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Nursing Management and Change Theory
In preparation for the upcoming inspection, several factors need to be considered and weighed by the nursing manager before actions are implemented. It is understood that when any large national health care corporation takes over a smaller hospital or system of hospitals, it is viewed primarily as a financial venture. The corporation as a whole views the medical aspects secondarily.
Following is a list of the types of considerations to be evaluated.
Is your unit making or costing the hospital money?
Is your unit using cost-effective measures in treating the patients?
Is your unit concerned only with health care and not bottom line costing?
Is your unit demonstrating a careful balance between excess cost and above-average health care for your patients?
Are there waste margins that can be trimmed? (e.g., using 4x4s with 3x3s would suffice? charting all consumables used so that proper billing can…
Argyris, C. (1990) Overcoming Organizational Defenses. Boston: Allyn & Bacon.
Bettelheim, B. (1943) "Individual and Mass Behavior in Extreme Situations," Journal of Abnormal and Social Psychology 38, 417-452.
Bushe, G. & Pitman, T. (1991) Appreciative Process: A Method for Transformational Change. OD Practitioner. September, 1-4.
Goffman, E. (1959) The Presentation of Self in Everyday Life N.Y.: Doubleday.
Had I better defined the problem early on in the call, I could have cut the frustration on both our parts by going directly to the objective of requesting an appointment via a message for cold signs and symptoms. eing more decisive would have led me to generate as many potential solutions as possible. I could have then been presented them clearly to the patient and allowed the patient to choose home advice, telephone treatment, or message to her physician for a call back (Hesketh 1997).
Acknowledgement of the cultural aspects of the person is necessary if nurses are to provide holistic care to the recipients of health-care services (Slusher and Newell-Withrow (1996). And, exposure to and personal interactions with people of diverse cultures foster an acceptance of multiculturalism that can be beneficial (Thobaben and Mattingly, 1993). However, I believe my knowledge regarding the cultural belief of a medical doctor…
Chaffee, M. (1999, July), "A Telehealth odyssey." American Journal of Nursing, 99(7): 27-32.
Crouch R, Dale J. (1998). "Telephone triage - how good are the decisions? Nursing Standard 12(35):33-39.
Hood, L., and Leddy, K.L. (2003). Conceptual Bases of Professional Nursing.
Hesketh, A and Dowling, M (1997). Facts not Fiction. Scotland UK: Centre for Medical Education University of Dundee.
Assists staff to effectively supervise and delegate to other team members;
Models coaching and mentoring;
Effectively builds an cohesive nursing team; and Assists staff in managing conflict. (2003)
In relation to 'Caring for Self, Staff and Patients' the Nursing Leadership Institute Competency Model states the following key competencies and behaviors as being necessary:
Recognizes the importance of building a sense of community in the work environment;
Demonstrates supportive behaviors in working with staff;
Rewards and celebrates staff successes in a way that is meaningful to the staff member;
Works to build a 1:1 relationship with each staff member;
Takes time to learn about the families of staff;
Remains flexible and sensitive to staff scheduling needs;
Supports staff during difficult interpersonal times;
Values the opinions and diversity of staff;
Shows appreciation when staff work overtime or change their schedules;
Recognizes and supports family responsibilities and needs;
Demonstrates a commitment to…
Aiken, L.H., S.P. Clarke, D.M. Sloane, J. Sochalski, and J.H. Dilber. 2002. "Hospital Nurse Staffing and Patient Mortality: Nurse Burnout, and lob Dissatisfaction." JAMA 288 (16): 1987-93.
Aroian, J.E, K.J. Horvath, J.A. Secatore, H. Alpert, M.J. Costa, E. Powers, and S.S. Stengrevics. 1997. "Nurse Manager Role Implementation." Journal of Nursing Administration 27 (4): 27-31.
Brown, Montague (1992) Nursing Management: Issues and Ideas. Jones & Bartlett. Online available at http://books.google.com/books?id=40jH7L2fgrwC&dq=nursing+staff+management+communication+staff+welfare
Daggett, L.M., J.B. Butts, and K.K. Smith. 2002. "The Development of an Organizing Framework to Implement AACN Guidelines for Nursing Education." Journal of Nursing Education 41 (1): 34-37.
4. What type of power does Cathy, the unit manager, possess? What about each of the charge nurses? Give examples from the case study to defend your choices.
As the nurse in charge of the intermediate care unit, Cathy Jones had position or coercive powers brought by her job description and responsibilities as the unit manager. Cathy's position power can also be considered as legitimate power because of her responsibilities within the hospital. Similar to Cathy, the three charge nurses also had coercive powers since they were to make their subordinates identify the reasons for decline because of their positions in the hospital.
5. Describe situations when you apply the different types of power. Use examples from home, school, work, etc.
Legitimate and reward powers are applicable at school and home where parents and teachers have the right to instruct children respectively and reward those with good behaviors. At…
Roskoski, J. (n.d.). Leadership Styles in Nursing Management. Retrieved September 11, 2011,
Zerwekh, J., & Claborn, J.C. (2009). Nursing Today: Transitions and Trends (6th ed.). St. Louis:
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.
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.
The budgeting process at CHOMP is varied and requires that nursing managers and department heads keep a close eye on the daily activities of staff. It is described as a structured process that begins with planning meetings in August with the financial services department. The department director and the Vice President sign off on the budget in December, and then all budgets are reviewed by the President's Advisory Committee which includes the CEO and the Vice Presidents.
Department directors also have to sign off on their budget in November or December. Budgeting decisions are made by each nursing department. The budget is generally two to three million dollars, including wage and non-wage budgets. The budget is flexible. Nurses need to stay between 95-105% for productivity with an aim of 100%. The budget is averaged so on days when full time employees exceed the hours budgeted based on patient numbers they…
About Us." (2005). Available:
Schmaedick, G.L. (1993). "Cost-effectiveness in the nonprofit sector: Methods and examples from leading organizations." Westport, CT: Quorum Books.
Ward Jr., W.J. (1994). "Health care budgeting and financial management for non- financial managers." Westport, CT: Auburn House.
Furthermore, the supervisor must have a keen understanding of the laws and guidelines of the institution so that he can help in interpreting them to the staff. During the interview, there were times when directions were asked of the manager from the employees on how to go about tackling a problem. Sometimes the problems were so technical requiring the quoting of laws. I realized that this is a vital part of the managerial skill that has to be cultivated in order to make an effective manager. Also as the manager was doing his rounds, I realized that many people were asking him to solve their problems, be it social or technical, therefore, a leader should be have the ability of solving problems in a logical and reasoned manner and also be able to motivate people towards the efficient completion of tasks.
Learning about human resource is vital to understand about…
Veo, P. (2010). Concept mapping for applying theory to nursing practice. Journal for Nurses in Staff Development, 26(1), 17-22.
Kingma, M. (2006). Nurses on the move: global health care Migration and the economy. Nursing Leadership, 19(2), 92-94.
Morgan, J.C., & Lynn, M.R. (2009). Satisfaction in nursing in the context of shortage. Journal of nursing management, 17(3), 401-410.
Redman, R.W., & Potempa, K.M. (2009). Nursing education in human resources in: A worldwide crisis. Collegian: Nursing Journal of the Royal College of Australia, 16(1), 19-23.
