THIS IS A DISCUSSION RESPONSE APA 6TH ED WITH INTEXT CITATIONS & REFERENCES.

 

Personal knowing is what you are known to others for. When someone gets to know someone, their personal knowing is what makes them stand out from other people. Personal knowing affects personal development because the way you treat people is related to what you know and what you actually do. Personal development is affected because you can better take care of people if personal knowing is not only acknowledged, but carried out. Personal knowing can only be viewed in the context of wholeness as no one really knows personal knowing than the knower. Personal knowing also incorporates compassion, passion and integrity (Chinn & Kramer, 2018). One professional strength I have as an OB nurse is the ability to relate to the patient and their situation. I have had babies all ways possible almost, and personally have been in a couple different hard situations so my ability to empathize with my patients is something that I am known for. Another professional strength I have is the ability to assess the patient’s beliefs and understandings and if they have beliefs that require any special attention, We take care of a good amount of Nepal refugees where I live and one thing they do is bring their family member food after she has the baby. Since this has become such a common thing for this community of patients, I have raised money to keep a small portable refrigerator around so the patient can keep it in their room. Just by addressing that small piece of detail, the patients are very happy to be able to store things at their bedside. One weakness I have is sometimes I can get attached to patients and I can spend a lot of time with them. I have trouble separating my work life from my home life and I feel sometimes I am empathetic to a fault. Using nursing theory, especially the self-care deficit theory, I can apply some of my own needs to this theory and use this theory to better help move through these needs. This will develop a weakness into a strength by working on what is needed and moving through the process of the self-care theory. Sometimes nurses are the worst about neglecting themselves and their basic needs, utilizing Orem’s self care deficit theory, one can recognize any areas they may be neglecting and pay attention to their needs (Lauder, 2001).

Chinn, P. l.  & Kramer, M. K. (2018). Knowledge development in nursing: Theory and process (10th ed.). [Pageburst version ]. Retrieved from https://pageburstls.elsevier.com/#/books/9780323530613/cfi/6/2!/4/4/[email protected]:0.0455(4), 545. Retrieved from https://prx- Journal of Advanced Nursing, 34

Lauder, W. (2001). The utility of self-care theory as a theoretical basis for self-neglect.

 

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“The sample for a rigorous qualitative study is not as large as the sample for a rigorous quantitative study. The researcher stops collecting data when enough rich, meaningful data have been obtained to achieve the study aims” (Grove, Burns, & Gray, 2013). “A substantial sample may be required to generate power sufficient to demonstrate significance” (Grove, Burns, & Gray, 2013) for a quantitative study. “Small scale quantitative studies may be less reliable because of the low quantity of data” (Mcleod, 2018)

Qualitative question: How do eating disorder patients with bulimia nervosa perceive cognitive behavioral therapy during their inpatient stay? Moving forward with this research question I would need patients who are in an inpatient setting, ones with bulimia nervosa, and I would perform interviews with those patients. The questions I would ask would include open ended questions allowing the patients to answer anyway they felt and me not persuading them to answer a certain way causing bias in the study.

Quantitative question: In patients with an eating disorder, specifically bulimia nervosa, how does the side effects of the mental illness affect the patients overall health? If I were to move forward with this question I would need to have patients who are diagnosed with an eating disorder, specifically bulimia nervosa. I would look at the research out there currently showing the different side effects on the body that comes from the disease. I could compare those stats with statistics from an inpatient unit on those eating disorder patients. This way I could show what is the current research on the disease and then have real examples to show for the research.

References:

Grove, S. K., Burns, N., & Gray, J. (2013). The practice of nursing research: Appraisal, synthesis, and generation of evidence. St. Louis, MO: Elsevier/Saunders.

Mcleod, S. (2018, December 05). Qualitative vs. Quantitative Research. Retrieved from https://www.simplypsychology.org/qualitative-quantitative.html

 

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Communication in the workplace is key. It is what makes employees feel comfortable, valuable and successful, which allows them to work to their fullest potential. Effective communication not only builds trust between employers and employees, but has a direct effect on the health and safety of nurses and their patients (Bergman, Dellve, & Skagert, 2016). The Clark Health Workplace Inventory is a tool that is used to determine if a work environment is perceived as healthy. After completing the survey, the results showed that my workplace is an unhealthy environment. Oddly enough, my coworkers and I have had many conversations about some of the very topics discussed in this assessment. That is why this result doesn’t surprise me at all. One of the question on this assessment asked specifically about staffing, which is something that my unit struggles with consistently. The absence of adequate staffing makes the workload difficult to manage. It leads to unnecessary stress. Also, there were several questions pertaining to clear communication through all the levels of the organization, which is something that I think my organization could get better at too. There are a lot of decisions made about the staff without actually getting the staff’s input on those decisions beforehand. It can make employees feel as though their thoughts or input doesn’t matter. No one can expect for every workplace to be perfect. In fact, any work environment has its issues and aspects that make people unhappy. However, overall employees should find some happiness in their jobs. Whether it be the impact of their work, location, coworkers, incentives, or opportunities for career advancement.

