Engagement In Professional Nursing

Clinical Governance

Discuss about the Engagement in Professional Nursing.

Consumers in the health care system have a role in ensuring they get the best quality service from the healthcare institutions. However, they should participate in shaping this service delivery in various ways. Firstly, they can take part in both scientific and empiric research related to health and the provision of services within the institutions they attend to (Sollecito & Johnson, 2013). The aim of most researches conducted is to identify problems, the causes and establish the most appropriate interventions for them. This can only be possible if the data obtained is from the consumers who are impacted by the kind of services provided. Thus the quality of life, patient satisfaction, better decision making process and general empowerment will be realized.

Secondly, consumers can participate in policy and decision process in the healthcare system as one category of stakeholders. Since any policy and decision adoption in healthcare ultimately affects the consumers, then it is imperative that they are involved in the process of coming up with these policies. This will not only increase the level of quality and satisfaction but also ensure that their rights have been considered as well as the legal implications of the adopted policies. In the same way, equity and accountability will be realized as there provision of services will be based on the opinions and needs of the consumers (Numerof & Abrams, 2013).

As a registered nurse, I can increase consumer participation in planning, implementation, and evaluation of care delivered in a number of ways. Firstly, I will strengthen by observing health laws and client rights mechanisms that include informed consent and complaint mechanisms. According to Yoder-Wise (2013), appreciating the diversity of consumers will ensure an in-depth understanding of their needs and with informed consent, there will be collaboration and participate in decision-making process aimed at meeting their needs. This calls for the provision of education to other health care providers on cultural awareness and sensitivity. This is a form of patient-centered care that protects the patient’s rights, one of the roles of nurses as patient advocates. Secondly, I will promote democratic processes which include complaint process in the healthcare system to maintain transparency justice and promote open disclosure. Thus information should be shared freely with consumers in order to develop a mutually-beneficial relationship in which there are trust and respect. Upholding patient dignity and respects will encourage the patients to participate in the planning, implementation, and evaluation of care delivery for the common good of both parties (Daly, Speedy & Jackson, 2015).

Quality and Safety

Medication safety is one of the standards of National Safety and Quality Health Service Standard (2012).  The purpose of this standard is to provide guidance and ensure health care providers competently prescribe, dispense and administer medications to their informed clients. Proper identification, documentation, and communication, as well as management, are required in all these processes to maintain quality and safety of the services offered to the consumers. The significant risks associated with medication safety include not observing the five rights of patient administration namely right patient, drug, time, route, dose, and frequency, lack of informed consent during the administration of medication. In addition, during prescription, errors may occur due to misdiagnosis or lack of comprehensive history taking, physical examination, assessment, and investigations that lead to wrong prescription (Vaismoradi, Jordan, Turunen & Bondas, 2014). Notably, prescription errors may also occur due to manual and electronic prescription and dispensation of drugs associated with standardized dosages that don’t put into consideration exceptional circumstances and patient condition. All these instances lead to a poor patient outcome, patient harm due to injury caused, diverse effects, prolonged and unnecessary hospitalization, high cost of treatment, reduced quality of life and even death.

As stipulated in NSQHS standards (2012), there is an estimate of more than 1.5 million people in Australia encounter instances of adverse effects from medication annually which lead to them seeking medical attention and hospitalization in more than 400000 and 190000 of these cases respectively. These admissions account for 2-3% of the total hospital admissions per year in Australia. Most of these cases involve the elderly in which there are about 30% admissions of people above the age of 65 years due to the adverse medicine. More than 50% of these cases are avoidable with adherence to best practice guidelines.

As a registered nurse I can employ several of strategies to improve patient outcome with regard to medication errors. Two of these strategies are manipulation of environmental factors that contribute to medication mistakes and continuous professional and patient education (Adams & Urban, 2013). Some environmental factors such as poor lighting clustered working environment, overcrowding, distractions and burnouts contribute to medication errors among healthcare providers. Thus addressing these causative factors can reduce the instances of errors and therefore ensure patient safety and improve their outcome. On the other hand, continuous staff education on the internal and external medication errors is paramount as a form of acquainting them on the existing medication related policies, procedures, and protocols. Patient education on medication is equally essential as it empowers them with knowledge on purpose, dosage, route of administration and anticipated adverse effects as well as drug interactions (Donchin & Gopher, 2013). 

