Nursing Internship Analysis: High Reliability Concepts

I have been fortunate enough to work in a teaching hospital for over a decade, on a unit that has a strong sense of teamwork. I have watched residents grow from unsure medical students to capable

Communication includes verbal and written, as well as the ability to document data. One of the most difficult transitions, and a main stress factor, is the new graduates’ ability to communicate with the physicians. Having the ability to be a leader is a key to success. “To be an effective leader, a nurse must show collaborative teamwork, which is consistent with AACN core competencies. To fulfill this competency, new graduates must be able to delegate to others to promote patient safety and health” (Theisen & Sandau, 2013). Conflict resolution with team members and patients was a noted as a skill that new graduates lacked. “Several new graduates expressed concern that they were unprepared to deal with conflict appropriately and professionally” (Theisen & Sandau, 2013). Due to the lack of experience, new graduates are unfamiliar with the proper ways to deal with conflict successfully. Mentorship has been an effective way in improving new graduates confidence in dealing with conflict, because they were guided through real situations. Organization, prioritization, and time management was another identified problem. The ability to prioritize patient care, which has a direct effect on patient safety, is a critical component of nursing. “Both new graduates and employers have

Slide 1: The expectations of nurses today are higher than ever with goals such as achieving top percentiles in nursing and patient satisfaction, to being among the top leaders in quality outcomes, and to build productive work relationships and environments. Nursing leaders serve as the primary link between staff, physicians, and the community. They are expected to be innovative, highly skilled, possess a certain degree of nursing knowledge, and produce qualified individuals to care for the growing population. According to Lorber, Treven, and Mumel (2016) “nursing leadership is pivotal because nurses represent the most extensive discipline in health care”. Because of this growing need for diversity in leadership and my background in the military, I decided to focus on the MSN Executive Track at Chamberlain College of Nursing.

In retrospect, what I learned in collaborative healthcare will be a solid foundation on which I will build my nursing leadership. To render care to the sick irrespective of their values, preferences, age, socioeconomic status, culture respect and dignity, demonstrate that the nurse leader is exhibiting compassion, ethics and knowledge. These aquacades must be continuously incorporated and utilized with professional clinical judgement and evidenced-based knowledge to yield the best patient outcomes (Finkelman, 2012).

Now, the graduate level nurse’s leadership attributes have been described in scholarly sources. Based on the documents of the American Association of College of Nursing (AACN) (2013), essentials of graduate nursing must be skilled in organizational and systems leadership role. Specifically, they are supposed to assume leadership roles in quality improvement and patient safety initiatives while working in the interprofessional team context. APN must use communication in an effective way, with regards to speaking, scholarly writing, and group interaction. Nurse leaders should also demonstrate the working knowledge of the current healthcare system and its essential components, including delivery and payment models, sites of care, roles of various stakeholders in the process of care delivery (AACN, 2013).

As a scholar and leader in the area of medicine, it is imperative to understand how to work as a team to provide the best possible care to patients. “Educators are responding to complexities of today’s medical knowledge by developing educational programs based on current learning theories, such as enactivism, where learning takes place within teams that are actively engaged in clinical environments” (Davidson, Morgan, & Simons, 2012, p. 291). This results in more patients that can place their trust in physicians and nurses who know how to work together as a team.

Leadership and collaboration are integral parts of every role of a DNP graduate (Chism, 2016). The competencies are part of the AACN Essentials, standards of the National Organization of Nurse Practitioner Faculties (NONPF), and Practice Doctorate Nurse Practitioner Entry-Level Competencies (Chism, 2016). The competencies must include leadership skills for greater patient outcomes. Chism (2016) maintains a DNP’s interprofessional collaboration with other discipline is imperative for successful results. A DNP with strong leadership skills will strengthen the practice, which will lead to improved healthcare

During Module 2, we were asked to select a nurse leader and perform an organizational analysis (Norman, 2017). While shadowing my supervisor, I realized that there was much more than bedside nursing. Along with supervising duties, you must be an expert in the area you supervise. Watching my supervisor made me realize that, I do not wish to work in a management position but made me appreciate all the hard work she does to make are unit flow smoothly. Although, the depth of knowledge and expertise in the pediatric and NICU population that she exuberates has inspired me to work harder so that I can become an expert in my

