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Nursing Administration Specialist
Dr. M's dilemma
The hospital has a very strong reputation within the community and an over hundred-year history.
The hospital has just been purchased by a university hospital system with an equally stalwart reputation.
The new management seems committed to changing the hospital for the better and restoring it to its former glory.
There is a commitment to change amongst Dr. M.
Patients desire change.
The hospital has rapidly grown in size from 50 to 300 beds and its standard operating procedures have not kept up with the current needs of patients.
It is losing money.
There are serious delays in transferring patients which could lead to a compromise of overall quality of patient health and also to inaccuracies in paperwork when patients are in a state of limbo. Not only do the transfers take place late at night, but the documentation is left to…
Chapman, A. (2013). SWOT. Business Balls. Retrieved from:
Nursing Administration -- Controlling
The FOCUS model requires the nursing administrator to find out what the main problem is, obtain information about this problem, communicate effectively with the nurses and patient, understand the needs of the nurses and the patient, and finally summarize these findings for the patient and nurses Dlugacz, 2009.
In this scenario, the process to be improved is responsiveness and willingness of the nurses to help the patient's situation.
Using the FOCUS model, the nursing leader should identify and clearly define the problem. To do this, they must recognize the role of the patient and the nurses in the situation and prioritize the potential improvements in the process Kreitner, 2008.
They also need to draft this problem statement in a clear way. The problem statement for this scenario is that the nurses feel inadequate in responding to the situation where the patient needs…
Dlugacz, Y.D. (2009). Value-Based Health Care: Linking Finance and Quality. New York: Wiley.
Kleespies, P.M., & Association, A.P. (2009). Behavioral Emergencies: An Evidence-Based Resource for Evaluating and Managing Risk of Suicide, Violence, and Victimization. Washington, D.C., DC: American Psychological Association.
Kreitner, R. (2008). Management. Mason, OH: Houghton Mifflin Company.
Zun, L.S., Chepenik, L.G., & Mallory, M.N.S. (2013). Behavioral Emergencies for the Emergency Physician. Cambridge, United Kingdom: Cambridge University Press.
It is thus possible for the institution to retain nurses by strengthening the interpersonal leadership and management skills that lead to empowerment within the healthcare environment. This is especially supported by studies that found that despite the fact that a nurses' pay is important, it is not as critical in enhancing retention as a positive work place or an empowered environment that promotes teamwork and encourages ongoing learning, trust, and respect. (Chan, 2001).
It must always be remembered that nursing retention is the result of a combination of factors. There is no easy solution, and managers and leaders need to choose the combination of approaches that will be effective in their specific organization, since there is no one range or combination of strategies that will fit all.
Buerhaus, P., Staiger, D.O. & Auerbach, D.I. (2003) Is the Current Shortage of Hospital Nurses Ending? Health Affairs 22: 191-198.
Buerhaus, P., Staiger, D.O. & Auerbach, D.I. (2003) Is the Current Shortage of Hospital Nurses Ending? Health Affairs 22: 191-198.
Chan, C.C.A. (2001). Implications of organizational learning for nursing managers from the cultural, interpersonal and systems thinking perspectives. Nursing Inquiry, 8(3), 196-199.
Faulkner, J., & Laschinger, H. (2008). The effects of structural and psychological empowerment on perceived respect in acute care nurses. Journal of Nursing Management. 16(2): 214-221.
Kanter, R.M. (1979). Power failure in management circuits. Harvard Business Review, 65-75.
In interacting, factors may also modify each other:
nurse who might return to work for a higher salary might decide to do so only later when her children are older. The incentive of salary is therefore modified by the factor of young children.
The table is significantly complicated by the inclusion of more than two factors:
Any combination of the factors could result in the majority of nurses returning to work. Individually, each nurse has his or her own motivations for doing so.
The iterative proportional fitting procedure can be used to calculate expected frequencies.
Note: pecifically, the indication of this study is that nurses would return to work were certain factors in the work situation to change. pecifically, the highest frequencies are assigned to work load and hours. These are also the two most common factors in causing burnout and stress in the profession. Concomitantly, if inactive nurses were…
StatSoft, Inc. (2008). Log-Linear Analysis of Frequency Tables. http://www.statsoft.com/textbook/stloglin.html
Williams, Kimberly a., Stotts, R., Jacob, Susan R., Stebauer, Cheryl C.; Roussel, Linda, & Carter, Donna (2006, April). Inactive Nurses: A source for alleviating the nursing shortage? In Journal of Nursing Administration, Vol. 36(4).
Batcheller, J.A. (2011). On-boarding and enculturation of new chief nursing officers.
Journal of Nursing Administration, 41(5), 235-239.
This article examines the on-boarding process for new chief nursing officers by examining the onboarding process for 6 new chief nursing officers. The examination is aimed at determining what type of support leaders new to an executive role requires and how to on-board leaders who are experienced, but who are new to a particular organization. The possible implications of this research is that if the on-boarding process is insufficient, then it may contribute to high turnover rates and the short length of chief nursing officer positions.
Carlson, C.L. & Plonczynski, D. (2008). Has the BARRIER cale changed nursing practice? An integrative review. Journal of Advanced Nursing, 63(4), 322-333.
This article examines whether the BARRIER cale, which identifies nurses' barriers to using evidence-based practice, contributed to an increase in the use of…
Storch, J., Rodney, P., Pauly, B., & Fulton, T.R., Stevenson, L., Newton, L., & Makaroff,
K. (2009). Enhancing ethical climates in nursing work environments. Retrieved September 27, 2014 from Canadian Nurse website: http://www.canadian-nurse.com/en/articles/issues/2009/march-2009/enhancing-ethical-climates-in-nursing-work-environments
The article examines the outcomes of the Leadership for Ethical Policy and Practice, which was a three-year participatory action research survey aimed at nurses, managers, and other team members. The respondents found that nurse leader support was a critical component when enacting ethical leadership initiatives. They also found that an ethical leadership model resulted in higher levels of job-related satisfaction at all levels of the healthcare management team.
Resources needed include manpower and positional aids mentioned previously in this report. Evaluation of the effectiveness of the change would be accomplished through data collection related to the frequency of pressure ulcer occurrence in patients and nurse compliance in the four hours supine positional rotation of patients. Questionnaires will also be administered to nursing staff in order to gain insight as to their attitudes, behaviors and perceived barriers to pressure ulcer prevention.
Phase V: Transplantation and Application
This study concludes that positional rotations of every four hours has been shown to be the most effective prevention of pressure ulcer formation in older patients in elderly care homes and further that that attitudes, behaviors and perceptions of barriers in the view of staff nurses predicts the effectiveness of the implementation of such a prevention program for pressure ulcer care. (Moore and Price, 2006)
Exact Nature of Practice Implications
____ Change the…
Moore, Z. And Price, P. (2004) Nurses' Attitudes, Behaviors, and Perceived Barriers Towards Pressure Ulcer Prevention Journal of Clinical Nursing 13, 2004.
Vanderwee, K.; Grypdonck, D.; Bacquer, De and Defloor, T. (2006) Effectiveness of Turning with Unequal Time Intervals on the Incidence of Pressure Ulcer lesions. JAN Original Research 10 July 2006.
Nursing: Utilization Review
Perceptual and attitudinal changes are needed to motivate readiness to learn. Self-directed education is key to adult learning and especially to continuing education in the health professions (McClaran et. al, 1999, p. 184). Studies show that nurses will identify their specific needs for training and education and seek them out. They are also able to learn from previous experiences and build upon them to expand their proficiency of management skills. They seek personal mastery, vision, and team learning in order to grow as individuals and team members. These adult learners, as Knowles expressed, are motivated to learn and seek out the information they need. With education to understand the realities of healthcare management and a chance to develop management skills, nurses have both expanded opportunities and responsibilities that can impact the world of healthcare and provide safer and more satisfactory patient care.
Goddard NL. Financial management. (1987).
Goddard NL. Financial management. (1987).
In Vestal KW. Management concepts for the new nurse. Philadelphia: JB Lippincott, 127-152
Gotoh H. Continuing education changes nursing. Japanese Journal of Nursing Administration. 1992, 2 (1) 62-69.
Hiemstra, R., and Sisco, B. (1990) Individualizing Instruction: Making Learning Personal, Empowering, and Successful. San Francisco: Jossey-Bass.
