Nursing Leadership And Management Discussion Question 5

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Question 1

In personal relationships, effective communication helps an individual to advocate oneself, get better understood by others and also express his/her feelings in a positive and safe manner. In therapeutic relationships, effective communication help build confidence in healthcare professionals, transmit information to patients and address issues that may arise for individualized care (Tappen et al., 2004). In an inter-professional healthcare team, effective communication increases communication, reduces the chances of error and improve patient care outcomes.

Question 2

The most important similarity between effective communications in the three interaction is the benefit of improvement of patient care outcomes. In all these communication, the final goal is to ensure the safety and quality of care. On the other hand, the main difference is involves the main persons affected (Tappen et al., 2004). In personal communication, the relationship is between two people; in therapeutic, it involves a healthcare professional and a patient; while two or more healthcare personnel are involved in the last type.

Question 3

Congruence between verbal and non-verbal communication refers to a situation where there is a coherent message passed through the two methods and the verbal and non-verbal messages are mutually enhancing (Eisenhauer, 2018).

Question 4

In communicating emotional messages, electronic communication such as email may lead to miscommunication as it does not allow for expression of emotions (Kumari, 2018). A face to face communication is appropriate emotions can be passed and read.

Question 5

In my clinical experience, I have seen ISBAR used in a variety of areas. Most importantly, the ISBAR framework is used by nurses when developing care plans for patients.

Question 6

Situation

The current state of patient

• Name of the nurse/ unit
• Patient name and location
• Current situation

Background

Patient history, clinical background and other additional information

• Reason for admission
• Summary of treatment
• Physician assessment
• Pertinent changes
• H & P

Assessment

What the nurse thinks is going on with the patient

• The nurse concludes present situation

Recommendation

What the nurse thinks should be done

• What the patient needs and when he/she should get it

Question 7

Dr. Roberts’ situation requires calmness and patient from the nursing department in responding. As a nurse, I would be slow to give an answer to the query. First, the approach involve asking for calmness in the doctor then explain the situation with the lab results.

Question 8

Accountability in delegation means that registered nurses retain the accountability of the patient care outcomes associated with delegation as long as the person who did the task dis it as instructed (Tappen et al., 2004). Legally, delegation is considered accountable if the right task, right person and direction of communication is present.

Question 9

The role of the two RNs in this unit will be to monitor the health of patients and administer the treatments and medications required. They will also be responsible for delegating roles in regard to the care of the patients to the UAPs. The LPNs will also be involved patient care record keeping and monitoring nursing staff and the UAPs. The UAPs will assist the RNs and LPNs in taking care of the patients in the unit after delegation.

Question 10

While in direct delegation involves a direct verbal directive about a task, indirect delegation involves the provision of approved list of activities already included in procedures and policies (Tappen et al., 2004)..

Question 10.1

When delegating patient care, one should consider whether the task is within the scope of practice of for the RN or LPN. Also, consider whether the assessment of client needs is complete. The task must be within the rules of delegation for UAPs. The UAP must also be trained for the task and their capabilities meet the client’s needs.

Question 10.2

In prioritizing care, the severity of illness should be the major factor. Patients who have severe illness are delicate and in urgent need of care.

Question 10.3

1. Among some of the tasks that I could delegate in my experience include feeding patients, record keeping and cleaning patient’s wounds.
2. My nurse preceptor was highly effective in delegating tasks to others. She considered the capabilities, skills and talents of nurses and other staff before delegating tasks.
3. The nurse preceptor was keen on conducting assessments to ensure that tasks were done as she wanted.

References

Eisenhauer, E. (2018). Informed Choices in Biobanking: An Examination of Participants’ Understanding and Congruence between Knowledge, Values, and Decisions (Doctoral dissertation).

Kumari, A., Tanwar, S., Tyagi, S., & Kumar, N. (2018). Fog computing for Healthcare 4.0 environment: Opportunities and challenges. Computers & Electrical Engineering, 72, 1-13.

Tappen, R. M., Weiss, S. A., Whitehead, D. K., & Fletcher, M. (2004). Essentials of nursing leadership and management. The Canadian Nurse, 100(1), 14.

 

 

 

Question 1

Communication is a fundamental aspect of any relationship. Communication refers to the sharing of information as well as the non-verbal messages (Weiss, Tappen & Grimley, 2019). Communication needs to be effective in every relationship because this is the basis for many interactions and their success. Communication can be effective in the personal relationship, the therapeutic and the interprofessional one when the person states the message clearly, assertively when necessary and engages in active listening in return (Weiss et al., 2019).

Question 2

Some relationships are different from others and can take on different tones. Personal relationships can be more informal as opposed to interprofessional and therapeutic ones and very often they are by choice. Boundaries must be established by nurses as to not overlap them. However, despite the differences, one key component in all these relationships is the trust and professionalism that is inherent. Professional relationships are limited to the location where you are practicing and therapeutic as well, but personal relationships have no specific setting (Professional Versus Social Relationships, 2018).

