Multigenerational nursing

Please, respond to the following discussion by using one reference from peer-reviewed Nursing Journal not older than 5 years.

Some of the challenges of having different generations in the workplace include a difference in education, particularly vocational training, and a difference in communication style. As current practices are studied and re-evaluated, traditional practices may be replaced by those that are more recently researched and are evidence-based. Veteran nurses may believe it is a waste of resources to change a practice that has been in place for so long and, in their view, has yielded adequate results.  Similarly, younger generations may readily dismiss suggestions and viewpoints from veteran nurses in favor of the new practices learned in school without considering that years of clinical experience can be just as valuable. This disconnect between nurses of differing generations may be rooted in a difference of communication style. For example, Baby Boomer nurses were trained to only voice their opinions when asked, whereas Millennial nurses’ were taught to speak up any time they have a problem with, or idea for, new practices; this difference in communication may lead the Baby Boomer nurse to regard the Millennial nurse as impertinent and disrespectful of authority instead of realizing that new nurse is actually trying to improve the patient experience (Phillips, 2016, p.198).

In my experience, some veteran workers can be set in their ways to a fault, even if there is clear evidence that practices they are accustomed to are simply not the best practices anymore. This is not to say that middle-aged or younger workers cannot share this attribute, however the veteran workers sometimes use their field experience as a rationale to ignore current research findings and continue using practices they deem appropriate. Also, as an employee that is frequently on the team that rolls out new technology and equipment, I feel that veteran workers take more time to warm up to change and can be somewhat hostile to a younger person, such as myself, training them.

As far as accommodations, we have certain older employees that will not perform job-necessary duties because of back issues, knee issues, or other medical issues in the same vein. As a result, these employees rarely get assigned total care patients, making the younger staff resentful because they feel they, literally, do all the heavy lifting while these older employees are routinely assigned the less acute patients. To a certain extent, allowances should be made for older workers, including nurses. After a lifetime of caring for patients, it is reasonable to deduce that the joints, particularly knees and back, can be irreparably damaged from repeated use. However, in my opinion if an employee is unable to perform the duties required of their job title, they should be doing a different job. It is not fair that one group of nurses consistently gets less acute patients, thereby doing half the work, but still receiving the same benefits as those nurses that pick up the slack. A potential solution would be for the nurses with physical limitations to shift to a position that utilizes their experience but is less physically demanding; such positions include resource nurse, case manager, or patient care coordinator. If this were fiscally feasible, the unit would be able to retain the wealth of knowledge provided by these seasoned nurses and still have room to hire new nurses that can help distribute the patient loads more equitably.

            Life expectancy in the United States has increased over the past few decades and older people are generally healthier than their predecessors, however the incidence of chronic conditions has also increased in this time frame (Tabloski, 2014, p.8). This indicates that there are more people to care for and these patients are more likely to have multiple comorbidities. This trend has the potential to put an enormous strain, economically and physically, on an already overburdened health care system and nurses, particularly bedside nurses, will bear the brunt of this (Tabloski, 2014, p.13). It is important that nurses engage in primary and secondary prevention with this population, including education related to diet, exercise, and proper medication utilization (Tabloski, 2014, p.13). By encouraging older patients to take an active role in preservation of function and overall health, nurses empower these patients to help decrease their risk for chronic conditions, like hypertension, and injury (Tabloski, 2014, p.13). Also, nurses must be educated on specific attributes of the older population, such as increased sensitivity to certain medications, decreased sensory perception, and increased susceptibility to mental health issues, such as depression, that may affect their physical health or motivation to maintain a healthy lifestyle.le

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Modern healthcare systems have become more chaotic, requiring nursing leaders to obtain skill sets that will allow them to adapt to change successfully (Huber, 2018). Huston (2008) suggests that preparation must come from educational models and management development programs that contain leadership competencies. Superior performance comes from strong leadership skills and behaviors (Thusini & Mingay, 2019). Strong skills and abilities associated with effective nurse leaders include social intelligence, management skills, and being politically astSocial Intelligence

Social Intelligence is the ability to connect with other people and influence them. A nurse leader with highly developed social intelligence possesses the capability to work collaboratively and engage in team-building with other health care professionals. Huston (2008) highlights collaboration and team-building skills as a competency essential to creating a positive and productive healthcare environment. Poor social intelligence can lead to non-productive conflict. 

Economic Factors

Concerning the relationship between nursing leaders and economics, technology, and the high cost of healthcare must be considered. Electric Medical Records (EMR) require funding to implement. Additionally, the cost of expensive equipment and supplies impacts nurse managers’ decision making on how much is needed to operate safely (Huber, 2018). The nurse leader must be aware of the high cost of healthcare at all times.

Political Skills

Being politically astute is a nursing competency that is needed for organizational goal attainment. Politically skilled nurse leaders maintain balance and accountability (Thusini & Mingay, 2019). By utilizing power prudently and clear decision making. The nurse leader must be proactive to healthcare organizational demands. 