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
eview On Nurses Shortage
The supply of professional nurses relative to the increase in demand for their services has been on a general decline over the years. As a career choice, nursing has been facing perennial shortage of professionals. Most healthcare organizations will affirm that their daunting tasks were recruiting fresh nurses and retaining the ones already in practice. The 2008 projections from the Bureau of Labor Statistics showed that the demand for professional nurses would increase from the then two million to three million, which represents sixty percent increment. In ideal situations, the number of those who have enrolled in nursing will be sufficient to supply the rise in their number. Nevertheless, this would not be the case if nothing were done to salvage the worrying trend of most students not graduating or resorting to other careers. According to Benjamin Isgur of PWHC Health and esearch Institute,…
American Association of Colleges of Nursing. (2009, September, 28). Nursing Shortage Fact Sheet. USA: AACN.
Buerhaus, P.I., Staiger, D., & Auerbach, D.I. (2009). The future of the nursing workforce in the United States: Data, trends, and implications. Boston: Jones and Bartlett Publishers.
Blakeley, J., & Ribeiro, V. (2008). Early Retirement among Registered Nurses: Contributing Factors. Journal of Nursing Management, 16(1), 29 -- 37
Cummings, G., et al. (2008). The Relationship between Nursing Leadership and Nurses' Job Satisfaction in Canadian Oncology Work Environments. Journal of Nursing Management, 16(5), 508 -- 518.
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 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.
(a) provides an account of your observations on the management of peripheral intravascular devices from your clinical practicum in NMIH202;
Clinical practicum NM1H202 introduces nurses to the management of peripheral devices via scholarly inquiry and clinical practice. The practicum includes a thorough training in handling, inserting, replacing, and dressing peripheral intravascular devices including peripheral venous catheters. Because the primary risk associated with peripheral intravascular devices is infection, proper management of the devices is crucial. Bloodstream infections can cause patient casualties, leading not just to humanitarian disasters but also financial ones as well.
Hand washing vigilance is a primary part of the introduction to peripheral intravascular device management. While it may seem like an abundance of common sense, hand washing and aseptic techniques themselves depend on continued knowledge acquisition and training. Nurses must stay abreast of latest products and tools that promote hygiene in relation to the management of peripheral…
Bregenzer, T., Conen, D., Sakmann, P., & Widmer, A.F. (1998). Is Routine Replacement of Peripheral Intravenous Catheters Necessary? Arch Intern Med. 1998;158:151-156.
Crnich, C.J . & Maki, D.G. (2002). The Promise of Novel Technology for the Prevention of Intravascular Device -- Related Bloodstream Infection. I. Pathogenesis and Short-Term Devices. Clin Infect Dis. (2002) 34 (9): 1232-1242
Crnich, C.J. & Maki, D.G. (n.d.). The role of intravascular devices in sepsis. Current Infectious Disease Reports 3(6): 496-506.
Elliot, T.S.J. (1988). Intravascular device infections. Journal of Medical Microbiology 27(1988): 161-167.
("Summary of the LPN Declaratory Ruling, 2003)
The selected tasks and shared responsibilities of the licensed practical nurse define such nurses as responsible for being adequately prepared for the nursing responsibilities they assume because they have obtained the validation of completion of an approved preparatory program and have evidence of the successful completion of a nursing licensing examination. A registered nurse, however, as the title conveys, must be registered as a specific health care professional, within a professional organization, rather than merely possess evidence of having a license, and has passed the necessary coursework to obtain his or her master's in the nursing profession. The LPN's validation documents state that he or she has reached the achievement of mastering all theoretical and nursing skill competencies required of an entry level practical nurse in caring for individuals in any age group. It states that the licensed practical nurse has the sufficient…
Carter, Melodie R. (Jun 2004) "ABCs of Staffing Decisions." Journal of Nursing Management. Retrived 2 Sept 2005 at http://www.findarticles.com/p/articles/mi_qa3619/is_200406/ai_n9425719
Nurse Practice Act. (2004) Retrived 2 Sept 2005 at http://www.arsbn.org/pdfs/practice_act/2004/nursepracticeact_2004.pdf
Summary of the LPN Declaratory Ruling." (Feb 2003) Connecticut Nursing Journal. Retrived 2 Sept 2005 at http://www.findarticles.com/p/articles/mi_qa3902/is_200212/ai_n9305171
Nursing BA vs. Associates
Nursing Competencies -- Associates vs. Baccalaureates
The difference competencies between nurses prepared at the associate-degree level nursing vs. The baccalaureate-degree level are significantly different on many levels. Today's nurses work in a healthcare environment that is undergoing a constant evolution at a speed never before imagined (NLN Board of Governers, 2011). Patient needs have become more complicated; nurses must implement requisite competencies in leadership, health policy, system improvement, research, evidence-based practice, and teamwork and collaboration in order to deliver high-quality care. Furthermore, nurses are also required to master different technologies that are also evolving extremely rapidly.
There are basically three different alternative paths to becoming a registered nurse. Some hospitals offer a three-year program that is administered in the hospital setting. Another option is a two to three-year program in which graduates receive an associate's degree and can be administered at a community college or any…
Mahaffey, E. (2002, May 2). The Online Journal of Issues in Nursing. Retrieved from The Relevance of Associate Degree Nursing Education: Past, Present, Future: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume72002/No2May2002/RelevanceofAssociateDegree.aspx
Moltz, D. (2010, January 7). Nursing Tug of War. Retrieved from Inside Higher Ed: http://www.insidehighered.com/news/2010/01/07/nursing
NLN Board of Governers. (2011, January). Transforming Nursing Education: Leading the Call to Reform. Retrieved from NLN Vision: http://www.nln.org/aboutnln/livingdocuments/pdf/nlnvision_1.pdf
Rosseter, R. (2012, April 2). The Impact of Education on Nursing Practice. Retrieved from American Association of Colleges of Nursing: http://www.aacn.nche.edu/media-relations/fact-sheets/impact-of-education
According to the Joint Statement on Delegation produced by the American Nurses Association (ANA) and the National Council of State Boards of Nursing (NCSBN) "the N assigns or delegates tasks based on the needs and condition of the patient, potential for harm, stability of the patient's condition, complexity of the task, predictability of the outcomes, abilities of the staff to who the task is delegated, and the context of other patient needs" (Joint Statement).
In this particular case, it is easy to determine the frustrating aspects affecting Ms. W. It can also be a relatively simple matter to correct the situation in order to ensure effective care for Ms. . The nursing supervisor in this case would sit down with Ms. W. And map out a strategy for the patient's care, remembering of course that the key to successful delegation "depends on the quality of N and NAP working…
Joint Statement on Delegation, American Nurses Association and the National Council of State Boards of Nursing (NCSBN).
Potter, P.; Deshields, T.; & Kuhrik, M.; (2010) Delegation practices between registered nurses and nursing assistive personnel, Journal of Nursing Management, Vol. 18, Issue 2, pp. 157-165
Elizabeth Kerr Porter
Elizabeth Kerr Porter "was a leader in nursing education and an advocate for nurses' rights," (ANA 2011). Porter advocated for nurses' labor rights in terms of the right to collective bargaining and professional organization. Her work helped improve working conditions for nurses and also lobbied against racial discrimination in the nursing professions. Porter served for many years as the president of the American Nurses Association and also as the Dean of the nursing graduate degree program at Case Western eserve University. Therefore, Elizabeth Kerr Porter promoted the interests of nursing education, enhanced the image of the profession, and also championed the labor rights interests of professional nurses.