Nursing and Issue of Falls
Falls are responsible for considerable morbidity, immobility, and mortality among older persons, especially those living in nursing homes. Falls can occur in a home, community, long-term rehabilitation, or acute care Setting (Laurence Z.. et.al, 1994). The risk of falls can be related mostly to mobility status, exposure to hazardous environments and risk-taking behaviors such as climbing ladders for seniors living in the community setting. Factors for a fall in hospitalized adults are greatly influenced by acute illness that often has a marked, albeit temporary, impact on physical and cognitive function compounded by care provided in unfamiliar surroundings in the long-term care setting, the risk factors for falls are influenced by impaired cognition, wandering or impulsive behavior, use of psychotropic medications, incontinence and urgency, lack of Exercise, unsafe environments, and low staffing levels. Patient falls are serious problems
In acute care hospitals and are used as…
Anuradha Thirumalai, (1998). Nursing Compliance with Standard Fall Prevention
Protocol Among Acute Care Hospital Nurses. Retrieved September 26, 2012 from http://digitalscholarship.unlv.edu/cgi/viewcontent.cgi?article=1191&context=thesesdissertations&sei-redir=1&referer=http%3A%2F%2Fwww.google.co.ke%2Furl%3Fsa%3Dt%26rct%3Dj%26q%3Dnursing%2520compliance%2520with%2520standard%2520fall%2520preventionprotocol%2520among%2520acute%2520care%2520hospital%2520nurses%26source%3Dweb%26cd%3D1%26ved%3D0CCAQFjAA%26url%3Dhttp%253A%252F%252Fdigitalscholarship.unlv.edu%252Fcgi%252Fviewcontent.cgi%253Farticle%253D1191%2526context%253Dthesesdissertations%26ei%3Dg-NiUPW8CuLB0QW_r4DgAw%26usg%3DAFQjCNE6__5zNu8vjRxc-jIFBXbBfKVIng#search=%22nursing%20compliance%20standard%20fall%20preventionprotocol%20among%20acute%20care%20hospital%20nurses%22
Dykes, P.C., Carroll, D.L., Hurley, A.C., Benoit, A., & Middleton, B. (2009). Why do patients in acute care hospitals fall? Can falls be prevented? Journal of Nursing Administration, 39(6), 299-304. doi:10.1097/NNA.0b013e3181a7788a
Laurence Z. Rubenstein, Karen R. Josephson & Alan S. Robbins, (1994). Falls in the Nursing
, 2010). It is perfectly conceivable that this nurse leader would welcome more collaborative or shared leadership responsibilities, particularly since the setting for empirical clinical research on this very issue was, in fact, an ICU (osengren, Bondas, Nordholm, et al., 2010).
Finally, it appears from this interview subject's input into this project that she is a competent and effective nursing leader, largely by virtue of her description of her supervisory and administrative style and inclination. However, her input lacked any substantial data on the basis of which a reviewer could evaluate her effectiveness as a clinical leader more specifically. Those particular skill sets may occur in combination but they undoubtedly also occur individually within different leaders (Stanley & Sherratt, 2010). A review of historical literature (such as in connection with Florence Nightingale) clearly demonstrates that good nursing leaders may or may not necessarily also be equally good clinical leaders (Stanley…
Armstrong, P.W. "A time for transformative leadership in academic health sciences."
Clinical & Investigative Medicine, 30(3); 2007: E127-132.
Davidson, S.J. "Complex responsive processes: a new lens for leadership in twenty-first-
century health care." Nursing Forum, 45(2); 2010: 108-117.
In any organization, leadership is a key element of success. The leader is the person who defines not only the organization's mission, but its tone and cultural, and determines how the organization's resources will be deployed to achieve these goals. This paper will examine the role of nursing leadership, in particular how leadership can change a nursing unit.
Leadership study has developed over the course of the 20th and 21st centuries to move from the basic principles of scientific management to modern conceptions of the transformative leader who emphasizes organizational culture and personal development. Where the leader as manager was intended to be replaceable, modern leaders are individualistic and as such they can have a significant influence over the organization.
One of the unique facets of contemporary nursing leadership is that it has both an internal and an external focus. Internally, the leader must guide the unit, but…
Antrobus, S. & Kitson, A. (1999). Nursing leadership: influencing and shaping health policy and nursing practice. Journal of Advanced Nursing. Vol. 29 (2) 746-753.
Laschinger, H. & Leitner, M. (2006). The impact of nursing work environments on patient safety outcomes. The Journal of Nursing Administration. Vol. 36 (5) 259-267.
Richardson, A. & Storr, J. (2010). Patient safety: A literative review on the impact of nursing empowerment, leadership and collaboration. International Nursing Review. Retrieved April 25, 2016 from http://u.osu.edu/electives/files/2014/05/Patient-Safety-Why-Teamwork-Matters-Week-3-124bq6a.pdf
egulations and Guidelines in nursing
The CMS-implemented Pay-for-Performance initiatives are designed to incentivize greater quality of care by all medical practitioners for all recipients of Medicare/Medicaid services (Fenter & Lewis, 2008). The fee-for-service model that the CMS still employs on a wide basis incentivizes a lower quality of care that leads to or includes more services, which has direct detrimental effects for patients and increases the cost burden on the Medicare and Medicaid programs and thus on the federal budget and on taxpayers (Fenter & Lewis, 2008). The Joint Commission on Accreditation of Health Organizations' Core Measures are a set of guidelines meant to modernize and standardize the processes and criteria of accreditation and ongoing measurement and quality assurance at health organizations (JCAHO, 2011). These standards are also related to care, but involve licensing and accreditation rather than payment and thus work as different incentives (JCAHO, 2011).
Fenter, T. & Lewis, S. (2008). Pay-for-Performance Initiatives. Journal of Managed Care Pharmacy 14(6): S12-5.
JCAHO. (2011). Specifications Manual for Joint Commission National Quality Core Measures. Accessed 3 April 2012. http://www.jointcommission.org/specifications_manual_joint_commission_national_quality_core_measures.aspx
Nursing Culture: Overcoming Barriers to Change
Introduction and Theoretical Framework
This program of study continues personal research and professional practice in the field of nursing within the area of public and private health systems. In an era characterized by increasing calls for more efficient approaches to healthcare delivery and accountability on the part of healthcare providers, there is a growing need for identifying opportunities to overcome organizational barriers to change that facilitate the implementation and sustainment of evidence-based practices over time. In order to accomplish this challenging enterprise, the nature of existing organizational barriers must be better understood, an issue that directly relates to the problem to be considered by the study proposed herein and which is discussed further below.
Statement of the Problem
According to Mannion, Davies and Marshall et al. (2005), the results of much of the research to date have identified a relationship between nursing culture and…
Banyard, V.L., & Miller, K.E. (1998). The powerful potential of qualitative research for community psychology. American Journal of Community Psychology, 26(4), 485.
Burton, S., & Steane, P. (2004). Surviving your thesis. New York: Routledge.
Dennis, C., & Harris, L. (2002). Marketing the e-business. London: Routledge.
Department of Health. (2000). The NHS plan: A plan for investment, a plan for reform. London:
The authors describe findings from a survey designed to gather baseline data about changes organizations experience after implementing the Clinical Practice Model framework, and report how the Clinical Practice Model Resource Center staff used the survey findings to build the capacity of individuals accountable for implementing this integrated, interdisciplinary professional practice framework into the organization's operations." (2002) The following model has been created for monitoring the progress of the nursing staff at the MD Anderson Cancer Center MEDVACM specifically checking progress in Years 1,3, and 5.
MD ANDERSON CANCER CENTER MEDVAMC
Job Performance Review Guide
PERFORMANCE GOALS AND OJECTIVES
ecome familiar with your department's business goals.
Work with your manager to define and document your goals. Include what you are expected to produce by your first review, activities needed to accomplish results, and success criteria.
Magnet Designation (2006) Inside UVA Online Vol. 36, Issue 14 August 26, 2006. Available at http://www.virginia.edu/insideuva/nursing_excellence.html .
Bailey, F. Amos (2000) Balm of Gilead Center, Cooper Green Hospital Pioneer Programs in Palliative Care: Nine Case Studies - Robert Wood Johnson Foundation - Milbank Memorial Fund October 2000. Online available at http://www.milbank.org/pppc/0011pppc.html#foreword .
Forrow, Lachlan (2000) Palliative Care Program, Beth Israel Deaconess Medical Center/CareGroupPioneer Programs in Palliative Care: Nine Case Studies - Robert Wood Johnson Foundation - Milbank Memorial Fund October 2000. Online available at
Nursing and Ethics
The emotional debate over abortion had been mischaracterized in the media, and hence disrupted any positive attempt to make progress in resolving the ethical and medical problems which have been created by the practice. A majority of Americans recognize and desire that abortion should be available when the life of the mother is at risk, or in the cases of rape or incest. However, liberal proponets like to expand this definition under the ubiquitous definition of the 'mothers health' which has been used to justify abortion on demand, for any reason. This latter expanded definition is significantly opposed by a majority of the ameircan population. In the midst of this struggle, comes the person needing medical care, who has neither been properly informed as to the dangers of the paractive, nor adequately counseled as to the options which exist regarding the future of her unborn child. The…
O'rourke, Kevin. PROXY CONSENT: DECIDING FOR OTHERS October 1980 accessed 23 April 2004. Available from: http://www.op.org/domcentral/study/kor/80100202.htm .
Bernard Lo, (July 2, 1987) "Behind Closed Doors: Promises and Pitfalls of Ethics Committees." NEJM 317;46.
Toward a More Natural Science, (1985) New York: Free Press,; p.211.
Curzer, Howard J. (6/22/1993) Fry's concept of care in nursing ethics. (response to Sara T. Fry, Hypatia, vol. 4, no.2, p.88, 1989) Hypatia.
The caregiver role includes those activities that assist the client physically, mentally, and emotionally, while still preserving the client's dignity. In order for one to be an effective caregiver, the patient must be treated in a holistic manner. Proper communication and advocacy is another role that the modern caregiver assumes when providing quality care (Carroll).
