It will be important to determine what has failed with this change in the past, as well as what has worked in the successful implementation of change with the same team to determine the best path forward. Furthermore, it is concerning that the nurse manager’s past attempts at communicating regarding quality improvement have resulted in a lack of feedback. As you discussed, it will be very important to build an implementation plan based upon the work described by Middaugh (2017), Heuston
(2007), “the AACN Synergy Model matches the patient characteristics with the nurses’ competencies to optimize outcomes”. This systems model was used to analyze the dilemma and to provide the best care to the patient. Even though she recovered for the pneumonia, the patient’s ability to return to her previous state of health was compromised by her multiple co-morbid conditions and her advanced age. The patient was not in a position to make decisions for herself and the patient’s daughter was in denial that her mother was dying and needed some educational resources such as palliative and hospice, chaplain to make informed decision. Initially the daughter was hesitant to talk about the code status and once she was provided the information she was more responsive to the course of events, participated in the decision making process leading to end of
Florence Nightingale was the first nurse to propose theories that would create an influential impact on nurses for years to come. Nightingale focused on the well being of her patients and what could be changed to improve their health (Johnson & Webber, 2015). This led to other nurses creating theories of their own to guide practice. Patricia Benner’s theory of Novice to Expert is a theorist that every new graduate can relate to. There are five stages that Benner addresses that each new nurse will go experience as they grow and learn: novice, advanced beginner, competent, proficient, and expert level (Johnson & Webber, 2015).
There is a correlation between health care members providing information in a timely manner to patients who need to make decisions about their care and treatment and the quality of care patients receive. Lack of care resulted from physicians being reluctant to refer patients to palliative care. Due to a lack of honest open discussions regarding diagnosis, prognosis and treatment options patient’s suffering was prolonged. Since palliative care focuses on improving symptoms, dignity and quality-of-life it is important that sufficient attention is placed on the complex needs of individuals. The delivery of palliative care has become challenging for nurses.
Many nurses and graduate nurses have not been adequately prepared to care for patients in the hospice and palliative care setting (Chmura, 2016). There needs to be a focus of education in the university and clinical setting on pain and symptom management and therapeutic communication skills with the dying patient and his/her family. One possible solution to this problem is the implementation of the dedicated education unit (DEU) model, developed by the University of Buffalo Science of Nursing in collaboration with the Center for Hospice and Palliative Care of Buffalo, New York.
This essay will be focusing on Margret who has required nursing interventions for her Type 2 Diabetes Mellitus (T2DM). There will be a discussion of what the condition is and its effect on the patient holistically; how it has impaired and impacted Margret’s normal health and how the condition has affected her family. There will be a demonstration awareness of how public health policies has impacted the health of Margret. What nursing models are will be briefly explained and how it can be used to support nursing care planning. Using the Assess, Plan, Implement and Evaluate process there will be a structured care plan which demonstrates awareness of the roles and responsibilities of nurses within an inter-professional care delivery.
Lazarus (1984) definition of stress (earlier mentioned) is a situation where an individual feels that the demands are more than the personal and socials resources. Utilizing the second concept in Lazarus’s theory- Cognitive appraisal, nurses experiencing compassion fatigue must assess whether their current situation threatens their well-being and whether there exists resources to meet the demands of the stressors (Gary Sturt, 2016). According to Gary Sturt (2016), there are the primary and secondary cognitive appraisal. During the primary cognitive appraisal, a nurse will be seeking answers as to the meaning of the current event (compassion fatigue) with regard to their well-being, that is, whether the current situation is irrelevant, good or stressful. During the secondary cognitive appraisal, a nurse will be seeking an answer as to whether there is the ability to deal with the problem (Gary Sturt,
For a nurse, effective discharge planning is important. According to BMJ (2008) discharge planning is a process that’s focuses on the coordination of services and care after a patient’s discharge from hospital. In Ian and Judi’s case the discharge planning they received left them in fear and desperation. AHRQ (n.d) express that effective discharge planning involves the client and family by giving them adequate preparation as this reduces unplanned readmissions, improves client outcomes and increase client satisfaction. It is evident in the article that Ian and Judy’s experience with discharge planning was less then optimal.
Limited resources, developmental threats, and weak self-care agency showed in her own awareness and perception of her health deviation self-care requisites. She is should be able to perform self-care and enroll in the treatment of her hypotension case although she lacks the knowledge, skills, and psychological security to do so. I interviewed K.H before discharge that I was concerned with the weak self-care agency shown in K.H
Week Nine Initial Discussion Post NURS6053, N-20 Throughout my working career as a registered nurse (RN) I have experienced various types of leaders. The purpose of this discussion is to talk about a particular manager and their leadership style.
The APNs can specialize in either of the four general areas; Nurse Anesthetists, Nurse Midwives, Clinical Nurse Specialists, and Nurse Practitioners. Each specialization requires it’s defined theoretical and practical or class hours, different from the other specializations. A nurse can further take a
Articulation agreements are frequently made between colleges so that students can transfer schools to finish their BSN or MSN degrees (“Registered Nurse,”n.d.). In order to be licensed, nurses must graduate from an approved nursing program and pass the NCLEX-RN, which is the National Council Licensure Examination. Nurses can also be certified in specific areas through professional associations, where separate tests may be required. Each state may also have certain requirements to complete.
The one piece of information that will most likely affect my nursing practice will be to ensure I inquire about a caregiver’s emotional state and how he or she is coping. As an intensive care unit (ICU) nurse, I see firsthand how caregivers resume care at the hospital for his or her loved ones, even though there are health care professionals ready to take care of personal needs. It seems as if a caregiver does not know when to stop giving. A caregiver will at times, succumb under mounting challenges and tribulations at some point and will need support. For caregivers experiencing stress, self-help groups can be beneficial (Tabloski, 2014).
Ms. Long has been admitted to a skilled nursing home after four months in the hospital, and has been assigned a public guardian since she is no longer able to make life decisions on her own. The guardian is faced with the problem of deciding whether maintaining/sustaining life-giving care or palliative/hospice care is appropriate for their charge. With the medical team, and a personal assessment, the apparent choice would be palliative or hospice care. Comfort care at this stage becomes the basic concern. The palliative care plan should be the consideration for the do-not-resuscitate (DNR) provision.