Taking A Leading Responsibility For A Forensic Care Setting

Pam should change Renee’s shift schedule, not because Felix’s wife complained, but because it is the right thing to do. Renee’s schedule engenders considerable risks. Pam knew Renee’s schedule was not sensible. Pam had noticed that Renee looked exhausted mid-rotation. Like many managers, she was afraid to make waves. It is burdensome to go against the status quo, particularly over scheduling, something that exerts a great deal of control over an individual’s live. Pam succumbed to her own feelings for Renee’s economic woes. In general, nurse managers which to extend their caring relationships to those that report to them, but that is not their primary obligation. Nurse managers have an obligation to ensure safe nursing practice and high quality

In every profession there are changes that propel how tasks are done; nursing is no stranger to this. One of the biggest changes that have come into nursing’s daily events is how report hand-offs are being done. Gone are the days of taped report that each off going nurse must tape about each patient and the oncoming nurse must listen to. Nurses are now being encouraged to move their report to the bedside, in front of the patient (Trossman, 2007). It is very important to know how this can affect the patient and even the nurse’s schedule. With every change, there are positives and negatives that can finalize the decision to keep or forego

The health care institution has been considering a wide array of solutions to improving the quality of patient care within the facility, and it is now believed that a suitable course of action is represented by the improvement of the nurse reporting at the bed of the patient, at the change of the shifts. This strategy is beginning to draw more attention within the medical community, but it has yet to be fully adopted by the health care institutions.

The hand over process of communication between nurses to nurses is done with the intention of transferring essential information for safe, and patient centered care. Traditionally, this shift report has been done away from the patient’s bedside, at the nurse’s station, or other place like staff’s room. In addition, the shift report used to be delivered through audio recording of the patient’s information. These reporting mechanisms did not include face-to-face reporting of the patient information, nor involvement of patient. Therefore, information regarding the patient’s care was not shared with the patient, leaving them out of his/her own care plan. Recent studies and development of Patient Centered Care Philosophy have challenged this belief of giving a report away from the patient. Tan (2015) said, “Shift report must not only be restricted in nurse to nurse communication, but it must involve patients as the recipients of care” (p. 1). Incorporating the patient into the end of shift report is essential for providing patient centered care and patient satisfaction. Nurses at the St Jude Medical center in the acute in-patient rehabilitation unit are not exceptional. Most of the end of the shift report between nurses are still done away from the patient. Aim of this paper is to make a change in the work place, which is the process of giving end of shift report at the bedside incorporating patient and families in the acute in-patient rehabilitation unit at St Jude Medical

Effective communication is crucial aspect of nursing yet too often is placed low on the priority list, especially at shift change. Information related to the care of patients is frequently disseminated at a crowded, noisy nurse station with several nurses rushing to leave and others attempting to get the information necessary to plan care and limit the constant distractions. It is this interaction that allows for information vital patient safety information to be communicated including the acuity of patients.

Traditionally, nursing shift-to-shift reports were organized methods of communication between only the oncoming and leaving nurse, designated to a location such as the central nursing station or nook of a hallway. Shift reports can be considered the foundation of how the day is going to plan out because it introduces the patient, diagnoses, complications, medications, consults, upcoming test and the entire plan of care. These reports are full of complicated and vital information and while set in certain locations that are vulnerable to interruptions, such as the nursing station, medical errors and miscommunication are more likely to be made. The Joint Commission’s 2009 and 2010 National Patient Safety Goals (Joint Commission, 2015) included two patient safety standards, first to encourage patients to be involved in their health care plan and second, to implement a standardized communication process for handoff reports between providers. Soon after in 2013, The Agency for Healthcare Research and Quality under the United States Department of Health and Human Services introduced a set of strategies to improve patient engagement along with safety and quality in patient care. Within these strategies the new method of nurse bedside shift report was developed, which suggests nurses to conduct shift-to-shift reports at bedside in the room of each patient, rather than out of the room. The benefits of this new method were

Quantitative data was collected as handovers at three sites were timed pre and post the practice change and this information was analyzed and presented in graphs demonstrating the any differences. Results were tabulated by numbers of patients and staff and average times computed by unit. The mean length of handover with traditional handover was 0.44 hours which deceased to 0.22 hours after the move to bedside handover. Data on the number of adverse patient safety outcomes during handover were gather pre and post implementation and tabulated. Qualitative data collected from nurse interviews, pre implementation of bedside handover indicted that they found the traditional handover to be “difficult and time consuming.” This data was presented in graphs, demonstrating the any differences with in the three sites. Nurses were also asked to estimate the time taken to complete shift handover pre and post implementation. Researchers used a mixed model, descriptive statistics to correlate results and draw conclusions.