It is in the role of patient advocacy and cost-cutting that most nursing leaders are directly involved with hospital policy. Technology has increased the ease and ability for adequate communication -- there are more translators, access to databases, etc. within the field, and certainly there is more information about healthcare available for the layperson. However, the manner in which modern medicine works -- the reality that it is the nurse as opposed to the doctor who tends to follow the patient throughout their care, lends greater credibility to the use of the modern nurse as…
Carroll, T. (2005). Leadership Skills and Attributes of Women and Nurse Executives -Challenges for the 21st Century. Nursing Administration Quarterly, 29(2), 146-54.
Gershenson, Moravick, Sellman and Somerville. (n.d.). Expert to Novice: A Nuse Leader's Evolution. Nursing Management, 49-52.
Kouzes and Posner. (1994). An extension of the leadership practices inventory management systema dn individual contributors. Educational and Psychological Measurement, 54(4), 959-66.
Vesterinen, Isola and Paasivvra. (2009). Leadship Styles of Finnish Nurse Managers and Factors Influencing it. Journal of Nursing Management, 17(2), 503-9.
ecause this is true, it is critically clear that the nursing leadership manager's role is one of a vital nature and that support for nurses in their role is the primary component that must necessarily be integral to leadership in nursing in dialysis units if the turnover of nurses is reduced to the lowest possible level. The nursing leadership manager's role is one that must proactively deal with burnout of these dialysis unit nurses instead of attempting to address these as they occur. Prevention is 'key' toward this end. As the demands grow for quality and competent nursing staff so does the need grow for competency in leadership nursing manager roles. ecause the dialysis unit nurse is very closely involved in their patient's care and because these patients are required to report for treatment several days a week for several hours a day the nurse's mental, physical and emotional state…
Aiken, L.H., & Patrician, P. (2000). Measuring organizational traits of hospitals: The Revised Nursing Work Index. Nursing Research, 49, 146-153.
Aiken, L.H., & Sloane, D.M. (1997). Effects of organization innovation in AIDS care on burnout among urban hospital nurses. Work Occupation, 42, 453-477.
Aiken, L.H., Clarke, S.P., Sloane, D.M., Sochalski, J., & Silber, J.H. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction [Electronic version]. JAMA, 288, 1987-1993.
Aiken, L.H., Clarke, S.P., Sloane, D.M., Sochalski, J.A., Busse, R.A., Clarke, H., Giovanetti, P., Hunt, J., Rafferty, a.M., & Shamian, J. (2001). Nurses' reports on hospital care in five countries [Electronic version]. Health Affairs, 20, 43-53.
If nursing students are being asked to absorb 30-40% more information during undergraduate years, it is logical to see that they do so early in their academic career -- almost as a prerequisite for more advanced practicum.
Then, of course, there is the matter of the learning curve in professional education. If one compares schooling for registered nurses with that of physician's assistants or physicians, one often sees a growing gap between the clinical abilities of nursing staff and actual patient care needs. This cause has been attributed to deficiencies in some skill sets of new graduates -- which has the effect of pushing nursing schools and curriculum toward more robust materials (Berkow, Virkstsis, Sewart, and Conway, 2008). However, is the solution simply adding more materials to memorize and read, or might it be more efficient to take a look at the time frame of the educational experience and ask…
Berkow, Virkstsis, Sewart, and Conway. (2008). Assessing New Graduate Nurse Performance. Journal of Nursing Administration, 38(11), 468-74.
Burritt and Steckel. (2009). Supporting the Learning Curve for Contemporary Nursing Practice. Journal of Nursing Administration, 39(11), 479-84.
Heller, Oros, and Durney-Crowley. (2009, July 30). The Future of Nursing Education: Ten Trends to Watch. Retrieved September 20, 2010, from http://www.nln.org/nlnjournal/infotrends.htm
Holzmer, W. (2006). Quality in Graduate Nursing Education. Nursing Education Perspectives, 26(4), 236-43.
The American Nurses Association (2008) define nursing informatics as the mixture of computer and information science and nursing towards improving healthcare delivery and patient outcomes. Nursing informatics is a career that has developed from the evolution of health informatics, which involves the use of knowledge to examine and translate health data into useful information that can be utilized in enhancing patient outcomes through improved processes. As the healthcare field continues to adopt technology rapidly, nursing informatics is one of the educational programs that has emerged to prepare the workforce towards effective use of health information technology to enhance patient care delivery (Dalrymple, 2011). Nursing informatics education include formal graduate programs that provide both theoretical and practical training (which includes working with an already practicing preceptor). The ANA Scope and Standards of Nursing Informatics Practice requires students in this profession to complete a formal practicum as part of practical…
American Nurses Association (ANA). (2008). Nursing informatics: Scope & standards of practice. Washington, D.C.: Nursesbooks.org.
Dalrymple, P. W. (2011). Data, information, knowledge: The Emerging Field of Health Informatics. Bulletin of the American Society for Information Science and Technology, 37(5), 41-44. doi:10.1002/bult.2011.1720370512
Gugerty et al. (2007). Challenges and Opportunities in Documentation of the Nursing Care of Patients. Retrieved from Nursing Workforce Commission of Maryland website: http://mbon.maryland.gov/Documents/documentation_challenges.pdf
McLane, S. and Turley, J. P. (2011). Informaticians: How They May Benefit your Healthcare Organization. The Journal of Nursing Administration, 41 (1), 29-35. doi: 10.1097/NNA.0b013e3181fc19d6
1997, the average pass rate for first time test takers on the NCLEX-RN was 93%. Since 1997, the national average pass rate on the NCLEX-RN has declined to 83.8% (National Organization for Associate Degree Nursing, 2002). The pass rate for the state of North Carolina and many other states has also declined in recent years.
Community colleges are the prime educators of new registered nurses in the United States. In 1997, 701 community colleges awarded 41,258 associate degrees in nursing (National Center for Education Statistics 1997). The combined ADN graduate pool constituted 60% of the U.S. graduates who took the NCLEX-RN exam in 2000,and these graduates represent the largest group of nurses entering the profession (National Council of State oards of Nursing 2001). On the other hand, baccalaureate programs graduated 37% of the total; and diploma or hospital-based educational programs, graduated 3%.(Teich, et al.)
In addition to educating the majority…
Adams, Carolyn, Valiaga, Theresa, Murdock, Jane. McGinnis, Susan & Wolfertz, Joanne (2002). Trends in Registered Nurse Education Programs: A Comparison Across Three Points in Time. In National League for Nursing (Ed.), pp. 1-10).:.
American Association of Colleges of Nursing (1999). Temporary Nurses Called A Serious Risk Threat At Hospitals. In (Ed.), p.).: American Association of Colleges of Nursing.
American Health Care Association.(1999).Facts and Trends, The Nursing Facility Sourcebook.Washington, D.C.:American Health Care Association.
American Hospital Association.1999.Trendwatch:RN Shortages in Hospitals. Washington, D.C.: American Hospital Association.
Motivation as a Factor in Nurse etention
The decreasing recruitment and retention of nurses throughout the United States and internationally is a growing concern that must be addressed and remedied. As front-line workers, nurses play an integral role in the provision of quality healthcare to those who are most in need - the patients. In order to remedy the problem of increasing numbers of nurses leaving the profession, it is crucial that influential factors be identified. This study will explore the effects that motivation has on the job satisfaction of nurses and on nurse retention. It is hypothesized that nurses who are more motivated in their jobs are more satisfied, and are thus less likely to leave the profession. The findings from this study will provide information as to what changes can be made so that nurses are more motivated in their profession.
Nursing retention is a prominent factor in…
Callaghan, M. (2003). Nursing morale: What is it like and why? Journal of Advanced Nursing, 42 (1), 82-9.
Cooper, E.E. (2003). Pieces of the shortage puzzle: aging and shift work. Nursing Economics, 21 (2), 75-9.
Donley, R., Flaherty, M.J., Sarsfield, E., Taylor, L., Maloni, H., Flanagan, E. (2002). What does the nurse reinvestment act mean to you? Online Journal of Issues in Nursing, http://nursingworld.org/ojin/topic14/tpc.14_5.htm .
Ma, C.C., Samuels, M.E., Alexander, J.W. (2003). Factors that influence nurses' job satisfaction. Journal of Nursing Administration, 33 (5), 293-9.
high turnover of nursing personnel. The three main risks associated with this issue are 1) poor quality care, 2) unhealthy work environments, and 3) negative financial performance.
The first risk -- poor quality care -- is the result of a high turnover of nurses, which can lead to inadequate staffing. When there are two few nurses on any given shift, patients receive less care and attention because the nurses on shift are stretched in too many directions at once. Patients are required to wait longer, especially in the E, which can be problematic for patients requiring immediate care. Such is what happened to Edith odriguez at King-Drew hospital in L.A: she died in the E lobby waiting area because of insufficient attention given her by an over-stretched staff (AP, 2007).
The risk management solution to this first issue is to develop a temporary pool of nurses who can work on…
AP. (2007). Woman dies in ER lobby as 911 refuses to help. NBCNews. Retrieved from http://www.nbcnews.com/id/19207050/ns/health-health_care/t/woman-dies-er-lobby-refuses-help/#.V0XO57grLIU
Den, H., Deanne, N., & Belschak, F. D. (2012). When Does Transformational Leadership Enhance Employee Proactive Behavior? The Role of Autonomy and Role Breadth Self-Efficacy. Journal of Applied Psychology, 97(1), 194-202.
Geiger-Brown, J. (2010). Is it time to pull the plug on 12-hour shifts? Part 1. The evidence. Journal of Nursing Administration, 40(3): 100-102.
