Charge Nurse Reflection

--------------------------------------------------------------------------------------------3 Rational for the nurse bedside shift report strategy --------------------------------------------------4 What is the evidence for nurse bedside shift report?

The idea of shift work is a common one, but for nurses this is not a simple changing of staff during a certain time, change of shift signifies a time of purposeful communication between nurses and patients, in order to promote patient safety and best practices (Caruso, 2007). During this time, there is the possibility for this critical opportunity to relay important information to become disorganized by extraneous information, rather than concentrating on the needs of the patient (Sullivan, 2010). Often the patient is left out of the conversation, and is not a part of the process. Patients and families can play an important role in making sure these transitions in care are safe and effective (AHRQ, 2013).

Patient Care Conference 72 Hour Reflection What went well? At the beginning of this shift, we listened to the report from the night shift nurse and went over the patient chart to get some information about the patient who we were going to be interacting with. We also went over DSM-5 about depression and took notes about expected findings we might see on this patient.

The project studied in this article used evidence-based practice TeamSTEPPS®, which stands for Team strategies and tools to enhance performance and patient safety. TeamSTEPPS® was used to improve teamwork and communication within the hospital setting. TeamSTEPPS® provided the nursing staff with a structured, yet simple way, to identify fall risk factors for each patient and patient-specific interventions. This project was guided by using the FOCUS-PDCA; find, organize, clarify, understand, select, plan, do, check, and act model. The FOCUS-PDCA methodology consists of nine steps that include “find a process to improve, organize a team, clarify current process, understand variations in the current process, select process improvement, plan

Monday October 26th: Today at Moses Cone hospital, I was in the role of student nurse. I had two patients; one a returning patient, and the other a new patient. The nurse I was working with is someone I have never worked with before or even seen on the floor, but she seemed to be familiar with the unit. It was about 3-5-45 minutes into the shift before we received hand off report. After about 8 minutes of waiting to get report on the rest of her patients, my nurse went ahead and started to see patients.

They surgery she had undergone was a right hip cannulated screw. My patient contributed in care and believed that partaking as much as possible will get her healthy and home sooner. Also, she believed in independence and doing things on her own if capable. After working with MG, I attained a great amount of knowledge in knowing: the

Collaboration among health care professionals is defined as assuming complementary roles and cooperatively working together, sharing responsibility for problem solving and making decisions to formulate and carry out plans for patient care. (Fagin, 2008). In any field of health care where physicians and nurses interact with one another for the purpose of quality patient care, it is vital for them to work together as one and understand the needs of their patients as well as each other’s roles and responsibilities. In short, teamwork should prevail for excellent patient service. Therefore, being in full partnership as a nurse with the physician and other healthcare professional is another recommendation that is applied by the RWJ-IOM report.

I realized that the previous nurse was not able to see what was happening because she barely assessed the patient during her shift. In addition, she failed to take into consideration the opinion of the caregiver. Once I start practicing, I plan to incorporate best practice guidelines to the care of my patients. Also, this experience gave me the opportunity to practice my skills and to test my ability to think critically in emergency situations. The most demanding aspect of this experience for me was to carry the interventions on my own.

One key element in teamwork is communication because it enables the team members to share information regarding the task at hand and

This learning actively greatly assisted in building my confidence, which I required in order to be successful in the new graduate RN role. Good collaborative working relationships are based on clear communication and collaboration with the patient and all members of the healthcare team. (Kieft, et al. 2014 ) This semester I had no issues with regards to speaking with physicians and other members of the healthcare team, and I continued to actively participated and contributed to daily rounds on all 3 critical care units.

Collaboration with your interdisciplinary team in nursing. Why collaboration is important to provide high quality and safe patient care Nursing in the last 20 years has changed dramatically. Even as a young licensed Practical Nurse I knew that being able to communicate with my fellow interdisciplinary team was going to be highly important. Not only for the care of the patients and their families, but to also gather the needed information to stay up to date on all changes in the facet of the healthcare industry.

Nurses’ participation in decision making using the team work practice model improves the quality of care patients receive, increases the patient and family’s satisfaction, and adds to overall nursing contentment all of which increases nursing engagement, retention and recruitment (2013). I feel that the interprofessional collaboration model and the shared governance models are very similar in achieving quality care and improving nurses' work environment, satisfaction, and retention. Either of these models would work for our nursing team. American Nurses Association (2017). Collaborative Health Care: How Nurses Work in Team-Based Settings.

Problem Recognition According to the Institute of Medicine (1999) 44,000-98,000 people die as a result of errors made in the healthcare system. System level failures and human error are often identified as causes of harm (Institute of Medicine, 1999). Patient safety is a focal point for healthcare organizations across the country (Ulrich & Kear, 2014). Many organizations strive to develop and maintain a culture of safety.

Great patient outcomes should be the main focus throughout the healthcare system. Nowhere are the stakes higher than in health care, where good patient outcomes hinge on team synergy and interdependence (Eggenberger et al., 2014, para. 3). When working as a team each person involved in the patients care provides their expertise. By coming together each and every aspect of the patient care is reviewed and the appropriate care plan is implemented. As discussed earlier, this form of teamwork improves communication amongst the different disciplinary team members which cultivates better outcomes for the patients.

“Collaboration is an essential feature of nursing work and is seen as a central nursing competency, nurses often find that collaborative practice can be challenging within contemporary health care settings” (Doane & Varco, 2015, p. 397). Some nurses go as far as to ignore or avoid the collaborative aspect of their work, there are many factors as to why they would do this, lack of knowledge sharing, a misconstrued perception of reciprocity and equity of status, the hierarchy of power between interprofessional colleagues, and some nurses elicited, “individual anxiety, avoidance behaviors and defensive professional efforts” (Doane & Varco, 2015, P. 397) as their reasons. The professional consequences of these actions for nurses are “a poorer comprehension and