Clinicals February 26th 0830-1700 skills day
WHAT: This was my first day teaching at our hospital skills day. I was very nervous because I knew I would be teaching charge nurses, house supervisors, clinical supervisor, nurses who have been praticing for several years as well as some really great new nurses.
SO WHAT: So what was what I kept trying to tell myself to help me not feel so nervous. So what if they have more experience than me they had to start somewhere too. So what if I am nervous I have survived presentations in class. My so what statements only helped for the brief moment I was thinking them. I was still nervous.
NOW WHAT: Now that my first of three teaching sessions is over. I can honestly say that I am not nervous for the other two teaching days. Everyone was kind. They listened and asked questions, they even acted like they learned something new. I was asked a few questions that I did not know the answers to, but I am looking up the answeres and going to get back to those who asked them.
Saturday, February 27, 2010
Chapter readings for February 22
Organiztional structure, power and the role of the nurse leader.
Chapter 13 discusses eight different types of power.
1. Reward power is the ability to grant favors or rewards for their employees to work toward.
2. Coercive power uses fear as the motivator for meeting goals set by managers.
3. Legitimated power is the power gained by a position or title
4. Expert power is gained as knowledge is gained
5. Referent power may be obtained by association with others who have power.
6. Charismatic power is a personal power
7. informational power is obtained when someone has information that other people need.
8. Self power comes with maturity, ego, security in relationships and is gained as a person gains control over his/her own life.
My thoughts about power are that it is good to be well rounded and have some of each of the diffferent types of power to draw from. I think that gaining knowledge, surrounding your self by others who have power, having information that others need, being charismatic, having control over your own life, and being able to recognize others contibutions and reward them for those contributions is what makes a good leader. Coercive power is the least effective for building good relationships with coworkers and family members. Unfortunatly coercive power is what I use too much in my home. For example do your homework or you will be grounded. It may work but nobody is really happy.
I am looking forward to working on increasing my personal power base especially in the self power area. For the past 7 years I have felt like instructors, homework, and time at school have been controlling my life not me. I plan to take my life back by spending more time with my family helping them with their homework not doing mine, and building relationships with them again. I can not wait to have time to plan menues and prepare healthy meals again. Having time for exercise again so I can feel better and think more clearly. I feel that as my self power increases I will be able to increase my confidence and build power in the other areas. One must care for themselves before they can care for others.
Organiztional structure, power and the role of the nurse leader.
Chapter 13 discusses eight different types of power.
1. Reward power is the ability to grant favors or rewards for their employees to work toward.
2. Coercive power uses fear as the motivator for meeting goals set by managers.
3. Legitimated power is the power gained by a position or title
4. Expert power is gained as knowledge is gained
5. Referent power may be obtained by association with others who have power.
6. Charismatic power is a personal power
7. informational power is obtained when someone has information that other people need.
8. Self power comes with maturity, ego, security in relationships and is gained as a person gains control over his/her own life.
My thoughts about power are that it is good to be well rounded and have some of each of the diffferent types of power to draw from. I think that gaining knowledge, surrounding your self by others who have power, having information that others need, being charismatic, having control over your own life, and being able to recognize others contibutions and reward them for those contributions is what makes a good leader. Coercive power is the least effective for building good relationships with coworkers and family members. Unfortunatly coercive power is what I use too much in my home. For example do your homework or you will be grounded. It may work but nobody is really happy.
I am looking forward to working on increasing my personal power base especially in the self power area. For the past 7 years I have felt like instructors, homework, and time at school have been controlling my life not me. I plan to take my life back by spending more time with my family helping them with their homework not doing mine, and building relationships with them again. I can not wait to have time to plan menues and prepare healthy meals again. Having time for exercise again so I can feel better and think more clearly. I feel that as my self power increases I will be able to increase my confidence and build power in the other areas. One must care for themselves before they can care for others.
