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Nurse Managers Career Planning
Nurse Managers have demanding and complex responsibilities that involve coordinating work of individuals with varying education, skills, and personalities of providing safe, high quality patient care. The Nurse managers are accountable for staff performance, resource utilization, financial management, and patient outcomes. The Nurse Managers also ensure that patient care is delivered in line with the standards of practice and organizational ethics and policies. According to Anonson et al., (2014), good nurse managers provide leadership and ensures that his/her department runs smoothly.
After evaluating myself with the skills inventory, I found that I have the various strengths and weakness in the following areas;
Personal and Professional Accountability
First, I noted that I am competent enough when it comes to personal growth and development. This is because I hold a Bachelors OF Science Nursing (BSN) degree which has equipped me to meet the demands weighed on today’s nurse. With this degree, I have acquired skills in critical thinking, case management, and health promotion in order to practice across various inpatient and outpatient settings. I also possess leadership skills that are crucial for anyone that would like to serve as a nurse manager. In my practice, I adhere to the expected nursing codes of ethics.
However, I am a novice when am required to make appropriate decisions surrounding the several ethical dilemmas in my practice. For instance, a teen who had been diagnosed with syphilis due to unprotected sex asked me to lie to her mum about her condition. Moreover, I am also an active member of several nursing associations such as the American Nursing Association (ANA); an important institution that safeguards our welfare as nurses.
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Career Planning
I am an expert in this area because I understand my role as a BSN nurse and what is expected of me. I also intend to pursue a master’s degree in Nursing. However, I have not yet decided on the program I need to pursue.
Personal Journey Disciplines
I noted that I am an expert in this area. I have vital management skills that can aid me in educating and supervising staff without micromanaging. I can use conflict resolution and negotiation skills to enhance collaboration between physician, staff, and clinical leaders. I can also mentor and coach stuff at all levels. Moreover, I am flexible hence I can adapt quickly in the field of healthcare as patients usually develop problems. However, I find it a bit challenging to make agent decisions of care on my own in accordance to the changing needs. I prefer consulting someone else before I can implement a decision.
Reflective practice reference behaviors/tenets
After rating myself on this area, I found that I uphold integrity and transparency in all my dealings. I also have the desire of developing my potential. For instance, I usually challenge myself to attain the standards that some of my predecessors in the field of nursing have set. This aids me to discover my potential, know my weaknesses and strengths whenever I want to attain certain goals.
However, I do not know how to create and maintain a balance that renews and regenerates my spirit and body so that I can grow continually. This is because I usually find myself being caught up in the profession, squeezing some personal time relax and rejuvenate has always been a challenge to me risking work burn out.
Reflective practice is one of the most important pillars in my career. It aids my making sense of human frailties such as mental and physical health and the dynamics between the relationship between human beings and the system in which they function.
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Often, leaders are charged with the responsibility of creating change processes in an organization (Schaffer et al., 2013). Change processes that involve upgrade of tools and techniques, human resources, and basic rules and controls within a hospital are the mandate of managers within the organization. With my leadership set, I will be able to make the change initiatives real and tangible rather than abstract.
I will also ensure that I awaken the enthusiasm and ownership of the proposed change within the organization. My leadership set also helps me to be accountable for filling the gap between strategic decisions and the certainty of executing the change within the workforce and structure of the institution. I will use my communication skills to ensure that the staff is updated on all change activities that are taking place and what we expect to achieve.
Thinking strategically is one of the goals for my leadership growth. I intend to improve my ability of seeing the big picture and learn to step back from daily tactical details of my practice and concentrate not only on the “how” and “what” but also on the “why.”By being a critical thinker, I will hold all my views and reasoning to intellectual reasoning standards. This will aid in reducing ambiguity and confusion in the understanding of ideas and thoughts. Achievement of this goal will place me at a suitable position thinking deeply and broadly. My thinking will be driven towards being adequate, precise, and logical for my intended purpose.
Schaffer, M. A., Sandau, K. E., & Diedrick, L. (2013). Evidence‐based practice models for organizational change: overview and practical applications. Journal of advanced nursing, 69(5), 1197-1209.
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Sports Medicine Practices: Reflective Essay
In this exercise, I had an opportunity to observe sports medicine practices at the clinic. Watching the Professor deliver various treatment services to athletes was an informative experience. This facilitated the transition of knowledge gained in class into practice. A basketball player had come to the clinic for her follow up clinical measures. The patient had suffered from knee injury during a tournament and had undergone surgical process three weeks ago.
According to the Professor, her condition had improved and needed therapeutic exercise to improve function and performance. During this exercise, the Professor was tapping muscle to recruit muscle with isometric exercises. This was interesting and it gave me the desire to explore and learn more about isometric exercises.