Dorothea Dix worked as both an educator and a nurse, but never actually combined her two careers. Dix devoted most of her career to raising awareness about mental illness. Dix advocated for the humane treatment of both…
American Nurses Association (ANA 2011). Elizabeth Kerr Porter. Retrieved online: http://www.nursingworld.org/ElizabethKerrPorter
Buckwalter, K.C. & Church, O.M. (2009). Euphemia Jane Taylor: An Uncommon Psychiatric Nurse. Perspectives in Psychiatric Care 17(3):125-131
Bumb, J. (n.d.). Dorothea Dix. Retrieved online: http://www.webster.edu/~woolflm/dorotheadix.html
Lewis, J.J. (n.d.). Clara Barton biography. About.com. Retrieved online: http://womenshistory.about.com/od/bartonclara/a/clara_barton.htm
Nurse Staffing Shortage Issue
Nursing Staffing Shortage
One of the greatest challenges to the continued development of a high quality health care delivery system is the continued and frequently increasing shortage of qualified nurses active in the profession of nursing. The nursing shortage has waxed and waned for decades but seems to currently be in a state of constant shortage (Fox & Abrahamson, 2009, pp.235-236). In addition the research associated with low levels of staffing and increased adverse patient outcomes has also increased, stating rather starkly that staffing shortages increase the odds that poor patient outcomes are a more frequent result, worse in some settings than others and also dependent on skill mix (Clarke, 2008, p.8). The consensus has and will likely remain that the system must learn to utilize existing practicing nurses in a smarter way by adjusting policy and practice to the situation at hand, i.e. there is…
Clarke, S.P. (2008 Dec) Nurse staffing and patient outcomes: getting to the heart of the matter in research, practice, and policy. Pennsylvania Nurse.;63(4):8-9.
Fox, R.L. & Abrahamson, K. (2009 Oct-Dec) A critical examination of U.S. nursing shortage: Contributing factors, public policy implications. Nursing Forum. 44(4): 235-244.
Flynn, M. McKeown, M. (2009) Nurse staffing levels revisited: A consideration of key issues in nurse staffing levels and skill mix research. Journal of Nursing Management 17: 759-766.
Nurse Patient atios and Quality of Care
This study reviews the broad level of issues that surround the nurse/patient ratio: a critical shortage of trained and experienced nurses; increased political and fiscal demands from all sectors of society; rising costs internally and externally combined with a rising number of under-insured; and the conundrum of nursing ethics and the ability to foster excellence in care and patient advocacy. We note that there remains an issue about hiring more nurses -- where will these nurses come from if the nursing schools do not increase their recruitment efforts and broaden their curriculum. In addition, we note that the large majority of patients and stakeholders primarily want two things when admitted to a healthcare facility: better paid nurses and more highly-trained professionals who are satisfied with their vocation.
Modern nursing is, by necessity, a mixture of complex balance: patient care vs. staffing; procedures…
More Nurses Make the Difference. (February 2012). The Lamp. 69 (1): Retrieved from: http://search.informit.com/au/documentSummary;dn=045435426132502;res=IELHEA
Safe Nurse Staffing: Looking Beyond the Numbers. (2009). Vantage Point, CNA. Retrieved from: https://www.nso.com/pdfs/db/newsletters/Safe_Nurse_Staffing_-_Looking_Beyond_the_Raw_Numbers_20094.pdf?fileName=Safe_Nurse_Staffing_ -_Looking_Beyond_the_Raw_Numbers_2009-pdf&folder=pdfs/db/newsletters
Aiken, L. (2001). The Hospital Nurse Workforce: Problems and Prospects."Draft
For the Council on the Economic Impact of Health System Change. Retrieved from: http://council.brandeis.edu/pubs/hospstruct / Council-Dec-14-2001-Aiken-paper.pdf
, 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.
Modern nursing has become a multi-disciplinary career that encompasses a number of roles and requires more expertise than ever before. In modern nursing, there are a number of stakeholders: patients, families, the community, insurance companies, governmental agencies, administrators, colleagues, staff and physicians. Healthcare solutions in the 21st century require a collaborate effort that remains focused on continual progress towards customer service satisfaction. The key is to understand the overall paradigm of healthcare and nursing management -- even through the terms "manager" and "leader" are often used interchangeably, they are not. In general, management organizes affairs, projects, and people -- therefore subordinates are involved. The manager is in charge, but not necessarily leaders in that they do as directed and then direct tasks. Leaders do not have subordinates, rather they have followers. Leaders motivate, challenge, coach and inspire vision, enable others to act and encourage (Carrroll, 2005; Kouzes and…
Communication between nurses is an important instrument for professionals to deliver safe, quality healthcare as a team. Therefore, provision of quality healthcare in hospitals, depends entirely on the capability of the health practitioners to communicate efficiently between each other. However, little healthcare education addresses inter-professional communication, and this may account for the major medical errors. In addition, communication is significant given the interdependence of professionals and the important role they play towards providing quality patient care. Various factors constitute effective and ineffective communication (Manjlovich, Antonakos and onis, 2010). espect is a factor that may facilitate effective communication while negligence is a factor that may facilitate ineffective communication.
The operating room is a crucial facility in the hospital setting. Many of the errors that arise in the operating room result from failed communication between the nurses, healthcare team and the patient. In addition, there are factors that may bring…
Manajlovich, M., Antonakos, L.C., & Ronis, L.D. (2009). Intensive Care Units,
Communication Between Nurses and Physicians, and Patient Outcomes. American Association of Critical-Care Nurses, 18(1), 21-30
Marshall, S., Harrison, J., & Flangan, B. (2009). The Teaching of Structured Tool
Improves the Clarity and Content of Inter-professional Clinical Communication. Quality and Safety in Health Care, 18(2), 137-140.
Nursing Fiscal Plan
The author of report is asked to assess a budget framework and compare what has happened to what is set to happen through the rest of the year and ascertain how best to close out the year. The author is asked to assess budget line item requests for the duration of the year as well as what expenses can and should be deferred until the new fiscal year. The budget projections that were accurate are to be labeled as well as what factors have caused the inaccuracies. As to the latter, it is asked if those inaccuracies were controllable or predictable.
The author is asked to do a bit of research on patient acuity symptoms and to ascertain the best approach for that process vis-a-vis quality patient care. The author is asked what strategies pertaining to motivation, communication, care delivery and so forth need to be implemented…
Brennan, CW, and BJ Daly. "Patient Acuity: A Concept Analysis." Journal of Advanced
Nursing 65.5 (2009): 1114-1126. CINAHL with Full Text. Web. 29 Apr. 2013.
Ekwall, A, M Gerdtz, and E. Manias. "The Influence of Patient Acuity on Satisfaction
With Emergency Care: Perspectives of Family, Friends and Careers." Journal Of
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.
Either style may be beneficial in some situations but detrimental to organizational objectives (i.e. patient health and welfare) in others. A typical example of an appropriate use of authoritarian leadership would be in a working group consisting of individuals who have varying degrees of expertise and professional experience, particularly if they also have little experience working together as a group. On the other hand, the democratic style might be more appropriate in working groups consisting of very similarly skilled individuals with similar degrees of experience, especially where they have also worked together extensively and have demonstrated good self-management, decision-making, and collaboration within the group.
