Student Nurse Compliance Case Study

To the Public/Clients: Nursing is a profession that is responsible to patients and also to public. It is the right of the society to expect the best possible quality of care. So it is essential for nurses to stay abreast of current best practices. Nurses should have the knowledge of updated systems and modern equipments. Attending seminars and conferences, completing required competency tests, reading related books and articles, and complying with the required certifications are some of the ways to be proficient with the changes taking place in nursing field. Nurses should be aware of consumer’s increased level of knowledge and the increased accessibility to information from various sources (Hood, 2010, p. 307-308). Nurses are expected to be exercising reasonable judgment and deliver reasonable care to patients. Nurses have the obligation to act in the best interest of the patient. For example, recently one of my patients expressed her wish to change her code status. She stated that she is very tired because of her critical illness. She wants to go home to die peacefully. She told me that since her family is not listening to her wish she is frustrated. I informed her about hospice care at home and she requested to get more information from them. As a responsible nurse, I spoke with the physician and got the order for hospice evaluation for that patient. Finally, she was able to go home under hospice care. This shows the

Communication is one of the basic survival skills of human and also a fundamental part of nursing. Effective communication would help to promote a positive nurse-client relationship which is crucial for the delivery of quality nursing care (Sheppard, 1993; McCabe 2003).

Communication is usually taken for granted in our every day to day living as we use it without thought. Good communication skills are needed in the workplace and especially with nursing staff to and from patients when giving first hand care. Good or bad communication can make there experience within the health care setting a positive or negative one and can leave a lasting impression. A good health care provider can use there communication skills to put a patient at ease with a few comforting words or gestures, a lack of positive communication in the health care setting could leave the patient feeling neglected, ignored and not valued as a patient.

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

Workload was described to be heavy, stressful, increase in intensity and overtime hours. As a result 25.8% consider resigning, 20.2% consider retiring and 25.6% consider leaving profession. Another problem that was observed at individual level was poor commitment to care. One of the factors that often limited nurses to provide therapeutic care was the change in nurse to patient ratio. As nurses assignments increase with the increase in the number of patients (i.e. 1 nurse to 6-8 patients) the quality of care provided decreases. Nurses’ ability to maintain safe environment became challenging. As part of caring, nurses also showed decreased amount of time spent with their patient. This eventually led to nurses being less satisfied with their current job. Self – efficacy was often low. Nurses felt that they did not have enough knowledge and skills required for professional practice (Newhouse, Hoffman, & Hairston, 2007). This often led into stressful transition and the ability to care for a patient even harder. New graduate nurses often had difficulty maintaining leadership role. They often felt that they did not have the ability to self advocate and raise their voice to be heard by others. They often feared that they would be over heard and that no one would listen to them (Mooney, 2007).

When people think about nurses, many ideas come to mind. They think of the hideous old starched, white uniforms, a doctor’s handmaiden, the sexy or naughty nurse, or a torturer. The media and society have manipulated the identity and role of nurses. None of these ideas truly portray nurses and what they do. Nurses are with the patients more than the doctors. People do not realize how little they will encounter the doctor in the hospital until they are actually in the hospital. People quickly realize how important nurses are. Because nurses interact with their patients constantly, nurses are the ones who know the patients best.

Effective communication is essential for a nurse in a leadership position. If a nurse is not able to convey or transfer pertinent information to other team members or clients, conflict or problems can arise. A nurse is able to effectively communicate through creating synergy, establishing a purpose or goal, actively listening, being truthful, and being responsible. When a nurse leader is able to successfully communicate, patient safety increases and medical errors decrease which leads to a higher percentage of positive patient outcomes. Effective communication fosters positive nurse-patient and nurse-team member relationships.

An important aspect of nurse practice is communication as it is the process of transferring information, feelings and ideas (RCN, 2015). It also provides knowledge based on identifying behaviour patterns, establish a relationship between nurse and patient and it is also

I’ve been a nurse for over 11 years, primarily as a staff nurse on the medical/surgical and intensive care units at the local hospital. During this time I’ve worked closely with other team members including nurse educators, nurse specialists, and nurse practitioners. All of these advanced practice nurses displayed a significant degree of knowledge and compassion regarding patient care. Like myself, they all also have a tremendous amount of passion for influencing patients to improve their health and thereby improve their lives and have the best outcomes possible during illnesses. While I imagine even physicians want to help all people and at some point, we all feel we are destined to save the world, the nurses I’ve encountered work to put this into practice.

