Comment 1

Knowing scientific management theory as defined as supervising by way of focusing on task accomplishments rather than interpersonal relationships (Huber 2014). Some routines in health care that seem to be inefficient in regards to scientific management are the overwhelming focus on tasks, the evaluations based on tasks accomplished, and the pressure to join committees to add more tasks to nurses’ duties. A lot of times nurses have trouble tending to the needs of their patients because they are so focused on getting the tasks done so as to not get in trouble. Many times tasks are added to the nurses’ workload making it hard to complete everything on time. This causes incidental overtime which is also greatly frowned upon. Finally, the committees are supposed to be a good thing, allowing nurses to participate in shared governance. The issue arises when the requirements for the committees capitalize on the time the nurse should be working or decompressing from the stress of daily work. Some examples of participative decision-making at the hospital that I work at are unit forums and shared governance council. The unit forums allow for nurses and aides in the unit to meet and discuss issues to resolve amongst themselves. Shared governance councils allow for nurses to meet with administration to discuss issues at the bedside that can only be fixed by administration.

Comment 2

The scientific management theory states that humans are motivated by money, and there should be a separation between managers and workers. The expected result is a dramatic increase in productivity of the workers and profits for the organization. Some of the routines in the health care setting that are inefficient is nurse-to-patient ratio and staff retention. I feel the nurse-to-patient ratios are unsafe as it overloads the nurse and nursing assistants in carrying for high acuity patients with a higher prevalence of medical errors and oversight. When staffing is is done according to census instead of census it creates an unsafe environment for the patients and the staff. Without adequate staffing, patient care is inadequate and the patients suffer. Which in turns causes patient surveys to report negative feedback giving the hospital low numbers.Staff retention is important to ensure there is adequate staff to meet the demands of an aging population with numerous chronic illnesses. When facilities ignore the concerns of staff or do not provide attempt to implement change that benefits the staff and the patients, morale falls and staff leave. When nurses feel their safety and license are in jeopardy, they will seek out a better work environment they feel safe in. The facility I work for currently does annual retention surveys that allow its employees to voice any concerns and share what they feel the facility is doing well or could improve on. The nurses are asked various questions in regards to the leaders and managers they work directly under and whether their needs are being addressed. The facility offers committees that focus on allowing staff to have voice. Some include unit base council for each unit of the facility, committee for staffing concerns and safety committees that focus on sentinel events. 

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Comment 1

An effective leader is empathetic, understands multiple leadership skills as well as flexible. Leadership skills involve an ability to understand emotional intelligence and skills needed to become a nursing leader. Self-awareness involves the ability to understand one’s emotions and feelings and how these affects and influences others. Self-awareness is significant to leadership effectiveness, and many leaders exercise it. It is a way of exploring tendencies, beliefs, individual personalities, natural inclinations as well as value system (Huber, 2018). People react to things, synthesize and learn differently. Self-awareness help to spend time occasionally in self-reflection to achieve a better insight in ourselves. It assists the managers to determine the gaps in management skills that promote skill development. It assists managers in stress management and motivation, with intuitive decision-making and finds most effective situations. Self-awareness helps people to strengths as well as cope with the weaknesses.

An example, a person good in seeing the big picture surrounding the decision but not good in concentrating at the details may need to consult the subordinates or the colleagues who are more detail-oriented in making main decisions. Combining detail-oriented and big picture oriented decision makers may produce high quality decisions. In a team, a good leader is important (Huber, 2018). For instance, in the hospital nurses may be busy and the patient may require multiple things, some have a change in condition, and some may be in great pain. Nurses who are well-organized, manage time and help other colleagues make differences, enables him or her to run smoothly and less stressful. Nurses using the self-awareness are able to use their feelings and emotions as a guide in decision-making. As nursing, one needs to understand how his/her emotions and attitude affects and influences other employees.

