Healthcare Professionals and Teams

1. Share what you had expected to learn about the topic before beginning the unit.

This week’s topic is healthcare professionals. The term healthcare professional is a very broad term. There are members of the healthcare team that have no background in medicine at all. For instance, the orderly who transports the patient from the surgical suite to the medical/surgical floor who spends his summers doing outside sales jobs and has no medical training. The other end of the spectrum is the individual with advanced doctorate degrees in areas of medicine with specific language that is not used in the general population. That individual is extremely intelligent but can’t communicate to another individual what his knowledge means without the use of a special medical dictionary and thesaurus. Being a medical professional doesn’t mean that you even have the specific knowledge to help in the situation at hand. As a paramedic I would encounter individuals on an emergency scene that would say, “I am a nurse” when asking that “nurse” for further qualifications to determine my resources I would find out that they were a nursing student doing their pre-requisites while working as a CNA in a podiatry clinic. Not exactly relevant to emergency care in the out of hospital setting. I have been a registered nurse for less than 6 months. When asked about specific areas of nursing where I have no experience I am as clueless as a small child on their mothers lap. However, put me in a room with a patient who needs a Rapid Response or a Full Code and I am as calm and comfortable as I can be and able to critically evaluate patient presentation, vital signs, applicable past history, contributing events to the patients deterioration and a wide range of other information.

2. What you actually learned from the unit.

The most important thing I learned in this unit was the limitations of what it means to be a healthcare professional. Nursing has such a broad range of skills and specialties that being a “Nurse” doesn’t guarantee any level of proficiency in any given setting. One individual might be the world’s leading figure on wound care and the last person in the world you would want starting an IV for you.

Another aspect of this topic that stuck out was how each member plays a role on a team. There are some members of the team that far exceed their educational limitations. Their experience with people and their own individual knowledge far outweigh their formal educational credentials. The most important take away from this topic as a whole is not to prejudge the members of the team you are working with but to adequately assess the level of knowledge and expertise and individual brings to the table.

3. Discuss your feelings/experiences from the activities (individual and team)?

We had a team exam this week. While this exam reduced my workload in some aspects it also reduced my GPA in another. When you are working with a team where you are unable to determine their strengths and weaknesses ahead of time, I learned that it is vitally important to allow time to evaluate their contributions to the team as a whole and not just hope for the best…

4. How you will utilize the information learned in your nursing practice.

When I am the individual with no formal experience with a given subject I like to ask a lot of questions. I like to ask how things were identified, how the individual processed them up to that point, and how they knew it was applicable to the given situation. I then like to tell that individual what I was thinking and why, where my thought process came from and ask them to evaluate the direction I was headed and give me feedback and what else I should have considered. When you have no experience with a given subject, the best way to overcome this shortcoming is to utilize the collective experience of your team and integrate their knowledge into your own experience.

5. You personal feelings about the material covered.

IHC is moving towards decentralized nursing stations in their new addition to the Utah Valley Hospital. I think this is going to eliminate a lot of learning and experience from medical unit staff. Being able to learn and process information from the most experience nursing staff and have that information assimilate down to the least experienced staff is going to become obsolete. The most experience and the least experienced may never even see each other in the decentralized setting. The least experienced staff will have an increase in never events while the most experienced staff may never realize there was someone her experience could have helped. But at least the administration will have cut down on socializing…..

There is a book by Tony Dungee titled “Extreme dreams depend on Teams.” Eliminating the team setting in the hospital environment is a big mistake. Building effective teams where the weakest members can learn and grow from the strongest members is essential to having everyone grow together.

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Legal and Ethical Issues in Quality and Safety in Nursing

I was surprised at several of the directions we were taken during assignments and discussions with this topic. I wasn’t sure exactly what we would focus on for legal and ethical issues because there are so many of those issues in healthcare. What surprised me the most is how quickly those issues arose with certain patients. One example is the 27 year old female patient suffering from chronic pain related to fibromyalgia. Seems like an issue of chronic pain and how to deal with it. The assignment went almost immediately to medical assisted suicide for this patient. I have experienced low back pain from falling down some stairs while fighting a house fire. That low back pain haunts me almost a dozen years later. I actually get angry when I begin to feel that pain. It frustrates me, it messes with my head, yet I have never thought of killing myself over that pain. While my pain isn’t as severe or as debilitating as others pain might be, I still don’t go down the road of suicide to escape that pain. It wasn’t something I had considered and therefore took me by surprise on this assignment.