Leadership vs. Management
The principal difference between leadership and management is that leadership pertains more to people whereas management pertains more to operations (Marquis & Huston, 2008). Generally, organizational leadership involves improving the organization by addressing motivational issues and other factors that contribute to the morale…
Marquis, B.L. And Huston, C.J. (2008). Leadership Roles and Management Functions in Nursing: Theory and Application. (6th ed.). Philadelphia: Lippincott, Williams, & Wilkins.
Medley, F. And LaRochelle, D.R. "Transformational leadership and job satisfaction."
Nursing Management, Vol. 26, No. 9; (1995). Retrieved January 9, 2011 from:
Third, lack of attention to evidence-based practice can lead to inconsistent delivery of care services.
Evidence-based practice relates to almost every aspect of health care at every stage of a client's relationship with the institution. For example, evidence-based practice informs the types of questions asked during the diagnostic procedures and might even impact the diagnosis itself (Bennett & Bennett, 2000). Evidence-based practice impacts the methods by which infections are prevented (Cantrell, 2009). Evidence-based practices impact the extent to which nurses are empowered to make sound, safe, and effective decisions (Scott & Pollock 2008). Evidence-based practice has the potential to transform the structure of a health care organization like MMH. This is because evidence-based practice changes the hierarchical structure in the organization due to the increased responsibility of nurses for conducting their own research. Alternatively, evidence-based practice can be an extension of organizational change. Health care organizations reducing the hierarchical nature…
Artinian, B.M., West, K.S., & Conger, M.M. (2011). The Artinian Intersystem Model. New York: Springer.
Bennett, S. & Bennett, J. (2000). The process of evidence-based practice in occupational therapy: Informing clinical decisions. Australian Occupational Therapy Journal (2000), 47, 171-180.
Burns, N. & Grove, S.K. (2009). The Practice of Nursing Research. St. Louis, MO: Saunders.
Cantrell, S. (2009). Performing under pressure: Caring for decubitus ulcers. Healthcare Purchasing News. Aug 2009.
This can also include aspects such as taboos, perceptions of pain as well as concomitant factors such as education and socioeconomic status, language barriers, and advance health care planning. ( Mitty and Post, 2008).
Good examples that can be given are the strategies employed by the nurse in oncology in helping cancer patients to make informed decisions about their treatment. The nurse can assist these patients by providing access to informed decision making; which implies making sure that the patient understands both the nature as well as the risks of cancer treatment. This can include explaining to the patient the risks and benefits of aspects such as alternatives to screening for cancer; and by helping the patient to make various decisions in relation to his or her values and preferences. For example, the nurse can clarify the difference between screenings for various types of cancer; for instance the fact that…
Marquis B. And Huston C. ( 2008) Leadership Roles and Management Functions in Nursing: Theory and Application. New York: Lippincott Williams & Wilkins.
Oncology nurses are key to ensuring that patients' decision making is truly informed.
Retrieved from http://www.thefreelibrary.com/Oncology+nurses+are+key+to+ensuring+that+patients%27+decision+making+is...-a0187773050
Mitty E. And Post L. (2008) HEALTHCARE DECISION MAKING: Nursing Standard of Practice Protocol. Retrieved from http://consultgerirn.org/topics/treatment_decision_making/want_to_know_more
Others include delays in data accessibility, albeit shorter delays and the continued need for source data verification (Donovan, 2007).
Other obstacles have occurred in the developing of mobile healthcare applications. These have included mobile device limitations, wireless networking problems, infrastructure constraints, security concerns, and user distrust (Keng and Shen, 2006).
A third problem that has been encountered is that of a lack of education on not only the importance of the information technology but also training on how to use the specific pieces of equipment. The tools that are provided to people are only as good as the training that is provided on how to use them. The tools may be able to do wonderful things, but if those that are using them do not know how to get the best use out of them they will in the end be less efficient.
According to an Institute of…
Al-Assaf, Al F., Bumpus, Lisa J., Carter, Dana, and Dixon, Stephen B. (2003). Preventing Errors
in Healthcare: A Call for Action. Hospital Topics. 81(3), 5-12.
Brommeyer, Mark. (2005). e-nursing and e-patients. Nursing Management -- UK. 11(9), 12-13.
Damberg, Cheryl L., Ridgely, M. Susan, Shaw, Rebecca, Meili, Robin C., Sorbero, Melony E.,
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
Advisory Board Web site. (2004). Available at: http://www.advisory.com .
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.
nursing client relationships and how the study is a valid research for practitioners. It has 26 sources in Harvard Style.
esearch titles must be limited to fifteen words. In this case the author has exceeded the limitation by one count which is negligible. The importance of relevance of the title to the body of the research is that it must collaborate with the core study area. In the first line the author has already specified the relationship of the nurse-client at the beginning and categorizes it as a "partnership" whereas the title of the study must not reveal the results or even the anticipated results.
Authors and Abstracts
The authors T. Hostick and F. McClelland both the authors indicate in their abstract that the article aim in establishing nursing behavior when they are engaged in a nurse-client relationship. The abstract though is limited in expressing the content of the study…
Hostick, T. & McClelland, F. 2002, Partnership: a co-operative inquiry between Community Mental Health Nurses and their clients. 2. The nurse-client relationship. Journal of Psychiatry and Mental Health Nursing 9, 111-117.
Beyea, S.C. 1997, Research utilization begins with learning to read research reports, Research Corner, AORN, February. Accessed on 29-9-2003 at http://www.aorn.org/journal/research/rc297.htm
Author not available, 2003, Reading Nursing Research to Critique a Study and to Summarize Findings for Use in Practice, Available at http://classes.kumc.edu/son/NURS460smith/460critiquingreseach.html
Forchuk, C. 1989, Establishing a Nurse-Client Relationship. Journal of Psychosocial Nursing vol.27,no.2. Available at http://willmar.ridgewater.mnscu.edu/library/338271.htm
Verbal intervention is the first thing to try, and can often be effective for many standard situations if it is approached with patience and true compassion and understanding (Mohr 2008). At the same time, keeping space between the person intervening and the aggressive client/patient is important in order to ensure everyone's safety as the situation progresses (Nursing Planet 2010). Verbal intervention is not always effective, however, and drug and physical interventions might be necessary for everyone's safety (Mohr 2008; Nursing Planet 2010).
Attitudes Towards Abusers and Victims
It is very tempting to have feelings of nothing but anger, resentment, and disgust towards people who abuse others regardless of the situation, and in fact it can be very difficult to develop any other feelings towards such persons. I have attempted to cultivate some measure of compassion for these people, as it is almost certain that their lives and specific experiences have…
Mohr, W. (2008). Psychiatric-Mental Health Nursing. New York: Lippincott Williams & Wilkins.
Nursing Planet. (2010). "Nursing Management of Aggression." Psychiatric nursing.
Accessed 15 November 2010.
Senior nursing staff ought to aid peers in their career development through helping them practically employ theoretical knowledge and promoting testing of novel skills within an encouraging, safe work climate. This illustrates a combination of leadership and developmental tasks, that together lead to the creation of proficient practitioners via practice-grounded learning. These nursing personnel ought to employ a supportive approach to leadership, incorporating mentorship, guidance and tutoring as their key values. Substantial support on the part of nursing supervisors is known to decrease emotional fatigue and buffer adverse impacts of their work environment. Thus, it would prove especially advantageous if supervisors offer junior employees emotional backing and provide proper performance-related feedback for improving their self-confidence (Seitovirta, 2017).