Ihan, M., et al. (2006). Long working hours increase the risk of sharp and needlestick injury in nurses: the need for new policy implication. Journal of Advanced Nursing, 56(5): 563-568.
Healthcare Practices in Nursing Today
Over the last 50 years, health care systems all over the world have experienced rapid and significant changes. Some of these changes have been the result of innovative developments in medical science and technology that have greatly benefited patients, prolonging and saving the lives of millions. Some of these changes, however, have had the unfortunate result of limiting patient access to prescribed treatment and diminishing the overall quality of care.
Significant challenges are being faced in health care as systems restructure and reinvent themselves in a difficult and often painful effort to make more efficient use of their available resources (ICN, 2001). Since health care is such a labor-intensive industry, the stresses on these systems inexorably trickle down to affect those employed by the system. Nurses, who are the most highly trained caregivers who have ongoing, regular patient contact, stand at the very heart of…
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We can compare the healthcare workplace to what is seen by a person when he/she looks through a kaleidoscope: since there are numerous different patterns that appear as the moments pass by. The shortage of nurses which has been publicized widely and the high turnover rates amongst the nurses are some of the unwanted patterns which have occurred. The dependence of healthcare institutions on the nurse-managers for the retention and recruitment of nurses is steadily increasing (Contino, 2004).
There are a number of routes through which the critical care nurses have become the leaders. Most of these routes don't have any educational or managerial training as a part of the process. There is a need for effective strategies for the care leaders who provide critical care in order to inspire the staff and manage the departmental operations in an effective manner to get positive results. One of the strategies…
Adams, J., Erickson, J., Jones, D., & Paulo, L. (2009). An evidence-based structure for transformative nurse executive practice, Nursing Administration Quarterly, 33(4), 280-87
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Ales, B.J. (1995). Mastering the art of delegation. Nurs Manage. August; 26: 32A, 32E.
American Organization of Nurse Executives (2005). AONE Nurse Executive Competencies. Nurse Leader, 3(1), 15-22.
achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #4, the MSN Essential IV, and the Nurse Practitioner Core Competencies # 7.
The achievement of course outcomes has prepared me to meet the fourth MSN program outcome: which is to evaluate the design, implementation, and outcomes of strategies developed to meet healthcare needs. Completing the course has also promoted the MSN Essential IV, and the Nurse Practitioner Core Competencies # 7. MSN Essential IV is "translating and integrating scholarship into practice," which is a core component of professional nursing. Through the course, we recognize the value of evidence-based practice as we integrate research outcomes within the practice setting. We also resolve practice problems, work as a change agent, and disseminate results.
Program Outcome #4: Evaluate the design, implementation, and outcomes of strategies developed to meet healthcare needs (MSN Essentials)
Evaluating the design,…
Campinha-Bacote, J. (2011). Delivering patient-centered care in the midst of a cultural conflict. Online Journal of Issues in Nursing 16(2).
Drenkard, K. (2012). Strategy as solution. Journal of Nursing Administration 42(5): 242-243.
Litaker, D., et al., (2006). Using complexity theory to build interventions that improve health care delivery in primary care. Journal of General Internal Medicine 21(2): S30-34.
"Population-Focused Nurse Practitioner Competencies," (2013). Retrieved online: http://www.aacn.nche.edu/education-resources/PopulationFocusNPComps2013.pdf
Family centered care is a noble belief deeming family members and health care staff as equal partners and working collectively to address the needs of the kid. Competency rises when a system synergizes as nurses and patient / family member's honors each other's commitment to heath care. Patient family centered care is a continuous process in order to address the needs and duties of families (St. Jude Children's Hospital, 2014).
Words and concepts that describe this phenomenon
Dignity, respect, information sharing, participation and teamwork
Identifying terms (concepts) that can summarize, label or name this phenomenon
Each family and child is different: Families have diverse backgrounds, life experiences, customs and traditions, education, cultural values and notions. Care should be facilitated equally to all patients whilst catering the choices and needs of each family (St. Jude Children's Hospital, 2014).
Open communication between family, patients and healthcare staff: It's productive to openly voice…
Ahmann, E. And Dokken, D. (2012). Implementing Patient- and Family-Centered Care: Part II - Strategies and Resources for Success. Pediatric Nursing. Volume 38, Number 2.
Mastro, K.A., Flynn, L. And Preuster, C. (2014). Patient- and Family-Centered Care: A Call to Action for New Knowledge and Innovation. The Journal of Nursing Administration. Volume 44, Number 9, pp 446-451.
St. Jude Children's Hospital. (2014). What is Patient Family Centered Care? Retrieved from: http://www.stjude.org/stjude/v/index.jsp?vgnextoid=0342a1673c82f110VgnVCM1000001e0215acRCRD&vgnextchannel=6772fdb506543110VgnVCM1000001e0215acRCRD
Nurse Administrator Interaction
It is possible to learn from one's own experiences about best practices. By looking at our interactions with others, we can identify behaviors that work and those that do not, through the process of reflection. When I think about my previous work environments, and the experiences that I have had with nurse administrators, there is opportunity for reflection there, both on good behaviors and bad.
A good practice environment has the following components. The nurse administrator needs to build trust with the team, and trust with the other internal stakeholders in the organization, in order to maximize effectiveness (Newhouse & Mills, 2002). There are a number of behaviors that can help to build trust. Communication is perhaps the most important. People need to know in their day-to-day activities what is expected of them, what they will be evaluated on, and where they stand with respect…
Newhouse, R. & Mills, M. (2002) Enhancing a professional environment in an organized delivery system: lessons in building trust for the nurse administrator. Nursing Administration Quarterly. Vol. 26 (3) 67-75.
Borawski, D. (1995). Ethical dilemmas for nurse administrators. Journal of Nursing Administration. Vol. 25 (7-8) 60-62.
Communication is one of the most important aspects of nursing, as the case study of the student and the instructor indicates. The student nurse failed to communicate to the instructor the patient's abnormal oxygen saturation reading -- a reading that could have had very serious consequences for the patient. An entire week going by before this information is relayed to another nurse is highly unacceptable, considering how much emphasis is placed upon preventing medical errors from occurring (Cimiotti, Aiken, Sloane, Wu, 2012). Thus, it is imperative that student nurses appreciate the ramifications of failures in communication -- ramifications that could be potentially fatal for patients and, by extension, legally adverse for the health care facility. Stressing the crucial importance of nurse to nurse communication is vital to the well-being both of the health care organization and the well-being of the patient.
Importance of Nurse to Nurse Communication
Cimiotti, J., Aiken, L., Sloane, D., Wu, E. (2012). Nurse staffing, burnout, and health care -- associated infection. American Journal of Infection Control, 40(6): 486-490.
Dall'Ora, C., Griffiths, P., Ball, J. (2016). 12-hour shifts: burnout or job satisfaction?
Nursing Times, 112(12/13): 1-2.
Dall'Ora, C., Griffiths, P., Ball, J., Simon, M., Aiken, L. (2015). Association of 12 h shifts and nurses' job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries. BMJ Open, 5(9): e008331.
ADN vs. BSN
The ADN vs. The BSN:
A comparison of both nursing degrees
Students wishing to enter the profession of nursing are often faced with two clear choices: that of an ADN (associate degree in nursing) and a BSN (Bachelor of Science nursing degree). An ADN generally takes two years and is often offered by a community college or state school. As a result, it is substantially cheaper than a four-year BSN. Obtaining an ADN still allows a nurse to sit for the NCLEX-N. "The coursework of an associate's degree in nursing covers the following general subjects: fundamentals of nursing, infection control, nutrition and dietetics, basic microbiology, basic medical nursing, pediatric nursing, and more" ("What you need to know," 2014). It should be noted that an ADN does not have to be a terminal degree and there are ADN 'bridge' programs that allow practicing nurses currently possessing…
ADN vs. BSN: Which should you choose? (2014). Monster. Retrieved from:
The future of the associate degree in nursing program. (2014). Nursing Licensure.
Retrieved from: http://www.nursinglicensure.org/articles/adn-program-future.html
Nursing in the Contemporary World
Nurses as the Most Highly Trusted Health Professional
ecent studies indicate that nurses are the most highly trusted health professional group.
ecent studies indicate that nurses are the most highly trusted health professional group.
Discuss the components of nursing's contemporary image that places nurses in this position of trust
Nursing profession has undergone tremendous development to attain the respect and valuation within the society. The current trend states that nursing ranks as the highly trusted health professional group. One of the components for this development is the tremendous efforts put by women to wrestle the profession from men in the historic periods. This struggle towards development of the profession reflects on different perspectives: environmental, political, cultural, and social. Extensive nursing education in the contemporary world supplements the efforts of nurses in their service provision (Im & Ju, 2012). This helps to put nursing professional group…
Cherry, B., & Jacob, S.R. (2011). Contemporary nursing: Issues, trends, & management. St.
Louis, Mo: Elsevier/Mosby.
