My Reflection On My Capstone Rotation

Nursing is a predominately caring and compassionate field. Nurses care for their patients and the patients family day in and day out. Yet nursing is not immune to hostile behavior towards their fellow nurses. Lateral violence is the politically correct term for addressing “bullying” in the workplace (Hippeli, 2009). In nursing, the phrase: “Nurses eat their young”, can be commonly heard to describe bully-type behavior. Beacher & Visovsly (2012) describe horizontal or lateral violence done by nurses to nurses as hostile, aggressive, and harmful behavior by a nurse or group of nurses towards a coworker or group of nurses via attitudes, actions, words, and/or behaviors

A number of emotions were felt during this experience, in regards to transitioning from a student nurse to the registered nurse role. Primarily, the transition in role from student nurse to registered nurse was similar to any clinical experience I have had at Midlands Technical College. I was placed in a medical-surgical rotation. I felt slighted that not only were we required to complete a data tool but we also participated in the teamwork model demonstrated in prior semesters. Personally, I did not feel a transition during this particular clinical experience.

Nurses prefer working in an environment where they feel appreciated in both their actions and decisions. In the event that they are ignored, they tend to experience subjection and they are likely to resist. At one time, our healthcare facility sought to implement the bedside shift reporting (BSR). This process would have required that nurses be informed and trained on the use of the documentation. However, this did not happen, on the start of the month each nurse received a formal letter form the chief nursing officer informing us that we would be reporting to a newly hired nurse educator who would evaluate our performance in implementing the BSR. This was met with anger and most of the nurses seemed to have decided that they would not accomplish

One of the critical core components of Skilled Nursing Facility is medication administration. As cited by Tenhunen, Tanner, and Dahlen (2014), they stated that 88% of the residents living in the nursing homes are aged 65 years old and older. They discussed that every five of administered medications in nursing home has one probability of error. This means that about half of the residents have the possibility of two or more medication errors daily. This applies to the Pasadena Care Center (PCC) because its residents are mostly older adults who require medications on a daily basis. Moreover, residents are prescribed with multiple medications, which make them vulnerable to medication errors. The staff at PCC is trying their best to ensure safe medication administration, however, it still in need of a major change. The goal of the proposed change is to decrease the medication errors in this organization to ensure patient safety.

During my clinical rotation during my last semester of nursing school, I was able to work one on one with a BSN degree nurse named Judy in the ICU. Judy had three years of experience in the ICU setting. She had been a medical surgical nurse prior to her ICU transfer. The ICU at this hospital consisted of two associate degree level nurses and two BSN level nurses on my shift. I rotated three days in this particular ICU. I worked with Judy all three days of my rotation. I was excited about being placed with her for she seemed knowledgeable and skilled. We were given a male post trauma patient to work with all three days. This patient was a 30 year old male admitted for trauma related injuries and was considered unstable and was to be monitored in ICU. This patient had been involved in a motor vehicle accident and

Incivility is an umbrella term used to describe any type of negative behavior directed towards another individual that may impact the way that they behave and/or feel. While incidences of incivility may be visible in most professional careers, it’s significance in nursing has prompted a provisional statement from the American Nurses Association. “The nurse creates an ethical environment and culture of civility and kindness. Disregard for the effects of one’s actions on others, bullying, harassment, intimidation, manipulation, threats, or violence are always morally unacceptable behaviors” (American Nurses Association, 2015, p. 4). Dumont, Meisinger, Whitacre, & Corbin (2012)

Acts of incivility such as bullying, lateral violence, or harassment in the work place negatively affects nursing performance, mental health, and retention within an organization or even the profession of nursing (Warrner, 2016). A policy in the American Nurses Association (ANA) proclaims that the nursing profession will not tolerate violence of any kind from any source (ANA, 2015b). The Code of Ethics for Nurses by ANA requires nurses to promote an ethical environment and culture of civility with an emphasis on treating all parties with dignity and respect (ANA, 2015a). A study conducted in a rural Kentucky hospital’s medical- surgical units concluded that educational trainings in itself did not reduce the frequency of experiencing incivility in their unit (Armstrong, 2017). Nevertheless, nurses in the study reported that educational trainings increased their ability to recognize and appropriately respond to workplace incivility (Armstrong, 2017).