I personally feel that leaders ought to believe in and respect human dignity. Their leadership approach ought to integrate empathetic listening, encouragement, attentiveness, motivation, and preserving a rewarding organizational culture. It implies…
Importance of the Issue
Nurse need to keep the records and specific information about their patients. The services in the hospitals require that every detail of the patients be kept in the records. For patients whose conditions recur, record helps the medical practitioners understand the health history of the patient. Proper records in the hospital are helpful in patient transfers (Voyer et al. 2014). Often, patient referrals are common in hospitals and thus records help the doctors in the new hospital to attend to the needs of the patient. The family members of the patients require the health records of their patients to arrange for better treatments. The law requires the nurses to keep records of the nature of services they offer to the patients. Often, the records of each patient are permanents in the hospital where they are kept physically or electronically. Records are essential because they…
What causes staffing shortages in the field of nursing? Staffing shortages can be the result of many variables—turnover, unmet demand for services due to a lack of RNs, overwork (nurses calling in sick), and so on. Buchan (2002) identified the problem of staffing shortages in nursing as having an underlying cause in the nature of the health system itself as well as a social one: “Nursing in many countries continues to be undervalued as women’s work, and nurses are given only limited access to resources to make them effective in their jobs and careers” (p. 751). This is especially true in countries like Saudi Arabia, where nursing is viewed as woman’s work but is not valued highly by society—though it is recognized as being highly needed (Alyami & Watson, 2014). To address the issue of staffing shortages, the Institute of Medicine (IOM, 2012) has called for more nurses to…
Reeves, S., Macmillan, K., & van Soeren, M. (2010). Leadership of interprofessional health and social care teams: a socio-historical analysis. Journal of Nursing Management, 18(3), 258-
This study looks at the work between nursing and other professional teams that involve healthcare partially or fully. In this case, the inter-professional work is between nurses and social care teams and the subject is looked at from a socio-historical perspective. Indeed, the report looks at leadership when it comes to such inter-professional teams. Over the last quarter of a century, there are many that have been calling for more collaboration between such people so as to improve the overall quality of health care. It is indeed regarded by many to be one of the key approaches that can be undertaken to accomplish a higher standard of care. Rather than each team or group being its own proverbial island, there needs to be…
Personal Nursing Philosophy
My Nursing Autobiography
I have dreamt of being a nurse all my life. My mother and older cousins tell me stories of how I loved to line up my dolls and animals, place bandages over them to nurse their 'injuries' and stick branches in their armpits to have a feel of their temperature. Well, I believe these stories because to this day, these are the very things that keep my life going; I derive so much satisfaction from just being able to help people when they are in no position to help themselves. I took an elective nursing course in high school, where I was supposed to report at the local facility at least once every week to assist in the administration of basic care to patients. This marked the beginning of my career in nursing, and since then, I have logged almost 15 years of experience…
Reed, P. (2012). A Treatise on Nursing Knowledge Development for the 21st Century: Beyond Postmodernism. In P. Reed & N. Shearer (Eds.), Perspectives of Nursing Theory (6th ed.) (pp. 37-46). Burlington, MA: Jones & Bartlett.
Reed, P. & Lawrence, L. (2008). A Paradigm for the Production of Practice-Based Knowledge. Journal of Nursing Management, 16(4), 422-432
Volker, D.L. & Limerick, M. (2007). What Constitutes a Dignified Death? The Voice of Oncology Advanced Practice Nurses. Clin Nurse Spec., 21(5), 241-247
SWOT analysis focuses on identifying the internal strengths and weaknesses, along with the external opportunities and threats, for an organization. In this case, the SWOT analysis will be done on a specific situation, with a large number of items under each. The initial SWOT analysis for the situation presented is as follows
The problem has been identified
Restructure nursing management
Poor customer perceptions/negative publicity
Gain more funding
Board could deny financing
New leaders (Dr. M and Chief of Staff
Union constrains solutions
Build more individual accountability
Unions/culture could present roadblocks to change
A new CEO can accelerate this process
Nurses lack independence
New leaders = new culture
Capacity issues make it tough to change how things are done
Dr. M is a pro
Modest level of education in the department
Increase the level of education
Physicians are another potential roadblock…
As noted above, one of the most prominent leadership theories that has been applied to the nursing profession is transformational leadership. Properly applied and managed, transformation leadership can also be used to facilitate creativity in the workplace. For instance, according to Vesterinen, Isola and Paasivaara (2009, p. 504), transformational leadership can create changes and, by definition, is capable of transformed individuals and the organization in which they work. By providing the leadership needed to motivate employees to bigger and better aspirations, transformational leaders can therefore encourage the creative spark among their followers in ways that might not otherwise be possible (Vesterinen et al. 2009). Indeed, Vesterinen et al. (2009, p. 504) specifically state that, "A transformational leader motivates inspirationally, stimulates intellectually and considers employees individually." Taken together, these positive outcomes are valuable in any organizational setting, but they can be particularly important in health care settings.
Why understanding organisational culture…
Fourie, WJ & Keogh, JJ 2011, October, 'The Need for Continuous Education in the Prevention
of Needlestick Injuries,' Contemporary Nurse: a Journal for the Australian Nursing
Profession, vol. 39, no. 2, pp. 194-201.
Hutin, Y, Hauri, A, Chiarello, L, Catlin, M, Stilwell, B, Ghebrehiwet, T & Garner, J 2003, July,
Evolving Practice of Nursing and Patient Care Delivery Models
How the Practice of Nursing is Expected to Grow and Change: The Future of Nursing has a few healthcare delivery challenges unique to it, but there are several such issues that commonly occur in other nations, as well. Population aging is one issue that generates demand for increased healthcare services. A growing number of individuals, from all age groups, suffer from chronic illnesses; about 50% of U.S. citizens have been diagnosed with arthritis, diabetes, cardiovascular diseases, mental disorders, and hypertension (Reinhard & Hassmiller, n.d.).
A 2009 report by the AARP (American Association of Retired Persons) pertaining to chronic problems notes that patients and caregivers have firsthand experience of the absence of patient care-related coordination amongst healthcare workers, typically leading to needless repeat hospitalizations, repeat procedures and examinations, and arduous hospital-to-home moves. An acute dearth of professionals (such as nurses) is being…
ANA. (2011). ADVANCED PRACTICE NURSING: A NEW AGE IN HEALTH CARE. American Nurses Association, 1-7. Retrieved from: http://www.nursingworld.org/FunctionalMenuCategories/MediaResources/MediaBackgrounders/APRN-A-New-Age-in-Health-Care.pdf
Reinhard, S., & Hassmiller, S. (n.d.). The Future of Nursing: Transforming Health Care. AARP Internation: The Journal. Retrieved from: http://journal.aarpinternational.org/a/b/2012/02/The-Future-of-Nursing-Transforming-Health-Care
Ridge, R. (2011). Future of Nursing special: Practicing to potential. Nursing Management, 32- 37. Retrieved from: http://www.nursingcenter.com/journalarticle?Article_ID=1176058
Wilson, A., Whitaker, N., & Whitford, D. (2012). Rising to the Challenge of Health Care Reform with Entrepreneurial and Intrapreneurial Nursing Initiatives. The Online Journal of Issues in Nursing. Retrieved from: http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-17-2012/No2-May-2012/Rising-to-the-Challenge-of-Reform.html
Putting Conflict Management Into Practice: A Nursing Case Study
The healthcare industry is paramount to both economic growth and societal well-being. In the United States nearly 17% of GDP comes from the healthcare sector. Nurses in particular plan a critical role in the delivery of products and services to society. Newly issued legislation regarding treatment, health insurance, and overall healthcare coverage, has exacerbated the importance of the nursing role. This role, as many are aware, can be particularly stressful. Aspects such as illness, customer service, treatment errors, and more, can occur on a daily basis. As a result, conflict within the healthcare facility is likely to occur. Power conflicts can also occur within the nursing unit itself as individuals attempt to achieve status and wage increases. C.G. Vivar in an April 2012 issue of the Journal of Nursing Management outlines steps to help avoid and mitigate conflict within the work…
1) Bullough, Vern L. And Bonnie Bullough. The Emergence of Modern Nursing (2nd ed. 1972)
2) VIVAR, C.G. (2012), Putting conflict management into practice: a nursing case study. Journal of Nursing Management, 14: 201 -- 206. doi: 10.1111/j.1365-2934.2006.00554.x
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…
Abramson, S. (1980). Adverse Occurrences in Intensive Care Units. Journal of the American Medical Association 244 (14): 1582-1584.