Question 3

The concept of congruence in communication refers to the balance and harmony between what is spoken and what is shown. This means that if someone is talking and you are actively listening you should demonstrate it by summarizing what is said at intervals and ask questions, focus solely on the speaker avoiding distractions, and providing feedback (Use Active Listening Skills When Coaching Others, 2020).

Question 4

In large organizations it is customary to communicate via e-mail with any employee regardless of their location. This makes it accessible to exchange information. One of the pitfalls of e-mail communication is that a message can be sent accidentally to more than one receiver, thus engaging in a breach of confidentiality and exposing information to unnecessary parties (Weiss et al., 2019). In the vent that specific information needs to be shared with one person in particular it is best to place a phone call and speak directly to avoid putting the information in the wrong hands.

Question 5

When communicating with physicians ISBAR has proven to make the process of communication precise and productive while reducing miscommunication and preventing adverse effects (Weiss et al., 2019). I have personally communicated with doctors using the ISBAR method when sharing critical information regarding patient’s condition in order to obtain new orders or medication.

Question 6

Patient: Jane Doe, 65 y/o

Room: 101 Door

Diagnosis: COPD exacerbation admitted on 5/25/2020

Patient’s attending physician is Dr. ABC. Ms. Doe is AOx4, no known allergies, verbal and ambulatory, she is currently in bed awaiting chest x-ray to r/o pneumonia, received breathing treatment at 14:30 and it was effective for shortness of breath. Last vital signs are B/P=131/75 HR: 94 RR: 20 Temperature: 97.8 Sat: 96% at 2L via NC continuously. She is on a regular diet and will be discharged home tomorrow.

The system currently used in my facility is verbal hand off report at the bedside and this is effective because we have the opportunity to ask questions and seek clarification when needed as well as visualize the patient at time of report.

Question 7

I would notify the doctor that I am the nurse assigned to this patient, apologize for the delay and look for the lab results, if they are available, I would hand them if not I would call the laboratory and inquire on the results. Then I would analyze why the results were not ready and if this was a mistake of mine I would work on it as to not have it happen again.

Question 8

Accountability in delegation specifies that the person delegating is responsible for the outcome of the action associated with the delegation as long as the person who the task was delegated to performed it competently (Weiss et al., 2019). Delegating beyond the scope of the person can incur in legal repercussions for the person delegating. They can face disciplinary action stated by the board of nursing of their state once the information has been gathered and analyzed (MNA, 2020).

Question 9

The responsibilities of the RN include assessment, IV medications, blood administration, care planning, obtaining physician orders and teaching. The LPN can obtain vital signs, administer some IV medication depending on the state and provide physical care. The NAP/UAP can assist with personal care, hygiene and feeding (Weiss et al., 2019). Keeping these tasks in mind, Dennie and Elias can delegate safely those tasks that are within the scope of each person in the staff. The RNs can divide the workload evenly to perform assessments and provide IV medication, the LPN can obtain vital signs and administer oral medication and the UAP/NAP can assist with meals and hygiene activities. In this manner all patient’s needs are safely met by the appropriate staff member

10. Discuss the differences between direct delegation and indirect delegation.

Direct delegation refers to a verbal indication to perform a task in an indicated situation from an RN who chooses a staff member to delegate to based on ability to perform this task.  Indirect delegation involves a list of approved tasks that may vary depending on the institution (Weiss et al., 2019)

Question 11

The RN must follow the rights of delegation to ascertain this is done safely and appropriately. The RN needs to consider whether the person being delegated on has the skills necessary to carry out the task and that the instructions and expectations are clearly stated and understood by both parties.

Question 12

It is necessary to assess the census in order to assign fairly and safely to the rest of the staff what needs to be done. It is important for example to be aware of which patients require total care to be able to assign the right personnel, so all the needs are met.

Question 13

a. I have had patients who were not able to feed themselves and in many occasions I could have delegated this task to a UAP however, because they were already attending to other patients and their needs I decided to complete the task as to not delay it and cause distress in the patient.

b. My preceptor had many years of experience in nursing which made her very capable of delegating and supervising others.

c. My preceptor when delegating tasks to other staff would supervise at intervals, ask if there was any difficulty in completing the task and evaluated the results after. She obtained feedback from the person she delegated to and she would use this as experience for the next time she had to delegate.

References

Accepting, Rejecting & Delegating a Work Assignment: A Guide for Nurses. (2020). Retrieved from https://www.massnurses.org/nursing-resources/nursing-practice/accept-reject/legal

Professional versus social relationships. (2018, October 31). Retrieved from https://www.cno.org/fr/exercice-de-la-profession/outils-educatifs/ask-practice/social-versus-professional-relationships/

Use Active Listening Skills When Coaching Others. (2020). Retrieved from https://www.ccl.org/articles/leading-effectively-articles/coaching-others-use-active-listening-skills/

Weiss, S. A., Tappen, R. M., & Grimley, K. A. (2019). Essentials of nursing leadership and management (7th ed.). Philadelphia, PA: F.A. Davis Company.