I would say that this surprise is what I learned or re-learned during this unit. That just because I wouldn’t consider something in a specific situation doesn’t mean others aren’t considering it. This reinforces the idea that we really need to come to understand our patients and what they have on their mind. What might seem simple to us might be debilitating to them. Coming to a full understanding of their mindset, their coping mechanisms and the resources they are using to address their medical issues.

This assignment served as a reminder to me to step out of my own mind and try to understand what is going on in my patients. Their worries, fears and ability to identify and solve problems are so much different than mine. Rather than force my views on them, taking the time to understand their views will serve me well in the future and help me gain wisdom.

 

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Quality Improvement Strategies

 

QSEN- The song of my people

Quality improvement to me has always been one of those topics where we talk about making improvements but don’t actually discuss what it is we are going to improve. Or possibly that our focus is an improvement in an area that isn’t directly related to better health or an accurate measurement of health.

Quality improvement is essential in any competitive industry. Healthcare is no exception. Learning statistics like we perform 2,200 heart surgeries a year shows our advancement in medical technology. Following that statistic with the knowledge that that same number of surgeries are performed incorrectly or on the wrong patient demonstrates the need for constant quality improvement.

This unit actually pointed me in the direction of resources that are available for me to be a better healthcare worker. I found the information at QSEN to be  helpful in providing me with additional resources for that improvement.

During this unit we had several team based discussions. These discussions are always beneficial in analyzing our thinking and the thoughts of our colleagues. This allows us to gauge our own level of knowledge and make adjustments where needed.

I personally don’t believe true healing revolves around patient satisfaction. I believe true healing revolves around making tough and necessary changes to incorporate a better lifestyle for ourselves and our family. As a medical surgical nurse true healing comes as a result of a patient centered approach to a medical plan of care. Providing a safe and comfortable environment is essential in helping patients heal from medical procedures, however, patients need the truth about what is necessary for adequate healing and not just to be told what makes them happy.

Quality in Nursing Care

The topic for this week was Quality in Nursing Practice. We looked at different elements of quality that were important to us and elements that we felt would be important to our patients. As we approached this week I wasn’t sure what I would learn from the material but kept an open mind as I evaluated what others thought were important and what the material presented as important.

One thought that stuck out to me is that quality can be something different for each individual. Not so much that quality itself is different but the means by which each individual measures and evaluates it. That stuck in my mind that its important to understand the perspective of the individual you’re interacting with. Quality from a patient standpoint is going to be evaluated differently than quality from a corporations standpoint.

Understanding each patient I interact with and how they feel about quality care is the lesson I have taken from this weeks material. Being able to assess this in each patient and then provide quality care to their level of expectation is the challenge moving forward.

Critical Thinking

This week we were asked to consider the following questions,

  • What do you consider elements of quality care when receiving healthcare services?

One of the first elements of quality care when receiving services is problem solving. As a patient there are problems, pain control, infection control, are just two of many possible problems. What is being done about the pain? Is the pain management effective? Are my needs as a patient being met by the healthcare team?

Communication is another important element when receiving services. Does the healthcare team explain what is being done and why it is being done? Am I comfortable with what is going on before it gets done? It is important to me to receive the proper communication prior to administration of services.

  • What do you consider elements of quality care as a professional nurse?

As a nurse I believe in the same elements to providing quality care. Problem solving is one of the primary ways we are patient advocates. Do we have the tools and resources available to us to solve the patients problem? If not, what do we need to obtain to adequately solve that problem so that healing can occur?

Communication is an effective treatment to many patient anxieties. Communication can be a form of distraction regarding pain relief. It can be a treatment when patients are struggling to cope. Communication can be source of knowledge if that is lacking. Proper communication to the patient is crucial to a trusting, and healthy healing environment.

  • Are the two similar or different?

They are one and the same. When the needs of the patient are met by the competent care of a nurse a great deal of healing can take place.