Tuesday, February 16, 2010
Clinical hours 2/11/10 1300-1430 and 1700-0230
WHAT: From 1300-1430 I attended a meeting with my manager and other RN's who will be teaching at the skills labs
SO WHAT: We discussed how to organize the day including how much time would be avaiable for each station. We rescheduled the days for the skills labs. The new days will give the manager time to schedule each RN and education day to attend the skills lab, this will hopfully maximize attendance. The new days will also give those teaching more time to prepare.
NOW WHAT: Now I have more time to do more research and prepare more. I also feel better about how the skills lab day will be presented.
1700-0230
WHAT: I returned to clinicals to meet with my instructor and mentor. I also did an experiment on the PCA pump to determine how long the pump will infuse before it resets. I also did some research for my project. By 0230 I was tired and the hospital had quieted down so Deb sent me home.
SO WHAT: The clinical objective learned was delegating. The PCA pump experiment was delegated to me. By delegating this task to me the supervisor was able to attend to other needs. The ability to delegate is an important skill to have as a supervisor. When someone takes on too many task they usually do not get accomplished to the maximum benefit.
NOW WHAT: I will work on my delegation skills. I do not use my CNA's like I could mostly because I enjoy patient care for example getting the ice water, warming heat packs, offering snacks, ets. When I do all of these things instead of asking my CNA to help I usually get behind on my charting, which is my least favorite part of nursing, therefore my charting is usually not as good as it should be.
WHAT: From 1300-1430 I attended a meeting with my manager and other RN's who will be teaching at the skills labs
SO WHAT: We discussed how to organize the day including how much time would be avaiable for each station. We rescheduled the days for the skills labs. The new days will give the manager time to schedule each RN and education day to attend the skills lab, this will hopfully maximize attendance. The new days will also give those teaching more time to prepare.
NOW WHAT: Now I have more time to do more research and prepare more. I also feel better about how the skills lab day will be presented.
1700-0230
WHAT: I returned to clinicals to meet with my instructor and mentor. I also did an experiment on the PCA pump to determine how long the pump will infuse before it resets. I also did some research for my project. By 0230 I was tired and the hospital had quieted down so Deb sent me home.
SO WHAT: The clinical objective learned was delegating. The PCA pump experiment was delegated to me. By delegating this task to me the supervisor was able to attend to other needs. The ability to delegate is an important skill to have as a supervisor. When someone takes on too many task they usually do not get accomplished to the maximum benefit.
NOW WHAT: I will work on my delegation skills. I do not use my CNA's like I could mostly because I enjoy patient care for example getting the ice water, warming heat packs, offering snacks, ets. When I do all of these things instead of asking my CNA to help I usually get behind on my charting, which is my least favorite part of nursing, therefore my charting is usually not as good as it should be.
Wednesday, February 10, 2010
February 8th class reading and discussion
1. How does the philosophy of your employer's organization differ from your own?
Timpanogos Regional Hospital mission statement and vision is: Above all else, we are committed to the care and improvement of human life. In recognition of this commitment, we strive to deliver high quality, cost effective healthcare. Timpanogos Regional Hospitals values are: Commitment to patients through compassionate care, clinical excellence, continuous improvement, and cost efficiency.
For the most part I agree with this philosophy. The only part that I sometimes have a hard time with is the cost efficiency. I feel like sometimes there is too much emphasis in this area and patient care suffers. Nurse staffing for example seems to be one of the first things cut back on. When nurse staffing is cut back the patient to nures ratio is higher and nurses have less time with each patient. Patients often interperate this as being less compassionate and caring which defeats the other value of compassionate care.
2. How is your employer's philosophy the same as your?
The parts Timpanogos Regional Hosptials philosophy that is the same as mine is the commitment to the care and improvement of human life, compassionate care, clinical excellence, and continuous improvement. As an Registered Nurse at Timpanogos Hospital I strive to always give compassionate care to all of my patients. I also strive to make improvements in my nursing practice by seeking advice from mentors and participating in educational opportunities when even I can.