Leadership and Management

Time management skill is crucial in the role of a professional nurse. Time management requires that a nurse has to organize their working environment in order not to waste time to look for needed equipment and supplies in untidy places. Not only will this save time for both the patient and the nurse but also ensure workplace safety as it prevents any incidence that can result in injury. Another aspect that can guarantee a saving of time in the clinical area is proper planning by listing all the tasks that should be accomplished in a particular period of time. Planning ensures that the most important tasks are prioritized and performed first. Thus scheduling and creating time blocks for tasks can promote organization and time management within an institution (Yoder-Wise, 2013).

Secondly, self and social awareness are a skill that is crucial in leadership. Self-awareness involves having an in-depth understanding of oneself by doing self-reflection to understand emotional response to situations and how the responses impact the quality of leadership and the professional relationship with others. Improved interaction and general moderation improve relationship with other; both consumers and colleagues and therefore the quality of service delivered and outcome improves (Kelly & Quesnelle, 2016). On the other hand, social awareness involves caring about others by understanding their needs and providing strategies on how to meet them. Compassion, one of the qualities of professional nurses, helps one to develop this skill as they practice active listening and emotion identification. This skill is important because it ensures that all the physical, emotional, spiritual and mental aspects of all individuals in the health care system are addressed to promote dignity and satisfaction in all stakeholders.

One of the skills I would like to develop further over the course of my transition year is interpersonal communication. This can help me interact professionally with co-workers and clients. Some of the strategies I will use to achieve this are self-disclosure that will involve talking openly about personal values and beliefs but in a respectful manner while remaining calm in all situations where there is disagreement with others. In such circumstances am also expected to disagree politely. Secondly, I should suspend or suspend uncalled for emotions, reactions, and prejudgments in the effort to develop problem-solving skills that are important in the interpersonal communication (Arnold, & Boggs, 2011). Therefore learning collaboration skills will enable me to appreciate personal strengths and weaknesses as well as those of others. This is necessary to ensure that everyone is assigned duties with reference to their strengths and interests to avoid conflict within the working environment.

Organizational Culture

Learning culture has a number of primary defining characteristics. Firstly, proactivity which is a personal initiative undertaken in preparation of anticipated challenges. Learning culture demands that all parties involved don’t only take actions to solve the existing problems but also in anticipation of the future. Secondly, commitment to learning by striving to acquire skills among those involved is always evident in any learning culture. To gain the skills required, most individuals most often experiment, get feedback, analyze, reflect and assimilate. Thirdly, learning culture is characterized by the belief that environmental management is possible by adapting to the ever-changing environment and having control over it. Fourthly, there is a strong belief that it is human nature for individuals to learn and apply the knowledge acquired in solving problems if they are provided with necessary and adequate learning resources. Additionally, it is characterized by a positive orientation to not only the past and present but also the future by acknowledging the need for expertise and aiming at achieving it by continuous learning and assimilation of learned knowledge and skills. Furthermore, there is a commitment to investment of proper multichannel communication system through which all stakeholders can connect with others pass and receive information in the process of learning (Bach & Grant, 2011). Lastly, it shows commitment to the respect of cultural diversity that is a source of different perspectives that are important in solving problems in various environments (Wentz, 2011).

As a registered nurse I can contribute to the culture of learning by making continuous medical education and learning a routine in the institution by integrating it with talent, abilities, and interests to promote capability development. Active participation should be exhibited by all that are committed to the learning process to acquire the desired skills and expertise (Avillion, 2015). In most instances, job promotion and responsibility are based on these achievements. Thus as a nurse, it is imperative to realize the professional interests and objectives and aim to achieve them through attainment of expertise. Furthermore, I can I can devote my time and resources towards quality service delivery by all health care providers through sharing of knowledge and information regularly. The demand for quality and standard services from all care providers can compel participation and commitment to learning which consequently impacts personal growth (Zhan & Finch, 2012).

