one as well-being Tom’s friend.

Evaluation of Leadership and Management Skills Use and Responsibilities and Action Taken

· The nurse was very compassionate and professional in her approach. These are great qualities to aspire to have when being a leader.

· Other skills used were “intelligence, confidence, personal integrity, and interpersonal relationship skills” (Marquis, 2012, p. 11).

· “Confidence and Courage: Believe in yourself and your convictions; have the strength to assert yourself and push forward when you believe in something. Leaders need to have ‘executive presence’” (Mancilla, 2015, p. 38).

· “It is important that leaders or managers understand the ethical and moral dimensions of what they do so they can act professionally, morally and with integrity, while also creating the culture and setting an example as to how other members of the staff will act” (Ellis, 2016, p. 58).

· “Only when managers are able to support staff in ethical and moral decision making can they help reduce the impact of moral distress in their teams” (Ellis, 2016, p. 58).

· When members of the nursing team act ethically and respectfully for their patients and their families, it allows for a more therapeutic relationship to be made and better patient outcomes that adhere to their individualized wishes and wants, especially in regards to advanced directives and end of life care.

Conclusion

Briefly summarize the leadership and management skills witnessed and practiced within the case study videos. Relate it to real life situations that will be encountered by nurses, especially when they are experienced by new graduate nurses.

References

(2016). Healthcare violence now a public health issue: Moving beyond limited occupational risk review. Hospital Employee Health, 43-44.

Cogo, S. B., & Lunardi, V. L. (2015). Anticipated directives and living will for terminal patients: An integrative review. Rev Bras Enferm, 68(3), 464-474.

Ellis, P. (2016). Leadership skills: the ethically active manager. Wounds UK, 12(1), 58-60.

Mancilla, D., Guyton-Ringbloom, C., & Dougherty, M. (2015). Ten skills that make a great leader. Journal of AHIMA, 38-41.

Nursing Care and Do Not Resuscitate (DNR) and Allow Natural Death (AND) Decisions. (2012). ANA Position Statement, 1-14. Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Ethics-Position-Statements/Nursing-Care-and-Do-Not-Resuscitate-DNR-and-Allow-Natural-Death-Decisions

Wilson, J. (2016). An exploration of bullying behaviors in nursing: A review of the literature. British Journal of Nursing, 25(6), 303-306.

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WAC PAPER:

Annotated Bibliography

– Patient Education and Service

Olubunmi Salako

Methodist College

N450: Leadership and Management in Nursing

Professor Lucia Bobby

January 2021

Annotated Bibliography

Annotated Bibliography

Salem, O. A., Aboshaiqah, A. E., Mubaraki, M. A., & Pandaan, I. N. (2018). Competency based nursing curriculum: Establishing the standards for nursing competencies in higher education. OALib, 05(11), 1-8. 

https://doi.org/10.4236/oalib.1104952

Competency is one of the essential standards of all health care professionals when offering care to patients. In this article, Salem et al. (2018) observe that the practice of

good nursing starts primarily with the study of nursing programs and in the development

of a nurse with high efficiency in the nursing skills. Additionally, the researchers

examine the concept of nursing competencies and their significance in implementing

national transition programs. The paper is objective as it uses college of

nursing standards, which are already tested and proven effective in assessing

competency. The biases, however, rest in the fact that the researchers fail to examine

other essential competency dimensions, such as quality of care and patient satisfaction.

The writers are competent researchers who have served in many nursing schools as

professors and researchers and government agencies that perform health

functions. The lead author, Salem, O.A, is an Associate Prof. of Nursing Administration Department of Nursing Administration and Education, Faculty of Nursing, Menoufia University. The authors declare no conflicts of interest regarding the publication of this paper. The article is relevant because it highlights the importance of competency in observing standards of nursing practice.

Darwin John, B., & Jacob, S. (2019). Impact of an educational intervention on care burden among the caregivers of patients undergoing hemodialysis. International Journal of Nursing Research, 5(3), 81-85. 

https://doi.org/10.31690/ijnr/86

Compliance with standards of practice is one of the most important drivers of patient education. In this article, Darwin & Jacob (2019) state that hemodialysis patients’ quality of nursing care should conform to care standards. To them, this practice is regarded as a starting point for the better and excellent technique. Thus, the researchers examine the effectiveness of education and training interventions on nurses’ compliance to hemodialysis patients’ nursing care standards. However, one of the sources of biases is the researchers’ use of non-experimental designs, which are not useful in assessing the observed patterns’ causality. The writers declared no potential conflicts of interest about this article. The authors have taught and headed nursing faculties in the Department of Medical-Surgical Nursing, MGM New Bombay College of Nursing, Navi Mumbai, Maharashtra, India. The paper is relevant because it explores the efficacy of providing educational programs to promote nursing care standards.

