Week 5 Discussion Respones
Please create a 1-2 paragraph response to each of the prompts in the attached document. References must be included at the end of EACH response.
CLINICAL:
Lisa Otten
RE: Week 5 Discussion Prompt
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Overall, this has not been a very easy several weeks and things did not improve this week. Besides working full time plus during unprecedented times in the ER and school that takes all my waking hours, I recently found out I also have to move and then yesterday, I tripped and hurt my back. So sitting right now is very painful and I have been mostly horizontal for the last 24 hours. Shoes got left in the bedroom doorway while I was out getting my clothes out of the dryer. I tripped on them when I came back in carrying the laundry basket and did not see them. They were not there when I went out. Needless to say, my back has been in spasm, intense burning in my left thigh and pain down my leg. I really did not need this to happen right now and my challenges come from having a difficult time sitting to do my school work. I was also suppose to go to my clinical today but I called them as I was not able to stand or sit for more than 15 minutes without having spasms. I have so much to do and this is only adding to my stress. So my discussion today will be regarding falls and home safety.
Home safety should always be addressed as falls can lead to injuries. Anyone can fall but as we get older, but we are more at risk to be injured. The Mayo Clinic Staff (2019) states, ” In fact, falls are a leading cause of injury among older adults”. No matter what the setting is, we should assess if the patient has a high risk to fall due to medication effects, chronic disease, weakness or previous falls. Along with those factors, the home can be safer by removing hazards. The Mayo Clinic Staff (2019) says to make the home safer:
· Remove boxes, newspapers, electrical cords and phone cords from walkways.
· Move coffee tables, magazine racks and plant stands from high-traffic areas.
· Secure loose rugs with double-faced tape, tacks or a slip-resistant backing — or remove loose rugs from your home.
· Repair loose, wooden floorboards and carpeting right away.
· Store clothing, dishes, food and other necessities within easy reach.
· Immediately clean spilled liquids, grease or food.
· Use nonslip mats in your bathtub or shower. Use a bath seat, which allows you to sit while showering.
Good sturdy shoes with non slip soles provide safe footing for walking. Make sure there is plenty of light in the home and that assistive devices such as canes or walkers are used if needed. We must get our patients and families to invest in their safety. Prevention is the key to their safety and maintaining independence. Most of all, do not leave shoes in doorways.
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Vivien Mackay
RE: Week 5 Discussion Prompt
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Hello Professor Kincaid and classmates.
For this week’s two areas of difficulties I have encountered at my clinical site has something to do with leadership roles and conflicts in management. It is certainly something that is inevitable and bound to happen once in a while every place we go.
In leadership we have to deal with people. If there are people involve, definitely there will be conflict at times. Working with people is a meaningful element of having a job, and it could be a tough situation if there are conflicts involved, especially if there are personalities involved.
This week, at the clinical site, one of the two higher leadership positions are in conflict in terms of opinions regarding a patient’s admission and management of his care. As a student being present during a heated discussion, I was asked for my opinion and kind of caught off guard and placed in the middle. I had to stay focus and objective, and always have to be mindful of who I am as a person, and stick to the philosophy i hold dearly to my heart. Speaking up in terms of what I believe in my heart to be true and better for the patient is what I decided to go with. When I was asked about my opinion, I politely responded that my opinion is basically based on what ethics and morals I stand for, and that is to always choose safety over anything else.
Dealing with many different types of personalities, different cultures, different leadership styles at any job site can be challenging. As a nurse leader, it is important to know and be confident to take a stand, and be firm and go for what I believe is right and good for my patient always. In any leadership role, having a thoughtful and consistent approach can make all the difference. If any unprofessional and disruptive actions are tolerated at a jobsite, it can compromise patient safety, increase turnover and absenteeism, and reduce joy in work. It is always better to make every focus of any health care decision to be patient-centered more than anything else (Angelo, 2019)
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PUBLIC HEALTH
Audrey Petitcar
RE: Discussion Prompt
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A therapeutic alliance can also be viewed as having rapport with a patient. In my area of nursing at this time working with mental health patients the relationship to be build and maintain is therapeutic with the environment as well. This type of relationship is goal driven to help the patient return back to their community functioning at their ultimate potential. The relationship is active on both sides while upholding respect and boundaries. In turn, trust is built, and a bridge begins to lead the patient towards specific goals that may have once been impossible or difficult to attain. In MH, this relationship maybe difficult to form or sustain, but with EBP may help foster a positive outcome.