The athlete was made to practice the following exercises; in prone position and sandbag on the athlete ankle, she was asked to move her body up and down for five minutes. In supine position, she was asked to move up and down with her legs straight for five minutes.
The athlete was also made to balance using one leg. I think these activities are neuromuscular re-education aimed at ensuring that her gait and posture is improved. All this time, I was reflecting on muscle actions as taught in class, which helped me understand better the importance of evaluating the level and strength of therapeutic exercise based on the athlete’s needs.
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The professor asked the athlete to have brace on her ankle throughout. This is important because there are many unexpected situations and her injured knee needs to be protected. I also observed many other athletes in taking therapeutic exercises in the clinic. One practice I observed is that after every training session, they did some stretching to relax the muscles so as to prevent injuries and to reduce soreness. Other preventive measures they used included TENS, hot pack, ice pack, and whirlpool. This was a great experience as I got to observe how these techniques worked practically.
This was a great opportunity to learn the responsibilities and practices in the sports medicine clinic. I realized that treating people is not easy task as perceived theoretically in sports medicine publications. There are many decision making processes that requires one to be adequately informed in sports medicine practices. I will continue studying hard to acquire adequate knowledge. This will ensure that I apply appropriate treatment measures that are patient centered in the future. I am grateful to the Professor for giving this opportunity.
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In recent times, scientific underpinnings to practice have become a major issue of concern where those performing roles in the nursing field are required to self-assess themselves for preparedness. Doctor of Nursing Degree was conceived with the objective of accelerating the translation of evidence and research into practices and also improvement of practices into expertise levels (Wysocki et al, 2015). It is essential to have a self-assessment as a DNP nurse so as to reflect on the experiences.
The reflection would entail the linkage of previous learning and the current experiences. The purpose of reflection is to gauge the extent of preparedness to advance in the nursing practice through exhibiting some advanced level skills and personal development. Through reflection, evaluation and synthesizing of information regarding the nursing practice contributes to one’s growth and development while also controlling an individual’s learning.
AACN approved the DNP for the advanced practice nurses who would be required to have sophisticated skills that would be implemented and used in the performance of their roles (Wysocki et al, 2015). The curricular competencies and essential elements in the DNP program are clearly outlined in the AACN. It is necessary to carry out a personal reflection to assess the compliance to these essentials and possession of competencies crucial for nursing practices.
Scientific underpinnings to practice are one of the essentials provided by the AACN which requires DNP graduates to have a reflection to evaluate the outcome competencies after completing the degree program (Wysocki et al, 2015). One of the competencies I would reflect on as per the scientific underpinnings to practice is the development of the care delivery approaches crucial during the performance of roles.
Assessment and reflection while considering the essentials for competencies in safety and quality patient care are another factor I would address where accountability is ensured (Kesten, 2015). The final competency is the ability to evaluate and develop effective strategies during management of the ethical dilemmas. The reflection would address these essentials of the scientific underpinnings to practice which informs the extent of preparedness.
To meet the pertinent DNP competencies, I would be required to possess some abilities, knowledge and vital skills essential for nursing practices. The DNP has been helpful in the integration of attitudes, informatics skills, and knowledge which culturally support evidence-based and culturally sensitive practices at high levels in the nursing field e.g. the leadership level (Kesten, 2015). My self-assessment after completion of the course, reflects on the competencies of the DNP as outlined by the AACN.
The learning outcomes and competencies outlined would form the basis of the self-evaluation. My increased sensitivity to different populations and diverse organizational cultures and improvement in communication skills are some of the skills identified after self-assessment which meet the pertinent competencies of the DNP (Hallas et al, 2012). These skills are essential learning outcomes for an accountable DNP graduate.
The self-assessment also helped me evaluate my enhanced skills in leadership and also handling complex clinical issues that are increasing over time. The enhanced knowledge to improve patient outcomes and nursing practice was also acquired. Through the self-assessment, I was able to evaluate the vital knowledge acquired after the DNP program. I was prepared to influence and design the best healthcare policy options with the focus on various factors such as quality, accessibility, and cost (Hallas et al, 2012).
Other factors focused on are safety, equity, efficacy and proper regulations. The acquisition of this knowledge and competencies is pertinent for a DNP graduate. After completion of the learning course in DNP, more insight on how to integrate theory and practices with the aim of ensuring quality care to all was gained. The self-assessment was important for me as it helped me evaluate my abilities in analyzing practice data and effective evaluation of outcomes in the nursing field.
The integrative abilities in implementing the nursing interventions based on science are pertinent to the DNP competencies which are an indicator of the benefits of learning the course (Hallas et al, 2012). The massive benefits in the form of skills, knowledge, and abilities gained after learning the course as identified through the self-assessment are pertinent to the DNP competencies (Terhaar et al, 2016).
