Safety, Quality, and Leadership in Nursing
Katherine E. MacEnany
Normandale Community College
Safety, Quality, and Leadership in Nursing
The focus of this writing is to establish the role of a professional nurse within organizational systems. To coordinate this writing an interview was conducted with a professional nurse who identified his experiences with safety, quality, and leadership. Through examination of leadership roles, team collaboration, client outcomes, safety, social justice, and political influence, the responsibility of the professional nurse can be appreciated.
Nursing and Leadership Roles
The discussion of professional nursing was conducted with a recently graduated Registered Nurse (RN) named A.
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The nurse’s role includes teaching the client, as well as their families, how to care for themselves. Nurses can teach clients many skills, such as self-care, how to administer medications, and components of a healthy diet. Further, the expectation of the nurse is to provide education tailored to their client’s individual needs dependent on education level, age, cultural background, language, and personal experience (Trakalo, 2014).
Collaborative Strategies and Team Building
The team that provides care to patients at this facility would include the nurses, NSTs, OT, PT, respiratory, and the providers. Among these care teams, the providers are also assigned within teams that are focused around a set of medical issues such as orthopedics, hematology, and neurology (A. Jimenez). Nursing staff is a key influence to the interdisciplinary team as it is the link between providers, and the care team. As nurses assess the patients day in and day out, they are fundamental to monitoring and reporting patient changes within the team.
While A. Jimenez stated that the facility lacked scheduled exercises to foster team building, he still felt the members of the team have a strong sense of group cohesion because of how closely they communicate day-to-day. According to Birx, LaSala, and Wagstaff (2011), “Group cohesion is the outcome of team-building activities and is associated with positive feelings toward coworkers, which are an aspect of job satisfaction” (p.175). A. Jimenez
Throughout the readings communication was identified as a vital component for establishing and maintaining relationships. Porter-O Grady sanctioned for leaders to establish firm rules of engagement to help support a positive group dynamic (2013). While Kelly & Tazbir explained that friction and conflict were a normal part of group development and were representative of the Storming stage of group process (2014). Moreover, they explained that with assistance from the team leader the team can overcome these obstacles, strengthen inter-professional relationships, and enter into the Norming stage (Kelly & Tazbir, 2014). Here the team is able to participate in the effective exchange of communication and begin making progress toward goals. This represents progression into the Performing stage of group process (Kelly & Tazbir, 2014). When the team has met its intended target they are ready to anylze the outcomes of their work and enter the final stage of group process—Adjourning (Kelly & Tazbir,
The collaboration of a nurse with an interdisciplinary team is important because it involves discussing client care and decisions of their care. This is especially important when caring for a patient with multiple problems (ATI Leadership pg.41). The knowledge and skills combined together as a team are of great use in developing an interdisciplinary plan of care for the patient with multiple problems. It should be recognized by the nurse that the collaboration of the team can accomplish more successful with a team rather than alone (ATI pg.41).
It's important for nurses to be actively involved with an interdisciplinary team because of the increasing complexity and scope of patient problems. As these complexities and problems increase, patient care necessitates the combination of efforts of physicians from different disciplines. Actually, comprehensive patient care in today's healthcare settings incorporates attempts to solve problems that are beyond the scope of expertise and training of a single professional. Therefore, the active involvement of nurses in interdisciplinary teams is vital for the provision of comprehensive and effective patient care that help in dealing with the evolving patient problems
Effective collaboration between registered nurses and physicians has been shown to reduce morbidity and mortality rates, cost of care, and medical errors and to improve job satisfaction and retention of nursing staff (Maxson et al., 2011, p. 31). To be an active part of an interdisciplinary team will give the nurse the opportunity to be a part of a group of people that will and can make it better not only for the patient but for the medical system as a whole. The outcomes are positive in every way.
