2 Responses to discussion. Leadership

  

ALI  Response 1

The work environment assessment showed by place of employment score of 66, mildly healthy. I would agree with this. I want to point out, the low scores on the questions were referring to management only.  Based on these results, the workplace is not entirely civil. The floor staff works excellent together, but we avoid the director at all costs, as far as bringing things up or going to seek them out. It is felt firmly among floor staff that all the director of our unit makes us feel like we are not doing enough, and she cannot stand to be on the unit. This is mainly because we “just aren’t doing things right.”  Often, she has come down and just cleaned up things, asking what we have been doing and why we cannot keep up. We feel belittled and not 100% when she is around. “The toxic environment leads to a decrease in the nurse’s job satisfaction resulting in increased absenteeism and unnecessary turnover. (Schoville & Aebersold, 2020, p. 2).

There have been incivility incidents in the workplace, and people were unsure of what to do at that moment, making it uncomfortable for all. It seems many of the times those incidents get swept under the rug. I can think of the director with a raised voice at one of the providers in the nurse’s station in front of all floor staff.  This was highly inappropriate, and the provider was very hurt. Not being handeled properly, it made everyone uncomfortable.  The provider was going to write an incident report, but in the end, did not. Like many other times, when the director makes people cry, it is ignored because there is no one else to tell.  If we do seek out a higher up, we feel there will be retaliation anyway.

The DESC model is an excellent approach to structuring a civil conversation. DESC stands to Describe your specific situation, express your concerns, state other alternatives and consequence statement. “Using DESC model in conjunction with cognitive rehearsal is an effective way to address specific incivility incidents.” (Clark, 2018, p. 21).

 
 

One way to keep the workplace civil is to have high levels of emotional intelligence. In doing this, staff will be happier and conflict management will be easier.  Keeping personal thoughts and feeling to the side will help the leader focus on the actual problem and the solving. “First, as a leader, it is important to bracket your own emotional responses.” (Marshall & Broome, 2018, p. 286).

 
 

“Interactions among employees can affect their ability to do their jobs, their loyalty to the organization, and most important, the delivery of safe, high-quality patient care.” (Clark, 2018, p. 18).

References

 
 

Clark, C. M. (2018). Combining cognitive rehearsal, simulation, and evidence-based

 
 

    scripting to address incivility. Nurse Educator. doi:10.1097/NNE.0000000000000563

 
 

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert  

 
 

    clinician to influential leader (2nd ed). New York, NY: Springer. 

Schoville, R., & Aebersold, M. (2020). How Workplace Bullying and Incivility Impacts Patient 

    Safety: A Qualitative Simulation Study Using BSN Students. Clinical Simulation in Nursing,

    45, 16–23. https://doi-org.ezp.waldenulibrary.org/10.1016/j.ecns.2020.01.003

Chr Zei Response 2

Workplace civility is essential in providing high-quality care for patients and promoting effective communication between staff. The American Nurses Association (ANA) acknowledges the importance of nurses encouraging and participating in being civil by abiding by ethics and fostering respect. When a workplace lacks civility, it can harm patient care as there is increased employee turnover and a lack of effective communication between staff (Clark, 2015). Civility allows employees to communicate effectively, not always to agree, but to allow for a healthy discussion. Many employees who experience incivility don’t speak up and lose motivation to provide high-quality care. Incivility costs a workplace financially due to a lack of retaining employees and decreased productivity (NIH Record, 2019).

Often, it is the workplace leader’s job to workplace civility and a teamwork mentality. An effective leader must have a clear vision for the team to follow, and when issues develop, the leader is ready to evaluate and resolve the problem. A good team leader ensures that employees have appropriate resources to conduct their jobs and motivate them to collaborate (Marshall & Broome, 2017). A workplace inventory is a tool used to assess how healthy a work environment is. The place that I am employed with scored 79, which indicates mildly healthy. In my opinion, my workplace is civil, for the most part, with some situations and employees that often require redirecting and effective communication. For example, two employees both expressed that they thought they were trying to interfere with patient assignments. These individuals saw a situation in their minds that one another was trying to sabotage each other when I, as the supervisor, made clinical decisions regarding patient assignments with the physician on call. When we all sat down together to discuss this, these two individuals realized that they were feeling overwhelmed at the time and may have misinterpreted the actions of each other. We resolved the situation by creating a safe and neutral space for both parties to express their concerns and mediate the discussion to end with a civil conversation and a healthy conclusion.

