Nursing is a very demanding profession.   Having so many things coming at you at once is difficult.   Having critical thinking skills includes making a quick decision on what it is of highest priority.   Focus on the highest priority along with keeping the other issues in your mind so they are not forgotten can be difficult.   Rebecca I think you are very correct when you say the nurse can “develop a better outcome for the patient and self.” 

A nurse must be able to delegate tasks to help them finish these tasks in a timely manor.  For example if you have a patient asking to use the restroom, a doctor on the phone,  and you notice the faucet in the patients bathroom is leaking.   The nurse could asking the Patient Care Assistant to take the patient to the restroom.   Asking the Unit Clerk to call maintenance to fix the faucet.   And speak to the doctor on the phone.   Within a minute all three tasks were done in a timely manor.    

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The ability to stay focused and prioritize the med pass as distractions continue to occur in the middle of it is critical to safety and also has its set of challenges through all areas of nursing.  The demand for the nurses attention is usually always more than they have to give and this can be compounded by staff that do not possess critical thinking skills and ask questions before processing through information first.  The nurse is responsible to multi task while using EBP and critical thinking skills in a flurry of never ending activity.  I enjoy the end result when all care and tasks are complete for your assignment and the feeling of accomplishment throughout the med pass or other duties that relate to your daily tasks.  I also enjoy the ability to mentor other staff members that may have been the ones asking multiple qustions that were in the realm of their capacity to problem solve.  The amount of work that a nurse can complete when demands continue to barrage you are incomprehensible at times.  These are days that I am proud to be a nurse and possess critical thinking skills.  

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Marcia Stapleton    2 posts   Re: Topic 10 DQ 2  Evidence based practice (EBP) is a large key to improving patient outcomes and therefore is an essential component of the BSN prepared nurse.As nurses, if we strive for improving the capacity for evidence based care in our facilities, we will make significant strides in achieving the best possible outcomes for our patients.We must, continue to look outside our current practice to seek better practices for our patients (Halm, 2010).  In continuing to integrate EBP into my personal work environment, two ways would be through my role as a clinical nurse leader and through exemplifying a culture of learning and valuing applied research to the everyday routines of practice.Working as a nurse supervisor, I have a role as a clinical nurse leader.This role includes working with policies, workflows and new ways of doing things.Clinical nurse leaders support EBP in all of these roles by always asking the question “What is best practice?” Clinical nurse leaders also can assist in directing other nurses to data bases available to look into EBP research.In our facility, we have Up to Date embedded into our electronic medical record, which gives us quick access to EBP. Asking the “What is best practice?” question leads nursing into looking for EBP research to support the practices they are working with and exemplifies EBP as a culture.  Two obstacles that challenge the ability to integrate EBP into a work environment include time to read and implement new research and support from other staff (Halm, 2010). Reading and implementing EBP research takes time. Some ideas for overcoming this barrier are allowing BSN staff to have a certain number of hours allotted each month to EBP. The concept of EBP teams is awesome and seems like a great idea to overcome both of these barriers (Halm, 2010). If a facility could give these EBP teams allotted time each month to pursue a EBP project relevant to their practice this would overcome the barrier of time. Maybe we could have EBP committees a requirement for all nursing. EBP teams also can help overcome the barrier of support, as there will be support from the team for EBP which will build a culture the upholds the value of EBP.  Reference  Halm, MA., (2010). “Inside looking in” or “inside looking out?” How leaders shape cultures equipped for  evidence-based practice. American Journal of Critical Care. 19(4), 375-378. Doi:10.4037/ajcc2010627

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What are some of the potential benefits you could share with your colleagues, to encourage nurses to participate?  

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Re: Topic 2 DQ 1  Workplace violence in the health industry is greater than any other sector of employment, in fact the Federal Bureau of Statistics reports that violence in the healthcare is “3.8 times higher than all of private industry.” (Wolfe, 2018) In fact, the National Nurses United, the largest union of registered nurses reported workplace violence rates increased by 110% from 2005 to 2014. Examples of workplace violence include direct physical assaults (with or without weapons), written or verbal threats, physical or verbal harassment, and homicide (Occupational Safety and Health Administration OSHA, 2015). Nurses in the Emergency Room are at greatest risk for violence. Three out of four nurses routinely experience acts of verbal and physical violence, including, hitting, kicking, yelling and cursing from patients and visitors according to the January 2015 issue Journal of Emergency Nursing.  Statistically violence in emergency rooms is on the rise, however, our organization has specifically seen a drastic increase of violence in the emergency room. Long wait times due to failing healthcare systems, patients suffering from mental health issues and substance abuse are contributing factors. Law enforcement in our county readily bring patients who are altered on drugs or suffering from mental health issues to our facility because other hospitals mental health services have shrunk or they have removed the programs their services and other hospitals require them to stay with the patient while we readily accept them and dismiss the officers, making our hospital the easier and more time efficient option for them. Because of the growing higher population of older adults in our specific area due to several large senior living communities and long term care/rehab facilities within the vicinity of our campus, we see a large number of patients that suffer from situations and diseases that alter the mental status of the individual.  The implications are devastating. Nurses who experience violence in the workplace often suffer emotional, psychological, physical and professional consequences. Nurses often experience symptoms of post-traumatic stress after a violent incident. They may avoid talking about the event, have flashbacks, feel fearful angry, frustrated or helpless, they may also avoid patients or situations that may trigger all of these feelings. Nurses lose cognitive focus after a violent event. (Gillespie et al, 2010). Workplace violence is very costly. It is estimated that it costs billions of dollars a year. (Higazee and Rayan, 2017). Not to mention loss of work for the professional due to injury. Some nurses choose to leave the profession all together.  Busby,G. ( Jan, 2017). Incidence and Costs of Workplace Violence. Journal of Emergency Nursing. Vol. 41. Issue 1.  Gillespie,G.L., Gates, D.M., Miller, M. & Howard, P.K. (2010). Violence Against Healthcare workers in the Pediatric Emergency Department. Advanced Journal Emergency Nursing Journal. 32 (1), p.68-82  Higazee, M.Z.A., Rayan, A. (2017). Consequences and Control Measures of Workplace Violence among Nurses. Journal of Nursing and Health Studies.Vol.2 No.3:22.  OSHA (2015). Caring for our Caregivers. Preventing Violence a Roadmap for Healthcare Facilities. Retrieved o https://www.osha.gov/Publications/OSHA3827.pdfn October 20, 2019 from  Wolfe, E., (3 Oct. 2018). Violence Against Emergency Staffers Seen as Increasing. Fairwarning reports. Retrieved on October 20, 2019, from https://www.fairwarning.org/2018/10/violence-emergency-rooms-workplace-physicians-nurses/

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