Ahmadi, M. (1989). Traditional vs. Nontraditional Work Schedules. Industrial Management 31(2), 20-23.
Bennett, M. & Hylton, J. (1990). Modular Nursing: Partners in Professional Practice. Nursing Management 21(3), 20-24.
Beauchamp, T.L. & Childress, J.F. (1994). Principles of Biomedical Ethics, 4th ed. New York: Oxford University Press.
Osteomyelitis in the Diabetic Patient
Management OF OSTEOMYELITIS IN THE DIABETIC PATIENT
Osteomyelitis is an infection of the bone or bone marrow which is typically categorized as acute, subacute or chronic.1 It is characteristically defined according to the basis of the causative organism (pyogenic bacteria or mycobacteria) and the route, duration and physical location of the infection site.2 Infection modes usually take one of three forms: direct bone contamination from an open fracture, puncture wound, bone surgery, total joint replacement, or traumatic injury; extension of a soft tissue infection such as a vascular ulcer; or hematogenous (blood borne) spread from other infected areas of the body such as the tonsils, teeth or the upper respiratory system.2(p807) Bacteria such as Staphylococcus aureus, Pseudomonas, Klebsiella, Salmonella, and Escherichia coli are the most common causative agents of the disease, although viruses, parasites and fungi may also lead to the development of osteomyelitis.3
1. Stedman's Medical Dictionary. 27th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2000.
2. Butalia S, Palda V, Sargeant R, Detsky A, Mourad O. Does This Patient With Diabetes Have Osteomyelitis of the Lower Extremity?. JAMA: Journal of The American Medical Association [serial online]. February 20, 2008; 299(7):806-813. Available from: Academic Search Premier, Ipswich, MA. Accessed September 19, 2012.
3. Lavery L, Peters E, Armstrong D, Wendel C, Murdoch D, Lipsky B. Risk factors for developing osteomyelitis in patients with diabetic foot wounds. Diabetes Research & Clinical Practice [serial online]. March 2009; 83(3):347-352. Available from: Academic Search Premier, Ipswich, MA. Accessed September 19, 2012.
4. Turns M. The diabetic foot: an overview of assessment and complications. British Journal of Nursing [serial online]. August 12, 2011;:S19-S25. Available from: Academic Search Premier, Ipswich, MA. Accessed September 19, 2012.
The purpose of this paper is to explore how I can deal with situations in practice in a more effective way. There are many situations I have faced in my own experience in which I have dealt with communication difficulties and conflict in an organizational setting. It is definitely easy to get hooked on an emotional level with these encounters. For example, I have had one coworker who consistently invades my personal space on a regular basis. Whenever I see her, she gets uncomfortably close -- so close I can smell her breath. Another nurse fails to cleans up her work area after procedures and consistently leaves a mess for the next person to clean. This is not only irritating but potentially dangerous and not good practice.
Furthermore, other nurses seem to like to talk a lot about personal issues on the job. For example, one…
CRM Learning. (2007, November 16). Working With You Is Killing Me, Video Training Dealing with Difficult People. Retrieved from YouTube: https://www.youtube.com/watch?v=Y_pIMvP-otY
Curtin, L. (2002). Quantum leadership: Upside Down. American Nurse Today, 56-57.
Perkins, K. (2013). "Investigation"... An original leadership concept. Nursing Management, 34-39.
Nursing Health Care Informatics
"…At the beginning of the 21st century, nursing informatics has become a part of our professional activities…[and has] advanced the field of nursing by bridging the gap from nursing as an art to nursing as a science…" (Saba, 2001, 177).
Nursing Health Care informatics relate to and address technology and other cutting edge issues of great interest in the healthcare field. According to the AMIA, Nursing Informatics is the "…science and practice (that) integrates nursing, its information and knowledge, with management of information and communication technologies to promote the health of people, families, and communities worldwide." New and relevant knowledge presented in the genre of informatics helps to empower nurses and other healthcare practitioners to deliver the most effective patient-center care possible. This paper presents several informatics in the belief that applying healthcare technologies and practices that are genuinely progressive and helpful to today's nurse is…
AMIA (2009) Working Group Nursing Informatics. Retrieved March 9, 2014, from http://www.amia.org .
An, J.Y., Hayman, L.L., Panniers, T., and Carty, B. (2007). Theory Development in Nursing
And Healthcare Informatics. A Model explaining and Predicting Information and Communication Technology Acceptance by Healthcare Consumers. Advances in Nursing Science, 30(3), E37-E49.
Cipriano, P.F. (2011). The Future of Nursing and Health IT. Nursing Economics, 29(5).
Nursing is not only a profession, it is a ministry. Nurses not only provide care for their patients, they oftentimes minister to them in order to provide comfort and in some cases, peace of mind. Nursing is a profession that the healthcare system cannot do without. We know that the profession of a physician goes back to even Biblical times, but even though nursing has been around for many years, it does not date back as far as the profession of a physician does. This is not to say that nursing is less important than any other profession. The field has grown so much over the past few decades and nursing is a profession that is in high demand. Nurses now have to decide if they want to do a traditional educational path or get the four-year degree; they must stay ahead of nursing trends in order to gauge the…
Delaney, C., & Piscopo, B. (2007). There really is a difference: Nurses' experiences with transitioning from RNs to BSNs. Journal of Professional Nursing, 23(3), 167-173. Retrieved May 3, 2012, from the ScienceDirect database.
Franklin, P.D., Archbold, P.D., Fagin, C.M., Galik, E., Siegal, E., Sofaer, S., et al. (2011). Building academic geriatric nursing capacity: Results after the first 10 years and implications for the future. Nursing Outlook, 59(4), 198-206. Retrieved May 3, 2012, from the ScienceDirect database.
Ozbolt, J.G., & Saba, V.K. (2008). A brief history of nursing informatics in the United States of America. Nursing Outlook, 56(5), 199-205. Retrieved May 3, 2012, from the ScienceDirect database.
Wildman, S., & Hewiston, A. (2009). Rediscovering a history of nursing management: From Nightingale to the modern matron. International Journal of Nursing Studies, 46(12), 1650-1661. Retrieved May 3, 2012, from the Science Direct database.