Pollack Porter, K. M., Rutkow, L., & McGinty, E. E. (2018). The importance of policy change for addressing public health problems. Public Health Reports, 133(1_suppl), 9S-14S. 

https://doi.org/10.1177/0033354918788880

Health policies play an integral role in addressing the health problems of a particular group. Pollack et al. (2018) state that some of the nations’ leading public health successes cannot have been possible without promoting policy change. Using policies such as Ten Great Public Health Achievements and Motor vehicle safety as examples, they observe that such laws have reduced morbidities and mortality rates. However, one potential bias is that they fail to provide an accurate metric for evaluating the effectiveness of health policies on target populations’ health outcomes. The researchers are qualified health professionals who hold masters and doctoral degrees in public health and nursing. Pollack Porter, Ph.D., MPH, is a Professor of Health Policy and Management and Vice Dean for Faculty. Her work uses injury epidemiology, health impact assessment (HIA), and mixed methods to advance policies that create safe, healthy, and equitable environments where people live, work, play, and travel. The article is relevant to the topic as it sheds light on the importance of policy formulation in reducing many public health problems.

Stabile, B. (2020). The persisting importance of rhetoric and equity in health policy and outcomes. World Medical & Health Policy, 12(2), 86-89. 

https://doi.org/10.1002/wmh3.344

One of the purposes of health policies is to reduce disparities across different groups. In this scholarly article, Stabile (2020) examines the persisting importance of rhetoric and equity in health policy analysis, implementation, and outcomes. The author argues that applying social determinants of health and intersectional rhetorical frames can improve life and health outcomes in morbidity and mortality. One bias of the study is that it fails to explain how morbidity arising from such policies can be differentiated from regular occurrences. The author provides an authoritative source because he works for the World Medical Health Policy. The article is relevant to the topic as it examines the significance of health policies in reducing disparities.

Gamache, R., Kharrazi, H., & Weiner, J. (2018). Public and population health informatics: The bridging of big data to benefit communities. Yearbook of Medical Informatics, 27(01), 199-206. 

https://doi.org/10.1055/s-0038-1667081

Health informatics plays a vital role in improving awareness and promoting health education. Hence, Gamache et al. (2018) examine the recent public and population health informatics literature to identify the synergistic bridging of electronic data to benefit communities and other populations. The study’s primary source of bias is that it uses very few studies to conduct a systematic literature review. The researchers are trained health care professionals with a doctoral level of qualification. The research is relevant in reducing barriers to the access of health care services among different groups and classes.

Rahimi, B., Nadri, H., Lotfnezhad Afshar, H., & Timpka, T. (2018). A systematic review of the technology acceptance model in health informatics. Applied Clinical Informatics, 09(03), 604-634. 

https://doi.org/10.1055/s-0038-1668091

Embracing health care innovations can help to improve the quality of care and patient outcomes. In this paper, Rahimi et al. (2018) examine the published studies on the technology acceptance model (TAM) use in health information systems development and implementation. Using a systematic literature review, they ide4ntify telemedicine, electronic health records, and mobile applications as the three major health information systems used in care. One potential bias of the study is that the researchers may fail to identify other uses other than the three. The authors are qualified health professionals with a doctoral-level qualification in research. This study is relevant in identifying ways in which information sys5tems can be employed to improve patient outcomes.

Morabia, A. (2020). Pandemics and the development of scientific methods in the history of epidemiology. Colombia Medica. 

https://doi.org/10.25100/cm.v51i3.4564

In this article, Morabia (2020) explores the models developed to curb pandemics in epidemiology history. Pandemics are important events that can exert urgent pressure to determine new approaches of studies to prevent them. Using the plague and malaria as cases in point, the researcher assesses the essential tools used to avoid future pandemics. One bias of the study is that it fails to examine the modern pandemic, such as COVID 19, and its informed practice. The researcher holds a doctoral degree in epidemiology and public health. He is an epidemiology professor at the Barry Commoner Center for Health and the Environment at Queens College, City University of New York. This study is useful in providing evidence-based interventions to reduce the spread of pandemics.

