Category: Professionalism

Death and Dying

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.

Post-Leadership Interview

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

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.

Ethical Considerations for EBP

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!

EBP Final Reflection

Evan Carrell

EBP Final Reflection

August 1, 2021

This project was valuable in many ways. Working in a team is always a challenge, as combining multiple writing styles and preferences into one paper requires adjustments. In my future nursing practice, I will inevitably encounter situations where I will need to collaborate with colleagues who I disagree or clash with. Additionally, this foundational experience allowed me to practice finding appropriate research articles that fit well with the group’s PICOT question. The ability to find evidence to back up a research question will certainly be something I’m faced with in the clinical setting. In order to successfully write this paper, I had to pull outcomes from multiple different clinical trials and evaluate them based on their relevance, variables and reproducibility. Being able to pick out the strengths and weaknesses of a clinical trial is a very valuable skill to have, as doing so is vital in the process of eliminating redundancy, while increasing search efficiency.  

In the instance of the research into our topic specifically, I learned a lot about the benefits of music therapy. None of the studies we found cited any observable disadvantages or adverse effects associated with this intervention. The results from these studies showed me the benefits of implementing music therapy hospital wide. I can say for certain that in my future practice, I will utilize music therapy in the treatment of my patients.

As far as my individual team contribution, I learned that I work best with structure, and laying out a clear outline of what my work will look like helps me organize my thoughts. Luckily, my teammates operate similarly, and our work came together fairly smoothly

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