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Please, write one paragraph response to the following Discussion by using one reference from peer-reviewed Nursing Journal not older than 5 years.

Evidence based practice plays a major role in nursing, EBN is any practice that relies on scientific evidence for guidance and decision making. Organizations with forthcoming leadership reinforce staff will boost the use of evidence based practice. Informal and formal leadership is necessary across all organizational levels and nursing roles when implementing evidence based practice (Huber, 2018). Nurse Managers can ease and support EBP work in ways like setting up unit expectations, discussing the importance of EBP, promote staff questioning, track progress and much more. Encouraging nurse to attend project work conferences will promote the use of evidence based practice. Economics do affect nursing practice

 We all agree that finding a large amount of research support Evidence based practice ameliorate quality and safety of health care which amplify health outcomes and decreased variation I care and reduces costs. A lot of money is spent on healthcare in the United States than any western country. Nurse’s work 12 hours shift, patient are awaken every 2-4 hours for vitals, patient with indwelling catheter ends up with infection. In the United States EBP has been the Triple Aim in healthcare. EBP has been found to license clinicians and result in higher job satisfaction. Although it has brought many positives outcomes it is not used throughout the United States or the rest of the world due to multiple barriers that have continued to persist over the past decades. Study shows there is a gap between the research evidence available and the implementation of it in clinical practice. The reason for that is because clinicians can overwhelmed with information or lack skills to assess information , sometimes it is reviewed but not apply to clinical decision-making (Stephen-Haynes,2014). Not having many research evidence available, nurses tend to make decisions based what was already available and not any updated information. While sometimes it provides positive outcomes, sometimes it ends on costing the facility when the effects are not so positive. Patients are concerned about achieving better outcomes while controlling the cost of medications and treatment. It can cause patient not to seek help until it’s too late. The more research we find the more we can implement into our practice and the more it can decreased cost for patients and also the hospitals.

In summary we talked how evidence-based practice (EBP) improves healthcare quality, patient outcomes, and cost reductions, and abundance barriers persist in healthcare settings that need to be rapidly overcome. We talk about how the cost of treatment affects nursing care and how clinicians sometimes may not review any new research due to being burn out.

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Please, write a response to the following discussion in one paragraph. APA format needed without cover page, one reference from peer-reviewed Nursing Journal required.

             Minorities such as the Hispanic population are having to deal with chronic conditions without the ability to access healthcare. They lack healthcare access because they are unable to afford a healthcare plan nor are they able to pay for doctor visits. In addition, they are unable to afford their daily medications that are needed to help control their health conditions. Many of the low-income Hispanics on average have an income of less than 25, 000 per year. They are financially unstable and worried about their finances. Because of this low income, they are unable to afford the costs associated with their illnesses leading to a lack of follow-up visits, lack of adherence to the medication regimen and many simply do not see a doctor. For the Hispanic population, diabetes is the most common chronic health condition affecting their family (Saulsberry, Blendon, & Benson, 2016).

            A program that has helped many people in the United States to obtain healthcare coverage is the Affordable Care Act. When ACA was signed into law in 2010, it allowed for the largest number of people to obtain coverage in fifty years (Sommers, Maylone, Blendon, Orav & Epstein, 2017). Because of ACA, there have been increased primary care visits, improved blood pressure control and PAP testing rates. Under the healthcare law, healthcare companies cannot refuse to insure people with pre-existing conditions. People with pre-existing chronic conditions have the most to gain because they are covered and will not be denied care. ACA has provided medical adherence, open communication with healthcare providers and it has improved access to healthcare and services to low income Hispanic communities. I hope that ACA continues to be a law, one providing better healthcare and access to all in the United States.

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Please, write a one-paragraph report to the discussion posted bellow by using one reference from peer-reviewed English Nursing Journal not older than 5 years.

Despite case management’s humble beginnings, the overall importance of case management has increased exponentially over the years. Over the past 25 years the role of case management (CM) in the health care field has evolved (Huber, 2018).  The patient-centered primary care model is currently preferred. It requires quality-driven prevention and outpatient management in order to produce favorable outcomes for patients.  Case Management is an essential part of the primary care model. In the early 1990’s the effectiveness of case management was unclear (Huber, 2018). CM nurses were unnoticed and rarely paid for their services (Huber, 2018). Health insurance companies acknowledge that the utilization of case management nurses produces quality and cost containment outcomes (Huber, 2018).

According to Huber (2018) case management is the coordination of care and advocating for patients and their family’s health care needs and services.  CM empowers patients to understand and access quality, efficient health care (Joo & Huber, 2018).  They also often take responsibility for vulnerable patients (Joo & Huber, 2018).  Case management nurses bridge the gap between fragmented care and effective care. 

Case managers at the health care facility that I work for often work closely with social workers and other healthcare professionals. The ensure that an appropriate level of care is provided to the patient.  They also reduce length of stay in the hospital thus reducing healthcare costs.  CM at my job also reduce readmission by setting up follow up appointments as needed.

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