Elhami, S., Saberi, K., & Ban, M. (2017). The challenges of implementation of professional ethics standards in clinical care from the viewpoint of nursing students and nurses. World Family Medicine Journal/Middle East Journal of Family Medicine, 15(9), 149-153. 

https://doi.org/10.5742/mewfm.2017.93117

In this study, Elhami et al. (2017) stress the importance of ethical practices in upholding care practice standards. To them, the process of observing professional ethics amounts to providing nursing care and are inseparable parts of the profession. They use the descriptive cross-sectional study to determine the barriers of observance of professional ethics in clinical care standards. While the study does not present any bias, descriptive design may measure correlation without causation. The researchers are senior lecturers in leading medical schools in Iran. The lead author is the head of the Student research committee, Abadan school of medical sciences, Abadan, Iran. This study is relevant to the topic as it explores the relationship between upholding ethics and embracing nursing practice standards.

Name: Olubunmi Salako

Date: 1/26/2021

Identification of Scenario & Proposal for Integration of Coursework

Identify the leadership scenario you have chosen for the assignment: Scenario #3: Patient Education & Services

Integration of Coursework

For this assignment, you are to integrate knowledge, content, and/or skills learned in your non-clinical nursing and general education courses. You must use two non-clinical nursing courses, with at least one being an upper-division course. You must also use two general education courses, with at least one being an upper division course. (Note, if any of the courses were not taken at Methodist College, you will need to provide a syllabus for the that course with this assignment.) You will use the knowledge, content, and/or skills from your chosen courses to help you make an argument for the benefits of a BSN for a nurse leaders and to help you devise and carry out a solution to the problem in the scenario.

1. Non-Clinical Nursing Course

Course number & title:N211: Standards of Nursing Practice

Course content to be used: I intend to use the nursing ethical principles of totality and integrity and the principle of beneficence in my scenario analysis. I will use these principles to justify to the charge nurse why it is essential to show compassion and consider J.B’s needs and concerns when offering medication, education, and therapies. Also, I will use these principles when preparing my plan of action.

2. Non-Clinical Nursing Course

Course number & title: N431: Health Policy

Course content to be used: In this course, I learned key healthcare components such as organization and financing of patient care services. I also learned how reimbursements are structured. I plan to use this knowledge to identify health issues affecting J.B and advocate for appropriate healthcare policies to advance his needs. Also, I will strive to determine processes that can be influenced by advocacy groups, healthcare professionals, and governments to help J.B and patients with similar concerns. I will also use the knowledge acquired during this coursework to explore how J.B’s socio-cultural practices, legal, political, and economic factors impact healthcare delivery, and practice. I will participate in political processes as well as grassroots legislative initiatives to influence healthcare policy that provides the needs of aged patients such as J.B. Most importantly; I will take into account the impacts of healthcare policies on various issues such as access, equity, social justice, as well as affordability in healthcare delivery when developing my plan of action.

3. General Education Course

Course number & title: HS 200: Introduction to Informatics for Healthcare Professionals

Course content to be used: In HS 200, I learned about lower-level informatics concerning computer applications and healthcare information systems. In particular, I learned about general computer information, healthcare specialty applications, and healthcare information systems. I plan to use my knowledge of healthcare informatics to enhance J.B’s privacy and confidentiality while at the same time ensuring ethical use of electronic and digital channels of communication. Understanding healthcare informatics components and concepts will help me evaluate social, legal, and political factors affecting patient-centered care to J.B and old patients. Moreover, I will use the knowledge acquired during this course work for civil engagement, conduct inquiries and analyses, and engage J.B and patients from different cultural backgrounds. I can apply health informatics’ evidence-based practices, especially in leadership and management, to develop my action plan.

4. General Education Course

Course number & title: PH 300: Epidemiology

Course content to be used: In PH 300, I acquired essential knowledge about the scope of practice and scientific methods involved in the study of epidemiology. Specifically, I learned how to apply epidemiologic methods to clinical sciences and use findings from investigations and analyses for policy generation. I plan to use this information to inquiry and analyze the source of J.B’s feeling of loneliness and other concerns. I will assess various alternatives to solve J.B’s problems through quantitative reasoning and deductive and inductive reasoning. In essence, I will use the knowledge acquired during this course to understand patterns and causations of J.B’s disease. Moreover, I will assess social and behavioral epidemiology and unique applications.