The orientation program for new students is essential in impacting success positively. Having gone through the orientation program as a new student, I would gain more insight and a lot of information essential in enhancing my success at Chamberlain (Price et al, 2015). The orientation is important for me as I can acquire fundamental information needed to connect with people that would influence my success in Chamberlain.
Through the orientations, insight and a better understanding of skills and belief essential for progressing well thus influencing success while in Chamberlain is efficiently gained. Crucial information on the survival tactics and handling complex issues enhance personal growth and academic success (Price et al, 2015).
In a nutshell, it is important for everyone who undergoes the DNP degree program to ensure the best skills, abilities and knowledge is acquired after completion of the course. Such efforts would ensure the competencies gained impact the nursing practice positively.
The pertinent DNP competencies are essential due to the impacts it has brought to the nursing field by enhancing the development of both effective strategies during management of the ethical dilemmas and care delivery approaches crucial during the performance of roles (Price et al, 2015). The adoption and integration of these competencies into practice would revolutionize the nursing field for the better.
References
Hallas, D., Biesecker, B., Brennan, M., Newland, J. A., & Haber, J. (2012). Evaluation of the clinical hour requirement and attainment of core clinical competencies by nurse practitioner students. Journal Of The American Academy Of Nurse Practitioners, 24(9), 544-553. doi:10.1111/j.1745-7599.2012.00730.x
Kesten, K. S. (2015). Assessment of APRN Student Competency Using Simulation: A Pilot Study. Nursing Education Perspectives, 36(5), 332-334. doi:10.5480/15-1649
Price, D. M., Buch, C. L., & Hagerty, B. M. (2015). Measuring Confidence in Nursing Graduates Within the Framework of the AACN Essentials. Nursing Education Perspectives, 36(2), 116-117. doi:10.5480/13-1162.1
Terhaar, M. F., Taylor, L. A., & Sylvia, M. L. (2016). The Doctor of Nursing Practice: From Start-Up to Impact. Nursing Education Perspectives, 37(1), 3-9. doi:10.5480/14-1519
Wysocki, Kenneth, Patricia C. Underwood, and Susan Kelly-Weeder. 2015. “An essential piece of nursing’s future: The continued development of the nurse practitioner as expert clinician and scientist.” Journal of the American Association of Nurse Practitioners, April. 178-180. Academic Search Premier, EBSCOhost (accessed September 2, 2016).
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The perioperative period includes various processes and procedures that bring about multiple and challenging changes to a patient (Nursing and Midwifery Board of Australia, 2010). A major surgical intervention is accompanied with multiple stressful components such as worries about survival, length of admission to hospital, one’s physical condition after the surgery, separation from the family, and the financial implication, factors that significantly impact on a patient’s recovery (Gouin and Kiecolt-Glaser, 2012).
For example, based on my reading, the patient revealed that during pre-operative phase, he experienced psychological stress and anxiety brought about by the thoughts of fear of death, physical deformity related with the surgical intervention, longer stays in the hospital, longer recovery period, and the cost of the whole surgical procedure and care. He affirmed that the fear, anxiety and stress slowed his recovery (Hudson & Ogden, 2016).
The physical environment of a patient such as lights and sounds can also affect a patient’s recovery (Nelson, et al., 2016). The patient also described the sounds from the equipment and people in the vicinity of the recovery unity as having affected his sleep and sensory, occasionally bringing back the thought of the surgery procedure. This deprived him of emotional peace.
Besides, the patient described his confinement to the hospital bed in the recovery unit under the extensive monitoring machines as a painful and scary experience that distressed him (Hudson & Odgen, 2016). According to Gouin and Kiecolt-Glaser (2012), pain and distress during perioperative period can be influenced by emotions triggered by the physical environment factors result in physical changes in a patient, thus slowing his recovery period.
Surgery also results in inability on the patient. During the perioperative period, a patient is unable to engage in certain duties, responsibilities and activities. This leads them to have low self-esteem and feels insecure (Marks, 2015). The patient also described that during his recovery period, he experienced sudden changes in his social and family life as he could not return immediately to his normal life and perform the duties he valued most.
This made him loose sense of self-esteem and raise insecurity concern on his part. Besides, having to live with a life-changing diagnosis for the rest of his life was traumatizing and frustrating altogether as it was associated with some form of isolation from friends and family. Nonetheless, he acknowledged the contribution of his carers (immediate family and clinicians) who gave him hope in life (Hudson & Ogden, 2016).
Having read the patient’s experience, I have come to appreciate the need for social and spiritual support for a patient undergoing major surgical intervention. The social support is crucial for enabling the patient understand the aftermath implications of the surgery and consequently prepare him on how to live with it.
Spiritual support offers the needed help to a patient to have hope in life again during and after the surgery and treatment procedure (Hudson & Ogden, 2016). Conclusively, I have come to understand the need for perioperative nurses to understand the possible implications of the illness from the patient’s perspective to facilitate their recovery and offer the needed emotional support during their recovery period (Nelson et al., 2016).
