Nursing is a profession of change. The environment a nurse works in changes, technology is updated to provide the best patient care and nurses are learning about the updates to best evidence the field is relies on. Additional environmental changes for nurses include restructuring of the organization, quality improvement and employee retention (Marquis & Huston, 2012). These types of changes are typically planned (Marquis & Huston, 2012). Planned change is a purposeful, calculated and collaborative effort to bring about improvements with the assistance of a change agent (Roussel, 2006 as cited in Mitchell, 2013). However, attempts at change may fail when change agents take an unstructured approach (Wright 1998 as cited in Mitchell, …show more content…
Description of the health care setting and communication networks. The hospital environment is a non-profit critical access hospital in a rural area. The nursing unit within the hospital is medical surgical specialty unit. There are18 beds in this unit that manage acute medical surgical patients and swing bed patients with a vast range of diagnoses and care requirements. The medical-surgical unit also serves as a specialty unit for the management of acute care ventilator patients. There 50 medical surgical employees reporting to the unit manager including RN’s, nursing assistants and health unit coordinators. Since this is a smaller hospital, there is a simpler organizational structure than what is seen in a large hospital. However, it consists of a formal structure, one with departmentalization and work division as well as evident rank and hierarchy (Marquis & Huston, 2012). The rank and heirarchy begins with the Board and Administrators including the President and Vice President. Admissions, medical records, billing, Human Resources, Information technology are next on the hierarchy. Third, nursing department and rehab (Physical therapy, Occupational therapy, Respiratory therapy, Speech Language Pathologist), fourth, laboratory and imaging, and fifth, environmental services, dietary department, central
According to Porter-O’Grady, 2016 et al p 324, our healthcare systems today are at the center of what is considered major change. Much of the change today is directly related to the foundational principles, concepts and associated with complexity in systems and relationships, and an understanding by nurse leader and follower; of what it takes to make meaningful change. Nurse Leaders, registered nurses, advance practice nurses, and other followers, at every level of our organizations must be increasingly aware of meaningful and sustainable changes that improves our healthcare systems (Porter-O’Grady, 2016 et al p 324).
These changes are then reinforced to employees by the Charge Nurses in Morning Huddles and in special called Safety Huddles throughout the week. While management is very open to change, implementation of the changes must be carried out by the actual hands-on personnel, and this often times leads to fear of the unknown. As Yoder-Wise (2015) states, “All changes, whether perceived as positive or negative, large-scale or simply, are scary and generate fear” (p. 307). In the short time I have worked in the ED, I have seen both support and resistance among co-workers regarding change processes. While some embrace change, others resist, and are set in their ways viewing change as inconvenient and an addition of time-consuming steps to an already stressful environment. Most whom I work with, when presented with the facts and evidence behind the change, view it positively and have no problem implementing it.
The topic of ethics is prevalent in health care and addresses a broad range of topics in nursing. In almost every interaction with a patient there could be a situation that may bring up the question of ethics. Fortunately, there is the realization that placing the nurse in the care of a patient, may put the medical personnel in an environment where the ethics are questioned. There are whole departments dedicated to advising nurses in these situations. There are also ethic committees to help guide you when you find yourself in a situation that may question your practice or circumstances.
Deontology is an ethical theory concerned with duties and rights. The founder of deontological ethics was a German philosopher named Immanuel Kant. Kant’s deontological perspective implies people are sensitive to moral duties that require or prohibit certain behaviors, irrespective of the consequences (Tanner, Medin, & Iliev, 2008). The main focus of deontology is duty: deontology is derived from the Greek word deon, meaning duty. A duty is morally mandated action, for instance, the duty never to lie and always to keep your word. Based on Kant, even when individuals do not want to act on duty they are ethically obligated to do so (Rich, 2008).
This concept is taken from module 1 of block 6 entitled “Ethical Issues in Nursing Practice”.