Im, E., & Ju Chang,, . (2012). Current Trends in Nursing Theories. Journal of Nursing
Scholarship, 44(2), 156-164. doi:10.1111/j.1547-5069.2012.01440.x
For example, although many nurses were taught to place infants in the prone sleeping position to prevent aspiration, there is now persuasive evidence that supine (back) sleeping position decreases the risk for sudden infant death syndrome." (p. 28)
This also implicates the practice dimensions of nursing. According to the primary text, evidence-based practice is particularly important as a way to dissuade against poorly informed or assumption-driven decision-making. here non-evidence-based practice is in place, the risk is higher that error or unwanted health consequences may result from treatment approaches. By contrast, the use of evidence-base practice provides the nurse with a set of empirically formed guidelines on how to approach each patient. Instinct such as that often relied upon so heavily in non-evidence-based practice, should be integrated with the understanding afforded by comprehensive research. Only then can the practicing nurse apply practical treatment decisions without falling into otherwise discredited customs or…
Polit, D.F., & Beck, C.T. (2008). Nursing Research: Generating and Assessing Evidence for Nursing Practice, (8th ed.).
Bar code medication administration (BCMA) is one of the keys to minimizing medical errors in a manner consistent with evidence-based practice (Poon et al., 2010). However, universal embrace and utilization of BCMA remains stagnant. easons for resisting the transition to BCMA include nurse perceptions. Holden, Brown, Scanlon, & Tzion-Karsh (2012), for instance, found nurses reporting low perceived usefulness of BCMA in spite of the wealth of evidence supporting the technology. Perceived ease of use of BCMA was moderate, suggesting that it is mainly attitude factors preventing nurses from implementing BCMA in their institutions. When perceptions of the usefulness of BCMA increase, then compliance with BCMA standards can become more widespread. Any program that attempts to increase the utilization of BCMA must focus first on human factors including attitudes. This requires that all nurse leaders, as well as nurse educators, prepare advance practice nurses for using BCMA as a matter…
Duffield, C.M., Roche, M.A., Blay, N., & Stasa, H. (2011). Nursing unit managers, staff retention and the work environment. Journal of Clinical Nursing, 20(1-2), 23-33.
Roberts, B.R. (2013). Doctor of nursing practice: Integrating theory, research, and evidence-based practice. Clinical Scholars Review, 6(1), 4-8. doi: http://dx.doi.org/10.1891/1939-2095.6.1.4
Nurse etention Capacity
Standards & Analysis on Nurse etention
The demand for nursing staff in the United States has significantly increased and according to the Center for American Nurses, employment in these positions have increased to an amazing 83% which is now at the highest it has been since 1980, and considering that this role is the biggest job in healthcare offering over 2.6 million jobs, the problem in hospitals, healthcare facilities, and in home care is the lack of nurses (Bureau of Labor Statistics, 2011). Furthermore, there are many reasons as to why experts and the healthcare facilities are unable to hire enough people to fulfill the positions within their establishments, and most research has determined that the main reasons there is such a shortage in nursing jobs is because of the poor management and leadership within the nursing work environment, the increased amount of responsibility and work load…
Bureau of Labor Statistics. U.S. Department of Labor, Office of Occupational Statistics and Employment Projections. (2011). Occupational outlook handbook 2010-2011 edition, registered nurses on the internet Washington, DC: Retrieved from http://www.bls.gov/oco/ocos083.htm
Chart Your Course International (2011). Nursing shortage. Retrieved from http://www.highretention.com/nursing_research.html
Monaghan, H.M. (2009). Effective leadership + nurse retention. Retrieved from http://www.visioninghealthcare.com/pdf/Article-Effective-Leadership-Nurse-Retention.pdf
Runy, A. (2006, January). Nurse retention. H&HN Magazine, Retrieved from http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/PubsNewsArticle/data/0601HHN_FEA_Gatefold&domain=HHNMAG
It is critical that NHAs are first qualified nurses, as their ability to relate to other nurses is essential to the organizational success of the nursing home ("Nursing home administrator jobs," 2011). Career paths for an NHA are rooted with education background and nursing experience. Although experience is necessary for being a successful NHA, a career path at minimum requires clinical licensing (Decker, & Castle, 2009).
The NHA is the management body over the facility, and their positions are in high demand. In the U.S. In 2008, approximately 17,000 nursing home administrators were responsible for the oversight of care for 1 million elderly adults and 1.3 million employees (Leister, 2009). Overseeing a large nursing staff, as well as vulnerable residents, are the daily demands of the NHA. The future of NHA field is concerning to researchers and professionals, as the number of licensed NHAs is on the decline. In Maryland,…
Decker, F, and Castle, N. (2009). The relationship of education level to the job tenure of nursing home administrators and directors of nursing. Health Care Management, 34(2), 152-160.
Leister, D. (2009). The vanishing nursing home administrator: stress and intent to leave.
Informally published manuscript, Capella University, Minneapolis, MI. Retrieved from http://gradworks.umi.com/3359575.pdf
Nursing home administrator jobs. (2011). Retrieved from http://www.nursinghomesjobs.org/nursing-home-administrator-jobs/
That is, though overall job satisfaction is rated significantly higher than the itemized individual aspects, most items were rated a point or two above the median level of satisfaction, not exactly demonstrating strong support for the environment as it currently stands but demonstrating a great enough degree of satisfaction to make effective work possible. Further analysis based on the more meaningful findings in this study, such as the impact of administrative stressors on overall job stress and job satisfaction and a determination of how self-perceptions of performance impact perceptions of environment, would help to inform and clarify the findings in relation to these other items.
Series 1: Mean
Series 2: Variance
1. Overall job satisfaction
2. The quality of patient care I perform
3. The help I receive from my co-workers
4. The help I receive from Administration (above charge nurse)
5. My time management skills
Babbie, E. (2011). The Basics of Social Research. Mason, OH: Cengage.
Doughty, J., May, B., Butell, S., & Tong, V. (2002). A Profile of the Social Climate of Nursing Faculty. Nursing Education Perspectives, 23(4), 191-196.
Hunter, J. & Schmidt, F. (2004). Methods of Meta-Analysis. Thousand Oaks, CA: Sage.
Teo, S., Newton, C.J., Chang, E., Pick, D., & Yeung, M. (2011). Do Australian public and nonprofit nurses cope with administrative stressors?.
Nursing Theorist: Sr. oy Adaptation Model
The oy Adaptation model for Nursing had its beginning when Sister Callista oy happened to get admitted in the Masters Program of pediatric nursing in the University of California, Los Angeles, in the year 1964. At that time, Sr. Callista was familiar with the idea of 'adaptation' in nursing, and it must be mentioned that Sr. Callista's adviser at that time was Dorothy E. Johnson, who believed firmly in the need to define nursing as a means of focusing the development of knowledge, for the practice of nursing. When Sr. Callista oy started working with children in the pediatric ward of the hospital, she was quite impressed with the basic resiliency of the small children who had been admitted into the wards for treatment. This was why when the first seminar in pediatric nursing was called for; Sr. Callista oy proposed that the basic…
"Callista Roy's Adaptation Model" Retrieved From
http://www.geocities.com/ninquiry2002/callistaroy Accessed 28 October, 2005
'Case Study" Retrieved From
http://www.geocities.com/ninquiry2002/casestudy.html Accessed 28 October, 2005
One need only read the newspaper "Classified" ads to realize that employers are trying many clever marketing tactics to attract prospective nurses into their organizations. Many are offering sign-on bonuses, extra benefits and other amenities to attract a limited supply of nurses. As both the general population and the elderly population grow, the number of nurses needed to care for them increases proportionally as well. The number of people choosing to pursue nursing as a career has been on the decline, mainly due to long working hours, low pay, high job stress and other factors. These factors will not resolve themselves if the nursing deficit continues to increase. In addition, graduate nurses find it difficult to enter the workforce due to their lack of experience and a shortage of mentors to teach them. The solution is simple, more nurses are needed, and soon. Novice nurses are fresh graduates who…
Durkin, Barbara.(2002) Reliving Hospital Mistake: Mom recalls overdose case February
24, 2002. Newsday, Inc.
Lang, Susan. (1996) Lack of nursing assistants is an impending crisis, says Cornell gerontologist. Cornell University. Cornell University. http://www.news.cornell.edu/releases/May96/nursingassistants.ssl.html . Accessed June, 2002.
National League for Nursing (NLN). (2000). Unpublished Data. New York, NY. http://nursing.about.com/gi/dynamic/offsite.htm?site=http%3A%2F%2Fwww.nln.org%2Faboutnln%2Fnews_tricouncil2.htm. Accessed June, 2002.
The nursing coursework I have taken so far focuses in particular on the second and fifth competencies, regarding information and technology. Courses like anatomy and physiology are fundamental information-gathering classes that provide a firm foundation for aspiring nurses. Thorough knowledge of the human body, its functions, and its diseases, plus knowledge of medicine are imparted through nursing classes. Furthermore, nursing instructors also demonstrate how technology plays a role in the profession. We use computers to access medical databases, for example. Therefore, the second and fifth competencies are related to one another. In addition to their use as information technology, computers also provide the backbone of almost all electronic medical equipment. Nursing courses also show how sophisticated machines such as CAT scans are implemented in hospitals.
I am particularly weak in particularly those competency areas that the nursing courses cover: information and technology. Regarding resource allocation, interpersonal skills, and systems understanding,…
Research and Nursing Questions
Research is a complex and nuanced concept which means that one approach might not, in and of itself, answer the full scope of one's research questions. This is why it can sometimes be useful to combine Quantitative and Qualitative research strategies. This can help to provide a multidimensional perspective on a given research problem. The text by Bennett & Braumoller (2006) refers to the combination of these approaches as a Mixed Methods research strategy.