References
Gouin, J., & Kiecolt-Glaser, K., J. (2012). The Impact of Psychological Stress on Wound Healing: Methods and Mechanisms. Immunol Allergy Clin North America, 31(1), 81-93
Hudson, B., F. & Ogden, J. (2016). Exploring the Impact of Intraoperative Interventions for Pain and Anxiety Management During Local Anesthetic Surgery- A Systematic Review and Meta-Analysis. Journal of PeriAnesthesia Nursing, 31(2), 118-133
Marks, R. (2015). Non-Operative Management of Knee Osteo-arthritis Disability. International Journal of Chronic Diseases & Therapy (IJCDT), 1(2), 9-16
Nelson, G., Altman, A., D., Nick, A., Meyer, A., L., Ramirez, P., T., Achtari, C., Antrobus, J., Huang, M., S., Wijk, L., Acheson, N., Ljungqvist, O., & Dowdy, C., S. (2016). Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced Recovery after Surgery (ERAS) Society Recommendations- Part 1. Gynecologic Oncology, 140(2), 313-322
Nursing and Midwifery Board of Australia (2010). Nursing and national competency standards for Registered nurse. Retrieved from: http://www.nursingmidwiferyboard.gov.au
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My clinical role largely involves billing, coding, and documentation of patients’ data to facilitate easy communication between insurance companies and the healthcare organization that I currently work for. My healthcare facility often sends the coding and billing information to insurance companies to claim payments. As a coding, documentation and billing specialist, I am charged with the responsibility of keeping clear health data and reviewing those records before assigning proper codes to specific diagnoses (Benoit, Bergeron and Bertrand, 2016; & Deloitte, 2016).
Coding, billing, and documentation of patients’ health data are governed by strict ethical, legal, and regulatory standards because they involve usage of confidential information. In this regard, clinicians have strict ethical and legal responsibilities to observe as far as documentation strategies, coding, and billing are concerned (Benoit, Bergeron and Bertrand, 2016).
Personally, I feel that it is in order for documentation strategies, coding, and billing to be governed by strict ethical, legal, and regulatory standards. Since clinicians have access to private patient’s records, they must maintain total confidentiality in their documentation strategies, coding, and billing (Deloitte, 2016). In addition, these clinicians have an ethical responsibility to access only that information that is related to the issue being addressed at any given time.
Their actions must comply with the ethical standards documented in the American Association of Professional Coders and the American Health Information Management Association (Benoit, Bergeron and Bertrand, 2016). As far as their legal and regulatory responsibilities are concerned, documentation, coding and billing specialists must maintain confidentiality requirements as outlined in the Health Insurance Portability and Accountability Act, (HIPAA). The ethical, legal, and regulatory standards that govern documentation strategies, coding, and billing, play a significant role in minimizing healthcare fraud and abuse (Deloitte, 2016).
Evidence-based research has become an important aspect of the healthcare industry in the recent past due to the role that it plays in improving healthcare delivery. According to JoAnn (2017), evidence-based research is necessary because it helps clinicians to generate the right type of data that they can use to improve the effectiveness of care. Clinicians often rely on different kinds of knowledge for them to make the right decisions in their relationships with sick patients.
Furthermore, they are expected to have a comprehensive understanding of the physiological, psychological, emotional, and social factors affecting their patients’ health for them to deliver the most appropriate care. Although clinicians can quickly obtain this information from existing literature, they must complement it by evidence from empirical research. Evidence-based research, therefore, provides clinicians with practical facts that they can integrate with their experiential knowledge to improve patient care (Kristensen, Nymann and Konradsen, 2015).
I incorporate evidence-based research to a large extent into my role as a clinician. I firmly believe that the safety of my patients depends on the availability of evidence that can adequately support the nature of care that I deliver to them (JoAnn, 2017). For this reason, I rely on data obtained from evidence-based research to improve healthcare services which serve to promote better outcomes for my patients.
I do not only rely on evidence-based research to change my care practices, but I also develop available evidence to fulfill existing knowledge gaps as far as improvement of patient safety is concerned. Over the coming years, I aspire to utilize evidence-based research to improve my skills as a clinician (Kristensen, Nymann and Konradsen, 2015).
Falls are common among seniors, especially those who are suffering from chronic health problems such as diabetes (Graveande and Richardson, 2016). According to Graveande and Richardson (2016), a geriatric fall is a sudden occurrence among the elderly that signifies a decline in their homeostatic reserve. Geriatric falls pose a great risk of loss of independence to the elderly in the society today.
This calls for the greatest need to identity and implements the most appropriate health maintenance strategies that would improve care for this population and their families. Mazur, Wilczynski, and Szewieczek (2016) critically explore the importance of health maintenance specific to geriatric falls as it pertains to the care of the patient and their family.
