Category: Nurse’s Role

AH IV Reflections on the Older Adult

May 8, 2022 / ecarrell

Over the course of this semester, we were given insight into what the aging process really looks like and got the opportunity to challenge societal beliefs surrounding the lifestyle of older clients. That was my first major takeaway from this course. It is easy, as a younger person, to assume you know what it’s like to grow older and lose some capabilities you once had. However, it is not as simple or cut and dry as we’d like to think.

When our guest speaker visited, she spoke about what her life is like now in her old age. She has lost loved ones, including her spouse, but still has a healthy social life and plenty of hobbies. She drives, she has a friend group where she lives, and she loves visiting students and speaking at universities. I realized during her conversations with us, that I’ve only ever associated growing older with loss. I never thought about what I could gain from aging, and while it does make me sad thinking about how many loved ones I will lose over the years, I know that I will also gain many more.

The second insight I will take away from this course was the humility I felt during the creation of me and my partner’s life book. Our project focused on her great aunt, who is currently in her late 70s and lives locally. Before we began the interview process, we received hundreds of photographs from over the years of her life. From the surface, her life seems idyllic, and her family looked so happy. After interviewing her and delving further into her life story, we discovered that although she is very happy in her older years, she has been through a lot and faced many challenges, including tumultuous relationships with her children and grandchildren. I realized how important this concept will be going forward in my nursing career, and I will remember not to judge a book by its cover, and to never assume anything about a client’s life.

Disaster Nursing 444

December 7, 2021 / ecarrell

In the event of a disaster, nurses are expected to utilize their healthcare knowledge in addition to communication, teamwork, and proper use and understanding of equipment. Arguably the most important responsibility of the nurse is understanding the chain of command, such as the HEICS (Hospital Emergency Incident Command System). In this model, roles are formally structured with clear lines of authority and accountability, thereby increasing efficacy and patient safety.

It is understandable to see the ethical dilemma given the contradiction of the two ANA provisions. However, I think the best way to answer that is by implementing prioritization, casualty triage, and considering justice and equity. There is no cut and dry answer here, beyond evaluating the situation as it happens and acting accordingly, as nurses deserve priority care just as much as a civilian does.

Death and Dying

November 17, 2021 / ecarrell

Death with dignity has historically been a widely debated ethical issue. I have done several projects on this concept over the course of my schooling and have always maintained the belief that everyone deserves to die when and how they want, especially if they have a particularly aggressive disease. Terminally ill people will find ways to die without the assistance of medical personnel, so I think allowing the option to die with dignity is important to maintain autonomy. I was excited to read about Maine adopting this practice, as previously only a handful of states in America had legalized it.

I don’t think the death with dignity laws clash with “do no harm”. In the case where the patient has six months or less to live, they are 18 or older, and have the mental capacity to make healthcare decisions, I think the healthcare team has an obligation to help them quietly and peacefully end their lives. I think in this case, nurses and doctors would be doing more harm by refusing to assist in a patient’s death than actually following through with it. The nurse’s oath also states that we must devote ourselves to the welfare of our patients, and that includes their happiness. If dying before their brains and bodies start shutting down is what will make them happy, then I think we owe them that.

HealthInfoNet

October 20, 2021 / ecarrell

My thoughts about the use of EHR have pretty much always been positive. I have worked a few different jobs in the healthcare field, and it is very convenient to be able to look through a patient’s chart electronically and see their entire history. I understand that for some patients, it may be concerning to have all of their personal information in one place and may make them feel vulnerable.

HIE is a relatively new service available to medical professionals, as it was only introduced roughly twenty years ago. It has proven to be much more effective than other methods of data sharing such as fax, telephone, mail, or relying on the patient to bring their own medical history with them everywhere. For nurses specifically, HIE has completely revolutionized the care process. It allows nurses to get a complete picture of a patient’s past, whether it be surgical, medical, or their medication list. It simplifies the process of gathering data immensely, and it gives updated information, so that no matter where a patient goes to receive care, nurses will have the whole picture of their health. In the same vein, electronic health records can be used to detect major risk factors that may contribute to severe illness, which means that they also can help prevent medical events before they occur. I think that aspect of the EHR is most applicable to my future nursing practice. Being able to look at a patient’s history and see how they’ve trended over any number of years will not only save me time, but it will streamline the process of getting that patient the proper care that they need. As previously stated, EHR also improves the communication process between healthcare providers, which will definitely allow me to enhance care, as I can get answers and put in requests much faster.

