Archive | April, 2012

EBP Practice Environments

29 Apr

     Nurses who feel supported are more likely to use evidence-based practice (EBP) because it is important to feel like we are doing the right thing and we have people to back us up.  EBP is the right thing to be doing if there is strong evidence behind the policy or practice that proves patient well-being.  We want the best for our patients, so I feel that if the hospital and unit supported EBP efforts then these measures would be used more often by the nurses.  The same goes for the unit support.  The support of the people working directly above staff nurses, such as the nursing director and charge nurses, are important as well.  Knowing that they support this practice and have the resources readily available for use will help the nurses on the floor or unit practice without any inhibitions.  Of course, it all comes down to the individual.  If the individual nurse does not support their own efforts or other nurses’ efforts to implement EPB into their job, then no one can help them.  Possibly, they have worked in an environment where this was condoned and the nurses were only able to operate under the hospitals policies which were not evidenced-based.  Individual nurses like this may need additional resources to turn to for advice on practice standards and standing up for EBP.

     The culture on the floor or unit also has an effect on the measures to use or promote EBP.  The values and beliefs of the unit drive the importance of measures of practice.  Usually, those who stay on a unit for a long time may develop the environmental culture of their coworkers.  Some employers will not hire individuals who may go against the culture on the unit and/or disrupt its flow.  Depending on the unit or their boss’s overall attitude towards the use of EBP will change the confidence of a nurse who is going against the grain.  If EBP is not widely accepted, they may fall back on the idea to have the support of their coworkers.  For an individual to thrive they must be prosperous and successful.  To achieve this, it would be necessary to use EBP.  The same goes for a unit.  But in order for a unit to thrive, the coworkers who make it up must have the same motivation to thrive.  The use of EBP by all coworkers may be enough to make this change.  The group as a whole could innovate their future as a thriving unit within a thriving hospital system.

     Innovation is defined as the introduction of something new.  Selman (n.d.) has an excellent breakdown of this meaning, stating that innovation is “intentionally ‘bringing into existence’ something new that can be sustained and repeated and which has some value or utility” (para 6).  This is essential for nursing and happens frequently.  No matter what is being innovated, there are some characteristics that go hand-in-hand with innovation, these being communication skills, leadership, professional development, and lifelong learning. 

     Communications skills are essential for innovation.  They are what drives the idea and are important for “selling” it to co-workers and supervisors.  Meyer (2010) states that “[t]op-notch communication skills with senior executives, peers, partners help drive open innovation success” (p. 2).  Another skill that is important for innovation is leadership.  Leaders are people who strive for success, so of course they are going to be important people in the innovation process.  Innovation is an element of the leadership process; therefore, leadership will result in innovations (Selman, n.d.).  Essentially, they feed off each other.  The next characteristic of innovation is professional development.  Professional development is the building up of skills and knowledge related to that individuals job field.  In nursing, this is a constant process.  The medical field is ever-changing, which means that those who work in it need to be adaptable to this change and can respond in a timely manner.  Professional development building programs can lead to more satisfaction from the nurse to become more confident in their jobs (Wood, 2006).  The final characteristic is lifelong learning.  Lifelong learning is an important part of innovation because it is the motivating factor behind it.  It is what makes an individual, or leader, strive to achieve further excellence and continue innovating.  Skills that are needed for innovation are not able to be taught.  They are learned over time by active use and constant accommodation.  All of these characteristics are needed to be a successful innovator.  Successful innovators have to ability to thrive by changing their environment for the better. 

 

References

Meyer, A. (2010). Communication in Open Innovation. Retrieved from http://www.innovationexcellence.com/blog/2010/08/18/communication-in-open-innovation/

Sahlberg, P. (2009). Creativity and Innovation throughout lifelong Learning. Retrieved from http://www.pasisahlberg.com/downloads/Creativity%20and%20innovation%20in%20LLL%202009.pdf

Selman, J. (n.d.). Leadership and Innovation: Relating to circumstances and change. Retrieved from http://www.innovation.cc/discussion-papers/selman.pdf

Wood, J. (2006). Exploring staff nurses’ views on professional development. Nursingtimes.net, 102(13). Retrieved from http://www.nursingtimes.net/nursing-practice-clinical-research/exploring-staff-nurses-views-on-professional-development/203320.article

 

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Nursing and Medical Research: What is Christian?