Some of the factors that patients do not adhere to when their healthcare provider tells them too is due to patients being too busy. Often times life is very busy as we all know this but forgetting to take of yourself can have detrimental effects to your health. Some people think they can get better on their own without the help of a doctor so they feel like they will be fine or able to handle any health complication on their own. Another reason is that often people do not understand or they forget what the doctor is telling them about their prescribed treatment regimens and other patients decide to simply not follow it. As stated in the article by Sklar, Min Sen Oh & & Chuen Li, 2008 “Poor communication with healthcare providers was also likely to cause a negative effect on patient’s compliance (Bartlett et al 1984; Apter et al 1998)”. Miscommunication between a doctor and patient is at the root of most adherence problems. Often times patients leave their doctors office not knowing or having the slightest clue to what they should be doing. Instead of asking for help or clarity they just leave. Communication needs to be clear and effective for both the patient and the doctor. Non-adherence is wide spread when it comes to patients not adhering to what professionals tell them. Many patients will have significant risks because they forget,

Language and behavior. In any profession, there is specific language that goes along with it. A nurse’s terminology is made up of mostly medical terms that are a person’s anatomy and physiological make up, medications, diseases, procedures etc. To be an effective communicator in this profession being up to date on medical terminology is a must. This is called the standardized language of medicine. “When everyone understands what a condition, medicine, or procedure is, they are able to fulfill their roles accordingly, whether that is delivering medicine or billing for a medicine” (PCC Institute of Health Professionals, 2017). Along with language expectations, there are ways a nurse is expected to carry themselves. Patients expect their nurses to be compassionate, keep them informed, and have good bedside manner. This means

Problems with verbal communication in the healthcare setting emerge from the fact that nurses and others in the healthcare setting receive little education on how to communicate effectively with each other.

Those nurses may not have acquired the skills necessary to anticipate the needs of the team members. Moreover, they may not have learned how to cooperate, communicate, and integrate care. And, they fail to evaluate and adjust to their actions and are not able to give and receive feedback. They do not apply their knowledge and critical thinking to understand the current situation and how to act upon it. Some of the other factors that also contribute are lack of awareness of errors, lack of willingness to report errors, faulty memory, poor communication skills, or lack of patient knowledge, patient diagnosis and the names, purposes, and correct administration of the medication (Carlton & Blegen, 2006).

On a daily basis there is a lot of thought and focus directed at these patients to assure they are getting quality medical care; you may have caught a medication error, made multiple phone calls, waited on hold for what seems like forever, waited on doctors, ran to another floor all to get a patient something they needed or wanted, or may the nurse noticed an important change in the patients status that could dramatically affect their outcome. Most times the patient does not see or not even know about these behind the scenes battles to ensure quality care. Conversely, most often, especially when considering a patient in the hospital setting, our perception is our reality. Patients often do not know the ins and outs of procedure and protocol and rely solely on their perception of the care they are receiving. Studies have shown that patients desire to be perceived and cared for as individuals. Lying in that bed waiting on a nurse for 20 minutes for pain medication may just translate into lack of care on the nurses’ part to the patient but in reality the nurse was caught in another room with a different patient with a situation he or she couldn’t walk away from. Often nurses are stressed which can also convey a certain harshness to patients. In other cases maybe the job has become so repetitive that the nurse

In the medical fraternity, nurses make up the largest healthcare profession. The care of patients depends on the well-being of the nurses, and issues affecting them may affect patients, directly or indirectly. As a profession, nursing, can be both an extremely rewarding and challenging activity. A number of problems exist, and most are becoming worse because of lack of lack of mechanisms to address these issues. The three greatest issues affecting nursing today include improving health education, lack of respect for nurses and cost cutting. Although these problems are not clinical, they influence the efficiency of the performance of nurses in their delivery of services.