Incivility in the Workplace

Incivility in the workplace can cause employees to have little to no happiness in their jobs. Marshall & Broome define incivility as “ behavior of low intensity that can include such behavior as being rude, discourteous, impolite, or violating workplace norms or behavior” (pg, 76). I worked at a subacute rehabilitation center where the Director of Nursing behaved in this manner. She was very demeaning and aggressive when she would speak to the staff. It made for a very stressful environment. The nursing staff constantly felt like we were walking on eggshells, never knowing when we would have an encounter with her. There was a constant turnover of staff, not only among the staff nurses but mostly with the unit managers who worked directly under her. Even though she was a great nurse, I felt that she was not a good nurse leader for this reason. Although several nurses made her aware of their thoughts on how she treated and spoke to people, I can’t remember anything being done on a larger scale to combat the incivility. Looking back, I worked at this facility as a brand new nurse and really did not know that things could be done differently as far as leadership goes. I also wasn’t aware at the time of how working with this person impacted my views on the workplace as a whole. 

References

Bergman, C., Dellve, L., & Skagert, K. (2016). Exploring communication processes in workplace meetings: A mixed-methods study in a Swedish healthcare organization. Work, 53(3), 533-541. DOI: 10.3233/WOR-162366

Clark, C.M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18-23. Retrieved from https://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer

 

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Communication is the act of conveying information through ideas, feelings, attitudes, expectations, or perceptions by speech, gestures, writings, or behavior (Gifu, Dima, & Teodorescu, 2014).  Ineffective communication in the healthcare setting can lead to serious medical errors. Continuity of patient care occurs through clear and concise communication between healthcare professionals during handoff (Shahid, & Thomas, 2018). The writer used to work in an inpatient psychiatric unit where handoff was done quickly between shifts at the nurse’s station. There was no protocol or standard in place for patient handoff, and only verbal communication took place.  The writer experienced many occasions where the report writer received would not correlate with the patient’s actual condition. The unit was a high acuity unit meaning we had patient’s that were suicidal, homicidal, a flight risk, manipulative, and violent. Effective communication is critical in these situations to ensure the safety of the patient and employees (Marquis, & Huston, 2015).  An incident occurred regarding ineffective communication where a patient swallowed her eating utensils and had a history of consuming random items. The writer was given a verbal report about the patient at the beginning of my shift and was told that she was calm, cooperative, stable, and there are no issues to report.  The writer was not told about her history of swallowing items and that the writer needed to monitor her food tray to remove plastic silverware. The patient had to have surgery to remove the items. This situation could have been prevented with effective communication. Within the communication process, both the sender and the receiver of the message had different thoughts, ideas, and information that was exchanged (Marquis, & Huston, 2015).

Barriers to Communication

    The barriers to communication in this scenario were emotional barriers and interpersonal barriers. As a new nurse, the writer was not confident in communicating with my colleagues, who were more experienced and challenging their expertise. I did not have the self-confidence and the emotional intelligence to question authority and the processes in place. Another barrier was a loss of situational awareness in which we did not understand the patient’s current condition because we were not at the bedside during handoff. The formal organizational structure is also a barrier to communication because people at lower levels of the hierarchy do not feel that they have a voice to make a difference within the organization (Marquis, & Huston, 2015).

Strategy to Improve Communication

     Improving communication is critical to quality patient care and a reduction of errors (Marquis & Huston, 2015). After many mistakes due to ineffective handoffs, the psychiatric unit decided to implement the SBAR (Situation, Background, Assessment and Recommendation) as a communication tool for handoff at the Bedside. Performing the SBAR significantly reduced medication errors, falls, moreover, increased patient/employee safety and utilizing this tool created effectively communication between staff members and patients and created a sense of confidence to be able to take care of that patient without any doubts. Employees were required to walk in the patient’s room together to assess the patient and go over pertinent issues. The SBAR provides a structured format and standardized process for effective communication (Shahid, & Thomas, 2018).