Comment 2

Self-awareness means knowing your values, personality, needs, habits, emotions, strengths, weaknesses, etc. Human beings are complex and diverse. To become more self-aware, we should develop an understanding of ourselves in many areas. Key areas for self-awareness include our personality traits, personal values, habits, emotions, and the psychological needs that drive our behaviors. Individual leaders who are able to regulate their own emotions are better equipped to provide a “holding environment” for the people who work for and with them, creating a culture where people feel at ease.

In our highly competitive culture, this can seem counterintuitive. In fact, many of us operate on the belief that we must appear as though we know everything all the time or else people will question our abilities, diminishing our effectiveness as leaders. If you’re honest with yourself, you’ll admit that really the opposite is true. Because whether you acknowledge your weaknesses or not, everyone still sees them. So rather than conceal them, the person who tries to hide weaknesses actually highlights them, creating the perception of a lack of integrity and self-awareness.

Self-awareness helps managers identify gaps in their management skills, which promotes skill development. But self-awareness also helps managers find situations in which they will be most effective, assists with intuitive decision making, and aids stress management and motivation of oneself and others.

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Comment 1

My executive summary will be on change of shift admissions and effects on patient care. Change of shift is a vulnerable time for both patients and nurses. During change of shift, critical informatin regarding patients is communicated to the on-coming nurse and ancillary staff. Interuptions during hand-off, including admissions and transfers may hinder the integrity of communication between nurses and delay the completion of critical patient-centered tasks. I would like to create a policy to decrease the flow of traffic during critical shift change times between the hours of 7:15am-8:15am and 7:15pm-8:15pm.

Comment 2

I would like to describe differing approaches of nursing leaders and managers to issues in practice when discussing nurse-staffing ratios. This is a big issue in the country because aside from California, legally mandated nurse-staffing ratios do not exist. When it is discussed in the hospital now, nursing supervisors discourage it by telling nurses that it is not all it’s cracked up to be. Some hospitals can go under due to the need to staff appropriately. When talking to a nurse who has worked under both situations, she has said that the cost of healthcare ends up declining in a good way because nurses are making less overworked mistakes and patient-satisfaction is up. This can be the big difference between managers and leaders in the big picture of things. Managers will listen to nursing complaints of being overworked beyond safe circumstances and the manager will simply say, “this is what you signed up for when you became a nurse,” like we’re soldiers complaining about being shot at when we chose to be a soldier. We signed up for nursing to care for patients and participate in the optimization of their help. Leaders will listen to nursing complaints and ask themselves what can they do to help. At the end of the day, if more people were leaders, nursing shortages may not exist. Nurses would be happier and stay in their positions longer.  

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Comment 1

Imago dei means the image of God. It is a Christian concept of how man or human being was created in the image of God, and it bestows honor and dignity of each person irrespective of their social, mental and physical status (Shelly, 2006). Imago dei or the image of God is a theological term, and it applies to a human being only. The concept has its roots in Genesis. The concept of imago dei does not imply that we reflect the image of God in the real or literal sense but His intellectual, spiritual and moral nature.

Mother Teresa was driven by the concept of imago dei to care for the poor, the sick and also dying in Calcutta. This concept has motivated many Christians to care for the sick, the poor and the disenfranchised. Having an understanding that other human beings are created in the image of God is an important aspect that drives healthcare employees to care for a sick patient and also give those who are about to die a comforting and peaceful death (Shelly, 2006). The concept also help people in the societies to help each other in times of need. There is a saying in the healthcare sector that for the caregiver (nurse, physician, psychologist, social worker, etc.) the client or patient no longer remain a fellow human being in distress but the likeliness of eternal God. This awareness transform relationship between patients and caregivers to the recognition of the sanctity of other (Grove, 2015). The concept of imago dei is important in healthcare because it is the basis of the Western society’s comprehension of human rights as well as undergirds of the legal system. It also helps them understand the social service and healthcare agencies.

Comment 2

The readings from Meilaender made an interesting distinction between procreation and reproduction as well as between that of being begotten and being made. Procreation refers to the world as designed or given by the Creator, whereas Meilaender defines reproduction as the work of humans to, “master and reshape our world” (2013, p.10) or, stated another way, by conceiving through man-made technologies (2013). 