According to Mazur, Wilczynski, and Szewieczek (2016), exercise is the most appropriate health promotion strategy for geriatric falls because it helps to improve balance and minimize the risks of repeated falls. Exercise is a recommended health promotion strategy for geriatric falls because it serves to generate a greater amount of homeostatic reserve for the elderly patient. In addition to exercise, elderly patients who are at high risks of falling should eat a balanced diet as this provides them with energy that they may need to regain physical activity.
As Mazur, Wilczynski and Szewieczek (2016) explain, social support can help to reduce risk factors for future falls among the seniors because it drives away the fear that typically develops from past falls. Family members of elderly patients who are recovering from the effects of falls should pay attention to physical activity, nutritional strategies, and social support in their effort to promote positive health outcomes for their patients (Mazur, Wilczynski and Szewieczek, 2016).
I agree with the solutions provided by Mazur, Wilczynski and Szewieczek (2016) because they are supported by evidence-based research. In a well-organized research, Burton, Cavalheri and Hill (2015) have revealed that physical exercise programs help to improve balance in older adults who are at risk for falls. These researchers further assert that planned nutritional strategies contribute to induce positive health changes such as improved performance and reduced risk for falls in geriatric patients.
In a similar study, Durbin, Kharrazi and Mielenz (2016) support the use of social support, physical exercise, and dietary supplements in promoting health maintenance to geriatric patients. Since health maintenance solutions for geriatric falls are supported by evidence-based research, clinicians can utilize these ideas to make appropriate healthcare decisions for their elderly patients (Kristensen, Nymann and Konradsen, 2015).
The number of elderly adults who are being diagnosed with diabetes in the society today is on the rise. The major challenge faced by clinicians is defining the therapy goals for geriatric patients due to the existence of limited data about the aging process and drug response of this population (Kazerle, Shalev, and Barski, 2014).
Considering the complexities that surround the health status of geriatric patients, clinicians are charged with the responsibility of choosing a treatment plan that will maximize glycemic control, while at the same time avoiding exposing their patients to increased risks. Due to variations in physiological functions between adults and geriatric patients, the treatment approach for geriatric patients differs significantly from that of an adult (Graveande and Richardson, 2016).
Treatment of geriatric patients involves the use of medication as well as other interventions such as nutritional strategies and psycho-social support (Graveande and Richardson, 2016). This paper will focus on pharmacological or drug treatment alone. The best medication that should be used to treat geriatric diabetic patients includes; metformin, sulfonylureas, meglitinides, thiazolidinediones, alpha-glucosidase inhibitors, dipeptidyl peptidase-4 inhibitors, and sodium glucose co-transporters two inhibitors.
These medications are taken orally at highly controlled doses. Geriatric diabetes patients can also be treated using injectable therapies such as GLP-1 analogs, pramlintide, and insulin. Although similar medications can be used to treat diabetes in adults, the drug dosage differs significantly between the two populations due to variations in pharmacokinetic parameters. In this respect, the drug dosage given to geriatric patients are relatively lower than those administered to adults. The goal of delivering lower doses to geriatric patients as compared to adults is the need to maximize chances of glycemic control, without exposing the elderly adults to additional risks (Kazerle, Shalev, and Barski, 2014).
My learning progress in the course directly correlates to the stages in Benner’s Novice to Expert Theory. Benner’s Novice to Expert Theory assumes that a learner experiences a progressive form of knowledge acquisition that involves five stages namely; novice, advanced beginner, competent, proficient, and expert stages of skill acquisition (Josephsen, 2014). Since I began the course, I have successfully gone through the first stage of Benner’s theory known as novice stage.
When I started the course as a novice, I had no background experience, and I had difficulty differentiating between relevant and irrelevant aspects. Even now, I still take my time to understand course requirements and their significance in shaping my roles as a clinician. After familiarizing myself with a few course concepts, I will move to the second stage of advanced beginner.
At this stage, I will rely on rules provided by my instructor to perform every individual task. Furthermore, I will ask more experienced students to help me integrate practical knowledge and to set priorities for the course (Bowen and Prentice, 2016).
After learning course concepts for two years, I will progress to the competent stage of skill acquisition. Here, I will easily compare situations and make judgments on that scenario that require immediate attention. Additionally, I will integrate devised rules with those learned in the classroom to help solve complex matters. From the competent stage, I will move to proficient stage characterized by critical thinking and individual decision making (Bowen and Prentice, 2016).
While at proficient stage of skill acquisition, I will be able to easily see changes that take place in every situation and implement appropriate responses to promote success. It is at this stage where I will view the course as a whole rather than regarding its small components like I currently do. Later on, I will progress to expert stage of skill acquisition. Here, I will be able to grasp every situation more accurately than now.