Communication in shift change plays a major role in the nursing practice and role. Appropriate and effective communication is a tool assisting nurses in providing safe, thorough and quality cares about their patients and ensuring there is continued service delivery. Realizing the critical role of their patients and patients’ families in promoting patient safety, nurses need to engage their patients and family members in the whole communication process of exchanging information and planning the care. Nurses need to give their patients chances to participate in the discussion their health conditions, upcoming procedures, medical information, or treatment options. Bedside reporting give nurses opportunities to visualize the physical and psychological needs of their patients. Change of shift reporting is also a situation where the nurses exchange their clinical knowledge, and patients’ condition changes and allow their patients to express their understandings, concerns, and questions. This paper seeks to analyze bedside report and explain its relevance to the nursing practice.

The author made a problem statement that bedside nursing report is not persistence in nursing care and there is limited research to investigate. The author’s questions are specifically related to the concern of bedside clinical handover that needs to be addressed in healthcare organization, investigate patients’ opinions to help nurses become aware of patients’ needs and increase their skill in clinical bedside handover practice. Using qualitative research methodology to interview, explore, and observe patients’ experience will help the researchers to answer the research questions. Obviously, exploring the patients’ opinion of bedside nursing handover is a key to recognize patients’ perspective to provide for their needs in order to continue patient safety care and

Change of shift in the nursing profession is unique (Caruso, 2007). Information is transferred between nurses verbally and through written communication. In many facilities shift report from one shift to another involved sitting down and getting all your orders from a caredex and then talking with the previous nurse face to face going over pertinent information regarding their patients. This type of report usually happens in a report room or sometimes in the hallways or other common

This section tools? Provides an overview of the tools includes in this strategy included Blank incudes in this strategy Bed side Shift Report What is it how can help you get involved? information Inform the patient and family and family about the bedside shift report is and how they can take part is and how they can take Give to patient on the day of admission, this handbook explains what bedside shift report is, during bedside shift report • Ferment 1-page handout Tool 3 Nurse Format: Bedside Shift Report Training prepare nurses to conduct nurses shift report. Slides and “talking points to train nurses to conduct a bedside

This essay will explore my role as a shift leader and coordinator in a forensic care setting during a shift at my last placement. It will evaluate actions taken during this span of duty, lesson learnt and my learning needs. Nurses now work in management and leadership roles in addition to their clinical roles to meet academic, economic and management challenges (Grossman & Valiga, 2012). Similarly, Mannix et al. (2013) suggest that the role of a nurse in this modern day expands more than the usual clinical roles because nurses now take up management and leadership positions. In view of this, they need leadership and management skills to function well in these roles. Student nurses also need to gain leadership and management skill during their training to equip them with the required management and leadership skills necessary for managing a service and leading a shift successively (Nurses and Midwifery Council, 2015).

In order to collaborate successfully with the other members of the team, they have to ‘work together’. Collaboration implies “working together to achieve something that neither agency could achieve alone” (cited by Biggs in Day, 2006, p9). It involves effective communication and contribution to a common goal – and the health and wellbeing of the patient and shared responsibility of the outcome. Each team requires a quality leader, regular meetings attended by all members, joint assessment, regular reviews of patient records which should include ‘shared care plans’; joint decisions following consultation and task delegation to individual team members with the outcome being that “care must be structured, organised and systematically provided to each person in a variety of ways” (Creating an Interprofessional Workforce, 2007, p10).

A second measure that my institution does, and I am sure most do this as well, is an early morning safety huddle at the beginning of the shift where the RN’s and supervisors get together for a few words. Anything of interest or concern is brought up, any changes of patient conditions that may have transpired over the last couple of shifts and things like that. An additional similar meeting is held around 1400’ish to get a handle on if any RN may need supplementary assistance with any patient care or needs due to unforeseen circumstances that may have come up. Just to assure that no unnecessary errors may occur do to someone trying to hasten the care provided. Just as we have spoken about in the first module, it is all in the means of communication, which even this new nurse has realized it is of dire importance in order to provide effective, efficient care.

Advanced Professional Roles and Values MSN Program Conceptual Framework The MSN Program Conceptual Framework contains three roles that nurses can inhabit within their careers. The three roles are: Nurse as Detective, Nurse as Scientist, and Nurse as Manager of Healing Environment. The conceptual framework contains 10 model elements that includes: Teamwork and Collaboration, Professional/Legal/Ethical, Communication, Cultural Competency, Safety and Quality, Leadership/Education, Informatic/Technology, Genomics/Genethics, Evidence-Based Practice, and Compassionate Patient-Centered Care. The Role of “Nurse as Detective” The MSN Conceptual Framework defines the role of a nurse as a detective as, “The nurse uses clinical imagination coupled with