The use of Mixed Method research strategies is based on the view that researcher can produce greater on a subject by varying the approaches which are used to collect data. The idea that both qualitative and quantitative data gathering processes can produce a more expansive data set is driven by the understanding that there are often distinct limitations in the conclusions we can make from narrowly framed research investigations. (Bennett…
Bennett, A. & Braumoller, B. (2006). Where the Model Frequently Meets the Road: Combining Statistic [al,] Formal and Case Study Methods. APSA manuscript.
Media Relations. (2004). Nursing Shortage Fact Sheet. American Association of Colleges of Nursing
One of the primary role of the nurse, notes the authors, is to help educate the patient about the parameters of his or her disease. Part of the education process is teaching patients about the drugs recommended to them by their doctors or the pharmaceuticals they are already taking to alleviate symptoms. urses can use their knowledge to make patients feel more comfortable about their treatments, more well-informed, and therefore more in control of their course of treatment. Patients who are cognizant of the possible side-effects and benefits of the drugs they take to manage their disease are more likely to comply with guidelines for treatment because they understand the motives behind them. The authors also claim that patient education is an integral part of healing. The article's impact on the nursing profession is broad and extends beyond the limited subject matter they address in "Bisphosphonate therapy for metastatic bone…
In "Bisphosphonate therapy for metastatic bone disease: the pivotal role of nurses in patient education," authors Fitch & Maxwell (2008) focus on the importance of nurse awareness of oncology treatments. Nurse awareness of existing and cutting-edge oncology treatments fosters deeper patient trust and understanding. The more comfortable nurses are with their knowledge of bisphosphonates, the better their patients can understand the drugs as a part of their treatment. Fitch & Maxwell (2008) outline the different types of bisphosphonates, various methods of administration, and also detail their role in treating metastatic bone diseases and cancer with the ultimate objective of creating a more well-informed nursing and patient community.
The Fitch & Maxwell (2008) article is not an experiment related to bisphosphonates or bone disease. Rather, the article is a meta-analysis, a summary of existing and prior research on how bisphosphonates can help patients with metastatic bone diseases. The authors explain the use of bisphosphonates and their role in aiding recovery. Most importantly, Fitch & Maxwell (2008) urge nursing professionals to learn about and understand bisphosphonates. One of the primary role of the nurse, notes the authors, is to help educate the patient about the parameters of his or her disease. Part of the education process is teaching patients about the drugs recommended to them by their doctors or the pharmaceuticals they are already taking to alleviate symptoms. Nurses can use their knowledge to make patients feel more comfortable about their treatments, more well-informed, and therefore more in control of their course of treatment. Patients who are cognizant of the possible side-effects and benefits of the drugs they take to manage their disease are more likely to comply with guidelines for treatment because they understand the motives behind them. The authors also claim that patient education is an integral part of healing. The article's impact on the nursing profession is broad and extends beyond the limited subject matter they address in "Bisphosphonate therapy for metastatic bone disease: the pivotal role of nurses in patient education."
A person's health is an ever-changing state of being resulting from the interaction with the environment. Optimum health is the actualization of both innate and obtained human potential gained through rewarding relationships with others, obtaining goals and maintaining expert personal care. Adaptations can be made as required to maintain stability and structural integrity. A person's state of health can vary from wellness to illness, disease, or dysfunction. Professional nursing is founded on the need to promote wellness practices, the attentive treatment of persons who are acutely or chronically ill or dying, and restorative care of patients during convalescence and rehabilitation. It also includes the education and measurement of those who perform or are learning to perform nursing responsibilities, the support and communication of research to enhance knowledge and practice, and the management of nursing in healthcare delivery systems. Nursing practice centers on the application of a body of knowledge in…
Johnston, N., Rogers, M., Cross, N. And Sochan, a.(2007) Global and planetary health:
teaching as if the future matters. Nursing Education Perspectives 26(3), 152
Nyatanga, L. (2005) Nursing and the philosophy of science. Nurse Education Today 25(8), 670-675
They can reveal how many overworked and under-trained nurses kill and injure thousands of patients every year because hospitals sacrifice safety for not tracking their own medical errors. Statistics showed that only 14 States track these errors and hospitals in most States were not required to offer information on accidental deaths or injuries, not even to the families of the victims. Public custom databases, such as the Food and Drug Administration or FDA and the Health Care Financing Administration, tracked reports of a range of these medical errors and neglect from defibrillators to pacemakers, and from sutures to skin grafts. These incidents included thousands of patients accidentally overdosed because nurses typed the wrong dosage; did not hear the warning alarm on patients on life-saving machinery; patients' heads trapped in bed rails or strangled by post-surgical restraints (erens).
The Chicago-based National Council of State oards of Nursing computerizes disciplinary actions against…
Associated Press (2006). Former nurse convicted of drug theft. 1 page. Boston.com:the New
York Times Company
Berens, M.J. (2001). Medical errors. 3 pages. The IRE Journal: Investigative Reporters and Editors, Inc.
Cuomo, a.M. (2001). Nurse admits to narcotic theft at Long Island Hospital. 2 pages. Office fo the New York State Attorney-General: New York State
Nursing: Today and Throughout History
The occupation of nursing has been around for almost all of history in some form or another. In the ancient Roman Empire are found records of the nursing practice, where nurses provided care to in-patients at local Roman hospitals. In Constantinople—the Rome of the East—nurses were “known as hypourgoi” (Kourkouta, 1998). These nurses (both male and female) were tasked with jobs much like today’s nurses: they provided a wide variety of services to patients. Kourkouta (1998) states that the main tasks of the hypourgoi (male nurses) and hypourgisses (female nurses) were to give “psychological support of patients, everyday care of patients’ bodily needs and elementary comfort, cleaning of patients and providing them with proper food, the administration of medicines according to a doctor’s instructions, supervising wards when the physicians were not present, the performance of enemas, cuppings and bloodletting, the main therapeutic means used at…
Moreover, recent legislation such as the Affordable Care Act is expected to create an even greater need for nurses who can take on more advanced responsibilities. As one nurse stated on National Public adio: "…with the passage of the Affordable Care Act, which was passed in March, we're going to see 32 million new patients accessing the health care delivery system which previously weren't accessing this system. And currently, we don't have the capacity to provide high-quality, patient-centered care for this new expanded population" (NP, 2010)
Careers in nursing have become vast and varied, particularly for the highly educated, and pay for many of these careers is above $60,000 annually. While a nurse with a BSN who becomes an N can still advance in her career, enter management, or become a nursing professor, an MSN is necessary for nurses to enter one of the more prestigious and specialized subfields (Sacks,…
AACN. (2010, 10). The Impact of Education on Nursing Practice. Retrieved 02-14, 2011, from AACN: http://www.aacn.nche.edu/media/factsheets/impactednp.htm
Allen, J. (1988). Health Care Workers and the Risk of HIV Transmission. The Hastings Center Report, 18 (2), 2+.
NPR. (2010). Talk of the Nation: Role of Nurses in Primary Care May Expand. Retrieved 02-14, 2011, from NPR: http://www.npr.org/2010/11/16/131361359/role-of-nurses-in-primary-care-may-expand
OSHA. (2011). Bloodborne Pathogens and Needlestick Prevention. Retrieved 02-14, 2011, from OSHA.gov: http://www.osha.gov/SLTC/bloodbornepathogens/index.html
Nursing Counseling and Smoking Cessation Among Inpatients
The work of Li, et al. (2014) reports a study that examines the facilitators and barriers to effective smoking cessation as it relates to counseling services provided to inpatients by nurse counselors.
The study reports that the Taiwanese Health Promotion Administration reports that 4.8 million smokers exist in Taiwan and that nearly 50% of these smokers were interested in quitting smoking. Smoking cessation is beneficial to both smokers and those whom they love and are loved by in that smoking cessation not only saves lives of those who quit smoking but in addition results in reduction in the costs of personal and health care. According to the report, THPA's implementation of the "New Smoking Cessation Policy on the 1st of March 2012 to expand smoking cessation counseling services to both outpatient and inpatient settings." (Li et al., 2014, p. 5) Li et al.…
Li, I. et al. (2014) Facilitators and Barriers to Effective Smoking Cessation: Counseling Services for Inpatients from Nurse-Counselor's Perspectives -- A Qualitative Study. Int J. Envrion Res. Public Health. 11, 4782-4798.
Nursing and Diabetics elationship
Assess the past and present impact nurses, including advanced professional/advanced practice nurses, have made in addressing this health issue. The growing number of diabetics as well as the condition's characteristic lasting effects and associated high cost of treatment have given many health personnel sleepless nights. Due to its frightening numbers, the importance of nurses in assisting patients so as to reduce illnesses and deaths among diabetics is on the rise. Some of the roles the concerned nurses can play include patient examination for signs of the disease, placing the patient on effective treatment patterns, assisting the patient to create and work towards health objectives and provide quality care for problems related to the disease when they occur. By carrying out these roles effectively, nurses can be on the frontlines of diabetics training about the complicated nature of the disease and how crucial early treatment could be…
Levich, B. R. (2011). Diabetes management: optimizing roles for nurses in insulin initiation. J MultidiscipHealthc, 4, 15-24.