Post-Leadership Interview

October 14, 2021 / ecarrell

From the interview with my nurse, I learned that being a strong leader in nursing is a day-to-day decision that one makes. I never considered that someone that feels they can be a strong leader one day, can have a dip in self confidence the next. My nurse has not been out of school for very long, so I expected some level of limit to her knowledge, but she never once faltered if she didn’t know something. So, it surprised me when she revealed in the interview that she sometimes feels doubted and incapable in her career and as a leader due to her young appearance. Although, she is clearly a very competent nurse. We talked about how she has trained many new grad nurses and has acted as a clinical instructor. She also plans to further her education and take more classes, join committees, and obtain further practice certifications. She also mentioned her interest in being a charge nurse in the future.

As far as emotional intelligence, my nurse does a great job of empathizing with patients and coworkers and is easily able to put herself in their shoes. As a leader, it is vital that a person be able to manage and identify their own emotions and be able to understand how those emotions impact others. This is a critically important part of nursing and based on her responses during our interview and what I’ve seen in practice, I think she does a fantastic job of maintaining a level head and putting her patients first. She also spoke about the importance of safety when it comes to dealing with conflict as a nurse leader. Emotional intelligence plays a huge part in de-escalation, which she says is the primary approach she uses. Putting herself on the same physical level as a patient and validating their emotions is a great way to calm a patient down and resolve a situation. It shows them that you are there for them, on the same team as them, and are willing to listen and work with them to resolve the issue. She explained that getting a more senior staff member is warranted if the situation gets out of hand, which also shows EI, as she knows her limits and knows when to get help.

Furthermore, maintaining a balance between work and home life is a big part in maintaining a healthy mind. During the interview, my nurse discussed getting outside, spending time with family, friends and pets, and listening to music. These things help her decompress after work, but she also mentions how it’s nice to get to know her coworkers and make strong connections with them in order to gain trust and a feeling of reliability.

This interview, while at points enlightening, was not unexpected for me. I had a wonderful experience with this nurse as my clinical instructor and could see immediately that she maintained a strong presence on her unit as a leader. If anything, this interview strengthened my belief that she will continue to do great things and lead by example in her field. I aspire to have done as much as she as at this point in my career when the time comes and will use my knowledge of her practice and techniques to mold my own practice in the future.

Pre-Interview Reflection

September 23, 2021 / ecarrell

The health professional I have chosen was a clinical instructor of mine in a previous semester. I chose to write about her because she demonstrated a strong dedication to her practice, a vast wealth of knowledge, and a commitment to learning from her patients and her peers. I could tell that all staff on the unit, regardless of status or rank, were drawn to her and felt comfortable around her. I know that she worked on the unit for several years as a CNA before becoming a nurse, which strengthened her relationship with the staff and helped her to establish herself as a member of the care team.

The difference between formal and informal leadership is the presence of official authority. Formal leadership comes from structure and authority, and it is usually methodically appointed. On the other hand, informal leadership may not have the traits of an official role and may just be a known status that a person has grown into. Often, informal leadership is more of a position of influence rather than a different title. The nurse I chose to write about is more of an informal leader, as she is still very young and relatively new to her nursing role. She has not been formally appointed as a leader on the unit itself, however, I think her status as a clinical educator speaks volumes about her influence in the hospital, as she is clearly a trusted source of knowledge.

I am most interested in learning about how this nurse feels she is supported on the unit, and how she may be able to turn her informal leadership into formal leadership over time. I am curious to find out more about conflicts and ethical dilemmas she has faced, and how her informal leadership role has helped her to handle certain situations.

Public Health and Vulnerable Populations

September 22, 2021 / ecarrell

The health of vulnerable and marginalized populations is impacted by myriad factors including an individual’s socioeconomic status, and what kind of community they are immersed in. Individual factors also include sexual orientation, gender, ethnicity, religion, geographical location and disability, all of which contribute to the way that people view and receive care. Lack of income can influence level of education, transportation, stress levels, mental health, and lifestyle choices. Current healthcare systems don’t cater to individuals regardless of these factors, which creates a lack of access to resources, as well as opportunities. With healthcare not readily available, marginalized populations are less likely to seek out care and are more likely to face discrimination when they do, which creates a cycle of them not receiving necessary care.