Nursing Doctoral Business Proposal
The benefits of staffing Advanced Nurse Practitioners (ANP) as ANP Case Managers
A Nurse Practitioner (NP) is a registered nurse educated and certified to operate autonomously and collaboratively in an advanced and comprehensive medical responsibility. The practitioner has several additional roles under which they are to conduct diagnostic investigations, prescribe medications and undertake referrals to specialist clinical medications. esearch suggests that when nurses undertake prescription roles, it can result to increased efficiency, maximization of resources, and improve patient access to medicines and enable nurses to provide timely and extensive care packages (Cashin, Buckley, Newman & Dunn, 2009). In the advanced practitioner context, the roles that exist include the Clinical Nurse Specialist, the Certified Nurse Midwife, the Nurse Anesthetist and the Nurse Practitioner.
On the other hand, an Advanced egistered Nurse Practitioner (ANP) is also a registered nurse who possesses professional knowledge base, intricate decision-making skills and…
Cashin, J.A., Buckley, T., Newman, C., & Dunn, V.S. (2009). Nurse practitioner provision of patient education related to medicine. Australian journal of advanced nursing, 27(2), 12-
Carter, N. et al. (2010). The role of nursing leadership in integrating clinical nurse specialists and nurse practitioners in healthcare delivery in Canada. Nursing leadership, 167-185, doi:
Lowering the Nurse/Patient atio: A simple Step for Improving Care
Nursing is far from a static profession or discipline, and is in fact in a constant state of progression and change. Not all of these changes are necessarily for the better; increased healthcare demands, decreased abilities to pay for many patients and institutions, and a host of other factors can contribute to negative changes in the nursing work environment. When such factors arise it becomes all the more important for effective nursing researchers and practitioners to identify and advocate positive changes to the practice and the profession of nursing that can help combat the negative factors and ensure a consistent quality of care. In the current era of an ongoing shortage of nurses n the face of increasing demand and the approaching depletion of available nurses due to the aging population of nurses themselves, addressing the nurse-to-patient ratio…
Adomat, R., Dip, P. & Hewison, A. (2004). Assessing patient category/dependence systems for determining the nurse/patient ratio in ICU and HDU: a review of approaches. Journal of Nursing Management 12(5): 299-308.
Hassan, Z., Pryor, E., Autrey, P. & Turner, J. (2009). Hand Hygiene Compliance and Nurse-Patient Ratio Using Videotaping and Self Report. Infectious Diseases in Clinical Practice 17(4): 243-7.
Kane, R., Shamliyan, T., Mueller, C., Duval, S. & Wilt, T. (2007). The Association of Registered Nurse Staffing Levels and Patient Outcomes: Systematic Review and Meta-Analysis. Medical Care 45(12): 1195-204.
Mrs. Margaret Foley's Culturally Congruent, Personalized Nursing Care Plan
Case Scenario Overview
Mrs. Margaret Foley (Maggie) is a 46-year-old Aboriginal female has had an emergency open cholecystectomy. Although the case does not specifically indicate why the laparoscopic surgery was changed to an open procedure, this is common whenever the surgeon has trouble accessing the gallbladder for any reason such as a patient's smaller frame. Furthermore, this has several implications for the length of her stay and her care plan. There are also factors that indicate that Maggie will benefit from a nursing care plan that is attunded to her cultural needs due to the fact that multiple previous misunderstandings were mentioned in her case history. For instance, the case indicates that Maggie "felt uncomfortable" with the medical jargon used which was essentially incomprehensible to her and likely led her to not follow the care plan that was recommended for her.…
Nursing Higher Education and Leadership
Clinical leadership is very important because of the problems that characterize the health care sector, including workforce shortage, high rates of change, staff chaos, quality issues, and safety concerns, among others. From history, the preparation of nurses for key roles in the health care delivery system is quite important and should not be overlooked. (Joseph & Huber, 2015). I am trained both as a clinical nursing educator and perioperative nurse. Clinical nurse educators attain that title after much experience in nursing. They mainly coach nursing students and the newly graduated ones. Perioperative nurses on the other hand are registered nurses who help in the surgical department in hospitals, day surgery units, physician’s offices and clinics. Their main work is to assist in planning, implementation and evaluation of treatment for surgical patients. (Turunen et al., 2017).
As such, the perioperative nurse starts her work immediately the…
Nursing Practice Expected to Grow and Change
Ageing of population and healthcare providers, coupled with reforms to healthcare, will raise demands for professionals in the field, also expanding existing professionals' required skill sets and roles. Physicians, physician assistants, nurse practitioners, nurses, and medical assistants are included in this growth area. Fortunately, healthcare is characterized by a swiftly expanding and large workforce (with 23000 new entrants every month, nationally); this sector progressed even in recent economic recessions (Survey, 2013). Registered Nursing (RN) is one of the leading U.S. occupations which is projected to grow 26% and add the highest number of jobs by 2020 (an estimated 1.2 million RNs overall), as per U.S. ureau of Labor Statistics (Survey, 2013). This stems from a projected rise in demand, as well as a need for replacing the current ageing RNs. Nursing careers are being pursued in America increasingly; the number of students enrolled…
Buerhaus, P., DesRoches, C., Applebaum, S., Hess, R., Norman, L., & Donelan, K. (2012). Are Nurses Ready for Health Care Reform? A Decade of Survey Research. Nursing Economics, 329.
Dunbar-Jacob, J. (2011). The Changing Role of Nursing in Health Care Reform. Pittsburgh: Pitt Nurse. Institute for Nursing Centers Survey (2008). Retrieved from http://nursingcenters.org/PDFs/INC%20Highlight%20Report%2010_6_08.pdf.
NURSE-MANAGED HEALTH CENTERS. (2011). Retrieved from: http://www.nncc.us/pdf/NMHC_Quality_Standards.pdf
Pohl, J.M., Tanner, C., Barkauskas, V.H., Gans, D., Nagelkerk, J., & Fiandt, K. (2010). Nurse-managed health centers' national survey: Three years of data. Nursing Outlook, 58(2), 97-103
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
Nursing Concepts and Theory
Conceptual-Theoretical Structure paper
Personal belief about nursing theory and knowledge development process for nursing practice
All nursing theories play an important role in defining nursing and giving the roles that nurses need to play. Originally, the role of nurses was simply to carry out activities as instructed by doctors, however, over the years, this role has been changed to include more responsibilities as the nursing world has evolved. Nursing theories describe, predict and explain the various phenomena in nursing practice and thus create foundations for nursing practice. They also help to generate knowledge in the field of nursing and to point the direction which the field should develop in future. This view is supported by Carper (1978)
who states that nursing theories elaborate nursing practice and create professional boundaries for the profession. Nursing knowledge comes from research that has been conducted on nursing which forms scientific…
Anderson, A.M. (2005). Nursing Leadership, Management, and Professional Practice for the LPN/LVN (3rd ed.). Philadelphia: F.A. Davis Company.
Carper, B. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science, 1(1), 13-23.
Clark, M.J. (2003). Community health nursing: Caring for populations (Fourth ed.). Upper Saddle River, NJ: Prentice Hall.
Dayer-Berenson, L. (2010). Cultural Competencies for Nurses: Impact on Health and Illness. Burlington, Massachusetts: Jones & Bartlett Learning.
Nursing in the Rural Area
A WELL-DESERVED SECOND LOOK
Rural nurses are particularly endangered by the current and worsening shortage in nurses. As it is, rural nursing is already beset with issues that range from a lack of professional practice system, the need for larger incentives for nurses to work in the rural areas, a general unwillingness to live in these areas among the nurses and the foreseen depletion of the supply of rural nurses. Possible solutions and approaches have been proposed.