Additionally, I will no longer rely on rules and guidelines to make appropriate decisions on how to tackle issues related to the course. Moreover, I will operate from a deep understanding of every situation and make judgments that will generate positive outcomes (Josephsen, 2014).
In conclusion, as a clinician, I have an obligation to observe ethical, legal, and regulatory responsibilities during documentation, coding, and billing. Also, I must acknowledge the importance of evidence-based research by making clinical decisions based on facts obtained from empirical studies. A good example of a health situation in which I can effectively utilize evidence-based research is when designing a health promotion program specific to geriatric falls.
In this case, evidence-based practice will help me to deliver the most appropriate care for the patient and his or her family. Considering the little volume of knowledge that I have gathered as a novice, I believe that my learning progress in the course effectively correlates to the stages of Benner’s Novice to Expert Theory.
References
Benoit, M., Bergeron, J. & Bertrand, G. (2016). Decision-making tool: Telepractice and digital records management in the health and human relations sectors. Quebec: Conseil Interprofessionnel du Quebec.
Bowen, K. & Prentice, D. (2016). Are Benner’s expert nurses near extinction? Nursing Philosophy, 7(2): 144-148. Doi.10.111/nup.12114.
Deloitte. (2016). International review: Secondary use of health and social care data and applicable legislation. Author: Deloitte & Touche Oy, Group of Companies.
Durbin, L., Kharrazi, R. & Mielenz, T. J. (2016). Social support and older adult fall. Injury Epidemiology, 3(1):4.doi:10.1186/s40621-016-0070-y
Grave and, J. & Richardson, J. (2016). Identifying non-pharmacological risk factors for falling in older adults with type 2 diabetes mellitus: A systematic review. Disability and Rehabilitation, 39(15): 1459-1465.doi:10.1080/09638288.2016.119974.
JoAnn, M. (2017). Call to action: How to implement evidence-based nursing practice. Nursing, 47(4):36-43.
Josephsen, J. (2014). Critically reflective theory: A proposal for nursing education. Advances in Nursing, 2014: 360-594. Doi:10.1155/2014/594360.
Kazerle, L., Shalev, L. & Barski, L. (2014). Treating the elderly diabetic patient: Special considerations. Diabetes Metabolic Syndromes and Obesity, 7: 391-400.
Kristensen, N., Nymann, C. & Konradsen, H. (2015). Implementing research results in clinical practice: The experience of healthcare professionals. BMC Health Services Research, 16:48.doi:10.1186/s12913-016-1292-y
Mazur, K., Wilczynski, K. & Szewieczek, J. (2016). Geriatric falls in the context of a hospital fall prevention program: Delirium, low body mass index, and other risk factors. Clinical Interventions in Aging, 11:1253-1261.doi:10.2147/CIA.S115755.
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Question 1: various viewpoints and findings observed during literature review
The social cognitive process is critical especially when an individual is navigating complex social interactions. The way people perceive or interpret other people’s actions is important. However, most people diagnosed with atypical mental disorders such as autism lack appropriate social cognitive skills.
It has been postulated that people diagnosed with ASD are biased in visual cognition such as body language or facial assessment. This is a challenge among the adolescents because they are in a stage characterized by consolidation of their social self, their identity and understanding their roles in the social world (Loukas et al., 2015).
From the literature review, I identified two contrasting viewpoints about social cognition development in adolescence diagnosed with ASD; theory of mind (ToM) and adolescent’s sensitivity to social rejection (Leekam, 2016). According to the concept of sensitivity to social rejection, the studies stated that the developmental mismatch occurs due to poor regulation of the adolescent’s emotions and accounts for the poor social cognition skills in adolescents diagnosed with ASD.
On the other hand, ToM argues that individuals are trained to understand other people’s minds, thoughts, intentions and beliefs based on the principles they were taught at the age of 4, and that their social cognition is mainly influenced by their caregivers or parents (Leekam, 2016).
These two viewpoints have been integrated into the literature review and will be used during analysis to determine whether adolescent’s social cognition is determined by the affective theory of mind, sensitivity to social rejection or both. This is because adolescence stage is marked with increased social and emotional sophistication; therefore, the underlying themes that influence social cognition skills should be explored to empower adolescents diagnosed with ASD well-being and behavioral outcomes (Loukas et al., 2015).
Question 2: Thought processes when developing research question
A good research question should be relevant and manageable. Therefore, the research question was developed from issues of intellectual interest raised in practice and literature. The aspects that I find most interesting in this field are children growth and development. From the literature, it is evident that parenting skills greatly influence the children behaviors (Loukas et al., 2015). In this context, the adolescent stage is marked by distinct changes in their relationship with family, peers and the society. It is a stage when they should be taught on ways to assert autonomous control over their emotions, actions, and decisions.