I agree with your statement about student nurses. However, one concern I have is for nurses of the future (student nurses), it is my analogy that they will face great challenges in the future related to health professionals sharing a common understanding of patient safety standards and practices. Many students are left in the hands of even higher degree nurses who have heavy complex assignments and feel they do not have sufficient time to share with students the concept of interprofessional education and learning approach they need, which is collaborative learning. Collaborative learning refers to practice, procedures and situations in settings which learners engage in a common task where each individual is accountable to

I often have a hard time with delegation. There are times when our administrative assistants could be help us prepare documents for meetings, but I am often half done with a report, before I think about delegating. Coming from positions that I had to rely on myself has provided for difficulty letting work go to others. I understand that I will need to change the way I do things to continue to be effective and have enough time to complete my assigned tasks, otherwise my resilience will wane over time and I will become either tired, overwhelmed or unsatisfied with my job. Studies have shown that “innate resilience can be developed or enhanced though cognitive transformational practiced education and environmental support” (Grafton, Gillespie, & Hendersen,

For the busy manager, there never seems to be enough time in one day to do everything. You can create “To Do” lists, plan ahead, abide by a calendar, but in healthcare, an industry that is constantly changing, new tasks arise in response to external and internal environmental changes very quickly. In order to adapt to these changes, a skilled manager must know how to delegate. Merriam-Webster defines delegation as “the act of giving control, authority, a job, duty, etc. to another person”. The National Council of the State Board of Nurses defines delegation as "the transfer of authority to perform a nursing task from one person to another, while retaining accountability for the outcome.”Definitions may vary, but the significance of strategic delegation within an organization is tantamount to the very people who work within it. Delegation is a layered process that has implications for employees, managers, and the greater organization. Empowering staff through delegation is a such a challenge, that a leader with effective delegation skills is essential to the success of any organization. Effective delegation has the potential to boost staff morale, develop more competent employees, and gives managers time to address management level duties. In this paper we will discuss the basic, and most important elements of delegation and the impact it has in the workplace.

In my NUR-301 Class, I had the opportunity to practice on Interprofessional Education. Our nursing student team was partnered with first year pharmacy school students to learn about each other professions and to study on how we could work in a team of healthcare professionals to attain a common goal. As this was my first time experience to meet other students from a different department of Notre Dame of Maryland University, I was not sure what to expect from our discussions. Even if I have some experiences working both in hospitals and in a pharmacy, I was no fully aware of the responsibilities of a pharmacist directly to the patient or to the healthcare field specialists.

According to Twibell (2012) only 10% of nurse executives believe new graduate nurses are completely ready to practice safely and effectively. New graduate nurses reported that they lacked the confidence and skills to practice safely and effectively up to a year post-graduation. This has been found to influence the approximately 30% turnover rate for new graduate nurses in their first year of practice and 57% in the second. Research supports nurse residency programs as strong solutions to this project as they increase retention rates of new graduate nurses up to 96%. One characteristic of most residency programs is an assigned preceptor. I think your project will find that a preceptor training program would be beneficial to nursing

In a professional like yours, integration partnerships are critical; the unique contribution of each member is critical to the value of the work and to creating the context for service (Porter-O'Grady&Malloch, 2016, p. 336). When it comes to teaching nurses structure is important. Each class has to build off one another because in nursing is multi-dimensional. It is important to establish a structure that will best support this effort and the role characteristics of healthcare leadership that will guide its implementation focus on role clarity, autonomy with integration, professional team-based performance, shared decision making, and the means to ensure that the clinical work done is resource effective, timely, and value based, and works to

While advancing from a staff nurse to a preceptor, charge nurse, and now to the Patient Care Manager of the Children’s Emergency Department, I have embraced the teachings and challenges from each role, enabling me to learn and understand the daily life of each member of the nursing team. In each of these positions, I have taken on leadership roles that have allowed me to utilize my natural leadership abilities, yet have challenged me to grow in order to be an effective leader in a real-time hospital setting. During my time at New York Presbyterian/Morgan Stanley Children’s Hospital, I have been surrounded by great leaders who have ignited my inner passion of inspiring others and taught me to lead my team to the next level of their practice. As the chairman of the NYP Quality and