Approximately 20% or 54 million U.S. residents live in locations categorized as rural (ushy, 2006). These residents are distributed across 80% of the nation's total land area. About 99 or fewer residents occupy every square mile in these areas and experience the shortage of nurses more acutely than in urban areas. Moreover, they have generally lower annual income, less education and poorer health status than urban residents. Local…
Arnaert, A. et al. (2009). Homecare nurses' attitudes towards palliative care in a rural community in western Quebec. 11 (4) Journal of Hospice and Palliative Nursing:
Medscape. Retrieved on October 17, 2011 from http://www.medscape.com/viewarticle/715133
Blaauw, D. et al. (2010). Policy interventions. World Health Organization. Retrieved on October 18, 2011 from http://www.who.int/bulletin/volumes/88/5/09-072918/en
Bushy, A (2006). Nursing in rural and frontier areas: issues, challenges and opportunities. Vol 7 # 1 Harvard Health Policy Review: University of Harvard.
Charity, selflessness, altruism and entrepreneurship are, therefore, not contradictory. It is well-known that the well-paid traditional nurse is likely to be a better worker better able to devote more attention to her patient (Hardin & . Kaplow, 2001). Deductively, therefore, the independent nurse who is motivated to work well in order to be successfully self-employed would likely (although not necessarily) be a better nurse in terms of the intrinsic nursing characteristics than those employed by institutions.
Ironically, entrepreneur nursing can potentially make one into a better nurse, for aside from being motivated to perform excellently, the entrepreneur nurse can adopt her own style and afford to conduct thorough research into nursing theories and models that culminate in enhanced nursing.
The institutional nurse is classically overworked and, therefore, has little time for arbitrary activities; the entrepreneur nurse, on the other hand, can adequately fulfill the expectations of evidence-based nursing where she…
Hanink, E. (n.d.). Nurse Entrepreneurs. Working Nurse.
Hardin, D. & R. Kaplow (Eds.) (2001), Synergy for clinical excellence: The AACN Synergy Model for Patient Care. Sudbury, MA: Jones and Bartlett Publishers.
Johnson, P. (1977). Enemies of society. NY. Etheneum
Nurse Eduactor Strategic Plan
Nurse educator strategic plan
A strategic plan for a nurse educator
At present, I would say that my greatest strength as a nurse educator is my willingness to challenge myself in the pursuit of excellence. Within the next year, I will obtain my MSN with a specific concentration in education. Previously, I obtained certification as a Basic Life Support instructor (BLS). Also within the next year I intend to seek out certification in Advance Cardiac Live Support (ACLS) and Pediatric Life Support Instructor (PAL) with the intention of becoming both an ACLS and PALS instructor. These will enhance my capabilities as a nurse educator and provide greater specificity in the range and types of teaching I will be able to convey.
My second great strength as a nurse educator is the compassion I have for my patients and my genuine love of teaching. A nurse is…
Covey, S. (2012). 7 habits of highly effective people. Franklin Covey.
Gardner, H. (2007). Frames of mind: The theory of multiple intelligences. New York: Basic
Professional Nurse Educator's Group. (2013). Official Website. Retrieved from:
Nursing Intervention in Disaster
The possibility of occurrence of disasters is a reality. With this in mind there should be efforts made to prevent any upcoming or potentially disastrous events. These efforts are what are known as disaster prevention. Disaster prevention therefore refers to efforts put in place to ensure that adverse effects of events that are potentially disastrous are prevented even when the disaster cannot be controlled. Disaster prevention is done at various levels of the society and is undertaken so as to prevent all types of disasters. Nurses are involved to a large extent when it comes to the prevention and mitigation of disasters. Nurses are involved in institutions that can influence change and due to the unique skills that they posses they can make interventions in disasters. To perform efficiently, a nurse must be always prepared to make changes in plan actions at any time and at…
Harden, E.G., (2004). The role of nursing in disasters. Retrieved march 22, 2013 from http://helid.digicollection.org/en/d/Jdi018e/2.html
Rittenmeyer, L., (2007). Disaster preparedness: Are you ready? Retrieved march 22,2013 from http://www.nursingcenter.com/prodev/ce_article.asp?tid=726331
Wolters Kluwer Health, (2007). LWW Journals - Beginning with A. Retrieved March 22, 2013, from http://journals.lww.com/smajournalonline/fulltext/2007/09000/spiritual_issues_in_the_aftermath_of_disaster.32.aspx
Nurse's ole As esearcher
The nurse plays a unique role as a researcher. This involves them focusing on the latest treatment options, how they affect patients and the best times specific techniques should be utilized. Moreover, they must understand the numerous side effects of different therapies and how this will affect the patients they are working with. These areas help them to serve as confidant in comprehending how and when to apply certain procedures. (Allan, 2005)
At the same time, the nurse will understand the psychology, customs, behavior and biological factors which are contributing to a host of conditions. This enables them to comprehend the challenges patients are going through and the lasting impact this is having on them. When this happens, they can reduce suffering and improve their ability to cope with the issues they are facing. These insights will help patients to make a full recovery with reduced…
Allan, J. (2004). Clinical prevention and population health. American Journal of Preventive Medicine, 27(5), 470-481.
Allan, J. (2005). Clinical prevention and population health curriculum framework: The nursing perspective.
Allen, D. (2002). The Changing Shape of Nursing Practice. New York, NY: Routledge.
American Academy of Nurses. (2009). Nurses transforming health care using genetics and Genomics. Washington, DC: Author.
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:
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/
(Sussman and Bates-Jensen, 2007)
Assessment data is reported to enable the clear communication among clinicians about the wound and in making the provision for "continuity in the plan of care" as well as allowing for "evaluation of treatment modalities." (Sussman and Bates-Jensen, 2007) Wounds that are classified as red, yellow and black are those that require examination of deep tissue involvement. (Sussman and Bates-Jensen, 2007) The wound must be monitored during the healing process since monitoring provides the means of "checking the wound on a regular and frequent basis for "signs and symptoms that should trigger a full reassessment, such as increased wound exudate or bruising of the adjacent or periwound skin. Included in monitoring is the "gross evaluation for signs and symptoms of wound complications, such as erthema (change in color) or periwound skin and pus, which is indicative of infection." (Sussman and Bates-Jensen, 2007) Included as well should…
Aseptic Technique (2008) Aseptic Technique. Section G. NHS Foundation Trust. Online available at: http://www.cht.nhs.uk/fileadmin/departments/infection_control/policies/Section_G_-_Aseptic_Technique_Issue_2.pdf
Burney, R.E. et al. (1997) Core Outcomes Measures for Inguinal Hernia Repair. Journal of the American College of Surgeons. Vol. 185, Issue 6. Online available at: http://www.journalacs.org/article/S1072-7515%2897%2900108-7/abstract
Issues in Wound Care: Appropriate Use of Dressings. Report from a Wound Academy Expert Forum. Sponsored by the Molnlycke Health Care Wound Academy. September 2007. Online available at: http://www.molnlycke.com/Global/Wound_Care_Products/UK/Wound%20Academy/IssuesAppropriateusefinalSept07.pdf
Khan, Y. And Fitzgerald, P. And Walton, M. (1997) Assessment of the postoperative visit after routine inguinal hernia repair: A prospective randomized trial. Journal of Pediatric Surgery. Vol. 32, Issue 6. June 1997. Online available at: http://www.jpedsurg.org/article/S0022-3468%2897%2990644-8/abstract