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These moments also made the more mundane and laborious elements of the job seem more worthwhile, and I was definitely feeling less stress and more satisfaction upon the completion of my shift than I had the previous day, when such patient connections has not seemed possible.
Day 3
Though falls from hospital beds are more common than might be expected, a fall that occurred in the medical-surgical unit was deemed worthy of calling a meeting of available nursing staff to review fall prevention procedures and stress the importance of maintaining regular and frequent rounds as well as sitting with fall-prone patients whenever possible, even in short and frequently rotating shifts, to ensure that movement can be facilitated when desired. One nurse actually brought up the use of restraints, which were acknowledged to be available as a measure of last resort but which were not to be used except in extreme cases and with the permission of the lead nurse. This is in keeping with current research on the subject, which was actually referenced by the point nurse in this instance, especially when stressing the preferred techniques for mitigating risks of falls and the lack of desirability of the use of physical restraints (Shever et al. 2010). This experience was highly educational both in its specifics and in seeing the dynamics of practice and the influence of research in a practical setting.
Day 4
During a brief one-on-one instigated by the lead nurse during my shift today, I broached the issue of the communication issues I had noticed in the unit. I tried to approach the matter very nonchalantly and in an inquisitive rather than observational mode, but to my surprise the lead nurse cut right to the heart of the issue and acknowledged that there was no really clear or concrete communications system in place, and essentially shrugged off the...
I was rather disappointed at this display of leadership.
Day 5
Attempting to access part of the hospital database to input information regarding a patient, I found myself increasingly frustrated with the EMR system that had been put into place. Apparently this was a common complaint among the staff; the program was far from intuitive and often froze while trying to complete even relatively simple tasks. I later found that many such systems had been negatively associated with quality of care at many institutions following their implementation, which certainly made me wonder about this particular hospital (Furukawa et al. 2010).
References
Furukawa, M., Raghu, T. & Shao, B. (2010). Electronic Medical Records, Nurse Staffing, and Nurse-Sensitive Patient Outcomes: Evidence From the National Database of Nursing Quality Indicators. Medical Care Research and Review 67(11):77-89.
Heaven, C. & Maguire, P. (2008). Communications Issues. In Psychological Issues in Palliative Care, Lloyd-Williams, M, ed. New York: Oxford University Press.
Shever, L., Titler, M., Mackin, M. & Kueny, a. (2010). Fall Prevention Practices in Adult Medical-Surgical Nursing Units Described by Nurse Managers. Western Journal of Nursing Research 32(9): 17-24.
Simonazzi, a. (2009). Care regimes and national employment models. Cambridge Journal of Economics 33(2): 211-32.
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