Midsemester Self Review and Analysis

Mid Semester Self Review and Analysis

Course Clinical Objectives
1)Function as a client advocate through collaboration with health care providers.
I felt that I had the opportunity to advocate for the patient when I was able to attend a policy review committee meeting. In this meeting I had the opportunity to verbalize patient concerns specifically, regarding food brought in from the outside to the patient by family and friends. There was an issue regarding where the food would be reheated and who was responsible for patients keeping personal items in their room. Some staff were refusing to heat up the food in either the staff microwave or in the unit kitchen where there was a microwave to heat up patient’s food. The idea is that the kitchen was clean, and food brought from outside of the hospital was dirty, therefore food should not be heated up in the unit’s kitchen. The policy really didn’t address the issue, but several unit managers felt that staff should not reheat patients food on the unit, truly, in effort to discourage them from bringing in outside food. I was able to advocate for the client in reminding the managers that our dietary service does not cater to specialized diets such as vegetarian diet, or various foods specific to certain cultures that we service. After discussing the limited service that we offer to patients when it comes to their diets, the committee, made up of unit managers, decided that there was no know specific research that supported their concerns and would recommend clarifying and expanding that particular policy regarding food kept and served on the unit.
2)Communicate effectively, both verbally and in writing, with individuals,
groups and health care providers.
I felt I achieved this objective when I attended a meeting with the DON and all of the unit managers in the hospital. The meeting was a collaborative effort to request medication carts for all of the hospital units. I had used the equipment that they were requesting at a different hospital and I was able to give my opinion and views, as well as, discuss how that unit adapted to the change after implementing the use of the medication carts. The purpose of bringing all the unit managers together was to give everyone a chance to give input on how to word the request. The had made the request several times before and it was rejected. I had the chance to work with the nurse manager in charge of writing the request on behalf of the nursing department with the blessings of all the unit managers. I had the opportunity to take an active role in writing the request, suggesting key words and ideas. It was a great opportunity and I was glad the my preceptor respected my input.

Personal Objectives
1)Evaluate barriers of time management and select ways to decrease stress
and increase performance.
I had a wonderful preceptor. She was very organized and managed her time well. She was very technologically savvy and it was readily apparent. She had a routine that she tried hard to stick to. She was able to take on various duty with skill because of her time management ability. She was always moving. But the minute she wasn’t she was doing several things at once, following up on emails, returning emails, checking telephone messages, returning calls, scheduling interviews, reading mails, checking her calendar, reviewing discharge paper work, and intending to make discharge follow up phone calls. She even created a census form for all the units to use to make sure that bed control had all the needed information. So from her, I learned how to stay on task, how to prioritize, and the importance of using technology. Constant interruptions is a way of life for any nurse in any position.
2)Analyze person-position fit.
After spending time with the nurse manager, I concluded the position wasn’t for me. It seems to me that you have to be a very organized person and be detailed oriented. I think you also have to have a desire to be in this position, willing to take on the complexities, often with limited support and training preparing you for the position itself.

Review
My main objective was to gain insight into the world of hospital management. I wanted to know what really goes on. Is it comparable to long term care. Is management really management no matter where you go. Working with my preceptor, and gaining an understanding in the complexities of this role, I think an individual must be formally prepared for this position to be really successful. There are skills that are required beyond just good people skills. I think one must really be computer savvy not just computer literate. I think you really must possess good communication skills that flow from the top to the bottom and maintain professionalism at all times, knowing when to be light hearted and knowing when to be serious. You can learn a routine, but a person in this position has to able to use critical thinking skills, as well as, be knowledgeable about evidenced based practice and hospital policy. Overall, I think I have accomplished my objectives.

Discussion of professional growth
I have grown this semester professionally because I have a greater understanding of nursing from several points of views. And I think the turning point for me more than anything, was when I attended the meeting in the DON’s office with all the unit managers. I saw how hard they were fighting on our behalves. How they were trying to sway the ‘powers that be’ to create a better work environment for us. I saw their dedication. I heard their commitment to the staff. It all really came together for me. I was impressed with the support and positive energy that they gave to each other. They worked well together as a team. And they way the worked together, noting all their personality difference, ages and races, it inspired me to be more committed to my unit and want to help. Because I knew they cared, when they asked me what I thought about this or that, I didn’t feel the need to just whine and complain, but objectively identify the problem, discuss the root of the problem, and offer a solution.