15 Apr

Embryonic stem cell research is still a controversial topic today, and will likely always be.  Personally, I am on the pro side.  I believe that embryonic stem cell research is important to improve current health care needs and create possible cures for diseases.  Scientists believe that it one day could help cure diseases such as cancer, Parkinson’s, and genetic diseases.  On the other hand, many others may disagree.  The Church teaches its individuals to believe that life begins at conception.  This then in fact would ban any use of human cells because they are the start of life at all stages.  According to Hodges (n.d.), the Orthodox Church believes “that human life begins at conception, the extraction of stem cells from embryos, which involves the willful taking of human life — the embryo is human life and not just a clump of cells — is considered morally and ethically wrong in every instance” (para. 4).  Unfortunately, the embryo does have to be destroyed in order to extract stem cells, which is the overall cause of this controversy. 

It all returns to the question, where does life truly begin?  Some Christians would respond to this by saying that these embryos are already considered to be human life; I agree.  Others may further say that it is already a baby and destroying it would be committing murder; here I would have to disagree.  The extraction of the embryonic stem cell occurs within a week to two weeks after fertilization.  At this phase the embryo is deemed a blastocyst, not a fetus or baby.  In addition, the embryonic cells that used were made specifically for this purpose; research.   

While I don’t disagree with embryonic stem cell research, I think that it can be done by using other stem cells.  Stem cells are found in other parts of the body, such as cord blood and numerous adult tissues.  The only downfall to using these tissues for research is they form into limited types of cells while the embryonic stem cell can potentially form into any cell type within the human body.  At the least, fewer embryos could be used with the research weighing more heavily on other types of stem cells.  This type of research would definitely be the hardest type of study for a Christian to participate in.  Other unchristian research would include physician-assisted suicide, euthanasia, and cloning.

 
References

Hodges, Mark. (n.d.). Destructive Embryonic Stem Cell Research.  Retrieved from http://www.antiochian.org/stem-cell-research

Nurse Reflection

1 Apr

I have been a nurse for about a year now within an acute care setting. I work overnights on a surgical floor, so we are constantly admitting and transferring patients. I have had many instances similar to those that the nurse in Chapter 1 of the Doombos, Grenhout, and Hotz text experienced. Moments like these come up more frequently than one may think, but the nurse cannot always recognize them. Acute care nursing is a busy job. Most of the time there is not enough time during a shift to get everything done. I often find myself zipping from room to room checking off all the tasks on my list that I need to complete within my shift. This interferes with my ability to respond as a Christian nurse.

The overload that is on my shoulders cuts out the “free time” I get to spend with the patients. Many patients do not understand the patient load that is on a single nurse. This can make the situation even more frustrating. As Doombos, Grenhout, and Hotz (2005) were explaining, the small and personal tasks “take up precious time that acute care nurses, who provide care for multiple clients, can ill afford. But the client does not know this” (p. 18). For example, when I’ve been an a single patient’s room for 15 minutes already helping them reorganize their table, put their socks on, and so on; I begin to get frustrated. Not frustrated at the patient, but at fact that I have a million other things on my mind that I need to do that are a higher priority as a nurse. In nursing school it is drilled into our heads to complete the highest priority task first, but in the real world it is hard to carry through with that when you’re trapped in a patient’s room.

To overcome these situations, honesty with the patient may help the nurse. After completing the task you had needed to do with the patient, still try to connect with them and ask if they need anything else. If they need something else that will require a few minutes to complete, just let them know that you have another patient to see real quick and that you will be back in a few minutes. The patient should respects your honesty and gain your trust if you do carry through with your agreement. It is still important to have a close relationship with the patient, but reordering the way things are done may make the situation less stressful for all involved.

References

Doornbos, M. M., Grenhout, R. E. & Hotz, K. G. (2005) Transforming care: A Christian vision of nursing practice. Grand Rapids: William B. Eerdmans Publishing Co.