Not every situation in the workplace ends with a positive conclusion. It is essential to use cognitive rehearsing to practice what one wants to convey to another staff member. It is often challenging to discuss situations in the workplace, where emotions are heightened. As a leader, it is imperative to guide these discussions when necessary and not turn a blind eye. Ultimately

References

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American

Nurse Today, 10(11), 18–23. Retrieved October 08, 2020, from https://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf 

Marshall, E. S., & Broome, M. E. (2017). Transformational Leadership in Nursing (2nd

ed.). New York: Springer Publishing.

NIH Record. (2019, March 26). Workplace Civility Increases Productivity. Retrieved October

08, 2020, from https://nihrecord.nih.gov/2018/08/10/workplace-civility-increases-productivity.    

Evidence based practice

 

Discuss the following:

  1. Discuss some of the barriers that you would need to consider when desiring to make a change in practice.
  2. Discuss how you would manage the issues you identified at the micro and macro levels within the organization.
  3. Discuss the areas in which you may need to be mentored as you engage in an evidence-based practice project. What needs would you anticipate as they pertain to the development of an evidence-based practice project? 

Void

Reply to this discussion post (site sources if applicable)

My evidence-based practice project is to improve workplace violence by increasing awareness, responding to incidents and improving policies in place. With these new measures in place, the Emergency Department will be a safe place to work. To make my project successful, variables play an important part in improving the process and how to evaluate it.

     I will need to determine the independent and dependent variables to improve the safety of the Emergency Department. Workplace violence on the Emergency Department staff is the dependent variable and the independent variable is the number of workplace violence incidents they encounter. I would evaluate independent variables by collecting data from workplace incidents that had occurred in the last year and interview ED staff to collect data from as many members as possible about workplace incidents.

     The dependent variable is workplace violence (verbal, physical and emotional abuse) on Emergency Department on staff. Studies show that the Emergency Department has higher statistics of violence because of independent variables like stress, long wait times, unpredictable and challenging situations.

     If a process or improved policy is made, it can help improve other departments of hospitals and clinics where WPV occurs. Other dependent variables can include workplace violence in different departments on different staff members that are a part of psychiatric facilities, floors amongst the hospitals and outpatient clinics. When the evaluation of current policies and responses to “Code Greys” are reviewed and analyzed, we can implement changes depending on the variables that are collected.

nursing multidimensional care2

 

Module 11 Discussion – Reflection

Initial Post

Describe how you achieved each course competency including at least one example of new knowledge gained related to that competency.

Describe how this new knowledge will impact your nursing practice.

Course Competencies

  1. Explain principles of care for clients with oncological disorders.
  2. Identify components of safe and effective nursing care for clients experiencing fluid and electrolyte imbalances.
  3. Describe strategies for safe, effective multidimensional nursing care for clients with acid-base imbalances.
  4. Select appropriate nursing interventions for clients with upper gastrointestinal disorders.
  5. Select appropriate nursing interventions for clients with lower gastrointestinal disorders.
  6. Evaluate responses to nursing interventions for clients with endocrine disorders.

i nedd help

  

Pick any Acute Disease (Asthma • Atelectasis • Basal/Squamous Cell Carcinoma • Bronchitis • Chronic Obstructive Pulmonary Disease and Emphysema • Cystic Fibrosis • Influenza • Legionnaires’Disease • Sleep Apnea,Obstructive • Pleural Effusion • Pneumonia • Pulmonary Emboli • Sarcoidosis • Tuberculosis (TB) )

Must use the sample template for your soap note, keep this template for when you start clinicals.

Late Assignment Policy

Assignments turned in late will have 1 point taken off for every day assignment is late, after 7 days assignment will get grade of 0. No exceptions 

Follow the MRU Soap Note Rubric as a guide

Use APA format and must include minimum of 2 Scholarly Citations.

Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)