Arabi, A., Rafii, F., Cheraghi, M. A., & Ghiyasvandian, S. (2014). Nurses' policy influence: A concept analysis. Iranian journal of nursing and midwifery research, 19(3), 315-22.
Studies suggest that more computerized order entry of medications helps reduce errors by limiting interpretation errors due to handwriting (Meadows, 2003). Thus more order entry is involving computers to protect patients. A culture that supports safety and safe practices has also been adopted to provide nursing staff and patients information about drug therapy and medication to ensure that everyone is aware of the need for safe practices when utilizing and dispensing medications.
Describe the strategies used to ensure nursing practice is performed within legal requirements and ethical frameworks
Nurses now "live and work in a world where there is no single reality but many coexisting realities among which they must choose" (Johnston, 1999:1). Given that through more and more nurses are forced to make legal and ethical decisions and take steps that will determine the best processes to adopt to ensure that moral and legal processes are adopted and followed.…
Campbell, D.W. & Sigsby, L.M. (1995). "Nursing interventions classification: A content analysis of nursing activities in public schools." Journal of Community Health Nursing, 12(4): 229.
Caretto, V.A. & McCormick, C.S. (1991). "Community as Client: A Hand's on experience for baccalaureate nursing students." Journal of Community Health Nursing, 8(3): 179.
Johnston, M.J. (1999). Bioethics: A nursing perspective. Sydney: Harcourt Saunders.
Lumby, J. & Picone, D. (2000). Clinical challenges: Focus on nursing. St. Leanords:
Taking the history of a patient is a crucial aspect of patient assessment and treatment. A good history can mean the difference between a successful patient outcome and unsatisfactory outcomes. However, taking a complete and useful history is a skill that is developed by means of training and practice; it is not some talent that is innate (Bickley & Szilagyi, 2007; McKenna et al., 2011). According to Craig (2007) nurses are increasingly being asked to take patient histories. Given these growing responsibilities nurses need training and guidelines to taking an adequate patient history. The following is a summary and critique of Craig, L. H, (2007), A "Guide to Taking a Patient's History" in Nursing Standard, volume 22, issue 13, pages 42-48.
Craig (2007) takes a comprehensive approach to explaining the interview and history taking process. This approach is applicable for most any patient population; however, Craig does not…
Alarcon, R.D. (2009). Culture, cultural factors and psychiatric diagnosis: Review and projections. World Psychiatry, 8, 131 -- 139.
Bickley, L.S. & Szilagyi, P.G. (2007). Bates' Guide to Physical Examination and History
Taking. 9th ed. Hagerstown, MD: Lippincott, Williams & Wilkins.
Craig, L.H. (2007). A guide to taking a patient's history. Nursing Standard, 22 (13), 42-48.
The Shared Governance arrangement:
offers an apparatus for registered nurses to show guidance in the development of practice decisions authorizes all nursing staff to add to work redesign advances the quality of patient and family outcomes.
In the shared governance arrangement, the staff nurses are a big piece of the course, designated and chosen from their units to stand for an area of practice on one of many councils. it's all about shared choice making and authorizing staff nurses to affect their practice atmosphere and have a say in unit choices (Shared Governance at Henry Ford Hospital, 2011).
A new nursing deficiency is revitalizing shared governance. This pioneering organizational model gives staff nurses power over their practice and can expand their affect into administrative areas formerly controlled solely by managers. But nursing shared governance is tough to describe. Its configurations and procedures are dissimilar in every business. Shared governance, is…
Drenkard, Karen. (2010). Going for the gold: The value of attaining Magnet recognition.
Retrieved February 18, 2011, from Web site:
Estlund, Sarah. (2010). List of Nursing Labor Unions. Retrieved February 17, 2011, from Web
The data gathered is subjected to statistical analysis using statistical methods of linear regression and chi square testing.
The main purpose of the study was to confirm the hypothesis that consultation with CNS or RN in a drug-monitoring clinic has a significant positive impact on the well being of patients with rheumatoid arthritis. The study involved a single blinded randomized controlled trial over a period of three years. Subjects were chosen from the rheumatology out patient setting in a district general hospital with a drug monitoring service. A total of 71 subjects who were starting out on anti-rheumatic therapy were randomly assigned to either the interventional or the control group. While the interventional group was supervised by the CNS to assess patient needs (using Pendelton's framework) alongside drug safety evaluation, the control group was seen by an outpatient staff nurse purely for drug safety concerns. oth the groups were assessed…
Teri Britt Pipe; Kay E. Wellik; Vicki L. Buchda; Carol M. Hansen; Dana R. Martyn, 2005, "Implementing Evidence-Based Nursing Practice," Urol Nurs. 25(5): 365-370, Available at, http://www.medscape.com/viewarticle/514532
Ryan, S, Hassell, a.B, Lewis, M, & Farrell, a. (2006). Impact of a Rheumatology Expert Nurse on the well-being of patients attending a drug monitoring clinic. Journal of Advanced Nursing, 53(3), 277 -286.
Considine, J. & Botti, M. (2004) Who, when and where? Identification of patients at risk of an in-hospital adverse event: Implications for nursing practice. International Journal of Nursing Practice. 10: pp. 21-31
The preceding evidence lends itself to a number of specific nursing implications that are very likely to improve the conditions of a variety of patients affected with the miasma of symptoms that encompass dementia. The specific care for each individual patient will vary based on whether the data used to assess a particular symptom applies to that patient or not. In the case of the latter circumstance, the patient will merely forego the recommendation (which solely applies to patients suffering from that particular manifestation of dementia) in favor of one that coincides with the specific needs of that patient.
The empirical evidence of Vance and Cowen (2010) indicates that the deployment of light therapy yields positive affects for those suffering from Alzheimer's disease. The administration of light therapy from a light box generating between 1500 and 2500 lux will be used for one to two hours both in…
During normal waking hours, music therapy in the form of clock radios that serve as alarms throughout various points in the day (and which play music of the patient's choice) will be utilized, as well as aroma therapeutic practices in which lavender scents (in the form of candles and scented oils) will be used, since the study of Lin et al. (2007) has compiled empirical data to support lavender's alleviation of agitated behaviors. Based on Vance and Cowan's 2010 research that discourages inactivity and daytime napping, residents will be offered a variety of diurnal activities revolving around the outdoors, such as hiking, walking, and other forms of exercise agreeable to the patient.
Paragraph in the Introduction
The term Sundowning Syndrome (reviewed by Bachman & Rabins, 2006) has been used to describe the increased agitation of Alzheimer's patients during the late afternoon and early evening, and has been observed for more than 60 years. Volicer et al. (2001) helped confirm this tendency by monitoring circadian rhythms in dementia patients (with a mean age of 71) through the usage of body temperatures. The studies were extremely effective in producing statistical documentation that indicated a three hour lapse in the peak core of body temperatures for Sundowning patients as opposed to controls, as well as a five hour lapse in the peak motor activity between the same two groups. The strength of these research methods can be determined by the fact that they were able to quantify such information in immediately comparable forms. The fact that these results brought forth a conclusion that circadian control mechanisms were not in optimal operations for such patients is somewhat vague, and could be strengthened by expositions to determine why this is the case. The conclusion of these studies, however, is supported by the work of Serniczuk, Dyck, LaFerla, and Antle (2010) which found frequent SCN atrophy and optic nerve damage in post mortem dementia patients.
Nusing poblem 1: May's pain must be contained so she does not injue heself.
Because childen cannot always expess thei sensations of pain, thei pain may go unnoticed until it becomes sevee and fightening.
Nusing poblem 2: Vomiting and the possibility of choking.
Anxiety and pain can cause childen to vomit, making teatment of pain and administeing pope nutition difficult.
Nusing poblem 3: May is attempting to emove he oxygen mask.
A lack of knowledge on the pat of the child as to why cetain teatments ae administeed can esult in noncompliance.
Nusing poblem 4: The need fo social suppot when May's mothe is not pesent.
The unfamiliaity of the hospital envionment is exacebated by May's lack of paental cae.
Diagnosis 1: Pain management
Outcome: The FLACC: a behavioual scale fo scoing postopeative pain in young childen that can be helpful in detemining how to teat…
Almond, C. (1998). Children are not little adults. Australian Nursing Journal, 6(3), 27 -- 30.
Bruce, E., & Franck, L. (2000). Self-administered nitrous oxide (Entonox () for the management of procedural pain. Paediatric Nursing, 12(7), 15 -- 19.
Manworren R. & Hynan L.S (2003) Clinical validation of FLACC: preverbal patient pain scale. Paediatric Nursing 29(2):140-146.
McInerney, M. (2000). Paediatric pain. Pulse Information Sheet of Royal College of Nursing,
Besides facing stress, and having easy access to medications, critical care and emergency nurses may use recreational drugs more often because they are more likely to have a sensation-seeking personality trait (www.nurseweek.com/news/98-5/25e.html)."
Getting treatment for chemical dependency will help the nurse get back to his or her daily life, however the nurse will have to address concerns and/or consequences related to the addiction. He or she faces a "multitude of traumatic experiences both potential and real, such as arrest, license suspension/revocation; negative publicity; reactions of family, friends and co-workers; fines; board and legal hearings; inability to secure work other than nursing; physical illness; and possible lack of health insurance. In the treatment setting, issues such as these add complexity to the nurse's recovery (Anderson)."
