Unit One

Professional issues and Nursing Practice

Objectives for today

• Upon completion you will be able to:

– Refine communication skills

– Facilitate goal directed interactions

– Learn to care for the client with cancer

– Refine and reinforce diversity concepts, developmental level, cultural and spiritual assessments

– Prioritize nursing actions with multiple clients

– Review different types of community based nursing

– Refine the use of SBAR during the clinical setting

More of today's objectives

– Develop techniques that will assist the nurse leader in encouraging positive team participation.

– Differentiate between a policy and a procedure.

– Analyze and discuss considerations when determining staffing needs.

– Apply quality management principles to clinical examples.

– Identify and begin to use the steps of the quality improvement process.

– Apply the nursing process to assessing the needs of the health care team members.

Does it seem like an odd assortment??

• Each topic is very important but not long enough for a whole class period so it may

seem scattered but it is still very relevant.

What is evidenced based practice?

• Integrating research, best practice, clinical expertise, and patient values in healthcare decision making

– Where do you find the evidence?

• Research

• List serves

• Collaboratives

• Professional organizations

– Compare the evidence to practice

• Case study

– Evaluate the patients values in relation to the practice

Huber Chapter 22

Case Study

• A senior nurse wants to know

whether bowel sounds are a good

indicator for return of GI motility for

her patients after surgery?

What are some of the roles of the nurse

• List some of the roles of a nurse today

– Think globally

• Think internationally

– Think non-traditionally

» Think outside the box

Roles of Nurse cont.

• Ambulatory Care

• Home Care

• Long Term Care

• Rehabilitation

• Managed Care

Advocacy

• Why is advocacy so important for

nurses?

• Describe instances in the past 2

semesters where you were your

patients advocate?

Leadership

• How many of you consider yourself a leader?

• How many are uncomfortable being a leader?

– What situation are you a leader?

– What situation are you not a leader?

• How many of you did not understand the

thinking and higher level skills required of nurses today?

– Does it fit the stereotype in movies and sitcoms?

• What are some characteristics of nurse

leaders?

Understand the terminology in the text

• Leadership

• Management

• Leadership styles

• Followership

• Empowerment

Huber Chapter 1

Page 7

Leadership styles (pg 13-14)

• Authoritarian

– Activity determined by leader

– Ex. The military

• Democratic

– Relationship and person orientation

– Group decision making, group discussion

– Teamwork

• Laissez-Faire

– Freedom for work or individual decisions

– Minimal leader participation

Team participation

• What can each leader style do to encourage team participation?

• What would make you follow a leader?

• You are team leader, utilizing each leadership style, what would you do to motivate your team?

Ethical Dilemmas (pg. 743-749)

• Group work (15-20 mins)

– Ethics case studies.pdf

• How would you solve each dilemma?

• Looking at the definitions on page 745 Huber, what terms can you apply to explain the

actions or lack of actions of the people involved.

Teaching methods for the diverse client

• How do you learn?

• What barriers to learning do you experience?– How do you think your patients learn?

• What barriers to learning do they experience?

• How does Educational level affect learning?

• How does Socioeconomic level affect learning?

• How do support systems affect learning?

• How does Age affect learning?

• How does Culture affect learning?

Break Time

Come Back in 10 minutes

Policy and Procedure (pg. 220)

• What is a policy?

• What is a procedure?

• Why are these important?

• This week in clinical each of you need to locate the policy and procedures for your hospital.

– These will be your best friend when you are asked to do something you are unfamiliar with or only learned in school.

Policies (pg. 226-227) (Box 10.1)

• Serve as guides

• Help coordinate plans

• Control performance

• Increase consistency of action

• Should be written

• Usually are general in nature

• Refer to all employees

• Provide step-by-step methods• Are written in detail• Provide guidelines for commonly occurring

events

• Provide a ready reference• Guide performance of an activity• Should include the following:

– A statement of purpose– Identification of who performs activity– Steps in the procedure– A list of supplies and equipment needed

Procedures (Box 10.2)

Identify staffing needs

• Analyze and discuss considerations when determining staffing needs.

– How does census affect staffing?

– How does potential surgeries affect staffing?

– How would you plan staffing for OB and ER?

• Flexible census

Quality Management

– Apply quality management principles to clinical examples.

• What is quality management?

– Let’s discuss some examples of how quality management could be used in the clinical setting:

» Family visiting from out of town no money/no food

» Buy in from all levels of employees

PDCA

– Identify and begin to use the steps of the quality improvement process.

– Plan

– Do

– Check

– Act

The Nursing Process.

– Apply the nursing process to assessing the needs of the health care team members.

– The nursing Process:

• Assessment

• Analysis

• Planning

• Implementation

• Evaluation

End of Unit One

You are still responsible for the objectives I have not covered in lecture.

Read your textbooks!!

Unit Two

BIOPSYCHOSOCIAL CONCEPTS RELATED

TO HEALTH CARE

Objectives

At the end of this unit the student will be able to:

– Differentiate between aggressive, assertive, passive and responsive behavior and determine the effects of each.

– Analyze how effective communication principles relate to leadership and management.

– Formulate guidelines for making effective telephone calls to physicians.

– Differentiate between types of pain and therapies for mild, moderate and severe pain.

Behavior

Define each type of behavior and how it relates to leadership and teamwork:

– Aggressive

– Assertive

– Passive

– Responsive

Communication

• Analyze how effective communication principles relate to leadership and

management.

– Why is it important to communicate when in leadership?

– What might happen if the message is not communicated well?

Conflict Resolution

• How do we deal with Conflict?

• Case Study

– Your patient does not want to take their BP medication.

SBAR

– Formulate guidelines for making effective telephone calls to physicians.

– Who wants to role play??

• SBAR

– Situation

– Background

– Assessment

– Request/Recc.

Pain

– Differentiate between types of pain and therapies for mild, moderate and severe pain.

• How do you classify mild moderate or severe? Who says what number equates to

moderate or severe. Establish this with your patient.

• What non pharmaceutical techniques can be used to treat pain?

Pain Management for the Cancer Patient

• 0-2: Relaxation techniques, visuals etc.

• 2-4: Tylenol, NSAIDS

• 4-6: Darvocet, Vicodin

• 6-8: Oxycontin and Vicodin

• 8-10: Morphine, Dilaudid, Fentanyl Patch

Pain Management Cont.

• Non-pharmacological pain management

– Relaxation techniques

– Distractions (reading, television, visitors)

– Other interventions (ice packs,

heating pads)

Done with Unit 2

It gets better and will be more fluid after this!!