Nurses are facing many legal or ethical dilemmas in their career. Nurses should combine knowledge of ethical and legal aspects of health care and professional values into nursing practice. It is very essential to know what kind of dilemmas nurses may face during their profession and how they have been dealt with in the past.
“ The ADKAR model of change includes Awareness of the need for change, the Desire to support the change campaign, Knowledge of how to make this successful, the Ability to implement new strategies, Reinforcement of change implementation, and periodic re-evaluation (Hait,2006). These four elements promote evidenced- based practice change and the commitment from nurses to participate in professional activities.”(Robert & Pape, 2011, p. 43) A APRN’s we will have to be agents of change to provide the best care for our patients. When we identify a issue or concern we must have the ability to address it
Implementing a change in practice within these environments can produce anxiety or fear of failure in nurses, leading to a resistance to change. Several studies (Bozak, 2003; Lehman, 2008; Spetz, Burgess & Phibbs, 2012) expounded the need for a concise plan and clear communication between nurses and management when implementing a change of this nature. The use of Lewin’s Change Management theory can support nurses through the transitions and identify areas of strengths and resistances prior to implementing change. Without a framework for guidance, it can be difficult to keep on track.
An ethical dilemma is defined as a mental state when the nurse has to make a choice between the options and choices that he or she has at her disposal. The choice is a crucial task as the opting of the step will subsequently determine the health status of the concerned patient, hence it requires a great deal of wisdom along with proper medical and health training before any such step is opted as it is a matter of life and death. Strong emphasis should therefore be on the acquisition of proper knowledge and skills so that nurses do posses the autonomy to interact with patients regarding ethical issues involved in health care affairs and address them efficiently. It is normally argued that nurses are not provided sufficient
Implementing a change project is a challenging step of the Capstone Change Project. This paper focuses on steps that must be taken to implement a change, strategies to ensure the success, involved stakeholders and their roles, educational requirements, safety issues, ethical considerations, and external or internal regulations’ effects on the process. It also include the change theory, nursing theory, and evidence based practice influences on the implementation process.
A positive force for change centers on the nurse’s strong desire to change current practices. The combination of the turnover rate, low morale, and higher percentage of new nurses, is the driving
Nurses support and enable individuals, families and groups to maintain, restore or improve their health status. Nurse also care for and comfort when deterioration of health has become irreversible. A traditional ideal of nursing is caring and nurturing of human beings regardless of race, religion, status, age, gender, diagnosis, or any other grounds.
The sequencing of the human genome has a new approach to health care in regards to promotion, maintenance, and treatment. Genetic research is defined as a new approach to a better understanding of the genetic components of common diseases: Cancer, diabetes, stroke, and creating new gene-based technologies for screening, prevention, diagnosis, and treatment of both rare and common diseases. Nurses are a main aspect within the first line of care, and therefore will contribute fully in genetic-based and genomic-based practice activities such as collecting family history, obtaining informed consent for genetic testing, and administering gene-based therapies. Lea, D, (January 31, 2008). My paper is based on an article Genomics in the public
One day, Humphrey the rat, surfaced from his nest inside the small willow tree. He found himself bound at his neck by Freddy the cat. Humphrey pleaded with the Freddy to let him go, and Freddy finally let him go seeing that he just had a big meal. Weeks passed by and Freddy found himself trapped in a net that his owner left out. His owners would not return for some time so Freddy was there until he was freed. But here comes Humphrey out of his tree to see Freddy in the need of help, promptly he started gnawing through the net, which then set Freddy free. I know you are wondering what the purpose of this story is. Well the moral of the story is that there are times where you need to decide when to do the right thing despite what you desire
Every healthcare institution no matter the size has an organizational structure that promotes efficient management of departments. I found the theme of chapter six to be about a corporation’s personhood and the duties of a corporation’s governing board. It is critical to understand the structure of an institution because it facilitates the chain of command, lays out what department is accountable for what, and gives you a better understanding of the relationship the organization has with its employees (this is essential to know because chapter seven is about the distinction between an employee/independent contractor and their relationship with the hospital).