The Change Process

I have done lots of researched during this change project. I have learned alot on change management. The "change management" is a familiar one in most healthcare facilities today. But, how facilities manage change (and how successful they are at it) varies enormously depending on the nature of the change and the people that are involved. The key part is how well the people understands the change process. Not everyone is open for change, many people don't want to put forth the effort to change even though the change is for the better. It takes teamwork for any organizational change to be successful. This experience has been one to remember.

Coming to an end...

This course has been beneficial in that I had the opportunity to see management in a different light. I had the opportunity to view committees in action and really see how the process really evolves. My clinical experience was an opener.

Wrapping Up---almost

The end of the semester is almost here. I just participate in a community intervention project in another course, and only have the Change paper to finish up. It was really cool to go out into the community and make a visible difference in people's lives...papers and postings are important, but they get tiresome after awhile and it was neat to put all of that knowledge to use! I still haven't really jumped on the bandwagon for this blogging thing, but it serves as a unique forum; a little different than the Blackboard DB we use I suppose. The Change Project Paper. I vacillated for awhile on my Change paper topic; I had one I was really excited about, but then my preceptor had to go out on extended sick leave and I wasn't able to complete it. Next, I planned on implementing a second topic at the High School with the students there. That didn't work out because after I placed 5 phone calls with voicemails and sent 6 emails (literally), the Health supervisor for the DISD still did not make contact with me. Finally, I found a preceptor who was willing and able to meet with me for the interview, etc. My change project ended up being something I helped to design and implement where I work; something I was doing on the side and I didn't make the "change project" connection with it at first. It is a new Nursing Assessment flowsheet for the Extended Recovery patients we receive on the floor. Instead of having the same amount of paperwork for a patient we care for for 3 hours as one that we have for 3 days, we now have a shortened form that saves time, money, and the nurse's charting load. I am very proud of it and very happy with it; we all worked hard to design something that would work well for everyone and it has!

Looking ahead...

As the semester is ending, I am focusing on completing all outstanding projects and assignments this week. I have noticed that I have been meeting other students in the workplace with similar goals and that has beetn inspiring.
This week I sat down with my supervisor to discuss posting and introducing evidenced based practice articles on the unit. The idea didn't seem to go over as well as I had hoped. I thought that if nurses really understood the purpose behind the policy they may see more value in it, and be more apt to follow it, rather than just dismissing it because...

Meeting c the Chief

Hello cohorts...

Today I had the opportunity to sit down and talk WITH my chief nursing officer at her invitation. She had set up meetings to hear staff ideas and concerns. The one thing that I would really like to comment on is how this course and our discussions help prepare me for that conversation, in that it was positive and very professional. I am still riding high and all inspired from our conversations about being a professional and getting involved in politics at all levels. I am reminded of the nurse who courageously invoked safe harbor, and was HEARD. I took a dose of my own advice. And I came prepared considering all that we had discussed about what we could and should do to make a difference where we could in our profession, especially, when had the ear of a power player. I thought about the references that were cited throughout our conversations, about the importance of getting involved, not being apathetic, and in general, just being professional. I took all of that today with me to this meeting. I went prepared with my ideas and suggestions considering our most recent discussions 'efficiency vs excellence' and 'changing technologies.' Having had the opportunity to shawdow my preceptor and be apart of committee meetings, I was prepared to offer solutions and with valid rationale or at least, what I thought was valid. I came with a dream list of what I thought would make our unit more efficient. Then I demanded one single thing, a COW(computer on wheels) that worked the entire shift. I explained how a working COW was essential and the greatest stressor and source of inefficiency which translated to a certain level of customer dissatisfaction on our unit. And you know that really matters to administration.

I remembered one of the statements I made earlier in one of our discussions about administration being more concern about the bottom line than they were about nurses, trying to squeeze every drop out of us. I don't know exactly what is going to come down the hill, but I really felt like my welfare and my ability to perform mattered to administration. I felt like I had a 'voice' and was heard.

Thanks you guys because I took yawl with me. And I am really glad I had an opportunity to think intellectually about those kinda issues that affect our day to day professional lives. Because of those topics I went in prepared to affect change and not just to moan and groan helplessly.

VN Educators

Hello Everyone...

I have considered the idea of becoming an VN educator, but of course most places require a BSN. I taught Health Science Tech Ed at a local high school and it was fun, challenging in many ways that had nothing to do with content, nevertheless, fun. I do enjoy teaching, just as much as I love learning new things. I was trained as a VN in the Army and when I became a civilian LVN, I soon realize the differences in the training. I remember having to become IV certified in order to start an iv or to push iv medications that I had been admininstering for some time. There were big differences in what I had been doing in the US Army compared to what the Texas BON scope of practice allowed me to do. I would consider the idea of becoming a VN educator, but probably not anytime soon.