During this stage, it has been argued that the brain undergoes remodeling process. Whereas substantial research has been conducted on social cognition in autistic children, there is little attention in researching parent’s role in ASD adolescent’s social cognition, and whether support training of the parents and caregivers reinforce positive social cognition skills in ASD adolescents (Leekam, 2016). From this analysis, the knowledge gap was evident which led to the formulation of the research questions;
Does parallel complementary training for parents make them be well informed about their children social and intellectual development? Does it empower them with new viewpoints that help to improve social cognition in their children (autistic adolescents)?
Question 3: Developing research methodology
After developing the research questions, I evaluated six evidence-based studies to analyze the research method appropriate to this discipline critically. From these articles, I found out that it is important to establish appropriate study sample because excessive sample or too small study sample lack the statistical power that shows the significant effect. The literature review as the primary source that informed by choice and application of the mixed research method. This research method has a clear connection with the research problem as it provides a complete and comprehensive understanding of the research question (Leekam, 2016).
Moreover, the data collection process is through interviews and questionnaire which are an appropriate approach that facilitates the researcher to develop better and more contexts that have greater construct validity (Loukas et al., 2015). From the literature review, I also learned that the most commonly used data analysis method include chi-square, t-test, and ANOVA, which I have integrated into the proposal’s research methodology. Also, it is important to ensure that the data gathered is accurate. One advantage of mixed research method is that it facilitates triangulation (assessing the same phenomenon using several means of research methods) thereby enhancing the study validity and reliability (Loukas et al., 2015).
Question 4: Innovative part of this research proposal
It is evident that children’s social and cognitive skills development is influenced by their parenting style. Responsive parenting has been explored using various research frameworks such as socio-cultural and attachment; and have been found to have a strong foundation is children’s social and emotional skills (Loukas et al., 2015). In combination with the environment, these aspects shape the child’s social cognition needs including the various range of support required for the child’s learning process. It is these supports that enable the children to be actively engaged in problem-solving, self-regulation and execution of social cognitive skills (Walsh, Creighton, & Rutherford, 2016).
However, the social and emotional stability of parents with children diagnosed with ASD is small. Therefore, their parenting responsiveness is poor and negatively impacts on the child’s social cognition function. The benefits of SCTI-A training is well documented. The study proposes that integrating a parallel complementary training for the parents and caregivers will promote mutual engagement and reciprocate the parent-child interaction. That inturn enables the adolescent to become more active and to develop a trust and bond between the parents and to internalize the trust such that they can generalize the learned behavior to new social cognitive functions/ experiences (Leekam, 2016).
References
Loukas, K. M., Raymond, L., Perron, A. R., McHarg, L. A., & LaCroix Doe, T. C. (2015). Occupational transformation: Parental influence and social cognition of young adults with autism. Work, 50(3), 457-463.
Leekam, S. (2016). Social cognitive impairment and autism: what are we trying to explain?. Phil. Trans. R. Soc. B, 371(1686), 20150082.
One thing I have learned is that nursing student life is chaotic. Juggling between personal life, school responsibilities and other essential physiological needs are challenging. Therefore, time management skills a vital component of every great nurse.
This is because effective time management and task ease the transition process. In the time management assessment, my score was 28, which indicates that I have above average time management skills. This implies that there is still room for improvement (Ghiasvand et al., 2017).
The roles and responsibilities of a nurse practitioner are limitless. One has to be proficient in all healthcare aspects including financial management, interpersonal effectiveness, and leadership. To effectively manage all these responsibilities, it is important to have excellent time management skills. To start with, I will have to learn on ways to set priorities. Learning how to prioritize my tasks has been my greatest challenges.
This includes thinking through the situations using the following the following questions: which task is important? What is the consequence of not acting now? What is important? Although this feels like one is just dawdling, the process helps one learn how to prioritize activities through questioning, dialogue, and reflection. Through critical thinking process, one can break down the demands of the situation efficiently and quickly (Kourkouta & Papathanasiou, 2014).
However, it is also important to exercise some flexibility and patient. This is because part of the nursing profession is to confront the unknown. I have also learned that it is important to create a mental space so as to create a good tone for the rest of the day as it allows one to calmly assess the environment which helps one to prepare and plan. Lastly, it is important to take a break. I always find it difficult to take a break as I consider it time wasted. However, after this course, I have practiced taking 5 minutes breaks whenever necessary which greatly improves productivity and mental concentration (Ghiasvand et al., 2017).
Leadership theory that describes the leadership style
Nursing leadership plays an integral role in the healthcare institution. The leadership styles affect their productivity and patient outcomes. It is important to understand the various types of leadership styles found in the workplace as it influences nurse’s ability to work as a team and to deliver quality care. Nurse leadership goes beyond care planning, organizing and care coordination of the patients. It entails leading the nurse team and subordinates and facilitates smooth flow of healthcare processes (Vesterinen et al., 2013).