One of the many roles played by a nurse is to advocate for his or her patients,provide holistic care for them, and make surethat
According to Pepau the goal of nursing is to help the patient find their felt problem. The nurse and patient work together therefore they develop relationship between each other’s. These two individuals with common aim have interpersonal relation. Nursing is therapeutic in that it is a healing art, assisting an individual who is sick or in need of health care ( Pepau 1952). Nurse plays several roles in this relationship. As a resource person, nurse gives adequate information that help patient understanding of issues. As a counselor: a nurse helps patient to incorporate the sense of current life change event, and provides advice for change. Nurse plays role of leader by making sure patient undertakes maximum engagement to achieve treatment goals.
“Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles” (ICN 2010)
A professional nursing practice is predicated on many tenets, which ensure optimal functionality and growth. A successful organization requires the systematic employment of ethical values, as well as structural, organizational and relational leadership. In essence, a nursing practice must fortify its corporate structure, productivity, operational flow, and professional relationships in order to thrive. The purpose of an organizational meeting is to address the foundational elements of a successful practice. Along with delineating guidelines, a meeting should reinforce structure, a unified sense of purpose, and address lingering issues.
Interdisciplinary work teams includes staff from different level of clinical professionals such as nurses, nursing assistant, surgical technicians, anesthesiologists, physical therapist, occupational therapist, attending physicians who goal is to work and communicate together to improve patient quality care and safety. Working together as a team, will improve patient care and also help to delivered unique patient care quality and reduce medical errors. The use of interdisciplinary teamwork improved communication between different levels of healthcare workers, and limited adverse events, improved outcomes, decreased the length of stay and yield greater patient satisfaction ( Epstein, 2014). In healthcare setting or environment, patient safety
The American Nursing Association describes nursing as the profession or practice of providing care for the sick and infirm. They say it is the duty of nurses to protect, promote and optimize the health and abilities of a patient. It is also the duty of those in the profession of nursing to prevent illness and injury, facilitate healing, and alleviate suffering through the diagnosis and treatment of human response. Nurses also advocate for the care of patients families. Nurses play a very important role in healthcare and they are the primary caregiver for patients.
Kaakinen et al (2015) discusses the two types of health care teams that will be involved in the patient’s care: multiprofessional and interprofessional. The multiprofessional model is an older model that does not focus on holistic care. Care is fragmented with an autocratic leader, vertical communication, separate goals of the professionals involved, and families are peripheral to the process (Kaakinen et al., 2015). The preferred model is the interprofessional model emphasizing a team approach, holistic care of the patient, horizontal communication, and involvement of the family (Kaakinen et al., 2015). The nurse should keep this collaborative approach in mind when dealing with any patient case, involving all teams associated with the patient for the best outcome.
Team nursing is the essential care model in emergency room care, the nurse and other healthcare providers work as team to provide positive patient outcomes. We use all disciples in the delivery of care, we begin with the department director, this person oversees the department and is responsible for the care twenty fours a day, we move on to the clinical coordinator , this person is the nurse manager for the day to day operations, they are the ones where the delegation of task begins, they work directly with the physician and the other departments to progress the patient flow through the department, this is followed by the direct care nurse, who is responsible for the direct patient care, and delegates the patient needs to the ancillary staff , consisting of the emergency room tech, which draw blood , ekg’s, and direct patient care needs. These staff members are given a section of rooms they are responsible for, the direct care nurse , follows written orders, and assures patient outcomes by directing the care with her team. Team nursing has changed as stated in Finkelman ”the team model has changed to meet changes in
Teams working in a hospital or other healthcare setting may consist of several physicians, nurses, medical assistants, referral coordinators, pharmacists, therapists, and students among others. Such large teams can provide comprehensive care for complex and chronic illnesses, but when they fail to work well together, they
As a nurse it is their responsibility to provide total patient care to each and every patient that they are caring for. Part of providing total patient care to these patients lies the responsibility of teaching and education. Through effective teaching and education, patients can be made aware of their diagnosis, administering medications and complying with their regimen, severe side effects to watch for, strict diets, exercise, different treatment options, and whatever else is necessary for the patients’ well-being.
According to the World Health Organization (2016) the role of the nurse is to provide autonomous and collaborate care to individuals, families and communities by promoting health, preventing illness and providing care for the ill, disabled and dying. A nurse assesses patient’s physical, emotional and psychological