References

Gifu, D., Dima, I. C., & Teodorescu, M. (2014). New communication approaches vs. Traditional communication. International Letters of Social and Humanistic Sciences, (20), 46-55.

Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

Shahid, S., & Thomas, S. (2018). The situation, Background, Assessment, Recommendation (SBAR) Communication Tool for Handoff in Health Care – A Narrative Review. Safety in Health,4(1). doi:10.1186/s40886-018-0073-1

 

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150-180 words APA format with references and in-text citations. 

Health literacy, along with health numeracy skills, can influence the quality of care delivery across the spectrum of settings and is vital to maintaining patients’ engagement in their own health. Health literacy is defined as “the degree to which individuals have the capacity to obtain, process and understand basic health information needed to make appropriate health decisions and services needed to prevent or treat illness” (Health Resources and Services Administration [HRSA], 2015).  

The ineffectiveness of healthcare literacy in the current health care climate is not a new issue, however it is as relevant as ever. People need information they can understand and use to make the best decisions for their health. When organizations or people create and give others health information that is too difficult for them to understand, we create a health literacy problem. When we expect them to figure out health services with many unfamiliar, confusing or even conflicting steps, we also create a health literacy problem (Brach, C., Keller, D., Hernandez, L. M., Baur, C., Dreyer, B., Parker, R., … Schillinger, D., 2012).

 Health information can overwhelm even persons with advanced literacy skills. Medical science progresses rapidly. What people may have learned about health or biology during their school years often becomes outdated or forgotten, or it is incomplete. Moreover, health information provided in a stressful or unfamiliar situation is unlikely to be retained. People with limited health literacy often lack knowledge or have misinformation about the body as well as the nature and causes of disease (Marshall, E., & Broome, M., 2017).  Without this knowledge, they may not understand the relationship between lifestyle factors such as diet and exercise and various health outcomes.

Despite the growing interest in health literacy, little research has been done around health professionals’ knowledge of health literacy or understandings of the barriers to health literacy that patients face when navigating the health care system.  Improving both the healthcare workers knowledge and those of their patients decreases the barriers that prevent patients from seeking and receiving proper care (Loan, L., Parnell, T., Stichler, J., Boyle, D., Allen, P., & Barton, A., 2017).

Health literacy may cover choosing and comparing different health plans, prescription drug premiums, copays, and deductibles. As medical science is continuously evolving and progressing, it is easy to understand how health information can confuse and even overwhelm the average healthcare consumer. Improving health literacy is the responsibility of health organizations, healthcare systems, and healthcare professionals worldwide. It is critical for patients to develop health literacy so that they can take a more proactive role in their health. When patients are actively engaged, they are able to make more informed decisions which increases patient satisfaction, adherence, and can ultimately improve outcomes(Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., & Smylie, J., 2015).  Patient empowerment, engagement, activation, and maximized health outcomes will not be achieved unless assurance of health literacy is applied universally for every patient, every time, in every health care encounter, and across all environments of care (Loan, L., Parnell, T., Stichler, J., Boyle, D., Allen, P., & Barton, A., 2017).

References

Brach, C., Keller, D., Hernandez, L. M., Baur, C., Dreyer, B., Parker, R., … Schillinger,

  D. (2012). Ten attributes of health literate health care organizations. Washington, DC:

    Institute of Medicine. Retrieved from http://www.ahealthyunderstanding.org/

         Portals/Documents1/IOM Ten Attributes Paper.pdf

Health Resources and Services Administration. (2015). Health literacy. Washington, DC:

     Author. Retrieved from http://www.hrsa.gov/publichealth/healthliteracy/

Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., & Smylie, J. (2015). Health

   literacy: Health professionals’ understandings and their perceptions of barriers that

     Indigenous patients encounter. Biomed Central Health Services Research,14.

      doi:10.1186/s12913-014-0614-1

Loan, L., Parnell, T., Stichler, J., Boyle, D., Allen, P., & Barton, A. (2017). Call for

   action: Nurses must play a critical role to enhance health literacy. The Journal of the

     American Academy of Nuring,66(11), 97-100. doi:10.1016/j.11003

Marshall, E., & Broome, M. (2017). Transformational Leadership in Nursing (2nd ed.).  

    New York, NY: Springer.

 

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