Historically, healthcare in the United States has been disproportionately available to white, English-speaking, job-holding citizens, which creates a stark contrast between those with and those without access. In America, access to care has almost always been contingent upon either having money or having a job that comes with good benefits. Not everyone has the capabilities needed to acquire wealth or security, largely because of the factors mentioned above. In order to resolve these disparities, we must first tackle the systems that exacerbate the problems faced by vulnerable and marginalized populations. Ideally, America would have universal, publicly funded healthcare, which would allow for complete coverage of most healthcare services. This creates an equal playing field for citizens and non-citizens alike, regardless of race, gender, sexuality, financial status, or religion. However, the problem of access can still be a problem when we factor in geographical location, and profession. If someone is the sole breadwinner in a household that supports multiple family members, and they work all day and can’t make time for healthcare, then it’s important for healthcare workers to come to them. Making healthcare more accessible may mean that offices, businesses, or individuals need to be more flexible with when and where they offer care. I think another aspect that would be helpful is the implementation of case workers or social workers. Vulnerable or marginalized populations often have difficultly following up with healthcare professionals for many of the reasons previously discussed, and therefore may benefit from having a caseworker specifically assigned to make sure they have transportation, time off, and anything else that helps get them to their appointment.

I think that having a strong foundational knowledge about the social determinants of health will help me understand all future patients I may have. Our society tends to blame the individual rather than the system, and it’s important to gain insight into a person’s background before making assumptions or judgements. Someone’s life choices do not directly reflect their intentions, and as a future nurse, I must remember that it’s my responsibility to advocate for and understand where my patients are coming from.

Ethical Considerations for EBP

August 6, 2021 / ecarrell

Before EBP, my perception of the nurse’s role in ethical practice was veery narrow, and only consisted of concepts like HIPAA, and patient advocacy. However, I now understand that they have a much more involved position. Nurses spend a significant amount of time with all of their patients, which means they know them on the most intimate level. In that respect, they can identify and screen potential patients for research candidacy. Therefore, they also need to make sure that patients and their families have all of the information necessary to be able to make an informed decision about participation. Much of the informed consent process is done by nurses. In terms of the research itself, nurses make sure that data and evidence is well-constructed, has relevance, significance and is valuable. They also assess the quality of the research and work to improve the methods that aren’t efficacious based on their past experiences.

Knowing the process of the research ethics is helpful, as being able to plan and execute a clinical investigation is a very valuable skill in the field of nursing. Clinical research is the reason that modern science is as advanced as it is. Nurses see firsthand what is and what is not therapeutic, and this can become a trial-and-error sort of process in itself. So, it is very important for nurses to be a part of clinical research, as they are the primary data gatherers in the patient care setting. They are familiar with patterns of symptoms and outcomes and have great intuition about their patients.

The Evidence Based Practice course allowed me to get a better sense of what clinical research looks like, as well as what the initiation process entails. I learned that nurses have far more responsibility than I originally thought, but it makes complete sense that we do, as we know the patient care process better than anyone. I feel that my confidence has grown as far as my ability to gather and evaluate journal articles. Being able to identify the strengths and weaknesses of a study is a very good skill to have moving forward!

Assumptions

August 5, 2021 / ecarrell

The nurse’s role in evidence implementation and evidence generation is an important one. As nurses have such a critical and close relationship with their patients, they are the ones that monitor outcomes vigilantly. Therefore, they ensure that research is well-constructed, significant, and valuable. Additionally, since nurses maintain such an intimate relationship with their clients, they can use their experiences to guide clinical research, in order to improve patient outcomes, or evaluate current interventions. That includes identifying which of their patients may benefit from inclusion in a research study. Nurses also make sure that the actions of medical professionals are in conformity with the ethical standards of their practice.

Nurses are also typically the ones to get their patients’ informed consent about clinical research. That means that they are the ones to explain the implications of the study to the patient and their loved ones, meaning that they are responsible for being well-informed about the purpose and details of the research being conducted.