There are other complications which must be addressed during treatment of the impaired nurses. These issues include being considered a role model by everyone,…
Anderson, Jenny Lynn. "Treatment considerations for the addicted nurse." Behavioral Health
Management. (1994): 01 September.
(Substance abuse in nurses varies by specialty. (accessed 15 November, 2004).
Nursing profession is a complex and important field of human care. In addition to the challenge of high workloads and long hours, nurses are also faced with the challenge of caring for persons who are often hostile or otherwise difficult to handle as a result of the conditions they suffer from. In such cases, nurses must provide care with professionalism and friendliness, regardless of their personal feelings. To be able to perform their work effectively over the long-term, it is vital for nurses to receive as much support as possible from their leaders and peers. In addition to leadership systems such as the transformational paradigm and the synergy model, there are also technical support systems that nurses can benefit most profoundly from.
The nurse's relationship to the information systems and technology department, for example, is of optimal importance. According to the Biohealthmatics.com Website (2010), this relationship is currently tragically underutilized…
Bigelow, B. And Arndt, M. (2005, Spring). Transformational Change in Health Care: Changing the Question. Hospital topics: Research and Perspectives on Healthcare. Vol. 83, no. 2.
Biohealthmatics.com (2010). Nursing Information System. Retrieved from: http://www.biohealthmatics.com/technologies/his/nis.aspx
Polifroni, E.C. (2007, Jan.). Guest Editorial: Ethical Knowing and Nursing Education.
Ryan, M.K. And David, B. (2003, Dec). Gender Differences in Ways of Knowing: The context Dependence of the Attitudes Toward Thinking and Learning Survey. Sex Roles, vol 49, Nos. 11/12.
As a result, it becomes more difficult to ascertain exactly what mode of intervention would best be suited for helping children overcome health matters that are at least to some degree beyond their control.
That said, a defining strength of the research is its chosen method of intervention. The perspective that the health of the children at the center of this study cannot be improved without effectively improving the health habits of their respective families is a centering position and one that endows the study with a significant value to the public health. As the study finds in its conclusion, "social and structural environments in which Hispanic children are reared may play an important role in determining their risk for obesity and related behaviors." (Arredondo et al., p. 30) Even lacking any empirical validity and lacking the capacity to be replicated, it does offer an array of correlations that can…
Arredondo, E.M.; Elder, J.P.; Campbell, N.; Baquero, B.; Duerksen, S.; Ayala, G.; Crespo, MPH, Slymen, D. & McKenzie, T. (2010). Individual, Family, and Community Environmental Correlates of Obesity in Latino Elementary School Children. Journal of School Health, 80, No.1, pp. 20-30.
In the field of Nursing there are a number of challenges that will have an impact on the ability to attract and retain qualified candidates. To fully understand how this is taking place requires comparing recruitment strategies and determining selection criteria. Together, these factors will highlight the best practices for locating competent personnel.
Compare recruitment strategies.
Two strategies that are used most commonly inside the industry include: traditional / online strategies and loan forgiveness. In general, traditional and online strategies are most popular among employers. This is because they believe that using these mediums will attract the right candidates. A few of the most notable include: help wanted advertisements in local newspapers, job fairs and posting on different online job boards. The effect of these activities is that most facilities are unable to address critical needs in a number of areas (i.e. pharmacists, radiologists, nurses, doctors and technicians).…
Health Care Recruiting Strategies. (2012). Med Zilla. Retrieved from: http://www.medzilla.com/press51402.html
Marquis, B. (2009). Leadership Roles and Management Functions. Philadelphia, PA: Lippincott & Williams.
They advocate for this because they believe that every citizen has the right to health care, regardless of ability to pay, and that ultimately, this system will save money. This health care reform promotes the interests of nurses because most nurses believe that health care is a basic right, and that there are far too many uninsured patients who are receiving sub-standard care. They would like to see higher quality health care for their patients. In addition, most experts believe that there is the potential for a far bigger workforce for doctors and nurses under the new proposal, which will mean additional job openings and training for nurses, leading to greater employment and job security for nurses and other healthcare workers (McHugh, et al., 2008, p. 1).
Editors. (2008). ANA's health system reform agenda. etrieved 15 Dec. 2008 from the Nursing World Web site: http://www.nursingworld.org/MainMenuCategories/HealthcareandPolicyIssues/HS/ANAsHealthSystemeformAgenda.aspx
McHugh, Matthew D.; Aiken,…
Editors. (2008). ANA's health system reform agenda. Retrieved 15 Dec. 2008 from the Nursing World Web site: http://www.nursingworld.org/MainMenuCategories/HealthcareandPolicyIssues/HSR/ANAsHealthSystemReformAgenda.aspx
McHugh, Matthew D.; Aiken, Linda H.; Cooper, Richard a.; and Miller, Phillip. (2008). The U.S. presidential election and health care workforce policy. Policy, Politics & Nursing Practice, 9(1), 6-14.
Discussion #1 Diabetes (either type 1 or type 2) can cause many problems for the patient when the disease is uncontrolled. Please choose one of the problems associated with diabetes and describe what happens to the body to cause the problem. Examine what causes the problem in the patient with diabetes and create a teaching strategy for a patient who is at risk for the problem. Include the types of Insulin in your post, Lantis, Lispro, egular and Intermediate acting and illustrate how evidence-based practice can improve outcomes. Justify your answers and cite your references.
Type 1 diabetes is an autoimmune disease that destroys the insulin-producing beta cells in the pancreas such that it produces only a little or no insulin. Accounting for 5 to 10% of diabetes in the U.S., the disease occurs primarily in children and young adults. Prior to the discovery of insulin in 1921, everyone…
Drugs & Medications - Singulair Oral. WebMed. Retrieved http://www.webmd.com/drugs/mono-8277-MONTELUKAST+-+ORAL.aspx?drugid=6485&drugname=Singulair+Oral
Why Is This Medicine Prescribed? Med Line Plus. Retrieved http://www.nlm.nih.gov/medlineplus/druginfo/meds/a600014.html#side-effects [Type text]
Nurse, Legislation and egulation
Identify a legislative issue/policy change related to a workforce/patient care issue that you believe to be a priority. Describe legislative efforts surrounding your interest.
The developments and strides in distance education has proved to be a worthwhile evolution in educating as well as practice of modern nursing construct that now requires some really fast and accurate means of knowledge dissemination (Benner et al., 2010; IOM, 2010; Jones & Wolf, 2010). The advanced technology helps in extending the reach of multifaceted nursing faculty, where the students might be placed in remote areas and lack access to quality education in pursuing their nursing dreams as a career option (Jones & Wolf, 2010). The predicaments faced in these newly evolved settings, as envisaged by Board of Nursing (BON), are noted as under:
BON needs that the local educational regulations match with their own while approving distance education programs.
Anderson, K. M., & Avery, M. D. (2008). Faculty teaching time: A comparison of Web-based and face-to-face graduate nursing courses. International Journal of Nursing Education Scholarship, 5, 1-12.
Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical transformation. Retrieved from www.carnegiefoundation.org/newsroom/press-releases/educating-nurses-call-radical-transformation
Billings, D. (2000). A framework for assessing outcomes and practices in web-based courses in nursing. Journal of Nursing Education, 39(2), 60-67.
Chappy, S. L., Stewart, S. M., & Hansen, T. S. (2010). Eliminate border wars. Nursing Education Perspectives, 31(6), 392-394.
NURSING CRITIQUE ON LAW: LIFE, LIERTY AND THE PURSUIT OF PALLIATION: RE-EVALUATING RONALD LINDSAY'S EVALUATION OF THE OREGON DEATH WITH DIGNITY ACT Y DURANTE (2009)
The objective of this study is to critique the work of Durante (2009) entitled "Life, Liberty, and the Pursuit of Palliation: Re-Evaluating Ronald Lindsay's Evaluation of the Oregon Death with Dignity Act." The Death with Dignity Act was enacted by the state of Oregon on October 27, 1997. This act enables patients who are terminally ill to end their lives by use of self-administration of medications that are lethal in nature and that the physician has prescribed to the patient for this express purpose. The work of Durante (2009) examines the claims of Lindsay on this subject and reports that the evaluation of the experience of Oregon with physician-assisted suicide of Ronald Lindsay is "a much needed counterpart to moral speculation." (p. 28) According to…
Durante, C. (2009) Life, Liberty, and the Pursuit of Palliation: Re-Evaluating Ronald Lindsay's Evaluation of the Oregon Death with Dignity Act. The American Journal of Bioethics. 9(3): 28-45, 2009.
Death with Dignity Act (2014) Oregon. Gov Public Health. Retrieved from: http://public.health.oregon.gov/ProviderPartnerResources/Evaluationresearch/deathwithdignityact/Pages/index.aspx
Moreover, I feel that patients must empower themselves to become healthier. New technologies and access to a wealth of information on the Internet is helping patients learn more about their bodies so that health care becomes accessible to everyone. As nurses, we need to listen to what the patient's priorities are. If the patient prefers alternative medicine to what the doctor recommends then we should be willing to let the patient choose as long as we inform them of all possible outcomes. Instead of expecting the health care system to rescue them from destructive lifestyle choices, patients need their nurses to counsel them on improving their eating and exercise habits and reducing stress. To reduce stress in our own lives, we nurses need to learn how to remain positive and life-affirming. At the same time, we need to learn how to address sensitive issues related to death and dying, grief…