Jamie Williams
RE: Discussion Prompt
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During nursing school, I worked as substitute teacher so I have some experience with the student population from K-12. Students are often hesitant to share information with authority figures at school for fear of consequence to the student, himself/herself, and/or to the student’s family. It is important for students to be able to share information that may help to keep them healthy and safe regardless. Developing a therapeutic alliance is crucial in the role of a school nurse. According to Psychology Today, a therapeutic alliance is a relationship between a healthcare provider and a patient/client in which a union is formed for the mutual benefit of the interaction and engagement. Nurturing a therapeutic alliance between a school nurse and a student K-12 involves attention to body language. The school nurse should sit at eye level with the student, smile, and keep an open posture. The school nurse should monitor his/her tone and language, making sure to appear non-threatening and non-judgmental. To prompt the student to answer questions in more detail, the school nurse should ask open-ended as opposed to closed-ended questions. For instance, the school nurse will get more information if he or she asks “Describe the type of abuse you experience at home”, as opposed to “Do you get abused at home?” When appropriate, the school nurse may offer a personal story or a story from when he/she was a child. This helps the adult to seem more relatable.
The school nurse should definitely ensure that the student knows he/she may come and share any time on an open door policy. Lastly and most importantly, this therapeutic alliance must be built on the assurance that the school nurse is only there to help the student and in no way hurt, cause harm, or cause trouble.
CAPSTONE
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Kayleigh Moore
RE: Discussion
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Hi Class,
Working on inter-professional teams has been both rewarding when the team can work together, yet it can be a nightmare when the team does not work together. One experience I had in nursing school working in the ER, a frequent flyer patient had come in for alcohol intoxication and heat stroke. The nurses told me to not triage him first since he was a frequent flyer and he had just came in two days before. I tried to speak up to my preceptor and stated how the patient needed to get fluids and an IV started. My preceptor stated that if the other nurses who were taking care of him had not started on him to not get involved. It was hard because I knew it was wrong and it was a very dangerous situation due to it being 95 degrees outside. The ER doctor came over and started to yell at the nurses for not starting an IV on the patient due to his vitals and his state of dizziness and complaining loudly to the whole ER of being de-hydrated. I did not speak up stating that I recommended that we do an IV because I did not want to involve the other nurses even though I knew it was the right decision. In the end, we finally got the IV in and the patient was hydrated. Overall, I have learned that even if it can be daunting to speak up, it is important to for the patient. For an inter professional team to work together, there must be cooperation and an understanding amongst team members (Orchard et al., 2018). Going forward, I believe that if anyone has any hesitation in patient care.
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Audrey Petitcar
RE: Discussion
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This situation did not happen to me directly, but I one of the CRN that was addressed after the fact. An overnight RN in the jail was overseeing the pregnant inmates. The patient came in on Wednesday in the week giving false pregnancy due date. The patient said she was 6months pregnant, but was unable to see the visiting OB due to his days are Tuesdays. The patient was scheduled to see the OB the following week. On Friday, the inmate began c/o of abdominal pain. The unit officers did not allow the nurse to physically exam the patient outside of the cell door. The patient continued to c/o of pain and was sitting on the bed screaming for a couple of hours. the nurse finally called the infirmary MD and notified him of the patient complaints. Around 5-6am the patient was sitting on her bunk still screaming until they heard her say “My baby is here!” Upon looking into the cell, the nurse saw the patient holding her baby wrapped up in her blanket. This is now 7a the MD is due to be in at 730-8a. The nurse or the CO did not call 911 emergency or the DON/HSA regarding the incident. The doctor came in and sent the patient out via ambulance. It was later investigated by the Sheriff’s office and an attorney that the overnight nurse and MD were liable for neglect and they were terminated. Thankfully, the patient and her baby were ok. Cases as these and others should create a culture of nurses that speak up.
Speak up! It’s absolutely essential for us to do that. If we see something we don’t like, we can’t remain passive. I think it’s very important to develop our own communication skills in order to know how to deliver our message effectively-Angela Benefield
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