The term “begotten” goes along with procreation. If one is begotten, they have been naturally conceived. The child who is begotten is the union of his father and mother in physical, bodily form. This child has not been reproduced by human means. Their parents’ act of love has resulted in life being given to the child. Our text describes the begotten child as being different but equal to his parents because he is created of their flesh. To quote Meilaender, “The Father gives all that he is and has to the son. He begets him” (2013, p.15).

Conversely, “made” refers to a child who is conceived through human means, such as in vitro fertilization, surrogacy, artificial insemination, or some other technology developed by humans. This child is described as being created through our own reason and will, as opposed to God’s reason and will. The “made” child is not conceived through the human act of love, and thus, the most foundational component of human equality is absent (Meilaender, 2013).

I had not considered the difference between either procreation and reproduction or begotten and made, and I can very much see the validity in the argument put forth my Meilaender. However, I do not know that I completely agree or disagree. Like so many topics in ethics, I see a grey area. I do not think it’s as simple as agreeing or disagreeing. I feel that if I agree, I’m saying that the parents who love and cherish their children who were conceived through technological means were “wrong” in doing so, but the parents who had children through naturally conception but do not love and care for their children are “right.” To me that doesn’t seem right. At the same time, I also understand that, if this is truly God’s plan, I need not completely understand it in order to have faith in it. 

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Comment 1

Principalism has really evolved into a practical approach for ethical decision-making which concentrates on common ground moral principles for autonomy, justice, beneficence, as well as non-maleficence (Döring, 2011). Principalism is also referred to as four-principal approach because of the four ethical principles which entail bioethics.  Let us look at these four principals.

The first one is respect for autonomy. This involves respect for what happens to person’s own bodies. This implies that patients may decide the kind of treatment one want as well as their right to refuse medications, treatment, and surgeries and this decision must be respected by caregivers (Döring, 2011). A good example is blood transfusion in a patient who is a Jehovah Witness believer. Even though the patient totally in need of blood, we must respect the fact that Jehovah Witness followers refuse blood transfusions. The other principle is nonmaleficence. This means doing no harm (Döring, 2011). It implies making of best medical decision as well as abiding by rules and regulations to ensure that patients are safe. This can even be small assignments such as hand hygiene as a way of preventing various infections. The other ethical principle beneficence which involves promoting all that is good (Döring, 2011). It involves striving to improve patient’s health based on the situation. The last principle is justice. This means that fairness within treatment and patient care need to be practiced to carry out justice. Distribution of resources should also be given equally.

These principles should be ranked the way I have written them, i.e., respect for autonomy, nonmaleficence, beneficence, and justice with the first one being the most important. Allowing patients to participate in their treatment and making their medical decisions is very important (CİVANER, 2016). This allows for an equal diplomatic approach to healthcare where both parties are involved. Even when we bring in Christian biblical narrative of creation, redemption, fall, and restoration, autonomy is important because it allows patients to choose what they want (CİVANER, 2016). Eve when God brought a human into the world, He enabled them to choose what is right for them and what is wrong for them.

Comment 2

The four principal approaches consist of four universal ethical principles, it consists of respect of autonomy which states to make autonomous decision that people can take and that should be respected. The other principal is non-maleficence states about an obligation to not harm anyone; beneficence is the action to benefit others and to simply improve any situation. Lastly, justice is the principle that works on the distribution of benefits which also engage risks and costs (Page, 2012). Thus, the principle of biomedical ethics claims that no one principal is more important than the other.  Above all it is the justice that should be given to all. We should be just towards others and always respect others, their decision and autonomy. 

It is first the justice, and then respect after that comes non-maleficence and then beneficence. On the biomedical ethical grounds in the United State, it merges all the other grounds in one sphere and also differentiates one from the other in certain aspects. Justice trumps over all other values or principals and it is the one above all. Therefore, in the case study autonomy has been held above all. The doctor did not pressurize the family to take any decision instead gave Mike and his wife full autonomy to decide the right path and take the call.         

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