Complexity In Nursing

An individual's health behavior is influenced by feedback from his or her actions. Small decisions made today can have major, unforeseen consequences tomorrow. A moment's reflection also reveals that the health care system and nursing has the characteristics of a dynamic system in that what happens today affects

By looking back at our past, not only are we are able to determine what has worked and what hasn’t worked, but we can also derive inspiration from the key figures who have influenced positive change in the field of nursing. Knowing that change begins with one person, but can easily develop momentum, inspires me to become a leader and look for ways in which I can facilitate positive

Shirey, M. (2006). Authentic leaders creating healthy work environments for nursing practice. American Journal of Critical Care, 15(3), 256-268.

In the increasingly complex, ever changing environment of today’s healthcare, effective leaders are essential to help drive positive change resulting in increased access to care with positive outcomes for as many as possible. In its 2010 report, The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine (IOM) recognized that nurses are well positioned to play a key role in the transformation of our healthcare system in the United States (U.S.) (Institute of Medicine [IOM], 2010). In The Essentials of Doctoral Education for Advanced Nursing Practice, the American Association of Colleges of Nursing (AACN) specifically identifies organizational and systems leadership as a core competency for advanced

Change fatigue is an organizational term defined as poor emotional responses to attempted change (McMillan & Perron, 2013). Change leaders will fail to follow through, there may be a lack of data transparency, staff are impatient with efforts, resources are quickly diverted to other initiatives, and value is increasingly questioned (Reineck, 2007). It can result from rapid continuous and relentless organizational or individual changes that are implemented in daily work practices (Buchanan et al., 2005). Nurses, as frontline staff closest to patients, are the healthcare group most often subjected to initiatives regarding patient care improvement. Whether as a result of evidenced-based care practices, quality measures, financial incentives, or regulatory statues, the trickle-down effect of change stops with the RN (McMillan & Perron, 2013). Thus, nursing is in the most danger of developing change fatigue. As RN’s are typically the largest part of any healthcare organizational labor force, institutions need to leverage nursing’s power to avoid change fatigue and enjoy positive initiative outcomes (Iacono & Altman, 2015).

Nurses need to understand the constant changes in the nursing profession. The shift is in patient care that transforms from specialty care to primary care and to deliver the care in the community rather than in the acute care area. Nurses would be enabled to practice within the full extent of their education, training, and competency levels creating better care in the health care community (Institute of Medicine, October 5, 2010). As an RN in surgery our department is constantly implementing more defined models of patient care through the use of teamwork, professional collaboration, and education of staff and patients. The nurses in our department demonstrate strong leadership capabilities that ensure the completion of assigned tasks.

This week I read about chaos and disequilibrium in nursing. The healthcare system is experiencing significant changes. The reading made me realize that in times of change and disorganization, one can learn and grow in many ways. If we were to have a positive outlook and perceive times of change as opportunities to learn new skills and decision-making abilities, we would benefit more from it.

This nurse has really enjoyed the book Give and Take by Adam Grant, it has provided a new perspective about what is essential in achieving true success. Grant stated that in the past, success was thought to be driven solely on hard work and determination, but he has come up with new, widely respected, and accepted theories on excelling across all fields. Interestingly, many of the tenets he wrote about, have strong connections to the standards set out by the American Association of Critical-Care Nurses (AACN) to create a healthy work environment. Specifically, he mentions, perhaps indirectly, the importance of authentic leadership, skilled communication, true collaboration and meaningful recognition, this reader feels that is proof that his

Being a registered nurse affords one the option of working in many diverse healthcare settings. In any practice setting the climate of health care change is evident. There are diverse entities involved in the implementation and recommendation of these practice changes. These are led by the Robert Wood Johnson Foundation (RWJF), the Institute of Medicine (IOM), nursing campaign for action initiatives, as well as individual state-based action coalitions. Nurses need to be prepared and cognizant of the transformations occurring in health care settings as well as the plans that put them at the forefront of the future.

Change is rarely seen as blasé no matter what aspect of life is being modified. In Healthcare, it can be quite challenging. While there is an understanding of the need to grow and expand the knowledge base, many Healthcare professionals (HCP) hold steadfast to the model of care delivery that has been the norm. Certainly, it is natural to cling to all that is known when faced with the unknown, even if it has become apparent that the current course is no longer a viable one. A universal understanding of the need for change must exist if there is to be a commitment to change. During this period of evaluation of the current methodology, many things will seem uncertain. To this point, most changes to Healthcare have resulted in an increased demand for nurses, but a deficit of experienced nurses exists. Mandates for evidence-based practice (EBP), cost of care, crippling budget cuts, and decreased satisfaction of personnel due to staffing shortages has forced HCP to reinvent the wheel (Huber, 2010, p. 73). The one constant in this mind-boggling equation is that the patient must always come first.

Changes within healthcare are an essential component in quality and improvement. Organizational changes in the healthcare setting are most often implemented to (a) increase safety, (b) reduce wait times and delays, (c) increase the reliability of care, (d) reduce the cost of care, and (e) lastly to focus on patient centered care. Nursing theories are the result of nurses seeking to improve disparities and generate further nursing knowledge used in practice.

According to Sieloff and Raph, nursing management theories are used to describe, explain, predict or prescribe nursing acts. There are many ways to solve a nursing problem or issue, but nursing management theories are specifically designed for issues nurses and nurse managers come across on a daily basis. Hildebrandt and Persily’s theory of community empowerment is a perfect example of how nursing management could handle the challenges of relocating to a new unit.

After interpreting the journal article Designing a Measure of Complexity Compression in Registered Nurses written by: Krichbaum et al., identifies the true day to day essence’s RN’s experience’s. The research study utilized qualitative surveys completed by a random sample of 122 Minnesota registered nurses to further support the phenomenon of Complexity Compression. Through the benefit of using factor analysis, a widely known statically technique used to determine accuracy of theoretical hypotheses (Grove, Burns, & Gray, 2013). Therefore factor analysis, supports the phenomenon of Complexity Compression among nurses representing “factors ranged from .79-to.89” interpreted, evidence supporting the survey to be valid in accuracy (p.7). In conclusion,

body, mind, and spirit to do the work necessary to effect the change” (Roussel et al., 2016). Besides collaborating in groups, nurse leaders aided in creating the vision, identified goals that benefitted both staff and patients, and promoted and engaged staff in accepting and working toward the Health System’s goals. Their commitment to change showed as they were willing to take necessary actions to complete the work that was needed for change and continue to work after the

By empowering the community of nurses and sustaining employee engagement, patient and employee satisfaction would remain the same, if not increase (6 Leadership strategies for navigating perpetual change in healthcare, 2015). Change is tough for most people and the time to adjust varies with each individual. Taking some time to acknowledge each individual and their needs is an important factor to being a great leader (6 Leadership strategies for navigating perpetual change in healthcare, 2015).