3. Where are the areas of conflict and how do you resolve them?
As stated earlier the area of conflict for me comes when cost efficiency involves nurse stafing. On my unit we are working with our nurse manager reguarding this issue by offer suggestion for her to consider. We will see how it turns out in a few months.
1. How does the philosophy of your employer's organization differ from your own?
Timpanogos Regional Hospital mission statement and vision is: Above all else, we are committed to the care and improvement of human life. In recognition of this commitment, we strive to deliver high quality, cost effective healthcare. Timpanogos Regional Hospitals values are: Commitment to patients through compassionate care, clinical excellence, continuous improvement, and cost efficiency.
For the most part I agree with this philosophy. The only part that I sometimes have a hard time with is the cost efficiency. I feel like sometimes there is too much emphasis in this area and patient care suffers. Nurse staffing for example seems to be one of the first things cut back on. When nurse staffing is cut back the patient to nures ratio is higher and nurses have less time with each patient. Patients often interperate this as being less compassionate and caring which defeats the other value of compassionate care.
2. How is your employer's philosophy the same as your?
The parts Timpanogos Regional Hosptials philosophy that is the same as mine is the commitment to the care and improvement of human life, compassionate care, clinical excellence, and continuous improvement. As an Registered Nurse at Timpanogos Hospital I strive to always give compassionate care to all of my patients. I also strive to make improvements in my nursing practice by seeking advice from mentors and participating in educational opportunities when even I can.
3. Where are the areas of conflict and how do you resolve them?
As stated earlier the area of conflict for me comes when cost efficiency involves nurse stafing. On my unit we are working with our nurse manager reguarding this issue by offer suggestion for her to consider. We will see how it turns out in a few months.
Tuesday, February 2, 2010
February 1st reading on advocacy
Advocacy is speaking up for a patient when they are not able to speak for themselves.
I have not been in a situation where I have had to be a big advocate for a patient, but I have had several small expereince of little things I have done. Sometimes I think that as nurses doing our jobs we do not think that the small things we do every shift count as having been an advocate. For example every shift it is my job to do chart checks. These chart checks include reviewing the patients medications and making sure there is an order for each medication on the patients E-MAR. I also check to make sure that all orders for labs and any other test have been ordered, and that any other orders for the day have been compleated. A patient can look at their chart if they want to but because they may not understand all of the medical jargan it would not make sence to them. Therefore I feel that this simple part of my job is being an advocate for my patient.
Another time when nurses are being advocates and may not think much of it because they do it all of the time, is when we call the doctors. For example when our patients are not getting their pain controlled and there is a need to try something different. The patient can tell you about their pain but they can not call the doctor, and most patients do not have the knowledge about pain medication to know what to ask for.
I know that somtimes as a night nures we will debate about calling a doctor because sometimes they are just so darn cranky when you call at night. This is an area that I can improve on. Just because the doctor is cranky our patients should not have to suffer in pain all night.
Advocacy is speaking up for a patient when they are not able to speak for themselves.
I have not been in a situation where I have had to be a big advocate for a patient, but I have had several small expereince of little things I have done. Sometimes I think that as nurses doing our jobs we do not think that the small things we do every shift count as having been an advocate. For example every shift it is my job to do chart checks. These chart checks include reviewing the patients medications and making sure there is an order for each medication on the patients E-MAR. I also check to make sure that all orders for labs and any other test have been ordered, and that any other orders for the day have been compleated. A patient can look at their chart if they want to but because they may not understand all of the medical jargan it would not make sence to them. Therefore I feel that this simple part of my job is being an advocate for my patient.
Another time when nurses are being advocates and may not think much of it because they do it all of the time, is when we call the doctors. For example when our patients are not getting their pain controlled and there is a need to try something different. The patient can tell you about their pain but they can not call the doctor, and most patients do not have the knowledge about pain medication to know what to ask for.
