Complex Adaptive Systems ( Cass ) And The Relationships That Occur Within Them

Bedside reporting involves giving information or a report to the oncoming nurse in the presence of a patient. This method gives the patient an opportunity to ask questions and get clarification regarding his or her care. Bedside reporting increases patient satisfaction, quality of healthcare and nurse-to-nurse responsibility. Hospitals need to design a better handoff process that can easily reduce patient risks and increase patients’ involvement in their care. Emergency rooms shift reports usually take place at the nursing station of every patient care area. The departing nurse gives information verbally to the oncoming shift. Therefore,

The charge nurse is a person who has the duty of a specific department in a healthcare institution for their assigned shift. It should be noted that a charge nurse is a vital job because the person holding this job has to interact not only with the patient and his families, but also has to interact with doctors, nurses, and other staff members in order to update them about the patients that the charge nurse is looking after. The qualification of a charge nurse is to have a master’s degree from a recognized school that is accepted by most of the hospitals. Furthermore, the charge nurse is supposed to have specialization in a specific area so that she is looking after a particular department in the best way possible (Urden, Stacy, & Lough, 2013). The training of a charge nurse usually involves with diverse ways of dealing with the

Everyone wants a sustainable well-functioning health system (Marshall, 2011 qdt Porter-O’Grady, 2016 et al p 325). When nursing and other healthcare managers (nurse leaders) focus on increasing connections, diversity, and interactions they increase information flow and promote creative adaptation referred to as self-organization. Complexity science builds on the rich tradition in nursing that views patients and nursing care from a systems perspective (Porter-O’Grady, 2016 et al p 324 and Holden

Preadmission for example, in a nursing home is done by the manager, the patient’s GP or multidisciplinary hospital staff. It is the nurses or receptionist’s job to take the patient’s information and pass it on to the multidisciplinary team. Managers have the job of overviewing the situation. Discharges are granted by the doctor, social worker, occupational therapist or multidisciplinary team. The domestic assistant cleans the room before and after a patient, they also

Bedside reporting has the primary function of sharing patient information between nurses, as they change shifts. The nurse ending their shift would report all the changes that have occurred in the state of the patient and all measures which have been taken for the respective patient. This information would be transmitted to the nurse commencing her shift, who would then write and further transmit all patient information occurring during their shift, to the nurse coming to replace them.

Traditionally, nursing shift-to-shift reports were organized methods of communication between only the oncoming and leaving nurse, designated to a location such as the central nursing station or nook of a hallway. Shift reports can be considered the foundation of how the day is going to plan out because it introduces the patient, diagnoses, complications, medications, consults, upcoming test and the entire plan of care. These reports are full of complicated and vital information and while set in certain locations that are vulnerable to interruptions, such as the nursing station, medical errors and miscommunication are more likely to be made. The Joint Commission’s 2009 and 2010 National Patient Safety Goals (Joint Commission, 2015) included two patient safety standards, first to encourage patients to be involved in their health care plan and second, to implement a standardized communication process for handoff reports between providers. Soon after in 2013, The Agency for Healthcare Research and Quality under the United States Department of Health and Human Services introduced a set of strategies to improve patient engagement along with safety and quality in patient care. Within these strategies the new method of nurse bedside shift report was developed, which suggests nurses to conduct shift-to-shift reports at bedside in the room of each patient, rather than out of the room. The benefits of this new method were

Once the patients arrive to the unit, if the person belongs to either scheduled induction or C-Section, they are provided with a delivery room. If the patient does not belong to previously mentioned categories, and about to deliver, she is moved to a delivery room. One final category is, where patients come in because they feel that they are about to be in labor or the patients that experience various pregnancy related complications. These patients are monitored by the nurse, seen by the physician and put under observation. If any of those observation patients are about to go into labor, they will be moved to delivery room. The rest of the patients will be treated and discharged. A quick registration will be done for all patients as soon as they enter the unit. Additional documentation for triaged patients will be done after they are moved to triage. For patients in labor or C-Section, it will be done earliest of patient’s

It is no secret that communication is key when providing direct patient care in a skilled nursing facility. However, there is a noticeable lapse in the communication between the care team when providing care to the individual or groups of individuals. Two main parts of any care team are the registered nurse and the certified nursing assistant, as these are the two people whom have the most direct and impactful roles with residents in a skilled facility. The Registered Nurse and the Certified Nursing Assistant play similar roles in providing patient care, but have different roles in its entirety. The role of the Registered Nurse (RN) is defined as having the competency and skill to provide direct and indirect health care to individuals, their families, and communities around them. Services are also provided designed to give out medications, to promote comfort or healing, promote healing, and to also provide the dignity of their patients and patient’s families (American College of Rheumatology, 2015).