Role conflict is a situation in which one is expected to perform two roles of contradicting positions that are incompatible with each other. Role conflict reduces the general performance of a nurse and therefore the quality of service is affected negatively (Rundio & Wilson, 2015). Role conflict typically leads to role stress whereby a nurse is overwhelmed from performing duties that are not clearly defined for their profession. This leads to exhaustion and reduced job satisfaction. It is also detrimental in the interpersonal relationship between co-workers. Performing some duties that are beyond the scope of practice can lead to disciplinary action against the affected individuals. Consequently, there is demotivation in the practice which has eventual negative impacts to the consumers. Furthermore, the emotional and psychological wellbeing of a person involved in the role is affected. If severely affected, some may resort to malpractice and unethical behavior that leads to legal implications.

Maintaining emotional and physical wellness is advocated for in the nursing profession. Some strategies can be employed to facilitate this wellness. Firstly, in order to promote emotional wellness, I will find and establish a supportive relationship with other professional nurses, family, and friends in whom one can confide experiences, feelings and challenges. They can then share and build new perspectives about work and how to handle the challenges. There are instances where problems become overwhelming despite all the self-efforts. Under these circumstances, professional help can be sought from friends, relatives, and other professionals. This helps in the maintenance of emotional health and wellbeing (Edlin, Golanty & Brown, 2012). Secondly, I can promote physical well-being by performing regular exercises, taking enough rest and adhering to proper nutrition.  Physical exercises improve the body’s fitness, reduce stress and keep one alert. Physical exercises and good nutrition contribute to avoidance of lifestyle-related conditions such as obesity, hypertension, and diabetes among others. They also provide opportunities to interact with others and explore one’s talents and interests outside the professional practice (White, 2015) 

References

Arnold, E., & Boggs, K. U. (2011). Interpersonal relationships: Professional communication skills for nurses. St. Louis, Mo: Elsevier/Saunders.

Avillion, A. E. (2015). Nursing professional development: A practical guide for evidence-based education. Brentwood, TN : HCPro

Adams, M., & Urban, C. Q. (2013). Pharmacology: Connections to nursing practice. Boston: Pearson.

Bach, S., & Grant, A. (2011). Communication & interpersonal skills in nursing. Exeter [England: Learning Matters.

Donchin, Y., & Gopher, D. (2013). Around the patient bed: Human factors and safety in health care. Boca Raton : Taylor & Francis

Daly, J., Speedy, S., & Jackson, D. (2015). Leadership & nursing: Contemporary perspectives.

Chatswood, New South Wales : Churchill Livingstone Edlin, G., Golanty, E., & Brown, K. M. C. (2012). Health and wellness. Sudbury, MA: Jones andBartlett Publishers.

Korniewicz, D. M. (2015). Nursing leadership and management: The advanced practice role.Lancaster, Pennsylvania : DEStech Publications, Inc

Kelly, P., & Quesnelle, H. (2016). Nursing leadership and management. Toronto, Ontario :Nelson Education Ltd

NSQHS standards Sept 2012 (2012). . Retrieved from https://www.safetyandquality.gov.au/wp-content/uploads/2011/09/NSQHS-Standards-Sept-2012.pdf

Numerof, R. E., & Abrams, M. N. (2013). Healthcare at a turning point: A roadmap for change.Boca Raton: CRC Press.

Rundio, A., & Wilson, V. (2015). The doctor of nursing practice and the nurse executive role. Philadelphia : Wolters Kluwer

Sollecito, W. A., & Johnson, J. K. (2013). Mclaughlin and Kaluzny's continuous quality improvement in health care. Burlington, MA: Jones & Bartlett Learning.

Vaismoradi, M., Jordan, S., Turunen, H., & Bondas, T. (January 01, 2014). Nursing students'perspectives of the cause of medication errors. Nurse Education Today, 34, 3, 434-40.

Wentz, D. K. (2011). Continuing medical education: Looking back, planning ahead. Hanover,N.H: Dartmouth College Press.

White, L. (2015). Foundations of nursing. Australia: Delmar Learning.Yoder-Wise, P. S. (2013). Leading and Managing in Nursing - Revised Reprint. London:

Elsevier Health Sciences.

Zhan, L., & Finch, L. P. (2012). Accelerated education in nursing: Challenges, strategies, and future directions. New York: Springer Pub. Co.