Clinical Nurse Leaders: A Case Study

Week Eight Response to Jurgensen Michael, I chose the Clinical Nurse Leader (CNL) role in the emergency department (ED) for my project as well. However, the CNL facilitating the implementation of care for the ED boarded psychiatric patient is brilliant, and not something I had considered. Likewise, our ED boards psychiatric patients, frequently for numerous days prior obtaining inpatient placement for them. In various facilities a physician assistant (PA) assumes the responsibilities for establishing ED boarded psychiatric patient care, however, the CNL stands as a considerably superior individual to expedite care during the transitional period for the ED psychiatric patient boarding for extended periods (Jayaram, 2006).

It is the job of the APN to apply their skills to promote a culture of excellence. Promoting such a culture involves using all aspects of the quality competency. The Nurse Practitioner is in a unique position as a clinician and manager. According to Carney (2011), clinical managers have the capability to ensure the safe, ethical, and high quality of care due to their professional background, which is firmly grounded in ethical healthcare. Therefore, the APN has a distinct set of skills that will ensure positive patient outcomes.

Jean Russell of Michigan Insurance Company referred this file for medical case management. Instructions were given to meet with Flavia Tocco and assist with coordination of appropriate and related medical care, and identify needs to facilitate recovery. INTERVIEW SETTING I met Ms. Tocco at the St. John’s physical therapy department. Ms. Tocco was open to providing me information on her current and prior medical history.

Objective One During my clinical day three, I demonstrated entry-level competence in professional nursing practice in caring for patients with multiple and/or complex unmet human needs. I addressed safety needs, safety in medication administration, effective communication, and surveillance for my patients. First, I addressed safety needs my ensuring the appropriate safety measures were implemented for the patients. Some of the safety measures included, wearing non-skid socks, wearing a yellow armband which indicated fall risk, keeping the bed in lowest position, two side rails up, bed locked, and the call light within reach.

In order for the future of health care to change, changes must begin at the top with stakeholders, the hierarchy and nursing management, nurses as leaders within their organizations. According to Disch J. (2008), nurses as leaders within their organizations need to also step forward, CNEs have the background, perspective, and platform to help their organizations seriously tackle safety issues that jeopardize patient care and that face nurses and their colleagues daily, and are the essential building blocks of all health systems--and

Nursing administration on a national level is best described by The National Center for HealthCare Leadership (NCHL). This is a non profit organization that exemplifies quality care and leadership in the 21 st century. The goal of this organization is to improve healthcare on a national level through efficient and effective management that is in accordance with it’s mission. In keeping with it ’s mission, NCHL embarked upon an ambitious initiative with the support of the Robert Wood Johnson Foundation, examining the role of the senior leadership team in promoting quality and safety in his/her organization (Disch, Dreher, Davidson, Sinioris, & Wainio, 2011).

Educational Preparation of Clinical Nurse Leader (CNL) The vision for the Clinical Nurse Leader CNL role began in 2003-2004 in response to the Institute of Medicine’s quality and safety reports. In 1999, the Institute of Medicine released its report, To Err Is Human: Building a Safer Health System, which called on health care systems to reduce medical errors and improve patient safety. In 2002, the Robert Wood Johnson Foundation called for developing new practice models and enhancing collaboration between education and practice, and in 2003, the Institute of Medicine released its set of five core competencies that all clinicians should possess, regardless of their discipline, to meet the needs of patients in the 21st-century health care system. The Clinical Nurse Leader (CNL) is a master’s educated nurse, prepared for practice across the continuum of care within any healthcare setting.

National Patient Safety Goals (NPSGs) are critical in ensuring that healthcare providers offer quality care to their patients while minimizing potential risks of adverse events or injuries. The Joint Commission has established these goals as a tool to help healthcare providers identify opportunities to improve patient safety and reduce the risk of harm. As a nursing student, I have been learning about the NPSGs, and I have found them to be an essential guide to help me navigate my responsibilities in caring for patients. In this essay, I will discuss the NPSGs and give specific examples of how each goal relates to my experience this semester.