Inappropriate prescribing commonly occurs in adults aged 65 or older, who have a higher prevalence of chronic disease, disability, and dependency (Page II, Linnebur, Bryant, & Ruscin, 2010). Exposure to inappropriate medications is associated with increased morbidity, mortality, and health care utilization (Page II, Linnebur, Bryant, & Ruscin, 2010). Below is a list of measures that concentrate on the prescribing of correct medications in the hospital

With the growing reliance on medication therapy as the primary intervention for most illnesses, patients receiving medication interventions are exposed to potential harm as well as benefits. Medicines have proven to be very beneficial for treating illness and preventing disease. This success has resulted in a dramatic increase in medication use in recent times. Unfortunately, this increase in use and expansion of the pharmaceutical industry has also brought with it an increase in hazards, error and adverse events associated with medication use.

Lateral violence (LV), is described as one or more secretly or blatantly targeting their discontentment towards each other, themselves or those weaker than themselves. Some may classify it as bullying, aggression, horizontal violence (HV) or professional terrorism, and it 's characterized by facial expressions, spiteful comments, hindering of important information, criticism, blaming, and disregard in all degrees with some so severe they 've resulted in suicide. Lateral violence has been in literature for 20 years and still vastly exists today (Griffin, 2014). Due to the traumatic effect bullying has on a nurse physically and psychologically, along with the safety of the patients she cares for, interventions must take place immediately to bring it to an end. If LV is allowed to continue, the effects it has on the nursing profession are critical such as nursing shortages, staff burnouts, elevated nurse resignation rates and a decline in the amount and quality of work one performs accompanied with a high potential for patient related errors (Becher & Visovsky, 2012). Organizations, managers and nurses are all responsible for eliminating lateral violence in the nursing workplace because each role directly impacts this major issue through education, tolerance and interactions.

The problem of interest that I chose to discuss is lateral violence (LV) in nursing. LV is a deliberate and harmful behavior demonstrated in the workplace by one employee to another, it is a significant problem in the nursing profession (Christie, 2014). LV is the same thing as bullying someone. Studies estimate that 44% to 85% of nurses are victims of LV; up to 93% of nurses report witnessing LV in the workplace (Christie, 2014). LV can affect the victim’s physical and mental health, it can affect patient care and safety, and can be detrimental to the work environment. LV is often perpetrated by nurse managers and some nurses are afraid to report the LV for fear of retaliation or losing their jobs (Christie, 2014).

Nurses continually strive to bring holistic, efficient, and safe care to their patients. However, if the safety and well-being of the nurses are threatened or compromised, it is difficult for nurses to work effectively and efficiently. Therefore, the position of the American Nurses Association (ANA) advocate that every nursing professional have the right to work in a healthy work environment free of abusive behavior such as bullying, hostility, lateral abuse and violence, sexual harassment, intimidation, abuse of authority and position and reprisal for speaking out against abuses (American Nurses Association, 2012).

Elderly patients that take several medications compound the risk of developing an adverse drug reaction. Not only does the aging process have an effect on how elderly bodies process medication, but elderly people take more medications than their younger counterparts. According to Conry (2005), the elderly patient takes an average of 5 prescription medications and two non-prescription medications (Conry, 2005). While medications are frequently necessary to enhance the quality of life of the elderly, non-pharmacologic methods should be used whenever possible. Healthcare providers need to understand how aging impacts the body’s response to medications, which drugs pose more risk to

As a second year nursing student I felt mixed emotions of excitement and anxiety when I was thinking about my upcoming clinical placement because even though I have been working as a patient care assistant at Royal Darwin Hospital for a year and had already undergone clinical teaching block for one week . The responsibility of being a nurse is big and much complex than my current job [1.2 Fulfils the duty of care] especially when handling assigned patients. Thus, need to have a good supervision from my clinical preceptor to meet the best possible nursing care to my patient with in my scope of practice [2.5 Understands and practices within own scope of practice]. My four weeks of clinical placement was taken place in

About 2:30 in the afternoon, M.E. was in her patient’s room and J.P. confronted her in front of the respiratory staff and students that were present about why she was/wasn’t doing certain things and what was making her so slow; J.P. caught M.E. off guard and was very abrasive, belittling and verbally abusive; M.E. felt attacked and embarrassed, especially since this behavior took place in front of colleagues. J.P. felt frustrated that M.E. was not more competent and efficient in her care and confronted her about it. After the confrontation, there were no words spoken between the two of them for days and even though months have passed, there is still an obvious tension and unresolved conflict between these two individuals. There is currently a noticeable effort being put forth by both women but the conflict they experienced is not yet fixed.