Many leadership theories have evolved including trait theories, behavioral theories, contingency theories and the recently contemporary theories. My leadership style is informed by transformational theories. These are theories that focus on the relationship between leaders and group.
I feel more obliged to help the team members to fulfill their potential. As a leader, I understand that my roles and responsibilities include promoting teamwork between team members, encouraging positive self-esteem and empowering the team members to become more involved in the development and implementation of policies and procedures (Porter-O’Grady, 2016).
Comparison between management and leadership
Leadership and management terms are often used interchangeably in many disciplines; however, there is a big difference between two terms. According to my perception, nursing is a calling to leadership. Across the continuum, nurses are looked as leaders because we inspire, empower and motivate others. Nurses possess excellent communication and interpersonal skills and are risk takers.
These are the core responsibilities of a leader. Nurses do not need to be in a managerial position to deliver these responsibilities; they are energetic and devote their entire life to serve the society. Therefore, nurses are inherently leaders and are a mandatory role in healthcare (Nancarrow et al., 2013).
However, there are various types of leadership. Authoritarian leadership is dictatorial whereas democratic leadership involves democracy where team members are included in the decision-making process. The other types of leadership are delegated where the leader allows everyone to make independent decisions. From my assessment, I am a democratic leader.
This is because I listen to other people ideas and incorporate them during the decision-making process. On the other hand, nurse management focuses mainly in fields that deal with the management of staff and the service users. In this capacity, nurse managers are expected to fulfill the assigned tasks and projects. However, nurse managers and nurse leaders do complement each other (Porter-O’Grady, 2016).
Application of leadership concepts in work environment
Throughout this course, the concept of health-promoting leadership in workplace focuses on the interaction between the leadership behavior and the working environment. From my research, I have learnt that successful leaders are those who create healthy workplace. This is achieved by promoting positive climate among employees such as gratitude, compassion, and forgiveness. The main aim is to create an environment that respects each and brings out a sense of responsibility and integrity. This, in turn, creates a sense of commitment, peace, and the creation of healthy environments that are a representation of our life and values (Al-Sawai, 2013).
References
Al-Sawai, A. (2013). The leadership of Healthcare Professionals: Where Do We Stand? Oman Medical Journal, 28(4), 285–287. http://doi.org/10.5001/omj.2013.79
Ghiasvand, A. M., Naderi, M., Tafreshi, M. Z., Ahmadi, F., & Hosseini, M. (2017). The relationship between time management skills and anxiety and academic motivation of nursing students in Tehran. Electronic Physician, 9(1), 3678–3684. http://doi.org/10.19082/3678
Nancarrow, S. A., Booth, A., Ariss, S., Smith, T., Enderby, P., & Roots, A. (2013). Ten principles of good interdisciplinary teamwork. Human Resources for Health, 11, 19. http://doi.org/10.1186/1478-4491-11-19
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Vesterinen, S., Suhonen, M., Isola, A., Paasivaara, L., & Laukkala, H. (2013). Nurse Managers’ Perceptions Related to Their Leadership Styles, Knowledge, and Skills in These Areas—A Viewpoint: Case of Health Centre Wards in Finland. ISRN Nursing, 2013, 951456. http://doi.org/10.1155/2013/951456
Public service is at the core of the ability to deliver critical social services to its citizens by the government. Committed civil servants are the key stakeholders in this expected social contract between the government and its citizenry. As a public servant, my commitment is to provide service according to the competency of my academic qualifications to the best of my ability for not less than twenty years. According to Farrel & Goodman (2013), this will require discharging my duties with rationality, analytically and with the somberness expected with this social responsibility.
My commitment is driven by the passion for helping people and for making a difference and not by the paycheck alone. This commitment to delivering services with excellence is underpinned by knowing that my effectiveness will determine the success or failure by the government in its mandate. Knowing that I will be a role model for new public servants in the future drives me to commit to working while improving my skills so as to better impart knowledge (Besel, Williams, Bradley, Schmid, & Smith, 2016). My commitment is to provide quality service that gives value back to the taxpayers.
The following will constitute my plans which will assist me to meet the minimum requirements of the EHLS. This involves improving my computer literacy and my language skills to level two or higher on the interagency language roundtable (EHLS, 2017). Completing my bachelor’s degree is also part of my plan towards fulfilling this requirement. Committing myself to 6 months of full-time study in Washington together with an additional two months online survey is part of my plan to meet the demands of the EHLS program as well as working for the government after that.
References
BESEL, K., WILLIAMS, C., Bradley, T., Schmid, A., & Smith, A. (2016). The State of Public Service in America. In Passing the Torch: Planning for the Next Generation of Leaders in Public Service (pp. 3-8). Fayetteville: University of Arkansas Press. Retrieved from http://www.jstor.org/stable/j.ctt1ffjgmt.5