I know that somtimes as a night nures we will debate about calling a doctor because sometimes they are just so darn cranky when you call at night. This is an area that I can improve on. Just because the doctor is cranky our patients should not have to suffer in pain all night.
Friday, January 29, 2010
Clinicals 1/28/10 - 1/29/10 1800 - 0700
WHAT: I learned a little about the budget and staffing. I do not know if I can really explain it, but I will give it a try. The staffing budget has actual dollars involved, but that is not really what is looked at. What they look at is the census. The manager is allowed to have a certain number of employees per patient, but she does not have to worry about what wage each nurse makes. If all of her top payed nurse are scheduled and the census justifies the need for the number of nurses on it is okay. Employees are allowed to be scheduled an extra shift if they want but if the census is not high enough they are the ones who will be called off first then part time employees next.
The rest of the time I worked on my project. I got all my signs made and put up around the units and made my poster. Now all I have left to do is the teaching. I hope that counts for clinical hours so I can be done following Deb like a lost puppy. Just kidding she has been good.
SO WHAT: The clinical objective I meet was budgeting. I was also able to meet one of my goals. the goal was to learn what the budget is and how it affects staffing.
NOW WHAT: I feel better now about staffing and the budget because I understand that the census plays a bigger part in the decision making than just the money. Of course there could always be more money allowed per patient to keep the patient nures ratio down. That would probably be to much to ask for.
WHAT: I learned a little about the budget and staffing. I do not know if I can really explain it, but I will give it a try. The staffing budget has actual dollars involved, but that is not really what is looked at. What they look at is the census. The manager is allowed to have a certain number of employees per patient, but she does not have to worry about what wage each nurse makes. If all of her top payed nurse are scheduled and the census justifies the need for the number of nurses on it is okay. Employees are allowed to be scheduled an extra shift if they want but if the census is not high enough they are the ones who will be called off first then part time employees next.
The rest of the time I worked on my project. I got all my signs made and put up around the units and made my poster. Now all I have left to do is the teaching. I hope that counts for clinical hours so I can be done following Deb like a lost puppy. Just kidding she has been good.
SO WHAT: The clinical objective I meet was budgeting. I was also able to meet one of my goals. the goal was to learn what the budget is and how it affects staffing.
NOW WHAT: I feel better now about staffing and the budget because I understand that the census plays a bigger part in the decision making than just the money. Of course there could always be more money allowed per patient to keep the patient nures ratio down. That would probably be to much to ask for.
Thursday, January 28, 2010
Clinical 1-27 -10 - 1-28-10 1800-0700
WHAT: Deb and I discussed a project I could do. The project we came up with was to research urinary catherter aquired urinary track infections and how to prevent them, then teach my findings at the skills labs in February. Medicade's new law that they will no longer pay for hospital aquired UTI's is what inspired this project.
NOW WHAT: I obtained a copy of a prevention reminded on catheter care and made copies and hung them on the doors of the break rooms and bathrooms for all staff to see. I worked on my teaching posted. I will do more research and continue preparing for the class.
SO WHAT: The goal I meet was to have a project. This project is important because reseach shows that a hospital aquired UTI increases a patients hospital stay as well as increased risks for furthur complications and even death.
WHAT: Deb and I discussed a project I could do. The project we came up with was to research urinary catherter aquired urinary track infections and how to prevent them, then teach my findings at the skills labs in February. Medicade's new law that they will no longer pay for hospital aquired UTI's is what inspired this project.
NOW WHAT: I obtained a copy of a prevention reminded on catheter care and made copies and hung them on the doors of the break rooms and bathrooms for all staff to see. I worked on my teaching posted. I will do more research and continue preparing for the class.
SO WHAT: The goal I meet was to have a project. This project is important because reseach shows that a hospital aquired UTI increases a patients hospital stay as well as increased risks for furthur complications and even death.
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