According to Butts and Rich (2015), complexity science is a knowledge founded on physics and mathematics that operates using basic principles to elucidate the connection between variables. Butts and Rich add that complexity science is a developing field of interest that is catching the attention of scholars from different disciplines because it provides a different viewpoint on various phenomena of interest. According to Sturmberg and Martin (2009), although there has been an ongoing push for application of complexity science in health care, this is not an attempt to eradicate the reductionistic view. Complexity science only aims to fabricate a new and more comprehensive understanding of the world by unifying both the holistic and reductionist viewpoint (Sturmberg & Martin, 2009).

Due to the patient to nurse ratio on the floor, the floor RN would be more focused on the shift’s operations such as the administration of the medications, ensuring that the patient’s ADLs are taken care of, and collaborating with the inpatient care team when family had demands or questions. On the other hand, the APRN would look more closely on the bigger picture, the care provider would not only look into the patient’s daily needs but also the welfare of the family and the organization. The APRN may dig deeper into the signs and symptoms associated with the psychological or psychiatric aspects of the patient’s condition that can sometimes manifest as somatic or physical illness. For example, the patient might have been sleep deprived due to some emotional stress related to the upcoming court hearing. The APRN would explore on why the patient is having an issue with sleep deprivation, make the care plan, intervene appropriately, and then evaluate the outcome. The APRN could also refer the patient to a psychiatric or legal counseling and assist the patient and family members embrace wellness by establishing trusting care relationships, recognizing the clients’ needs but setting limitations, and reassuring them that the APRN would facilitate towards the resolution of their health care

Complexity is part of the nature of many things in our existence especially those that matter the most. The health industry is a complex system most of all due to the presence of the human factor within it. This particular complexity means that every situation is truly unique based on the psychological characteristics of each protagonist, the context within which they are evolving and the communal rules, sometimes unspoken, that govern the stakeholders. As a result, even a clear cut resurgence of an issue or scenario may fail to resolve if a leader blindly applies a previous strategy without first considering the specific intricacies of the situation (Plsek, 2003).

FG, personal communication, March 1, 2015). The telemetry floor manager is responsible for all aspects of the unit’s operation and management. Mr. FG main job duty is to ensure the floor runs smoothly without any obstacles while providing the best possible patient care. Mr. FG currently has 78 employees (including charge nurses, staff educator, staff nurses, nurse aids, and secretaries) who report to him and he is directly responsible for. Mr. FG delegates some of the daily functions of the unit to the charge nurses, so that the unit runs smoothly while he focuses on other important his other duties. Mr. FG consider himself very professional and approach his staff member in a very professional manner and expects his staff maintaining the same professionalism with him and other team member. He also expect his staff to work as team and resolve any issue on the floor to the best of their ability in this manner. Even though his position as a manager on the floor to lead the team, but whenever there is a problem, he would like his every single member of his staff to be onboard to come up with a solution. Encourages everyone to talk to him whenever they feel the need and known for maintain an open door policy (Mr. FG, personal communication, March 1, 2015). Mr. FG reports directly to Chief Nursing Officer and the vice president of patient care services.

Complexity theory is an approach that may be utilized to understand, study, and manage the complexity of a health care setting. Furthermore, complexity science provides the ability to evaluate the interrelatedness of the elements of a system and their influence and relationships with one another. Utilizing complexity theory, it is clear that the connections of a systems entities must be considered as they tend to complicate outcomes due to the nature of their unpredictability. However, some complex systems display characteristics of emergence within the chaos of complexity resulting in patterns that appear predictable (Kannampallil, Schauer, Cohen, & Patel, 2011).

In the professional setting, knowing the patient through his or her diagnosis, name, history of present illness, laboratory results or reason for staying in the hospital only contributes to the manner of physical care of the patient. However, recognizing the patient 's spiritual needs such as emotional support, mental positivity, and intellectual understanding of his or her situation gives a better assessment, as well as a trusting relationship between the nurse and the patient, as per personal experience. In the ward, it is evident that most of the staff nurses spend their time doing documentations, preparing medications, following-up laboratory requests, as well as reading through the patients ' charts to affirm the physician 's order. Throughout the duration of our shifts as student nurses, I see that the most that the staff nurses get to be conversant with the patient is when certain procedures (such as feeding through nasogastric tube, taking

These past few months have been a painstaking, yet another fruitful semester of brain squeezing activities. It was a challenge having four class courses to finish, a full-time job to fulfill, and a family to care for. Hard work and perseverance, with the grace of God and with the support of the people around me made it bearable. Now that the semester is almost over, the valuable lessons it introduced not only in my mind, but in my heart, encouraged me to be more skillful in listening to the patients and families I interact with every day. Being more sensitive and responsive to their needs, help me move to a higher level of compassion and care. In a chaotic situation, wherein, without the understanding of complex adaptive system (CAS), I