NU 415 Leadership and Management for RN’s Week 6 Discussion Board Microsystems and Quality Improvement Initiatives The complexity of health care today requires an environment where unique relationships of individual; family (giving them what they need) and healthcare team come together to impact health status, daily function capacity and nurturing, caring relationships (Nelson, 2008 et al p 2). According to Huber 2008, the successful delivery of health care into the 21st century will require micro-systems as a conceptual model, essential building blocks for organizing care. Bigger systems (macrosystems) are made of smaller systems, these, smaller systems (microsystems) produce quality, safety, and cost outcomes at the front line of care (Huber 2008 slide 1-5 and Nelson, 2008 et al p 2). Microsystems are embedded with clinical

Each morning patients came in for assessment and the treatment team developed or altered existing treatment protocols. I longed to be part of this team, working to stabilize each patient so they could return home to pursue their goals. The nurses stood out to me as the team members at ground zero in the unit, working directly with patients, and advocating for them in meetings. As a Nurse Practitioner, I will provide this same standard of holistic care to my patients, taking into consideration their biological, social, psychological and cultural needs while developing and implementing treatment decisions.

In making a journey through history, NL has transited from a domestic to a professional stage, where care is based on experience and knowledge and is moving towards gradual technification of care. Finally, nursing care is now a professional activity, which has passed from a seat of ignorance & lack of professional identity due to a lack of a body of knowledge of nursing, to a profession whose center of study is care, act of exclusive responsibility of the nurse. Nursing Practice today is dependent on specialized knowledge of care, and concepts of autonomy and leadership in the discipline that are valued today. In this way, nursing, due to its philosophical and historical conception, establishes itself in an internationally recognized position, distinguishing it as an autonomous profession in interdisciplinary work and leader in the delivery of care to individuals, families and communities (Malvarez S, 2005). 2.

Leadership is the ability to guide or influence others with an objective of achieving a desired outcome. It involves influencing beliefs, opinions, values, perceptions, or behaviors of an individual or a group, and it is an amalgamation of inherent personality traits, learned skills, and it is a response to situational stimuli. I believe that, at any particular moment, where two or more individuals are interacting, one of them will emerge as the leader the other(s). To me, this means leadership role is fluid, and it changes as situational stimuli changes. For instance, during interpersonal interaction involving two individual, the leadership role has potential to shift from one individual to the other, as the situational stimuli changes.

The Institute of Medicine (IOM) has a strong stance on nurses and leadership. They believe that nurses are a vital component to health care system and nurses in leadership roles can have a positive impact on such. Nurses are in all sorts of roles within the health care systems ranging from a staff nurse, nurse managers, to advance practice, all the way to congress (Finkelman & Kenner, 2013). In addition, they even serve in the boardroom within some health care organizations. Leadership doesn’t necessarily mean a nurse in a manager position, but a nurse who has an influence on staff.

In the leadership in care delivery course, we were assigned to a hospital to perform clinical hours and provide care to four patients. Additionally, the purpose of this paper is to explain and provide examples on how our patient care included the concepts of Quality and Safety Education for Nursing (QSEN) competencies, delegation, handoff reporting, and a reflection of the clinical experience. Quality and Safety Education for Nursing (QSEN) Competencies QSEN consists of six competencies: patient centered care, quality improvement, teamwork and collaboration, safety, informatics, and evidence based practice. To provide patient-centered care, I had to educate the patient when administering medications on why the patient was taking the medication and side effects. Care had to be individualized with each patient and it included providing respect with his or her decisions in their care.

Reflection Qualities that make an effective nursing leader are the same qualities that many other nursing staff and general public possess. Such as, the ability to support and empower their team members, be well organized, remain consistent with their expectations, and be able to communicate with their team. Support and empower the team members An example of this quality is a Licensed Practical Nurse (LPN) on one of the units at Wascana Rehabilitation Center (WRC), where I had one of my clinical rotations. This nurse would ask each staff member if they had any concerns during their daily huddles.